Anxiety sensitivity as a transdiagnostic risk factor for trajectories of adverse posttraumatic neuropsychiatric sequelae in the AURORA study

Short, Nicole A.; Rooij, Sanne J.H. van; Murty, Vishnu P.; Stevens, Jennifer; An, Xiuli; Ji, Yinyao; McLean, Samuel A.; House, Stacey L.; Beaudoin, Francesca L.; Zeng, Donglin; Neylan, Thomas C.; Clifford, Gari D.; Linnstaedt, Sarah D.; Germine, Laura; Bollen, Kenneth A.; Rauch, Scott L.; Haran, John P.; Lewandowski, Christopher; Musey, Paul I.; Hendry, Phyllis L.; Sheikh, Sophia; Jones, Christopher W.; Punches, Brittany E.; Swor, Robert A.; McGrath, Meghan E.; Hudak, Lauren A.; Pascual, José L.; Seamon, Mark J.; Datner, Elizabeth M.; Pearson, Claire; Peak, David A.; Merchant, Roland C.; Domeier, Robert M.; Rathlev, Niels K.; O’Neil, Brian J.; Sergot, Paulina; Sánchez, León D.; Bruce, Steven E.; Pietrzak, Robert H.; Joormann, Jutta; Barch, Deanna M.; Pizzagalli, Diego A.; Sheridan, John F.; Smoller, Jordan W.; Harte, Steven E.; Elliott, James M.; Kessler, Ronald C.; Jovanović, Tanja

doi:10.1016/j.jpsychires.2022.09.027

Cited by 9 publications

(5 citation statements)

References 42 publications

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“…On average, participants experienced a mean (SD) of 7.5 (5.7) headache days/month with moderate headache‐related disability (mean [SD] HIT‐6 score of 54.7 [8.7]). Participants reported “normal” 25 levels of depression symptoms (mean [SD] score 8.4 [9.1]) and stress (mean [SD] score 12.4 [8.7]), and mild symptoms of anxiety (mean [SD] score 8.3 [8.0]). On average, participants endorsed somewhat elevated fear of pain (mean [SD] score 31.2 [16.5]) and low anxiety sensitivity (mean [SD] score 16.3 [13.4]).…”

Section: Resultsmentioning

confidence: 99%

“…Though originally conceptualized as a multidimensional risk factor for affective psychopathology, Anxiety sensitivity is now recognized as a transdiagnostic construct of relevance to a variety of health conditions including chronic pain. 24,25 Individuals with high anxiety sensitivity are prone to interpret innocuous bodily perturbations (e.g., heart palpitations, increased respiration) as dangerous, which contributes to beliefs about headache triggers and resulting avoidance behavior independently of depression and anxiety. 26,27 Literature examining the relative contribution of headache symptoms and these diverse psychological factors to headache-related disability is lacking, which was the aim of the present study.…”

Section: Introductionmentioning

confidence: 99%

“…Anxiety sensitivity is a related construct denoting a tendency to attend to, and be fearful of, physiological sensations associated with arousal. Though originally conceptualized as a multidimensional risk factor for affective psychopathology, Anxiety sensitivity is now recognized as a transdiagnostic construct of relevance to a variety of health conditions including chronic pain 24,25 . Individuals with high anxiety sensitivity are prone to interpret innocuous bodily perturbations (e.g., heart palpitations, increased respiration) as dangerous, which contributes to beliefs about headache triggers and resulting avoidance behavior independently of depression and anxiety 26,27 …”

Section: Introductionmentioning

confidence: 99%

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Headache and psychological variables as predictors of disability in individuals with primary headache disorders

McCracken,

Lee,

Smitherman

2023

Headache

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ObjectiveTo examine the relative contribution of headache symptoms and psychological factors to headache‐related disability.BackgroundBoth headache symptoms and comorbid psychological factors (psychiatric symptoms and transdiagnostic constructs) negatively impact functioning among individuals with migraine and tension‐type headache, but few studies have explored their relative contribution to headache‐related disability. We hypothesized that psychiatric symptoms and transdiagnostic variables would afford incremental contribution to disability beyond headache symptoms, and we investigated the moderating role of headache diagnosis on these relationships.MethodsThis cross‐sectional study examined data from a southern U.S. university online sample of 1818 young adults (mean [SD] age 19.0 [5.1] years; 74.6% female) who met the International Classification of Headache Disorders, third edition criteria for primary headache disorders (46.6% episodic migraine, 11.6% chronic migraine, 38.3% episodic tension‐type headache, 3.5% chronic tension‐type headache) and completed measures assessing psychological factors and headache‐related disability. Headache, psychiatric symptoms, and transdiagnostic factors were examined in relation to headache‐related disability, after controlling for sex. Moderation analyses examined the conditional effect of diagnosis on disability.ResultsAs predicted, both psychiatric and transdiagnostic symptoms accounted for unique variance in headache‐related disability beyond headache symptoms (R2 changes of 2.7% and 2.3%, respectively). Significant three‐way interactions revealed the relationship between psychiatric symptoms and disability (b = −3.16, p = 0.002), and between transdiagnostic variables and disability (b = −2.37, p = 0.034). Tests of simple slopes showed greater psychiatric symptoms and transdiagnostic variables were associated with higher levels of disability. However, the associations of these variables with disability were strongest among individuals with chronic tension‐type headache (B = 3.93 for psychiatric symptoms and B = 4.62 for transdiagnostic symptoms, both p < 0.001).ConclusionPsychiatric and transdiagnostic factors contribute uniquely to headache‐related functional impairment, which may be important for expanding targeted assessment and behavioral interventions.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Headache and psychological variables as predictors of disability in individuals with primary headache disorders

McCracken,

Lee,

Smitherman

2023

Headache

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“…AS has been extensively studied in various affective disorders, such as general anxiety disorder, major depressive disorder and posttraumatic stress disorder [ 52 – 54 ]. Generally, AS is considered as an important transdiagnostic risk factor [ 55 ]. Extending previous studies, this study firstly found strong relationship between AS and irritability.…”

Section: Discussionmentioning

confidence: 99%

A cross-sectional analysis of the relationships between anxiety sensitivity and youth irritability: the mediated roles of insomnia and selective attention for threat

Li,

Tian,

Liu

et al. 2023

BMC Psychiatry

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Background Irritability is common in multiple psychiatric disorders and is hallmark of disruptive mood dysregulation disorder. Child irritability is associated with higher risk of suicide and adulthood mental health problems. However, the psychological mechanisms of irritability are understudied. This study examined the relationship between anxiety sensitivity and irritability among youth, and further explored three possible mediated factors: selective attention for threat, delayed reward discounting, and insomnia. Methods Participants were 1417 students (51.7% male; mean age 13.83 years, SD = 1.48) recruited from one high school in Hunan province, China. Self-report questionnaires were used to measure irritability (The Affective Reactivity Index and The Brief Irritability Test), anxiety sensitivity (The Childhood Anxiety Sensitivity Index), selective attention for threat (The Davos Assessment of Cognitive Biases Scale-attention for threat bias subscale), insomnia (The Youth Self-Rating Insomnia Scale), and delayed reward discounting (The 27-item Monetary Choice Questionnaire). Structural equation modal (SEM) was performed to examine mediated relations. Results Anxiety sensitivity was modestly related to irritability and insomnia (r from 0.25 to 0.54) and slightly correlated with selective attention for threat (r from 0.12 to 0.28). However, there is no significant relationship of delayed rewards discounting with anxiety sensitivity and irritability. The results of SEM showed that selective attention for threat (indirect effect estimate = 0.04) and insomnia (indirect effect estimate = 0.20) partially mediate the relationship between anxiety sensitivity and irritability, which explained 34% variation. Conclusions Anxiety sensitivity is an important susceptibility factor for irritability. Selective attention for threat and insomnia are two mediated mechanisms to understand the relationship between anxiety sensitivity and irritability.

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“…AS, or the fear of anxious arousal, is hypothesized to promote the interpretation of typical posttraumatic reactions as threatening, thus motivating avoidance and maintaining a sense of threat (McHugh et al., 2017; Schmidt et al., 2019). Consistent with this hypothesis, AS has been shown to be elevated among individuals with PTSD (Taylor et al., 1992) and prospectively predicts PTSD symptom onset, severity, and course (Boffa et al., 2016; Short, Lechner, Bell, et al., 2020, 2022; Marshall et al., 2010). Indeed, our research team has found that higher levels of peritraumatic AS predict heightened PTSD, depression, and anxiety after sexual assault (Short, Lechner, Bell, et al., 2020).…”

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confidence: 88%

Acceptability of a smartphone‐based intervention targeting anxiety sensitivity among women receiving emergency care after sexual assault: A pilot uncontrolled trial

Short,

Brady,

Lechner

et al. 2023

Journal of Traumatic Stress

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Anxiety sensitivity (AS), defined as the fear of anxious arousal, is a promising therapeutic target to reduce posttraumatic stress disorder (PTSD) symptom development after trauma exposure. Computerized AS interventions have been shown to be acceptable to individuals with PTSD symptoms and effective in achieving symptom reduction; however, to our knowledge, no research has examined AS interventions initiated in the immediate aftermath of trauma. We evaluated the feasibility, acceptability, and credibility of a brief (i.e., ∼75 min of psychoeducation, ∼2 hr of ecological momentary intervention) smartphone‐based AS intervention in a pilot study. Participants were 12 women who presented for emergency care after sexual assault with high levels of peritraumatic PTSD symptoms. Most women who started the intervention completed the majority of it and reported using the techniques provided. Results indicated that participants perceived the intervention as logical and believed it would help in reducing their symptoms. Qualitative feedback was mostly positive but also indicated concern regarding intervention length. Although not the purpose of the study, results indicated medium‐to‐large, statistically significant decreases in AS, g = 0.74, and PTSD symptoms, g = 1.20. Overall, these preliminary findings suggest that this novel smartphone‐based intervention targeting AS was feasible, acceptable, and credible in this small sample of women receiving emergency care following sexual assault. Treatment outcome data must be considered in the context of natural recovery; however, these promising preliminary feasibility, acceptability, and credibility data support continuing to pilot the feasibility and potential efficacy of the intervention to reduce AS and prolonged PTSD symptoms.

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Anxiety sensitivity as a transdiagnostic risk factor for trajectories of adverse posttraumatic neuropsychiatric sequelae in the AURORA study

Cited by 9 publications

References 42 publications

Headache and psychological variables as predictors of disability in individuals with primary headache disorders

Headache and psychological variables as predictors of disability in individuals with primary headache disorders

A cross-sectional analysis of the relationships between anxiety sensitivity and youth irritability: the mediated roles of insomnia and selective attention for threat

Acceptability of a smartphone‐based intervention targeting anxiety sensitivity among women receiving emergency care after sexual assault: A pilot uncontrolled trial

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