Associations between Lower-Order Anxiety Sensitivity Facets and PTSD Symptomatology among Trauma-Exposed Firefighters

Abstract

Firefighters are chronically exposed to potentially traumatic events, augmenting their risk of developing posttraumatic stress disorder (PTSD). The current study aimed to examine the incremental associations of lower-order dimensions of anxiety sensitivity (AS), examined concurrently, and PTSD symptom severity among a sample of trauma-exposed firefighters. We hypothesized that AS physical and cognitive concerns would be strongly associated with all PTSD symptom clusters and overall symptom severity, after controlling for theoretically relevant covariates (trauma load; years in fire service; alcohol use severity; depressive symptom severity). Participants were comprised of firefighters ( N = 657) who completed an online questionnaire battery and endorsed PTSD Criterion A trauma exposure. Results revealed that the AS cognitive concerns, but not AS physical concerns, was significantly and robustly associated with overall PTSD symptom severity, intrusion symptoms, and negative alterations in cognitions and mood ( ∆R2’s = .028–.042; p’s < .01); AS social concerns was incrementally associated with PTSD avoidance ( ∆R2 = .03, p < .01). Implications for firefighter-informed, evidence-based interventions are discussed.

The Influence of Transdiagnostic Vulnerability Factors on PTSD Symptom Clusters in a Veteran Sample

“…However, here we did not find any effect of anxiety sensitivity or the cognitive concerns sub-factor upon the avoidance symptom cluster. Notably, similar results were seen in Kreminski et al (2021), as well as previous research in both military and general populations (Lebeaut et al, 2021; Raines et al, 2017b) suggesting the results of this current study are not idiosyncratic to ADF veterans. The reason for this lack of empirical association between anxiety sensitivity and avoidance symptoms is unclear.…”

Anxiety Sensitivity Among Trauma-Exposed Non-Hispanic Black Adults

“…There is a large body of work on anxiety sensitivity, trauma, and PTSD among largely non-Latinx White persons (Bakhshaie et al, 2016; Brandt et al, 2015; Lebeaut et al, 2022; Raines et al, 2022; Zvolensky et al, 2020). This research has been influential in showcasing that individual differences in anxiety sensitivity are consistently related to poor trauma-related health (Raines et al, 2017b) and may represent a mechanism linking other vulnerability factors to more severe mental health in general (Raines et al, 2017a).…”

Anxiety sensitivity and intolerance of uncertainty among veterans with subthreshold versus threshold PTSD.

“…It has been suggested that fear of anxious arousal may intensify emotional reactions (e.g., psychological and physiological) to trauma cues, thereby leading to increased PTSD symptom severity (Taylor, 2003). Notably, AS exhibits cross-sectional (Lebeaut et al, 2022; Olatunji & Wolitzky-Taylor, 2009) and longitudinal associations (Boffa et al, 2016; G. N. Marshall et al, 2010) with PTSD symptoms in both unselected community (Bardeen & Fergus, 2016) and clinical veteran samples (Raines et al, 2017), such that higher AS is associated with greater PTSD symptom severity.…”

“…For example, Boffa et al (2016) found that higher levels of AS prior to a school shooting predicted greater PTSD symptoms after the shooting. When examining subdomain associations, AS cognitive, as compared to AS physical and AS social, exhibits the most robust association with PTSD symptom severity (Lebeaut et al, 2022; Raines et al, 2017). Cognitive concerns, versus physical or social, may be particularly relevant as PTSD is characterized by maladaptive trauma-related cognitions.…”