Interoceptive anxiety-related processes: Importance for understanding COVID-19 and future pandemic mental health and addictive behaviors and their comorbidity

Zvolensky, Michael J.; Kauffman, Brooke Y.; Garey, Lorra; Viana, Andres G.; Matoska, Cameron T

doi:10.1016/j.brat.2022.104141

Cited by 16 publications

(7 citation statements)

References 237 publications

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“…Most of the research on anxiety sensitivity and substance use behavior has been oriented from a negative reinforcement theoretical perspective (Brown et al, 2001; Guillot et al, 2014). That is, persons more likely to evaluate internal sensations as personally dangerous may be at higher likelihood for more intense emotional experiences, which in turn, leads to substance use to downregulate such perturbation (Zvolensky et al, 2022). The current results are in line with these observations, highlighting linkages to negative reinforcement and negative consequences expectancies.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, past work has found some evidence of differential effects of anxiety sensitivity lower order factors and substance use (Guillot et al, 2015, 2016). Fifth, data were collected between February 2021 and July 2021 during the COVID-19 pandemic, as have been documented in the literature (Zvolensky et al, 2022). Thus, high rates of probable anxiety disorder may be a function of or exacerbated by COVID-19-related stress.…”

Section: Discussionmentioning

confidence: 99%

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Anxiety-related constructs and smoking outcome expectancies among Latinx smokers.

Zvolensky¹,

Shepherd²,

Clausen³

et al. 2023

Experimental and Clinical Psychopharmacology

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Hispanic/Latinx (hereafter Latinx) smokers in the United States (US) experience unique smoking cessation-related challenges. Smoking outcome expectancies (i.e., positive and negative beliefs about the consequences of smoking behavior) have been linked to the maintenance of smoking and comorbidity with negative emotional states such as anxiety among Latinx smokers. However, past work has not characterized rates of probable anxiety disorder and elevated levels of anxiety sensitivity among English-speaking daily Latinx smokers from the United States or concurrently evaluated the explanatory relevance of anxiety symptoms and anxiety sensitivity for negative and positive smoking outcome expectancies. The present investigation sought to (a) determine the base rate of probable anxiety disorder and elevated anxiety sensitivity and (b) explore the unique roles of anxiety symptoms and anxiety sensitivity in relation to negative and positive smoking outcome expectancies. Participants included 338 English-speaking Latinx adult daily cigarette smokers from the United States (Mage = 35.53 years; SD = 8.65; age range 18–61; 37.3% female). Findings revealed high rates of probable anxiety disorder (50.9%) and elevated anxiety sensitivity (73.4%) among English-speaking Latinx smokers from the United States. Anxiety sensitivity, but not anxiety symptoms or disorders, was significantly related to negative consequences, negative reinforcement, positive reinforcement, and appetite/weight control smoking outcome expectancies. Overall, anxiety experiences were common among Latinx smokers, and anxiety sensitivity was a relatively more consistent and robust predictor of negative and positive outcome expectancies relative to anxiety symptoms and probable anxiety disorder.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Anxiety-related constructs and smoking outcome expectancies among Latinx smokers.

Zvolensky¹,

Shepherd²,

Clausen³

et al. 2023

Experimental and Clinical Psychopharmacology

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“…Wu et al 2009). Such elevated anxiety symptoms have been associated with poorer physical health (Sauer, Jungmann, and Witthöft 2020), life impairment across several domains (e.g., educational, occupational and interpersonal; Markiewicz-Gospodarek et al 2022), increased substance use (Zvolensky et al 2022) and higher rates of comorbidity with other mental health conditions (e.g., depression; Chen et al 2020). Some work has suggested that one useful and integrative perspective on emotional functioning in the pandemic pertains to coronavirus anxiety, which reflects physiologically based symptoms that are elicited by COVID-19related information and thoughts (e.g., 'I felt dizzy, lightheaded, or faint, when I read or listened to news about the Coronavirus'; S. Lee 2020).…”

Section: Introductionmentioning

confidence: 99%

“…2022), increased substance use (Zvolensky et al. 2022) and higher rates of comorbidity with other mental health conditions (e.g., depression; Chen et al. 2020).…”

Section: Introductionmentioning

confidence: 99%

Coronavirus Anxiety, COVID Anxiety Syndrome and Mental Health: A Test Among Six Countries During March 2021

Zvolensky,

Bakhshaie,

Redmond

et al. 2024

Clin Psychology and Psychoth

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The negative impact of the COVID‐19 pandemic on mental health outcomes is widely documented. Specifically, individuals experiencing greater degrees of severity in coronavirus anxiety have demonstrated higher levels of generalized anxiety, depression and psychological distress. Yet the pathways in which coronavirus anxiety confers vulnerability are not well known. The present investigation sought to address this gap in the scientific literature by testing the indirect effect of the COVID‐19 anxiety syndrome, which centres on the function of detecting and managing the environmental threat of virus exposure and its sequalae. Data were collected during the height of the pandemic (March 2021) and included 5297 adults across six countries. Structural equation modelling techniques revealed that the COVID‐19 anxiety syndrome evidenced a statistically significant indirect effect between coronavirus anxiety and generalized anxiety, depression and work/social adjustment. Overall, results suggest there could be public health merit to targeting anxiety related to virus exposure to improve behavioural health for those who are struggling with excessive fear and worry.

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“…Reductions in AS improve clinical outcomes among clinical and nonclinical populations [ 47 ], reductions in AS have been shown to be associated with positive outcomes in smokers who are motivated to quit [ 48 ], and AS can be effectively engaged through in-person and digitally delivered methods [ 49 , 50 ]. This is a critical consideration, given the overwhelming stress that the pandemic has placed on the health care system and the current paradigm shift toward providing care remotely [ 51 , 52 ]. In the context of mental health, digital health (eg, mobile health [mHealth]), telemedicine/telehealth, and health IT (eg, mobile phones, wearable sensors) can be used to develop scalable interventions that offer mental health care that is personalized to meet the unique needs of patients [ 53 - 55 ] and thus reduce the burden on the health care system.…”

Section: Introductionmentioning

confidence: 99%

A Smartphone-Based Intervention for Anxiety and Depression in Racially and Ethnically Diverse Adults (EASE): Protocol for a Randomized Controlled Trial

et al. 2022

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Background Clear health disparities have emerged in the rates of COVID-19 exposure, hospitalization, and death among Black, Hispanic, and American Indian (BHAI) individuals, relative to non-Hispanic White (NHW) individuals. BHAI populations have been disproportionately affected by lower behavioral health access and heightened negative mental health outcomes during the pandemic. Objective This project directly addresses health disparities in access to behavioral health care during the COVID-19 pandemic among BHAI populations via an adaptation of the established, initially validated, low-cost, mobile app Easing Anxiety Sensitivity for Everyone (EASE) among individuals with symptoms of elevated anxiety or depression or both. Methods The EASE trial is a 2-arm, prospective, randomized, blinded-assessor study with intention-to-treat analysis. Participants (N=800; n=200, 25%, Black; n=200, 25%, Hispanic; n=200, 25%, American Indian; and n=200, 25%, NHW) are randomized to receive either EASE or an active comparison condition for anxiety and depression. Participants compete an online prescreener, an enrollment call to provide informed consent, a baseline survey, a 6-month intervention period, and 3- and 6-month postbaseline assessments. Select participants also complete a 3- and 6-month postbaseline qualitative interview via phone or an online platform (eg, Zoom). Participants complete 2 scheduled daily ecological momentary assessments (EMAs) during the 6-month study period. These twice-daily EMAs guide a just-in-time approach to immediate, personalized behavioral health care. Results Outcomes include reductions in anxiety and depressive symptoms and functional impairment at 3 and 6 months postrandomization. We also will examine putative mechanisms (eg, anxiety sensitivity [AS] and COVID-19–specific stress and fear) of the intervention effects. Further, as treatment effects may differ across sociocultural factors, perceived discrimination, social support, and socioeconomic status (SES) will be evaluated as potential moderators of treatment effects on the primary outcomes. Process evaluation using data collected during the study, as well as individual interviews with participants, will complement quantitative data. Conclusions Data from this efficacy trial will determine whether EASE successfully improves symptoms of anxiety and depression and whether these improvements outperform an active comparison control app. If successful, findings from this study have the potential to decrease anxiety and depression symptoms among vulnerable populations determined to be most at risk of exacerbated, long-lasting negative health sequelae. Data from this study may be used to support an implementation and dissemination trial of EASE within real-world behavioral health and social service settings. Trial Registration ClinicalTrials.gov NCT05074693; https://clinicaltrials.gov/ct2/show/NCT05074693 International Registered Report Identifier (IRRID) DERR1-10.2196/40713

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Interoceptive anxiety-related processes: Importance for understanding COVID-19 and future pandemic mental health and addictive behaviors and their comorbidity

Cited by 16 publications

References 237 publications

Anxiety-related constructs and smoking outcome expectancies among Latinx smokers.

Anxiety-related constructs and smoking outcome expectancies among Latinx smokers.

Coronavirus Anxiety, COVID Anxiety Syndrome and Mental Health: A Test Among Six Countries During March 2021

A Smartphone-Based Intervention for Anxiety and Depression in Racially and Ethnically Diverse Adults (EASE): Protocol for a Randomized Controlled Trial

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