Anka A. Vujanovic

Anxiety sensitivity and anxiety and depressive symptoms in the prediction of early smoking lapse and relapse during smoking cessation treatment

INTRODUCTION The present investigation examined whether anxiety sensitivity, relative to anxiety and depressive symptoms, was related to duration to early smoking lapse and relapse (during first 2 weeks postquit) among daily smokers receiving smoking cessation treatment. METHODS Participants included 123 daily cigarette smokers (84 women; M(age) = 45.93 years, SD = 10.34) living in the Halifax Regional Municipality in Nova Scotia, Canada. RESULTS Anxiety sensitivity was significantly associated with an increased risk of early smoking lapse (i.e., any smoking behavior) at days 1, 7, and 14 following the quit day. Such effects were evident above and beyond the variance accounted for by gender, nicotine dependence, and nicotine withdrawal symptoms, as well as the shared variance with prequit (baseline) anxiety and depressive symptoms. In contrast to expectation, anxiety sensitivity was not related to smoking relapse (i.e., seven consecutive days of smoking) during the first 2 weeks of quitting. DISCUSSION Results are discussed in terms of better understanding the role of anxiety sensitivity, along with other affective vulnerability processes, in early problems encountered during a quit attempt.

Multimethod study of distress tolerance and PTSD symptom severity in a trauma-exposed community sample.

Despite initial evidence linking distress tolerance to posttraumatic stress disorder (PTSD) symptom severity, there is a need for the investigation of interrelations among multiple measures of distress tolerance and PTSD symptom severity. Therefore, the present study investigated concurrent relations among multiple measures of distress tolerance, as well as the relations between these measures and PTSD symptom severity, within a trauma-exposed community sample. The sample consisted of 81 trauma-exposed adults (63.1% women). Results indicated that Distress Tolerance Scale (Simons & Gaher, 2005) scores, but no other measures of distress tolerance were significantly related to PTSD symptom severity above and beyond the variance accounted for by number of traumas, trait-level neuroticism, and participant sex. Implications and future directions are discussed.

Integrating anxiety sensitivity, distress tolerance, and discomfort intolerance: a hierarchical model of affect sensitivity and tolerance.

The purpose of the present investigation was to concurrently examine the latent dimensional and hierarchical structure of anxiety sensitivity (AS) and two key theoretically relevant and related affect (in)tolerance and sensitivity constructs: distress tolerance and discomfort intolerance. These constructs were measured using the Anxiety Sensitivity Index (Reiss, Peterson, Gursky, & McNally, 1986), the Distress Tolerance Scale (Simons & Gaher, 2005), and the Discomfort Intolerance Scale (Schmidt, Richey, & Fitzpatrick, 2006). A total of 229 individuals (124 females; M(age)=21.0 years, SD=7.5) without current Axis I psychopathology participated by completing a battery of self-report questionnaires. A two-stage exploratory factor analysis was conducted to examine the lower- and higher-order latent structural relations among the variables. The factor solution was subsequently evaluated in relation to negative affectivity, anxious arousal, and anhedonic depression. AS and distress tolerance appeared to be related to one another as distinct lower-order facets of a common higher-order affect tolerance and sensitivity factor, whereas discomfort intolerance did not appear to demonstrate similar relations with either AS or distress tolerance at the lower-order or higher-order levels. A unique pattern of association with theoretically-relevant criterion variables was observed between the affect tolerance and sensitivity higher-order factor, the AS and distress tolerance lower-order factors, and the discomfort intolerance factor. Findings are discussed in the context of theoretical and clinical implications and future directions for the study of affect tolerance and sensitivity in relation to emotional vulnerability.

Distress Tolerance Theory, Measurement, and Relations to Psychopathology

In this article we present the theoretical and empirical bases of distress tolerance research. Although distress tolerance offers a promising lens through which to better understand various psychological symptoms and disorders, further theoretical development and empirical inquiry is needed to promote our understanding of the construct. Overall, a number of questions regarding its theoretical conceptualization and measurement, associations with related constructs and psychopathology, and role(s) in therapeutic change and intervention remain unanswered. Directions for future research are discussed to stimulate further empirical study on this theoretically and clinically promising topic.

Posttraumatic Stress Disorder Symptoms and Functional Impairment Among OEF and OIF National Guard and Reserve Veterans

The aims of the present investigation were (a) to examine associations between posttraumatic stress disorder (PTSD; diagnosis and symptoms) and different aspects of functioning, severity, and subjective distress among Operation Iraqi Freedom and Operation Enduring Freedom National Guard and Reserve veterans, and (b) to examine the unique contribution of PTSD symptom clusters to different aspects of functioning and distress. Participants were 124 veterans who had returned from war-zone deployment. A PTSD diagnosis and PTSD symptoms were significantly associated with nearly all of the psychosocial functioning and distress measures, controlling for Axis I disorders and other covariates. Of the PTSD symptom clusters, numbing/avoidance symptoms were the strongest predictors of interpersonal and social functioning, and hyperarousal symptoms were the strongest predictors of overall severity and distress.

Mindfulness-based acceptance and posttraumatic stress symptoms among trauma-exposed adults without axis I psychopathology

The present investigation examined the incremental predictive validity of mindfulness-based processes, indexed by the Kentucky Inventory of Mindfulness Skills, in relation to posttraumatic stress symptom severity among individuals without any axis I psychopathology. Participants included 239 adults who endorsed exposure to traumatic life events. Results indicated that the Accepting without Judgment subscale was significantly incrementally associated with posttraumatic stress symptoms; effects were above and beyond the variance accounted for by negative affectivity and number of trauma types experienced. The Acting with Awareness subscale was incrementally associated with only posttraumatic stress-relevant re-experiencing symptoms; and no other mindfulness factors were related to the dependent measures. Findings are discussed in relation to extant empirical and theoretical work relevant to mindfulness and posttraumatic stress.

Emotional Dysregulation: Association With Coping-Oriented Marijuana Use Motives Among Current Marijuana Users

The present investigation, conducted between 2005 and 2006, examined the relation between emotion dysregulation and motives for marijuana use among 136 (71 women; Mage = 20.61 years) young adult marijuana smokers. As expected, after covarying for theoretically relevant variables, the DERS–total score was significantly related to marijuana use coping motives, but no other motives for marijuana use. Further analysis indicated that the Non-acceptance of Emotional Responses subscale of the DERS accounted for the DERS-total score effect. Results are discussed in relation to better understanding the role of coping-motivated marijuana use within the context of an emotional dysregulation explanatory framework. Limitations of the study are noted.

Posttraumatic stress disorder and cannabis use in a nationally representative sample.

The present study examined the relations between posttraumatic stress disorder (PTSD) and cannabis use in a large representative survey of adults (N = 5,672) from the United States (Kessler et al., 2004). After adjusting for sociodemographic variables (i.e., age, marital status, ethnicity, education, income, and sex), alcohol use disorders, and nicotine dependence, lifetime and current (past year) PTSD diagnoses were associated with increased odds of lifetime history of cannabis use as well as past year daily cannabis use. Lifetime, but not current, PTSD diagnosis also was uniquely associated with increased risk for any past year cannabis use. Additional analyses revealed that the relations between PTSD (lifetime and current) and lifetime cannabis use remained statistically significant when adjusting for co-occurring anxiety and mood disorders and trauma type frequency. Overall, these findings add to the emerging literature demonstrating a possibly important relationship between PTSD and cannabis use.

An evaluation of anxiety sensitivity, emotional dysregulation, and negative affectivity among daily cigarette smokers: relation to smoking motives and barriers to quitting.

The present investigation evaluated the relations between anxiety sensitivity and motivational bases of cigarette smoking, as well as barriers to quitting smoking, above and beyond concurrent substance use, negative affectivity, and emotional dysregulation among a community sample of 189 daily cigarette smokers (46% women; M(age)=24.97 years, SD=9.78). Results indicated that anxiety sensitivity was significantly related to coping, addictive, and habitual smoking motives, as well as greater perceived barriers to quitting. These effects were evident above and beyond the variance accounted for by concurrent tobacco, alcohol, and marijuana use and discernable from shared variance with negative affectivity and emotional dysregulation. Emotional dysregulation was significantly related to stimulation, habitual, and sensorimotor smoking motives and greater perceived barriers to quitting, whereas negative affectivity was only significantly related to smoking for relaxation. These findings uniquely add to a growing literature suggesting anxiety sensitivity is an important and unique cognitive factor for better understanding clinically-relevant psychological processes related to cigarette smoking.

Posttraumatic Stress, Difficulties in Emotion Regulation, and Coping-Oriented Marijuana Use

In an effort to better understand factors that may explain prior findings of a positive relation between posttraumatic stress symptom severity and coping-oriented marijuana use motivation, the present study tested whether the association between posttraumatic stress symptom severity and marijuana use coping motives is mediated by difficulties in emotion regulation. Participants were 79 (39 women; M age = 22.29 years, SD = 6.99) community-recruited adults who reported (1) lifetime exposure to at least one posttraumatic stress disorder Criterion A traumatic event and (2) marijuana use in the past 30 days. Results indicated that difficulties in emotion regulation, as indexed by the Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004), fully mediated the association between posttraumatic stress symptom severity and marijuana use coping motives. Implications for the treatment of co-occurring posttraumatic stress and marijuana use are discussed.