Christina M. Luberto

Anxiety Sensitivity, Asthma Control, and Quality of Life in Adults with Asthma

Objective. The aim of this study was to examine the role of anxiety sensitivity (AS) in terms of asthma control and asthma-related quality of life in a sample of adults with a physician-verified diagnosis of asthma. Methods. Self-report measures assessing psychological and asthma symptoms were mailed to 368 asthma patients from a community allergy and asthma office who had been seen for a physician follow-up visit between 1 January 2009 and 1 January 2010. Participants in the current study were 127 asthma patients (74% female; Mage = 43.4 years, SD = 12.3) who completed and returned the self-report measures. Results. The results indicated that, after controlling for gender, age, negative affect, and number of comorbid medical problems, the physical concerns factor of AS (AS-Physical Concerns) significantly predicted asthma control and all domains of asthma-related quality of life (symptoms, activity limitations, emotional functioning, and environmental stimuli). Conclusions. These findings replicate and extend previous research and indicate that the fear of physical sensations negatively affects both asthma control and quality of life. These findings also suggest that targeting the AS-Physical Concerns may be a novel way to improve asthma control and quality of life.

The Role of Anxiety Sensitivity in terms of Asthma Control: A Pilot Test among Young Adult Asthmatics

The aim of the present pilot investigation was to examine the role of specific subfactors of anxiety sensitivity (physical, cognitive, and social concerns) in terms of asthma control among a young adult sample (N = 56; M age = 20.0; SD = 3.9; Range = 18—45 years). Results indicated that, after controlling for gender, cigarette smoking status, and negative affectivity, the physical concerns factor of anxiety sensitivity, relative to cognitive and social concern factors, significantly predicted asthma control. These findings support the theory that fear of physical sensations is associated with poorer asthma control and suggest that targeting the physical concerns facet of anxiety sensitivity may be a novel way to improve asthma control.

The moderating role of distress tolerance in the association between anxiety sensitivity physical concerns and panic and PTSD-related re-experiencing symptoms.

Abstract The present investigation evaluated the moderating role of distress tolerance (DT) in the relation between the physical concerns (PC) dimension of anxiety sensitivity (AS–PC) and panic and posttraumatic stress disorder (PTSD)-related re-experiencing symptoms in a nonclinical, undergraduate sample (n = 416; 300 females; M age=20.3 years, SD = 4.8). Consistent with prediction, there was a significant interactive effect between AS–PC and DT in regard to panic symptoms, such that greater AS–PC and low DT was associated with greater panic symptoms after controlling for the variance accounted for by negative affectivity and the respective main effects. However, contrary to prediction, AS–PC and DT did not significantly interact to predict PTSD-related re-experiencing symptoms. Also consistent with prediction, there was no interactive effect apparent for symptoms of depression or general anxiety, suggesting that the interaction between AS–PC and DT is specific to panic psychopathology.

Mindfulness-based cognitive therapy for youth with anxiety disorders at risk for bipolar disorder: a pilot trial.

Children and adolescents with bipolar parents have an elevated risk for anxiety disorders. However, antidepressant medications commonly used to treat symptoms of anxiety may accelerate the onset of mania in these already at‐risk youth. Therefore, studies evaluating innovative non‐pharmacologic treatments for anxiety in this population are urgently needed.

Integrative Care Therapies and Pain in Hospitalized Children and Adolescents: A Retrospective Database Review

BACKGROUND Complementary or integrative care therapies are promising adjunctive approaches to pain management for pediatric inpatients that are currently underused and understudied. The purpose of this study was to examine the potential benefits of integrative care therapies delivered to hospitalized children and adolescents at a large Midwestern academic pediatric medical center over a 1-year period. METHODS A retrospective chart review of an inpatient clinical database maintained by integrative care therapists over a 1-year period was used for the current study. Pre/post pain and relaxation scores associated with the delivery of inpatient integrative care therapies (primarily massage therapy and healing touch) were examined. RESULTS Five-hundred nineteen hospitalized children and adolescents were treated by integrative care therapists for primarily pain or anxiety needs. Patients had a mean age of 10.2 years (standard deviation, 7.0), 224 were female (43%), 383 were white (74%), and most (393 [77%]) received massage therapy. Mean pain and relaxation scores decreased significantly from pre- to post-therapy across all demographic and clinical subgroups (p≤.001). CONCLUSIONS Although integrative care therapies are increasingly requested and offered in childrens hospitals, provision of these approaches is driven primarily by consumer demand rather than evidence-informed practice. Future controlled studies should examine the incremental effects of integrative care therapies as an adjunct to conventional treatment, assess how these therapies work mechanistically, and determine whether they improve outcomes, such as pain and cost, for hospitalized children and adolescents.

Integrative Medicine for Treating Depression: An Update on the Latest Evidence

Integrative medicine (IntM) is a growing medical trend combining conventional medical approaches with evidence-based complementary therapies to promote well-being. Over half of individuals with depression use some form of IntM for symptom management. The purpose of the current study was to critically review the scientific evidence for IntM techniques in treating adult unipolar depression. We examined randomized controlled trials, systematic reviews, and meta-analyses published in the last one to three years using PsychINFO, PubMed, and Cochrane Library databases. The strongest evidence currently exists for mindfulness-based interventions and St. John’s Wort (SJW) as monotherapies, and there is relatively strong evidence to support the use of omega-3 fatty acids and exercise as adjunct therapies. However, there remains an overall lack of methodologically rigorous research to support the efficacy of many other IntM techniques. Providers should be aware that many patients use IntM techniques for depression treatment and inquire regularly about such use.

Anxiety Sensitivity and Reactivity to Asthma-Like Sensations Among Young Adults With Asthma

Anxiety sensitivity, particularly the physical concerns domain, is associated with more problematic asthma symptoms and greater functional limitations. It has been theorized that anxiety sensitivity fosters greater reactivity to asthma-related physical sensations; however, this theory has yet to be empirically tested. Thus, the present investigation sought to examine the role of anxiety sensitivity–physical concerns in terms of affective and physical reactivity to asthma-like symptoms. Participants were 101 undergraduates with asthma (76.2% female, Mage = 19.69 years, SD = 3.77 years, range = 18-49 years) who completed self-report measures and a straw-breathing task. Results indicated that after controlling for the effects of gender, asthma control (i.e., how well one’s asthma symptoms are managed or controlled), and negative affectivity, greater levels of anxiety sensitivity–physical concerns significantly predicted greater anxiety (4.7% unique variance) and asthma symptoms (6.9% unique variance) and lower levels of lung function (4.4% unique variance) after the straw-breathing task. These findings suggest that individuals with asthma who are fearful of physiological arousal are a particularly “at-risk” population for poor asthma outcomes because of this greater reactivity and could benefit from interventions targeting anxiety sensitivity.

Distress Tolerance and Perceived Barriers to Smoking Cessation

ABSTRACT. Background: The present study examined the role of emotional distress tolerance (DT) in predicting barriers to smoking cessation and number of quit attempts. Methods: The sample consisted of regular daily smokers (N = 126; 37 females; M age = 36.51, SD = 13.05) who completed self-report measures on affect and smoking. Results: After controlling for daily smoking rate and anxiety sensitivity, emotional DT significantly predicted internal barriers to cessation (6.9% unique variance) but not external or addiction-related barriers to cessation. Inconsistent with prediction, emotional DT did not significantly predict number of quit attempts. Conclusions: These results suggest that individuals who are low in emotional DT believe that quitting smoking will be difficult because it takes away an important affect regulation strategy, and there may be utility in targeting emotional DT in smoking cessation interventions.

Asthma and its relation to smoking behavior and cessation motives among adult daily smokers

Despite the negative effects of smoking on lung functioning and overall health, smoking is more prevalent among individuals with asthma compared to those without asthma. The purpose of this study was to examine the predictive ability of asthma diagnosis in terms of smoking behavior and reasons for quitting. Participants were 251 regular daily smokers: 125 smokers with self-reported, physician-diagnosed asthma and 126 smokers without asthma. Asthma diagnosis significantly predicted age of regular smoking onset, number of quit attempts, and reasons for quitting related to self-control suggesting that smokers with asthma may have more difficulty quitting and unique reasons for quitting.

Complementary and Alternative Medicine Use and Psychosocial Outcomes among Urban Adolescents with Asthma

Objective. Many adolescents with asthma use complementary and alternative medicine (CAM) for asthma symptom management. The purpose of this study was to investigate cross-sectional and longitudinal differences in psychosocial health outcomes between high and low CAM users among urban adolescents with asthma. Methods. Adolescents (Time 1: N = 151, Time 2: N = 131) completed self-report measures regarding the use of 10 CAM modalities, mental health, and health-related quality of life (HRQoL) following two clinic visits 1 year apart as part of a larger observational study. Multivariable regression analyses using backward elimination examined relationships between CAM use at Time 1 and outcomes at Time 1 and Time 2, controlling for key covariates and, in longitudinal analyses, Time 1 functioning. Results. Participants (Mage = 15.8, SD = 1.85) were primarily African-American (n = 129 [85%]) and female (n = 91 [60%]) adolescents with asthma. High and low CAM users differed significantly in terms of several psychosocial health outcomes, both cross-sectionally and longitudinally. In cross-sectional multivariable analyses, greater frequency of praying was associated with better psychosocial HRQoL (R2 = 0.22). No longitudinal relationships remained significant in multivariable analyses. Conclusions. Specific CAM techniques are differentially associated with psychosocial outcomes, indicating the importance of examining CAM modalities individually. Greater frequency of praying was cross-sectionally associated with better psychosocial HRQoL. When controlling for key covariates, CAM use was not associated with psychosocial outcomes over time. Further research should examine the effects of CAM use in controlled research settings.