Kristen M. Kraemer

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.

The role of intolerance of uncertainty in terms of alcohol use motives among college students

INTRODUCTION Hazardous drinking rates among college students are exceedingly high. Despite the link between worry and alcohol use problems, there has been a dearth of empirical work examining worry-related risk factors in terms of motivations for alcohol use. Therefore, the aim of the present investigation was to examine the unique predictive ability of intolerance of uncertainty in terms of alcohol use motives. METHODS Participants were 389 college students (72.2% female, Mage=19.92, SD=3.87, Range=18-58 years) who completed self-report measures for course credit. RESULTS As hypothesized, after controlling for the effects of gender, smoking status, marijuana use status, alcohol consumption, negative affect, and anxiety sensitivity, greater levels of intolerance of uncertainty were significantly predictive of greater coping (1.5% unique variance) and conformity (4.7% unique variance) drinking motives, but not social or enhancement drinking motives. CONCLUSIONS These results suggest that intolerance of uncertainty is associated with drinking to manage or avoid negative emotions, and interventions aimed at reducing intolerance of uncertainty may be helpful in reducing problematic alcohol consumption among college students.

Emotion regulation difficulties and posttraumatic stress disorder symptom cluster severity among trauma-exposed college students.

The present investigation examined the role of emotion regulation difficulties in predicting severity of the 3 posttraumatic stress disorder (PTSD) symptom clusters (i.e., reexperiencing, hyperarousal, avoidance) in a sample of undergraduates who reported exposure to at least 1 DSM-IV-TR Criterion A traumatic event (n = 297; 77.1% female, Mage = 20.46, SD = 4.64, range = 18-50 years). Results indicated that greater difficulties with emotional acceptance significantly predicted greater avoidance and hyperarousal symptom severity above and beyond the effects of number of trauma types endorsed and negative affect. Emotion regulation difficulties were not significantly predictive of reexperiencing symptom severity. Results from an exploratory analysis indicated that greater difficulties with emotional acceptance and greater difficulties accessing effective emotion regulation strategies when upset significantly predicted the DSM-5 negative alterations in cognitions and mood symptom cluster. These findings suggest that difficulties accepting ones emotional responses, in particular, may heighten emotional responding to and avoidance of trauma-related cues. Thus, individuals who experience such difficulties may be more likely to experience negative outcomes after experiencing a traumatic event.

The Role of Distress Tolerance in the Use of Specific Emotion Regulation Strategies

The present study evaluated the role of distress tolerance (DT), defined as the ability to tolerate negative emotional states, in the use of four specific emotion regulation strategies (suppression, avoidance, rumination, and reappraisal). Undergraduate psychology students (N = 431, 71.7% female; Mage = 19.80 years, SD = 3.71) completed self-report measures online for course credit. It was hypothesized that, after controlling for the effects of anxiety sensitivity and negative affectivity, DT would be negatively associated with suppression, avoidance, and rumination, and positively associated with reappraisal. Consistent with prediction, low DT significantly predicted greater use of suppression, avoidance, and rumination. However, contrary to prediction, DT did not significantly predict reappraisal. These results suggest that individuals who are unable to withstand negative emotions are more likely to use maladaptive regulation strategies.

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.

Associations between mindfulness and panic symptoms among young adults with asthma

Despite the well-documented associations between panic psychopathology and asthma, there has been a dearth of empirical work examining factors that may reduce the negative effects of panic for individuals with asthma. Thus, the goal of the present study was to examine the role of mindfulness skills (i.e. observe, describe, acting with awareness, nonjudgment, and nonreactivity) in symptoms of panic psychopathology (i.e. panic symptoms, anxiety sensitivity, and body vigilance). Participants were young adults with asthma (n = 56; 30.4% male, Mage = 19.5 years, SD = 2.7) who completed online self-report measures for course credit. After controlling for the effects of asthma control and negative affectivity, greater use of the mindfulness skill of acting with awareness, relative to the other mindfulness skills, significantly predicted fewer panic symptoms and decreased anxiety sensitivity. The skill of observing approached statistical significance in terms of predicting increased body vigilance and anxiety sensitivity. These finding suggest that targeting the skill of acting with awareness may be a novel way to decrease panic symptomatology among individuals with asthma.

The role of mindfulness skills in terms of distress tolerance: a pilot test among adult daily smokers.

BACKGROUND AND OBJECTIVES Low distress tolerance is associated with difficulties quitting smoking. Mindfulness is associated with improved cessation outcomes and may be one method by which to increase distress tolerance. The purpose of the current study was to examine the relationship between mindfulness skills and distress tolerance among regular smokers. METHODS Daily smokers (n=125; Mage=37.5, 70% male) completed self-report measures assessing smoking and emotions. RESULTS After controlling for age, gender, and nicotine dependence, and education the mindfulness skills of acting with awareness and accepting without judgment significantly predicted distress tolerance. DISCUSSION AND CONCLUSIONS For smokers, being able to pay attention to present moment vents and accept negative events without judgment is associated with a greater ability to withstand such events. SCIENTIFIC SIGNIFICANCE These findings suggest that mindfulness-based approaches to smoking cessation may be effective because of improvements in distress tolerance. However, future prospective and laboratory-based studies are needed to better understand the mindfulness-distress tolerance link among smokers.

Characteristics of postural control among young adults with asthma

Abstract Objective: We investigated whether young adults with asthma have impaired balance and whether this impairment is related to altered musculoskeletal function and/or psychological characteristics. Methods: 21 participants with a self-reported asthma diagnosis but no known postural instability or history of falls, and 18 control participants were recruited from undergraduate psychology courses. Participants performed a postural control task of maintaining the center of pressure (COP) in a fixed position with visual feedback (feedback condition) and while standing as still as possible without visual feedback (no-feedback condition). COP variability, regularity and task performance were used to characterize the quality of balance. To document group differences in musculoskeletal function, we measured neck and lower back angles as well as range of motion (ROM) of the neck in the frontal and sagittal planes. To document group differences in psychological state, we administered self-report questionnaires to assess symptoms of anxiety and depression, anxiety sensitivity and negative effect. Results: COP variability and task performance were similar between the groups, but participants with asthma exhibited more regular anterior–posterior COP dynamics. Participants with asthma had smaller ROM of neck extension, a more forwardly bent neck, greater thoracic spine angle, and they reported greater levels of the physical concerns facet of anxiety sensitivity. These musculoskeletal and affective variables moderated COP differences between the groups. Conclusions: Young adults with asthma showed a different postural control strategy in the absence of any obvious balance impairment. This change in strategy is related to musculoskeletal and affective characteristics of individuals with asthma.

Evaluating the role of mindfulness in terms of asthma-related outcomes and depression and anxiety symptoms among individuals with asthma

ABSTRACT The aim of the current study was to examine the unique role of mindfulness skills in terms of: (1) asthma-related outcomes (i.e., asthma control, asthma quality of life); (2) depression symptoms; and (3) anxiety symptomatology (i.e., anxiety sensitivity, panic symptoms, global anxiety) among non-smoking adults with current asthma. Participants were 61 (61.9% female; Mage = 34.72 years, SD = 13.58, range = 18–65) non-smoking adults with current asthma who completed a battery of self-report measures. Results indicated that, after controlling for the effects of race and age, greater ability to describe present moment experiences was significantly associated with better asthma-related quality of life and lower levels of anxiety symptoms. Though mindfulness skills together were associated with lower levels of panic symptoms, there were no significant individual associations between specific skills and panic symptoms. Greater nonjudgment of present moment experiences was associated with lower levels of anxiety and anxiety sensitivity. Greater nonreactivity was significantly associated with lower levels of depression symptoms and anxiety sensitivity. Lastly, a greater ability to observe present moment experiences was associated with lower levels of anxiety sensitivity. Mindfulness was not significantly associated with asthma control. These findings suggest that it may be useful to target the mindfulness skills of describing, nonjudgment, and nonreactivity among individuals with asthma, particularly those with elevated levels of anxiety and depression, in order to improve psychological and asthma-related outcomes.