Monica Garza

Problem solving moderates the effects of life event stress and chronic stress on suicidal behaviors in adolescence

The present study examined the unique and interactive effects of stress and problem-solving skills on suicidal behaviors among 102 inpatient adolescents. As expected, life event stress and chronic stress each significantly predicted suicidal ideation and suicide attempt. Problem solving significantly predicted suicidal ideation, but not suicide attempt. Problem solving moderated the associations between life event stress and suicidal behaviors, as well as between chronic stress and suicidal ideation, but not chronic stress and suicide attempt. At high levels of stress, adolescents with poor problem-solving skills experienced elevated suicidal ideation and were at greater risk of making a nonfatal suicide attempt. The interactive effects decreased to non-significance after controlling for depressive symptoms and hopelessness. Clinical implications are discussed.

Anxiety sensitivity and subjective social status in relation to anxiety and depressive symptoms and disorders among Latinos in primary care.

The present investigation examined the interactive effects of anxiety sensitivity and subjective social status in relation to anxiety and depressive symptoms and psychopathology among 143 Latinos (85.7% female; Mage=39.0, SD=10.9; 97.2% used Spanish as their first language) who attended a community-based primary healthcare clinic. Results indicated that the interaction between anxiety sensitivity and subjective social status was significantly associated with number of mood and anxiety disorders, panic, social anxiety, and depressive symptoms. The form of the significant interactions indicated that individuals reporting co-occurring higher levels of anxiety sensitivity and lower levels of subjective social status evidenced the greatest levels of psychopathology and panic, social anxiety, and depressive symptoms. The present findings suggest that there is merit in focusing further scientific attention on the interplay between anxiety sensitivity and subjective social status in regard to understanding, and thus, better intervening to reduce anxiety/depressive vulnerability among Latinos in primary care.

Interactive effect of negative affectivity and anxiety sensitivity in terms of mental health among Latinos in primary care

From a public health perspective, primary care medical settings represent a strategic location to address mental health disapirty among Latinos. Yet, there is little empirical work that addresses affective vulnerability processes for mental health problems in such settings. To help address this gap in knowledge, the present investigation examined an interactive model of negative affectivity (tendency to experience negative mood states) and anxiety sensitivity (fear of the negative consequences of aversive sensations) among a Latino sample in primary care in terms of a relatively wide range of anxiety/depression indices. Participants included 390 Latino adults (Mage=38.7, SD=11.3; 86.9% female; 95.6% reported Spanish as first language) from a primary care health clinic. Primary dependent measures included depressive, suicidal, social anxiety, and anxious arousal symptoms, number of mood and anxiety disorders, and disability. Consistent with prediction, the interaction between negative affectivity and anxiety sensitivity was significantly related to suicidal, social anxiety, and anxious arousal symptoms, as well as number of mood/anxiety diagnoses and disability among the primary care Latino sample. The form of the interactions indicated a synergistic effect, such that the greatest levels of each outcome were found among those with high negative affectivity and high anxiety sensitivity. There was a trending interaction for depressive symptoms. Overall, these data provide novel empirical evidence suggesting that there is a clinically-relevant interplay between anxiety sensitivity and negative affectivity in regard to the expression of anxiety and depressive symptoms among a Latino primary care sample.

Anxiety sensitivity and mindful attention in terms of anxiety and depressive symptoms and disorders among Latinos in primary care

The present investigation examined the interactive effects of anxiety sensitivity and mindful attention in relation to anxiety and depressive symptoms and psychopathology among 145 adult Latinos (85.5% female; Mage=39.9, SD=10.8 and 98.6% used Spanish as their first language) who attended a community-based primary healthcare clinic. As expected, the interaction between anxiety sensitivity and mindful attention was significantly related to number of mood and anxiety disorders, social anxiety, and depressive symptoms. No significant interaction, however, was evident for panic (anxious arousal) symptoms. The form of the significant interaction indicated that Latinos reporting co-occurring higher levels of anxiety sensitivity and lower levels of mindful attention evinced the greatest levels of anxiety/depressive psychopathology, social anxiety, and depressive symptoms. These data provide novel empirical evidence suggesting that there is clinically-relevant interplay between anxiety sensitivity and mindful attention in regard to a relatively wide array of anxiety and depressive variables among Latinos in a primary care medical setting.

Synergistic effects of pain intensity and anxiety sensitivity in relation to anxiety and depressive symptoms and disorders among economically disadvantaged latinos in a community-based primary care setting

The present investigation examined the interactive effects of anxiety sensitivity and pain intensity in relation to anxious arousal, social anxiety, and depressive symptoms and disorders among 203 Latino adults with an annual income of less than

Negative Affectivity and Problematic Alcohol Use Among Latinos in Primary Care: The Role of Emotion Dysregulation

30,000 (84.4% female; Mage=38.9, SD=11.3 and 98.6% used Spanish as their first language) who attended a community-based primary healthcare clinic. As expected, the interaction between anxiety sensitivity and pain intensity was significantly related to increased anxious arousal, social anxiety, and depressive symptoms as well as number of depressive/anxiety disorder diagnoses. The form of the significant interactions indicated that participants reporting co-occurring higher levels of anxiety sensitivity and pain intensity evinced the greatest levels of anxious arousal, social anxiety, and depressive symptoms as well as higher levels of depressive and anxiety disorders. These data provide novel empirical evidence suggesting that there is clinically-relevant interplay between anxiety sensitivity and pain intensity in regard to a relatively wide array of anxiety and depressive variables among Latinos in a primary care medical setting.

Exploring the Mechanism Underlying the Association Between Pain Intensity and Mental Health Among Latinos

Objective: Latinos are the largest and most rapidly growing racial/ethnic group in the United States. In Latino communities, alcohol is the most widely abused substance, yet there is little empirical understanding of the factors underlying problematic alcohol use among Latinos. The current study explored whether negative affectivity exerted an indirect effect via emotion dysregulation in relation to two alcohol-related outcomes. Methods: Participants were 316 Latinos attending a community-based primary care facility (Mage = 39.3, SD = 11.3; 85.4% female; 95.3% first language Spanish), who completed a variety of self-report and interview measures. Mediation analyses evaluated the indirect effect of negative affectivity via emotion dysregulation on problematic drinking and symptoms of alcohol dependence. Results: While there was no direct or total effect of negative affectivity on either alcohol-related outcome, negative affectivity was significantly associated with both problematic alcohol use and symptoms of dependence via emotion dysregulation. Effect sizes were in the medium range, K2 = .09 and .10, respectively. Post-hoc multiple mediation analyses evaluated subfactors of emotion dysregulation as mediators of the negative affectivity–alcohol associations. These results suggested that difficulties engaging in goal-directed behavior might be particularly important in explaining the association between negative affectivity and problematic alcohol use/symptoms of dependence. Last, independent mediation analyses evaluated emotion dysregulation subfactors and found that limited access to effective emotion regulation strategies and difficulties engaging in goal-directed behavior were, independently, significant mediators for both outcomes. Nonacceptance of emotional responses may also mediate negative affectivity and problematic drinking. Surprisingly, impulse control difficulties was not a significant mediator in any model. Conclusions: These data provide novel insight that among Latinos in primary care, emotion dysregulation is a possible mechanism underlying the indirect relationship between negative affectivity and problematic alcohol use and symptoms of dependence. Results also highlight specific facets of emotion dysregulation as potential targets of intervention. Future research should be longitudinal in nature, be conducted among more representative samples, and utilize measures that will better assess the potential variability in these associations. Results of such work may inform the development of alcohol treatment interventions incorporating the use of adaptive emotion regulation among Latinos in primary care.

Emotional nonacceptance within the context of traumatic event exposure: The explanatory role of anxiety sensitivity for traumatic stress symptoms and disability among Latinos in a primary care setting

Abstract There is limited understanding of pain and its relationship to mental health in Latinos, and limited knowledge about the biobehavioral mechanisms that underlie pain–mental health interrelations. To address these gaps, the present investigation sought to address whether anxiety sensitivity explained relations between pain intensity and anxious arousal, depressive symptoms, social anxiety, and depressive and anxiety disorders among an economically disadvantaged Latino sample. Participants included 349 adult Latinos (88% women; Mage = 38.8) who attended a community-based primary health care. In the multiple mediation model, anxiety sensitivity physical concerns accounted for the association between pain intensity and anxious arousal symptoms, cognitive concerns accounted for the association between pain intensity and depressive symptoms, and social concerns accounted for the association between pain intensity and social anxiety symptoms. This is the first study to demonstrate the explanatory role of anxiety sensitivity in pain-affective associations among disadvantaged Latinos.

Pain severity and emotion dysregulation among Latinos in a community health care setting: relations to mental health

OBJECTIVE Research has found that Latinos (versus non-Latino Whites) evince higher rates of posttraumatic stress symptoms (PTS) and posttraumatic stress disorder (PTSD), yet little attention has been given to intra-individual, emotion-related processes to explicate the higher incidence of these symptoms among Latinos. METHOD Participants included 183 trauma-exposed adult Latinos (88.5% female; Mage=37.7, SD=10.7 and 93.4% reported Spanish as their first language) who attended a community-based primary healthcare clinic in Houston. It was hypothesized that anxiety sensitivity would explain the relation between emotional nonacceptance and traumatic stress symptoms, namely re-experiencing, avoidance, and arousal difficulties as well as overall disability. Additionally, it was expected that the observed effects would be evident above and beyond the variance accounted for by number of traumas reported, gender, age, marital status, educational status, years living in the U.S., and negative affectivity. RESULTS Consistent with our hypotheses, difficulties accepting negative emotions were associated with increased trauma-related re-experiencing, avoidance, and arousal difficulties. Additionally, anxiety sensitivity was an underlying mechanism in the association between emotional nonacceptance and all but one facet of traumatic stress symptoms (i.e., re-experiencing symptoms) and disability. Alternative models yielded no significant effects, providing greater confidence in the direction of the hypothesized effects. CONCLUSION Findings are discussed in the context of their significance for informing the development of specialized intervention strategies that target anxiety sensitivity for Latinos in primary care with elevated risk for PTS and PTSD by their heightened levels of emotional nonacceptance.

Synergistic effects of pain intensity and experiential avoidance in relation to anxiety symptoms and disorders among economically disadvantaged latinos in a community-based primary care setting

BACKGROUND Although pain severity is often related to poorer mental health and is one of the most common presenting complaints in community health care settings, there is little understanding of the pain experience in relation to anxiety/depressive symptoms and disorders among Latino populations in medical contexts. METHOD To address this gap, the current study explored an interactive model of pain severity and emotion dysregulation in relation to anxiety/depressive symptoms and psychopathology among 274 Latinos who attended a community-based primary health care clinic [86.9% female; Mage=39.3 (SD=11.2); 96.0% indicated Spanish as their first language]. RESULTS Results indicated a statistically significant interaction between pain severity and emotion dysregulation for suicidal symptoms, social anxiety symptoms and number of mood/anxiety disorders, such that more severe pain and greater levels of emotion dysregulation related to poorer mental health. Both pain severity and emotion dysregulation were significant predictors of depressive symptoms, but only pain severity was a significant predictor of anxious arousal symptoms. CONCLUSIONS These novel findings suggest a clinically significant interplay between pain severity and emotion dysregulation among Latinos in. The results are discussed in relation to the need for new screening and intervention tactics that address interrelations between pain severity and emotional dysregulation among Latinos seeking treatment in community health-care-based settings.