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Differences in Anxiety Sensitivity Among Black and White Veterans

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Journal of Racial and Ethnic Health Disparities Aims and scope Submit manuscript

Abstract

Black Americans are at greater risk for more severe and enduring consequences of anxiety disorders than White Americans, highlighting the need to identify malleable risk and maintenance factors. The current study aimed to examine racial differences in anxiety sensitivity and anxiety sensitivity facets between Black and White veterans (N = 285; 58% Black, 77% Male; Mage = 43.51, SD = 11.87) presenting to a PTSD specialty clinic at a Veterans Affairs (VA) hospital. In addition to a diagnostic interview, veterans were asked to complete a brief battery of self-report questionnaires to assist with diagnostic clarification and treatment planning. Results revealed a significant difference in anxiety sensitivity total scores between Black (M = 44.5, SD = 17.2) and White veterans (M = 36.1, SD = 17.7), such that Black veterans evinced higher levels. When examining anxiety sensitivity subfacets, Black veterans also evinced elevated levels of physical (M = 14.4, SD = 6.6) and cognitive concerns (M = 15.2, SD = 6.5) compared to White veterans (M = 9.8, SD = 6.2; M = 11.7, SD = 6.6, respectively). Results indicate that anxiety sensitivity is a relevant risk factor among Black veterans. Future studies should examine the extent to which anxiety sensitivity is modifiable in such populations.

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Data Availability

Data, computer code and syntax, and materials can be made available upon reasonable request to the corresponding author (AMR). This study and analysis plan were not preregistered.

References

  1. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593–602.

    Article  PubMed  Google Scholar 

  2. Himle JA, Baser RE, Taylor RJ, Campbell RD, Jackson JS. Anxiety disorders among African Americans, blacks of Caribbean descent, and non-Hispanic whites in the United States. J Anxiety Disord. 2009;23(5):578–90.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Jones AL, Rafferty J, Cochran SD, Abelson J, Mays VM. Persistence, impairment, disability and unmet treatment of lifetime and 12-month anxiety disorders in Black men and women, 50 years of age and older. J Aging Health. 2022;34(3):378–89.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Breslau J, Aguilar-Gaxiola S, Kendler KS, Su M, Williams D, Kessler RC. Specifying race-ethnic differences in risk for psychiatric disorder in a USA national sample. Psychol Med. 2006;36(1):57–68.

    Article  PubMed  Google Scholar 

  5. Asnaani A, Richey JA, Dimaite R, Hinton DE, Hofmann SG. A cross-ethnic comparison of lifetime prevalence rates of anxiety disorders. J Nerv Ment Dis. 2010;198(8):551.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Breslau J, Kendler KS, Su M, Gaxiola-Aguilar S, Kessler RC. Lifetime risk and persistence of psychiatric disorders across ethnic groups in the United States. Psychol Med. 2005;35(3):317–27.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Sibrava NJ, Beard C, Bjornsson AS, Moitra E, Weisberg RB, Keller MB. Two-year course of generalized anxiety disorder, social anxiety disorder, and panic disorder in a longitudinal sample of African American adults. J Consult Clin Psychol. 2013;81(6):1052.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Hunter LR, Schmidt NB. Anxiety psychopathology in African American adults: literature review and development of an empirically informed sociocultural model. Psychol Bull. 2010;136(2):211.

    Article  PubMed  Google Scholar 

  9. Hopkins PD, Shook NJ. A review of sociocultural factors that may underlie differences in African American and European American anxiety. J Anxiety Disord. 2017;49:104–13.

    Article  PubMed  Google Scholar 

  10. Baum F, Fisher M. Why behavioural health promotion endures despite its failure to reduce health inequities. From Health Behav Health Pract. 2014;57–68.

  11. Reiss S, Peterson RA, Gursky DM, McNally RJ. Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behav Res Ther. 1986;24(1):1–8.

    Article  CAS  PubMed  Google Scholar 

  12. Taylor S, et al. Robust dimensions of anxiety sensitivity: development and initial validation of the Anxiety Sensitivity Index-3. Psychol Assess. 2007;19(2):176.

    Article  PubMed  Google Scholar 

  13. Zvolensky MJ, Shepherd JM, Clausen BK, Kauffman BY, Heggeness L, Garey L. Anxiety sensitivity among non-Hispanic Black adults: relations to mental health and psychosomatic states. J Racial Ethn Health Disparities. 2023;10(2):751–60.

    Article  PubMed  Google Scholar 

  14. Carter MM, Miller O Jr, Sbrocco T, Suchday S, Lewis EL. Factor structure of the Anxiety Sensitivity Index among African American college students. Psychol Assess. 1999;11(4):525.

    Article  Google Scholar 

  15. Arnau RC, Broman-Fulks JJ, Green BA, Berman ME. The Anxiety Sensitivity Index—revised: confirmatory factor analyses, structural invariance in Caucasian and African American samples, and score reliability and validity. Assessment. 2009;16(2):165–80.

    Article  PubMed  Google Scholar 

  16. Hunter LR, Keough ME, Timpano KR, Schmidt NB. Ethnoracial differences in anxiety sensitivity: examining the validity of competing anxiety sensitivity index subscales. J Anxiety Disord. 2012;26(4):511–6.

    Article  PubMed  Google Scholar 

  17. Friedman S, Paradis C. Panic disorder in African-Americans: symptomatology and isolated sleep paralysis. Cult Med Psychiatry. 2002;26:179–98.

    Article  PubMed  Google Scholar 

  18. Johnson MR, et al. Ethnic differences in the reliability and validity of a panic disorder screen. Ethn Health. 2007;12(3):283–96.

    Article  PubMed  Google Scholar 

  19. Seal KH, Bertenthal D, Miner CR, Sen S, Marmar C. Bringing the war back home: mental health disorders among 103 788 US veterans returning from Iraq and Afghanistan seen at Department of Veterans Affairs facilities. Arch Intern Med. 2007;167(5):476–82. https://doi.org/10.1001/archinte.167.5.476.

    Article  PubMed  Google Scholar 

  20. Hoge CW, Castro CA, Messer SC, McGurk D, Cotting DI, Koffman RL. Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. N Engl J Med. 2004;351(1):13–22.

    Article  CAS  PubMed  Google Scholar 

  21. Cohen J. Statistical power analysis for the behavioral sciences. Cambridge, MA: Academic Press; 2013.

  22. Carleton RN, Abrams MP, Asmundson GJ, Antony MM, McCabe RE. Pain-related anxiety and anxiety sensitivity across anxiety and depressive disorders. J Anxiety Disord. 2009;23(6):791–8.

    Article  PubMed  Google Scholar 

  23. Allan NP, Short NA, Albanese BJ, Keough ME, Schmidt NB. Direct and mediating effects of an anxiety sensitivity intervention on posttraumatic stress disorder symptoms in trauma-exposed individuals. Cogn Behav Ther. 2015;44(6):512–24.

    Article  PubMed  Google Scholar 

  24. Soto JA, Dawson-Andoh NA, BeLue R. The relationship between perceived discrimination and generalized anxiety disorder among African Americans, Afro Caribbeans, and non-Hispanic Whites. J Anxiety Disord. 2011;25(2):258–65.

    Article  PubMed  Google Scholar 

  25. Lee RT, Perez AD, Boykin CM, Mendoza-Denton R. On the prevalence of racial discrimination in the United States. PLoS one. 2019;14(1):e0210698.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Berger M, Sarnyai Z. “More than skin deep”: stress neurobiology and mental health consequences of racial discrimination. Stress. 2015;18(1):1–10.

    Article  PubMed  Google Scholar 

  27. Brown TN, et al. “Being black and feeling blue”: the mental health consequences of racial discrimination. Race Soc. 2000;2(2):117–31.

    Article  Google Scholar 

  28. Harnett NG. Neurobiological consequences of racial disparities and environmental risks: a critical gap in understanding psychiatric disorders. Neuropsychopharmacology. 2020;45(8):1247–50.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Broman CL, Mavaddat R, Hsu S-Y. The experience and consequences of perceived racial discrimination: a study of African Americans. J Black Psychol. 2000;26(2):165–80.

    Article  Google Scholar 

  30. Wang L, Lin H-C, Wong YJ. Perceived racial discrimination on the change of suicide risk among ethnic minorities in the United States. Ethn Health. 2021;26(5):631–45.

    Article  PubMed  Google Scholar 

  31. Walker R, Francis D, Brody G, Simons R, Cutrona C, Gibbons F. A longitudinal study of racial discrimination and risk for death ideation in African American youth. Suicide Life-Threat Behav. 2017;47(1):86–102.

    Article  PubMed  Google Scholar 

  32. Capron DW, Schmidt NB. Development and randomized trial evaluation of a novel computer-delivered anxiety sensitivity intervention. Behav Res Ther. 2016;81:47–55.

    Article  PubMed  Google Scholar 

  33. Norr AM, Allan NP, Macatee RJ, Keough ME, Schmidt NB. The effects of an anxiety sensitivity intervention on anxiety, depression, and worry: mediation through affect tolerances. Behav Res Ther. 2014;59:12–9.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Short NA, Allan NP, Raines AM, Schmidt NB. The effects of an anxiety sensitivity intervention on insomnia symptoms. Sleep Med. 2015;16(1):152–9.

    Article  PubMed  Google Scholar 

  35. Terlizzi EP, Zablotsky B. QuickStats: percentage of adults aged ≥ 18 years who had an unmet mental health care need because of cost in the past 12 months, by age group and sex—national health interview survey, United States 2019. Centers for Disease Control and Prevention, [Online]. Available: https://www.cdc.gov/mmwr/volumes/69/wr/mm6943a8.htm. Accessed 30 Apr 2023.

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Acknowledgements

This material is the result of work supported with resources and the use of facilities at the Southeast Louisiana Veterans Health Care System in New Orleans, LA.

Funding

Amanda M. Raines is supported by the United States Department of Veterans Affairs (Clinical Science Research and Development Service) under Career Development Award-2 IK2CX001978-02.

Author information

Authors and Affiliations

  1. Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, LA, USA

    Ava K. Fergerson & Amanda M. Raines

  2. Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA

    Ava K. Fergerson & Emily A. Cordova

  3. Michael E. DeBakey VA Medical Center, Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, TX, USA

    Darius Dawson

  4. South Central Mental Illness Research, Education and Clinical Center, Virtual Center, Houston, TX, USA

    Darius Dawson & Amanda M. Raines

  5. Department of Medicine, Baylor College of Medicine, Houston, TX, USA

    Darius Dawson

  6. McKinney, TX, USA

    Lora Rose Hunter

  7. School of Medicine, Louisiana State University, New Orleans, LA, USA

    Amanda M. Raines

Authors
  1. Ava K. Fergerson
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  2. Emily A. Cordova
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  3. Darius Dawson
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  4. Lora Rose Hunter
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Contributions

AK Fergerson: data analysis (lead), visualization (lead), writing original draft (lead); EA Cordova: writing original draft (supporting); D Dawson: writing review and editing (equal); LR Hunter: writing review and editing (equal); AM Raines: conceptualization (lead), writing review and editing (supporting), investigation (lead), data analysis (supporting), supervision (lead).

Corresponding author

Correspondence to Amanda M. Raines.

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Ethics Approval and Consent to Participate

All research was conducted in an ethical and responsible manner, aligned with the standards delineated in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Given that the data were collected as part of routine clinical care, informed consent for research was not obtained. However, the VA IRB (Reference Number: 621–629) approved use of these data for research purposes.

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This work does not contain identifying information; therefore, consent to publish is not applicable and was not obtained.

Competing Interests

The authors declare no competing interests.

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Fergerson, A.K., Cordova, E.A., Dawson, D. et al. Differences in Anxiety Sensitivity Among Black and White Veterans. J. Racial and Ethnic Health Disparities 11, 1301–1307 (2024). https://doi.org/10.1007/s40615-023-01609-2

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  • DOI: https://doi.org/10.1007/s40615-023-01609-2

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