Abstract
Background
The present study examined the role of anxiety sensitivity in adolescent posttraumatic stress disorder (PTSD) severity, above and beyond the effects of anxiety, depression, and emotion dysregulation. The four facets of anxiety sensitivity (disease, mental incapacitation, unsteadiness, and social concerns) as contributors to PTSD symptom severity were also assessed. It was hypothesized that anxiety sensitivity would significantly explain variance in PTSD symptom severity above and beyond the effects of the three well-established affective correlates.
Method
Trauma-exposed adolescents recruited from a psychiatric inpatient hospital (N = 50; 52% female; Mage = 15.06 years, SD = 1.41, range = 12–17; 44.0% White) completed a battery of self-report measures.
Results
Hierarchical regression analyses showed that the total anxiety sensitivity score did not account for a significant amount of variance in PTSD symptoms above and beyond the affective correlates. However, the individual facets of anxiety sensitivity accounted for an additional 10.8% of unique variance in PTSD symptoms above and beyond the affective correlates, with the mental incapacitation concerns subscale alone emerging as a significant predictor of PTSD symptoms.
Conclusions
The findings suggest that adolescent psychiatric inpatients may benefit from treatments targeting mental incapacitation concerns.
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Data Availability
The data and material that support the findings of this study are available from the corresponding author upon reasonable request.
Notes
To test the relationship between anxiety sensitivity and PTSD symptoms in the absence of the anxiety and depression covariates, exploratory analyses were conducted—a set of regressions in which anxiety was not included in Step 2 of the models, and a set of regressions in which depression was not included in Step 2 of the models. The results yielded a similar pattern of results to the original models. Specifically, in the model using the CASI total score without the anxiety covariate, depression (b = 0.51, 95% CI [0.23, 0.84], sr2 = .15) and emotion dysregulation (b = 0.28, 95% CI [0.00, 0.24], sr2 = .05) emerged as significant predictors in Step 2, with depression remaining a significant predictor in Step 3 (b = 0.39, 95% CI [0.06, 0.77], sr2 = .06). Similar to the original model, anxiety sensitivity (total score) was not significant. In the model using the CASI subscales (without the anxiety covariate), depression remained significant in Step 3 (b = 0.38, 95% CI [0.06, 0.75], sr2 = .06), while the mental incapacitation concerns subscale emerged as the only other significant predictor (b = 0.46, 95% CI [0.87, 5.53], sr2 = .08). In the next model (CASI total score, without the depression covariate), anxiety remained a robust predictor of PTSD in Step 2 (b = 0.60, 95% CI [0.48, 1.23], sr2 = .21) and Step 3 (b = 0.52, 95% CI [0.30, 1.12], sr2 = .12), while the CASI total score accounted for no significant variance. In the model using the CASI subscales (without the depression covariate), anxiety (b = 0.61, 95% CI [0.46, 1.30], sr2 = .14) and the mental incapacitations concerns subscale (b = 0.55, 95% CI [1.79, 5.97], sr2 = .11) remained significant predictors of PTSD symptoms in Step 3, consistent with findings from our original model. We thank an anonymous reviewer for suggesting these additional analyses.
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Funding
Dr. Zvolensky is supported by an award from the National Institute on Minority Health and Health Disparities (NIMHD) of the National Institutes of Health (NIH) to the University of Houston under Award Number U54MD015946. Dr. Viana is supported by an award from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) of NIH to the University of Houston under Award Number 1K23AA025920-01A1. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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All authors contributed to the study conception and design. Material preparation and data collection was performed by AGV. Analyses were performed by DYA and EST. The first draft of the manuscript was written by DYA and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Amarneh, D.Y., Trent, E.S., Zvolensky, M.J. et al. The Relationship Between Anxiety Sensitivity and PTSD Symptom Severity Among Trauma-Exposed Inpatient Adolescents. Cogn Ther Res 46, 827–837 (2022). https://doi.org/10.1007/s10608-022-10294-0
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DOI: https://doi.org/10.1007/s10608-022-10294-0