Browsing by Author "Paulus, Daniel J."
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Item Anxiety sensitivity and hazardous drinking among persons living with HIV/AIDS: An examination of the role of emotion dysregulation(Addictive Behaviors, 2016-12) Paulus, Daniel J.; Jardin, Charles; Bakhshaie, Jafar; Sharp, Carla; Woods, Steven P.; Lemaire, Chad; Leonard, Amy; Neighbors, Clayton; Brandt, Charles Philip; Zvolensky, Michael J.Hazardous drinking is prevalent among persons living with HIV/AIDS (PLWHA). Anxiety sensitivity is a vulnerability factor that is highly associated with hazardous drinking among seronegatives, but has yet to be tested in PLWHA. Additionally, there is a need to examine potential mechanisms underlying associations of anxiety sensitivity and hazardous drinking. Emotion dysregulation is one potential construct that may explain the association between anxiety sensitivity and hazardous drinking. The current study examined emotion dysregulation as a potential explanatory variable between anxiety sensitivity and four, clinically significant alcohol-related outcomes among PLWHA: hazardous drinking, symptoms of alcohol dependence, number of days consuming alcohol within the past month, and degree of past heavy episodic drinking. The sample included 126 PLWHA (Mage=48.3; SD=7.5; 65.9% male). Results indicated significant indirect effects of anxiety sensitivity via emotion dysregulation in all models. Indirect effects (κ2) were of medium effect size. Alternative models were run reversing the predictor with mediator and, separately, reversing the mediator with the proposed outcome(s); alternative models yielded non-significant indirect effects in all but one case. Together, the current results indicate that anxiety sensitivity is associated emotion dysregulation, which, in turn, is associated with hazardous drinking outcomes. Overall, these findings may provide initial empirical evidence that emotion dysregulation may be a clinical intervention target for hazardous drinking.Item Computer-Delivered Personalized Feedback Intervention for Hazardous Drinkers with Elevated Anxiety Sensitivity(2019-08) Paulus, Daniel J.; Zvolensky, Michael J.; Gallagher, Matthew W.; Neighbors, Clayton; Yoon, Jin HoRates of hazardous alcohol use among anxious/depressed persons is approximately two times that found in the general population. Hazardous alcohol use contributes to a variety of problems, ranging from interference with life functioning to psychological and physical complications. Yet, hazardous alcohol users with emotional symptoms/disorders remain a hard-to-reach and underserved group. This study aimed to evaluate the efficacy of a brief, computer-based personalized feedback intervention (PFI) to reduce alcohol consumption among hazardous drinkers with elevated anxiety sensitivity. The current study serves as an initial validation of a novel computer based integrated PFI for hazardous drinking and anxiety sensitivity. Seventy-four hazardous drinkers with elevated anxiety sensitivity (79.7% female; Mage=22.55) were randomized to receive the integrated PFI or attention control. Follow-up assessments were conducted at one-week and one-month post-intervention. The PFI was rated as statistically significantly more credible with greater expected reduction in alcohol use and anxiety sensitivity than control. Additionally, there was evidence for reduced alcohol consumption and perceived barriers to changing alcohol use as well as increased motivation to change alcohol use in the active condition but not the control over the course of the follow-up period. There were also reductions in anxiety sensitivity, anxious arousal, and drinking to cope with anxiety/depression, although these reductions were of similar magnitude in both conditions. There was no evidence for reduced anhedonic depression or improved drink refusal self-efficacy. Overall, effect sizes were small in size with medium reductions in alcohol consumption and anxiety sensitivity in the PFI. Despite a small sample size, this one-session online intervention offers promise in reducing drinking and improving motivation to change drinking among this high-risk group of drinkers. The computer-based format may allow for mass distribution of a low-cost intervention in the future; however, more follow-up testing in larger samples is needed prior to dissemination.Item Emotion Dysregulation Explains Associations between Anxiety Sensitivity and Hazardous Drinking and Drinking Motives among Adult Treatment-Seeking Smokers(Psychology of Addictive Behaviors, 2017-03) Paulus, Daniel J.; Valadka, Jaclyn; Businelle, Michael S.; Gallagher, Matthew W.; Viana, Andres G.; Schmidt, Norman B.; Zvolensky, Michael J.Smoking and drinking frequently co-occur. For example, alcohol use is associated with smoking lapses during quit attempts. However, little is known regarding psychological factors explaining drinking among smokers. Anxiety sensitivity is a risk factor associated with hazardous drinking and drinking to cope and/or conform, although little is known about mechanisms underlying such associations. One potential explanatory factor is emotion dysregulation. The current study examined emotion dysregulation as an explanatory factor underlying Anxiety Sensitivity and 5 alcohol-related outcomes: hazardous drinking, alcohol consumption, alcohol problems, coping-oriented drinking, and drinking to conform. Participants for this study were 467 treatment-seeking adult, daily smokers (48.2% women; Mage = 36.7 years, SD = 13.6) who reported smoking an average of 16.5 cigarettes per day. Results indicate significant indirect effects of Anxiety Sensitivity on hazardous drinking via emotion dysregulation, alcohol consumption, alcohol problems, drinking to cope, and drinking to conform. Effects were medium in size. Alternative models testing indirect effects of emotion dysregulation through Anxiety Sensitivity on outcomes, and Anxiety Sensitivity through outcomes on emotion dysregulation were nonsignificant and all had small effect sizes. Follow-up tests examined the path of effects from Anxiety Sensitivity through specific emotion-dysregulation subfactors. Thus, among treatment-seeking smokers, emotion dysregulation may explain the associations of Anxiety Sensitivity with alcohol-related outcomes. This pattern of findings highlights the potential importance of interventions targeting emotion dysregulation among hazardous-drinking smokers.Item THERE’S NO ‘I’ IN GCBT: IDENTIFYING PREDICTORS OF GROUP-LEVEL OUTCOME IN TRANSDIAGNOSTIC GROUP COGNITIVE BEHAVIORAL THERAPY FOR ANXIETY(2014-12) Paulus, Daniel J.; Norton, Peter J.; Zvolensky, Michael J.; Hayes-Skelton, Sarah A.Anxiety disorders represent a prevalent and impairing class of disorders. While individual and group cognitive-behavioral interventions have been efficacious in treating anxiety, this research typically looks at individuals or study condition as the unit(s) of analysis. Thus, an understudied area in group therapy is in the investigation of outcome with therapy group as the unit of analysis. Using data from 43 transdiagnostic CBT groups representing a heterogeneous composition of anxiety disorders, this study analyzed data at the level of therapy group to investigate predictors of group-level change associated with this treatment. Results demonstrated that gender heterogeneity and group cohesion positively predict group outcome while racial/ethnic heterogeneity negatively predicts outcome. However, results suggest that negative effects of racial/ethnic heterogeneity were limited to only the most diverse groups, which may need to integrate more multicultural perspectives in order to better integrate the different cultural identities. Results and implications are discussed in terms of CBT group composition and the implementation of culturally sensitive strategies into evidence-based treatments.