Browsing by Author "Viana, Andres G."
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Item Adversity and Childhood Anxiety: Identifying Parental and Affective Mechanisms(2023-12) Trent, Erika Sandra; Viana, Andres G.; Berger Cardoso, Jodi; Storch, Eric Alan; Zvolensky, Michael J.Introduction: The present investigation examined direct and indirect effects of contextual adversity on childhood anxiety symptom severity through parental emotion socialization and child emotion dysregulation. It was hypothesized that: 1) contextual adversity would be indirectly associated with emotion dysregulation through unsupportive emotion socialization; and 2) unsupportive emotion socialization would be indirectly associated with child anxiety symptom severity through child emotion dysregulation. Method: Sixty-two children ages 8 – 12 years (Mage = 10.3 years, SD = 1.2; 40.3% female; 45.2% racial/ethnic minority) and their mothers (Mage = 42.7 years, SD = 6.6; 48.4% racial/ethnic minority) completed a one-session, multi-informant (child, mother), multimethod (questionnaires, task-based state measures, behavioral observations) battery across three structured dyadic interaction tasks and a child speech task. Results: Unsupportive maternal emotion socialization did not mediate the relationship between contextual adversity and child emotion dysregulation; this finding was consistent across child-report, mother-report, task-based state measures, and observational data. Child emotion dysregulation mediated the relationship between unsupportive maternal emotion socialization and child anxiety symptom severity; this finding was consistent across child- and mother-report measures, but not task-based state measures or observational data. Discussion: Unsupportive parental emotion socialization practices contribute to child emotion dysregulation, which in turn places children at risk for anxiety problems. The present study’s findings have implications for personalized prevention and treatment efforts that target parental practices and emotion regulation skills among clinically anxious youth. Future studies should assess the impact of specific facets of contextual adversity on parental and affective mechanisms of childhood anxiety.Item Affective Vulnerability Across Non-Daily and Daily Electronic Cigarette Users(2019-12) Mayorga, Angie; Zvolensky, Michael J.; Minnix, Jennifer A.; Viana, Andres G.Electronic cigarette (e-cigarette) use has risen exponentially since its initial introduction. The widespread and growing use of these novel products has prompted increased research to evaluate use from a nuanced perspective that considers patterns and antecedents of use. Specifically, research has identified sociodemographic characteristics related to varying levels of e-cigarette use frequency. Yet, limited research has investigated broad-based psychological factors related to frequent and infrequent e-cigarette use. The current study sought to address this clinically relevant research gap within a cross sectional design. Several affective vulnerability states were evaluated, including anxiety sensitivity, anxious arousal, general distress, and anhedonia across 566 (51% female, Mage = 35.11 years, SD = 10.12) non-daily and daily past month, adult e-cigarette users. Results demonstrated that in comparison to non-daily e-cigarette users, daily users evinced significantly higher levels of anxiety sensitivity, anxiety sensitivity cognitive concerns, anxious arousal, and general distress. No significant differences were found for the criterion variables of anxiety sensitivity social concerns, anxiety sensitivity physical concerns, and anhedonic depression. Overall, the current study provides initial and novel empirical evidence that certain affective vulnerability constructs related to anxiety may be more strongly endorsed by daily e-cigarette users. Importantly, this work adds to evolving, but thus far highly underdeveloped, e-cigarette models by highlighting the need to consider anxiety-related constructs when evaluating e-cigarette use patterns and behavior.Item Associations between Anxiety Symptoms and Child and Family Factors in Pediatric Obesity(Journal of Developmental and Behavioral Pediatrics, 2015) Lim, Crystal S.; Espil, Flint M.; Viana, Andres G.; Janicke, David M.Objective: This study compared child weight status, social skills, body dissatisfaction, and health-related quality of life (HRQOL), as well as parent distress and family functioning in youth who are overweight or obese (OV/OB) with versus without clinical anxiety symptoms. Method: Participants included 199 children 7 to 12 years of age (mean age = 9.88 years) who were OV/OB, and their parents. Children completed social skills, body dissatisfaction, and HRQOL questionnaires. Parents completed the Child Behavior Checklist (CBCL) and child HRQOL, parent distress, family functioning, and demographic questionnaires. Children were placed in 2 groups based on CBCL anxiety problems scale scores: the OV/OB + clinical anxiety group included children with T scores ≥65 (n = 23) and children with T scores ≤59 comprised the OV/OB group (n = 176). Results: After controlling for covariates, children in the OV/OB + clinical anxiety group reported more body dissatisfaction (F[1,198] = 5.26, p = .023, partial η2 = .027) and lower total HRQOL (F[1,198] = 8.12, p = .005, η2 = .041) and had parents who reported higher psychological distress (F[1,198] = 5.48, p = .020, η2 = .028) and lower child total HRQOL (F[1,198] = 28.23, p < .001, η2 = .128) compared with children in the OV/OB group. Group differences were not significant for child weight status, social skills, or family functioning. Conclusion: Clinically significant anxiety among children who are OV/OB is associated with increased body dissatisfaction and parent psychological distress, as well as decreased HRQOL. Findings have implications for the assessment and treatment of anxiety symptoms in pediatric obesity.Item Cannabis Use through Emotion Dysregulation Influencing Mental Health Outcomes in Opioid Misusing Chronic Pain Population(2019-08) Orr, Michael Francis; Zvolensky, Michael J.; Blalock, Janice A.; Viana, Andres G.Cannabis is often used to manage pain, especially among persons who suffer from chronic pain. Yet, despite a large body of literature suggesting that cannabis use problems are associated with mental health problems, little work has examined mechanisms of this relationship within the context of a chronic pain population. Chronic pain is associated with emotion dysregulation. Consequently, individuals with chronic pain who experience more cannabis use problems may have less capacity to regulate negative emotions, which in turn, could be related to greater anxiety, depression, and negative emotional states (e.g., suicidal ideation). The current study explored whether emotion dysregulation explained, in part, the relation between cannabis use problems and anxiety, depression, and suicidal ideation among adults with chronic pain. Participants were 431 (74.60% female, Mage= 38.98 years, SD= 11.23) opioid-using adults with current moderate to severe chronic pain. The sample was predominately White (77.8%), with identifying as 13.1% Hispanic/Latino, 8.7% Black/African American, 3.3% Native American/Alaska Native, 2.7% multiracial, 0.9% Asian/Pacific Islander, and 1.1% other. Of the 431, 176 were current cannabis users, and 30.2% reported cannabis use problems. Of the 431, 186 were lifetime cannabis users. Results indicated a significant indirect relationship between cannabis use problems and anxiety, depression, and suicidal ideation via emotion dysregulation. Tests of specificity suggested a potential for a bi- directional effect only for suicidal ideation. These initial findings suggest that emotion dysregulation may be an important mechanism for the relationship between cannabis use problems and mental health among adults with chronic pain.Item CHILDHOOD ANXIETY: THE CONTRIBUTIONS OF EFFORTFUL CONTROL, INTERPRETATION BIASES, AND EARLY LIFE STRESS(2023-08) Raines, Elizabeth Mulkern; Viana, Andres G.; Zvolensky, Michael J.; Storch, Eric Alan; Berger Cardoso, JodiIntroduction: Research to date has failed to empirically test the mechanisms through which individual differences in effortful control may be protective against childhood anxiety disorder (CAD) symptoms, as well as whether these protective effects may be conditional on the degree of child exposure to early life stress (ELS; e.g., low socioeconomic status, poverty, social support, traumatic events). To this end, the present investigation examined 1) interpretation biases as an underlying mechanism in the relation between effortful control and CAD symptom severity, and 2) ELS as a moderator of hypothesized direct and indirect effects in a sample of 60 clinically anxious children ages 8-12 years. Method: Sixty clinically anxious children (Mage = 9.87 years, SD = 1.47; 50% female; 44% ethnic/racial minority) and their parent completed a multi-method, multi-informant assessment battery of effortful control, interpretation biases, ELS, and anxiety. Children also participated in a behavioral assessment of effortful control. Results: Multiple mediator models indicated a significant indirect effect of effortful control on self-reported CAD symptom severity through self-reported (but not behaviorally indexed) interpretation biases (Aim 1). Moderated mediation results revealed indirect effects of effortful control on child anxiety via interpretation biases at low and mean (but not high) levels of ELS (Aim 2). Discussion: In the context of low and mean (but not high) levels of ELS, anxious children with higher levels of effortful control were less likely engage in biased interpretations, which may lower their anxiety. Clinically anxious children with higher levels of ELS may require more intensive intervention to address the impact of ELS on their cognitive patterns and anxiety symptoms.Item COMPUTER-DELIVERED INTERVENTION FOR INDIVIDUALS WITH OBESITY AND ELEVATED ANXIETY SENSITIVITY(2021-05) Kauffman, Brooke Y; Zvolensky, Michael J.; Gallagher, Matthew W.; Viana, Andres G.; Blalock, Janice A.Obesity is one the fastest growing public health problems related to numerous chronic diseases and frequently co-occurs with negative mood states. One promising integrative, theory-driven approach to address the heterogeneity of affective vulnerabilities and obesity is to focus on transdiagnostic processes that underpin both conditions. Anxiety sensitivity (AS) is a transdiagnostic cognitive vulnerability factor associated with negative affect syndromes and obesity-related health behaviors. Thus, the current study was conducted to adapt and test a brief (single session), computer-delivered intervention for adults with obesity and elevated AS. Participants were 131 individuals with obesity and elevated AS who received either the AS reduction program (AST) or a health information control (HC). Latent growth curve modeling was utilized to examine the effect of treatment condition on change in AS, emotional eating, expectancies of eating to manage mood, exercise self-efficacy, and exercise avoidance from baseline to 1-week, 2-weeks, and 1-month follow-up. The mediational role of changes in AS on the relationship between treatment condition and changes in the outcome variables were examined. Results indicated AST was a statistically significant predictor of change in expectancies of eating to manage negative affect. Additionally, changes in AS had a statistically significant effect on changes in emotional eating and expectancies of eating to manage negative affect. Current data provide preliminary support for the utility of AST related to expectancies of eating to manage negative affect. Moreover, the current study provides a strong rationale for future work within this domain.Item Correlates and Predictors of Parenting Stress among Internationally Adopting Mothers: A Longitudinal Investigation(International Journal of Behavioral Development, 2010-04) Viana, Andres G.; Welsh, Janet A.This study examined correlates and predictors of parenting stress among internationally adopting (IA) mothers with the goal of expanding the knowledge base on the experiences of adoptive parents. One hundred and forty-three IA mothers completed pre-adoption (Time 0) and six months post-adoption (Time 1) surveys with questions regarding child-, parent-, and family-related characteristics. Mother reports of higher depression symptoms, higher expectations of child developmental and behavioral/emotional problems, and a greater number of children in the family at pre-adoption were significantly related to higher parenting stress six months post-adoption. In contrast, mother reports of higher expectations for child acceptance and higher perceived social support at pre-adoption were significantly related to lower parenting stress six months post-adoption. Higher maternal depression symptoms, higher expectations of child behavior/emotional problems, and a greater number of children in the family at pre-adoption together accounted for 22% of the variance in parenting stress six months post-adoption. Concurrent higher maternal depression symptoms and higher reports of child behavioral/emotional problems predicted higher parenting stress six months post-adoption over and above pre-adoption predictors, and accounted for an additional 33% of the variance. Results and directions for future research are discussed from a transactional perspective, with particular emphasis on the importance of pre-adoptive information for adoption research and practice.Item Development and Initial Validation of a Bio-behavioral Measure of Anxiety Sensitivity(2019-05) Bakhshaie, Jafar; Zvolensky, Michael J.; Gallagher, Matthew W.; Viana, Andres G.; Lu, Qian; Pavlidis, Ioannis T.Anxiety sensitivity (AS) is a relatively stable individual difference factor reflecting the fear of anxiety-related sensations. AS is a transdiagnostic factor of psychopathology. Despite well-validated self-report methods to measure AS, no study to date has used AS-specific stimuli to measure threat responses from a motoric fashion. Using a dual-task attentional control paradigm (i.e., approach versus avoidance) that employs AS-specific stimuli and motion-tracking technology, we sought to develop an easy-to-use bio-behavioral index of AS in sample of young adults (58.3% female, M age = 25.3, SD = 8.3; range = 18-56 years). Participants completed a self-report measure of AS (ASI-3) and subsequently took part in a virtual reality ball catching game to index their measures of approach and avoidance towards the AS-specific and neutral stimuli presented at either side of the game environment. The ASI-3 total score as well as the subscales cognitive and physical concerns showed significant bivariate correlations with the behavioral engagement with AS-specific stimuli, but not behavioral engagement with the neutral stimuli. After adjusting for age, gender, race, handedness, physical functioning, and negative affectivity, ASI-3 total score and the AS cognitive concern demonstrated significant relations with behavioral engagement with AS-specific stimuli. The present study provides preliminary, yet novel, evidence regarding the association between facets of AS with behavioral responses to AS-specific images. Future work is needed to replicate and extend the current results to clinical samples and test associations over larger periods of time.Item Development of a Personalized Feedback Intervention Targeting Pain-Related Anxiety for Hazardous Drinkers with Chronic Pain(2023-05-24) Rogers, Andrew Harrison; Zvolensky, Michael J.; Neighbors, Clayton; Viana, Andres G.; Derrick, Jaye L.; Case, Kathleen R.Objective: Hazardous alcohol use contributes to mental and physical health problems, disability, and may lead to an increased risk of premature death. Among individuals with chronic pain, the rate of hazardous alcohol use is elevated compared to the general population, yet, hazardous alcohol users with chronic pain remain an underserved group. There is a critical need to test alternative and complementary approaches to the implementation of effective interventions to reduce hazardous alcohol use among this high-risk segment of the general population; doing so in an integrated fashion may provide a more efficient and targeted intervention approach. Targeting pain-related anxiety, a transdiagnostic vulnerability factor that is prospectively associated with both hazardous drinking and chronic pain, may be beneficial. Thus, more work is needed to evaluate the benefit of targeting elevated pain-related anxiety among hazardous drinkers with chronic pain. Method: Our approach followed a staged model (1a/1b) consistent with NIH guidelines for developing and standardizing behavioral interventions. Phase IA involved collecting qualitative feedback from hazardous drinkers with chronic pain (N = 9; 77.8% female, Mage = 33.86, sd = 8.75) to refine intervention content and evaluate treatment acceptability and feasibility. For phase 1b, hazardous drinkers with chronic pain (N=118; 57.3% male, Mage = 35.24, sd = 11.90) participated in a pilot randomized clinical trial designed to compare pain-related anxiety/alcohol PFI (PA-PFI) to a health information control condition. assessment only among a sample of 130 hazardous drinkers with chronic pain. The primary aims focused on examining the effects of the PA-PFI on alcohol use, intention/motivation to reduce drinking, pain-related anxiety, and expectancies for alcohol analgesia/pain coping. Results: Results indicated that participants reduced drinking and primary outcomes changed in the expected directions. However, there was no effect of treatment condition on the changes in outcomes. Mean differences were in the expected directions, but did not reach statistical significance. Conclusion: Current data provide preliminary evidence for the utility of computer-based brief interventions to encourage behavior change, and targeting pain-related anxiety in the context of chronic pain may impact drinking behavior. However, the effects were limited in magnitude, and future work in this domain is warranted.Item Developmental Outcomes of Internationally Adopted Dhildren(Adoption Quarterly, 2012-09) Welsh, Janet A.; Viana, Andres G.This study followed 106 international adoptees over an 18-month period. Mothers completed the Ages and Stages Questionnaire (ASQ) at 6, 12, and 24 months post-adoption, assessing their children's development in multiple domains. Results revealed that the sample overall demonstrated linear improvement over time in most domains, but children with initially low scores remained significantly lower than others at the 18-month follow-up. ASQ scores were unrelated to age at adoption, but significant differences by birth country emerged. Across most domains, children from Eastern Europe had generally lower scores than children from other birth regions.Item Distress Tolerance Moderates the Relationship Between PTSD and Substance Use in a Sample of Inpatient Adolescents(2018-10-18) Barger, KatyThis study examined the moderating role of distress tolerance (DT) in the association between posttraumatic stress disorder (PTSD) symptom severity and history of illicit substance use in a sample of 66 trauma-exposed inpatient adolescents. Participants completed a battery of questionnaires that included the Child PTSD Symptom Scale (CPSS; Foa, et al., 2001), the Children’s Depression Inventory (CDI; Kovacs, 1992), and a modified version of the Youth Risk Behavior Survey (M-YRBS; Brener et al., 2004). Participants also completed the Paced Auditory Serial Addition Task—computerized version (PASAT-C; Lejuez, et al., 2003) as a measure of behavioral distress tolerance. Results revealed a borderline significant interaction between PTSD and distress tolerance predicting history of illicit substance use (p = .067). Examination of the conditional effects revealed that the relation between PTSD symptoms and illicit substance use was significantly positive among those with high (vs. low) levels of distress tolerance. Contrary to expectations, an increased ability to tolerate frustration during cognitively demanding tasks may represent a vulnerability factor for substance use among adolescents exposed to trauma. Replication with a larger sample is needed to test the generalizability of the findings.Item Distress Tolerance, PTSD symptoms, and Suicidal Ideation among Trauma-Exposed Inpatient Adolescents(2019-05) Barger, KatyObjective: The present investigation examined the moderating role of behaviorally-indexed distress tolerance (DT; operationalized herein as persistence in a cognitively demanding serial addition task) in the association between posttraumatic stress disorder (PTSD) symptom severity and suicidal ideation in a sample of trauma-exposed inpatient adolescents. It was hypothesized that the relation between PTSD symptoms and suicide ideation would be positive among those with high (vs. low) behaviorally-indexed DT. Method: The sample included 50 adolescents ages 12-17 years (52.0% female; Mage = 15.1 years, SD = 0.51, range = 12 - 17 years) with exposure to at least one traumatic event. Participants completed measures of PTSD symptom severity, health-risk behaviors, DT, and depressive symptomatology. Results: Adolescents who endorsed a history of suicidal ideation reported significantly greater PTSD symptoms (M = 19.76, SD = 12.47) compared to adolescents who denied suicidal ideation (M = 9.24, SD = 9.16), t = -3.44, p = .001. Although moderation analyses yielded a nonsignificant interaction, visual inspection and statistical analyses of the simple slopes revealed a trending conditional effect of DT on the relationship between PTSD and suicidal ideation, such that the relation was positive at high and moderate levels of DT (ps = .06). Conclusions: Findings revealed a positive relationship between PTSD and suicidal ideation at moderate and high levels of DT; however, statistical significance was not achieved. Replication with a larger sample is needed. The findings emphasize the need for early intervention focused on use of appropriate ways to regulate distress, especially among adolescents with high DT.Item Do Less Consistent Night-To-Night Sleep Patterns Impact Emotional Processing Among Healthy School-Aged Children?(2023-12) Myers, Annika Mariah; Alfano, Candice A.; Viana, Andres G.; Olvera, Norma E.While research has made considerable strides in understanding the complex, dynamic relationships between sleep and mental health, it remains hindered by simplified views of sleep and emotion across development (Meltzer, 2017). More recent research has instead attempted to examine sleep from a multidimensional “sleep health” perspective (Buysse, 2014). In the current study, we adopted this multidimensional approach by examining sleep regularity (i.e., variability of sleep patterns from night to night) in relation to the emotional processing of school-aged children. Among a sample of healthy school aged children (N = 53, 7-11 years, M age = 9.0; 56% female), we examined relationships between intra-individual sleep variability (IIV) of sleep across one week and various aspects of children’s emotional functioning, including anxiety and internalizing symptoms, and subjective and objective responses during two in-lab emotional tasks, one conducted after a night of healthy sleep and another after two nights of partial sleep restriction. Respiratory sinus arrhythmia (RSA) was assessed as an objective measure of emotional regulation during one task. Contrary to expectations, sleep IIV was unassociated with parent and child reported anxiety and internalizing symptoms, as well as subjective and objective measures of emotional functioning after baseline sleep. Sleep IIV significantly predicted change RSA after sleep restriction, such that greater sleep duration IIV and social jet lag predicted changes in RSA while watching negative emotional movies clips. Sleep regularity’s impact on emotional functioning across development warrants further exploration, especially its impact on emotional functioning after subsequent sleep restriction.Item Efficacy of an Integrated Sleep and Anxiety Intervention for Anxious Children: A Pilot Randomized Controlled Trial(2018-05) Clementi, Michelle A.; Alfano, Candice A.; Viana, Andres G.; Lu, Qian; Parrish, Danielle E.Less than optimal response rates and long-term outcomes following treatment for child anxiety disorders suggest that interventions may need to target more precise underlying mechanisms that maintain anxiety in order to improve treatment outcomes. Children with anxiety disorders report high rates of sleep-related problems and evidence suggests that sleep may impact exposure-based treatment outcomes given the role of sleep in facilitating extinction learning. Thus, addressing sleep as part of anxiety-focused interventions may produce superior outcomes in terms of both anxiety and sleep. Although three studies have shown purely anxiety-focused interventions improve sleep-related problems, wide developmental ranges, lack of control groups, and a proxy measure for sleep are notable limitations. Preliminary findings support the efficacy of Targeted Behavioral Therapy (TBT), an integrated intervention that targets sleep problems and anxiety in children with generalized anxiety disorder (GAD). The current pilot study used a randomized, controlled design to examine the efficacy of TBT compared to ‘gold standard’ cognitive-behavioral therapy (CBT) for anxiety among 20 children (ages 6-12) with primary GAD. Assessments were conducted at baseline, post-treatment, and 6-month follow-up, which included diagnostic interviews, multi-informant measures, and objective sleep monitoring (i.e., actigraphy). Sleep-related questions were also collected on a weekly basis, as well as more comprehensive assessment of sleep and anxiety at mid-treatment. Results indicate that sleep, anxiety, and global functioning significantly improved across both groups from baseline to post-treatment, and improvements were maintained at 6-month follow-up based on moderate to very large effect sizes. Objective sleep onset latency also decreased marginally for both groups at post-treatment. The TBT group demonstrated a significant decrease in child-reported anxiety from mid-treatment to post-treatment (i.e., after the sleep intervention) that was not observed in the CBT group. A linear decrease in weekly bedtime problems was observed for nearly twice as many TBT participants compared to CBT participants, suggesting progressive improvement in bedtime problems across 16-weeks of treatment with TBT. Findings demonstrate the potential utility of anxiety interventions for improving some sleep-related problems, but raise questions about the nature of sleep disturbances in anxious youth and specific aspects of sleep to be targeted during intervention. Future directions and limitations are discussed.Item Effortful Control, Interpretation Biases, and Child Anxiety Symptom Severity in a Sample of Children with Anxiety Disorders(2019-05) Raines, Elizabeth M.; Viana, Andres G.; Zvolensky, Michael J.; Storch, Eric AlanIntroduction: The present investigation examined associations between effortful control (and its subcomponents: attention control and inhibitory control) and anxiety symptom severity, by way of interpretation biases, in a diverse sample of clinically anxious youth. It was hypothesized that effortful control would be inversely related to interpretation biases and child anxiety symptoms. It was also hypothesized that interpretation biases would significantly mediate the association between effortful control and child anxiety symptom severity. Each subcomponent of effortful control (i.e., attention control and inhibitory control), as well as the total construct, was examined in tests of mediation. Method: Participants (N = 105; Mage = 10.09 years, SD = 1.22; 56.7% female; 49% ethnic minority) completed a diagnostic interview; self-report measures of temperament, anxiety, and interpretation biases; a performance-based assessment of interpretation biases; and a parent-child interaction task. Results: Multiple mediator models indicated a significant indirect effect of effortful control (completely standardized point estimate = -.24, SE = .06, BC 95% CI [-.36, -.14]), attentional control (completely standardized point estimate = -.22, SE = .06, BC 95% CI [-.34, -.12]), and inhibitory control (completely standardized point estimate = -.19, SE = .05, BC 95% CI [-.31, -.09]) on self-reported anxiety symptom severity through self-reported, but not behaviorally-indexed, interpretation biases. Multiple mediator models predicting behaviorally-indexed child anxiety severity were not significant. Discussion: Clinically anxious children with higher levels of effortful control (and its subcomponents) are less likely engage in biased interpretations, which may lower their anxiety. Future work should evaluate whether targeting these malleable temperamental constructs leads to clinically meaningful reductions in interpretation biases and child anxiety symptoms.Item Emotion Dysregulation and Growth Curve of Withdrawal Symptoms during a Quit Attempt among Treatment-Seeking Smokers(2018-08) Rogers, Andrew Harrison; Zvolensky, Michael J.; Vujanovic, Anka A.; Viana, Andres G.; Blalock, Janice A.Cigarette smoking remains the leading cause of preventable death in the United States, and withdrawal symptoms are central to the maintenance of tobacco use. Previous research suggests that individual differences in the propensity to experience negative affect may be related to more severe withdrawal symptoms. However, little research has examined how individual differences in the ability to regulate affect (emotion dysregulation) may impact withdrawal symptoms over time. Therefore, the current study examined the effects of emotion dysregulation on change in tobacco withdrawal symptoms over 12 weeks following a cigarette quit attempt among 188 treatment seeking smokers (Mage = 38.52, SD = 14.00, 46.8% male). Results from the study indicated greater emotion dysregulation was associated with greater quit day withdrawal symptoms as well as with as slower decline in withdrawal symptoms over the 12-week period (B = -0.001, SE = 0.0004, p = 0.006). The current study offers novel evidence into the role of emotion dysregulation in relation to withdrawal symptoms during a quit attempt. Assessing and reducing heightened emotion dysregulation prior to a quit attempt may be a potentially important therapeutic tactic for helping smokers achieve greater success in managing tobacco withdrawal.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 Evaluating a Mediation Model of Anxiety and Smoking Expectancies among Spanish-speaking Latinx Adult Smokers: Exploring the Role of Anxiety Sensitivity(2019-12) Shepherd, Justin M.; Zvolensky, Michael J.; Viana, Andres G.; Blalock, Janice A.Smoking remains the leading cause of preventable mortality in the US, including among Latinx individuals. While anxiety symptoms and disorders are among the variables most consistently implicated in smoking outcomes and processes, there is no empirical work identifying individual difference factors that may underlie relations between anxiety symptoms and smoking outcome expectancies among Latinx smokers. Therefore, the purpose of the current study was to examine anxiety sensitivity as an indirect variable underlying the relationship between anxiety symptoms and smoking expectancies among Spanish-speaking Latinx smokers. Participants included 363 Spanish-speaking Latinx daily smokers (58.7% female, Mage = 33.3 years, SD = 9.81). Results indicated that individual differences in anxiety symptoms had a significant indirect effect on negative reinforcement, negative consequence, positive reinforcement, and appetite-weight control expectancies for smoking through anxiety sensitivity. These novel findings suggest that anxiety sensitivity is relevant to better understanding the association between anxiety symptoms and smoking expectancies among Latinx smokers.Item Fatigue and Smoking Relapse(2023-08) Manning, Kara Faye; Zvolensky, Michael J.; Gallagher, Matthew W.; Viana, Andres G.; Alfano, Candice A.; Blalock, Janice A.The majority of smokers in the US report a desire to quit and most, who smoke, make a serious quit attempt each year, primarily on their own (i.e., self-guided quit). Smoking prevalence has stabilized as the remaining population becomes increasingly representative of “at-risk smokers” who are unable to quit. The experience of prolonged fatigue may be one underrecognized but highly common problem that may help in understanding smoking maintenance and relapse. Prolonged fatigue is defined as self-reported, persistent fatigue lasting 1 month or longer. Emerging work suggests that prolonged fatigue is common among smokers and that nicotine may be used to combat fatigue. However, there has been no research on prolonged fatigue in relation to actual smoking behavior. Therefore, the purpose of the present study was to better understand whether and how individual differences in severity of fatigue predict smoking behavior during an experimental relapse analogue task. Participants attended two counterbalanced experimental sessions- (1) smoking deprivation (16 hours smoking deprived) and (2) smoking as usual. It was hypothesized that greater fatigue severity would predict greater number of cigarettes smoked, puff velocity, smoking urges, smoking withdrawal, and shorter latency to first cigarette and inter-puff intervals. In addition, it was hypothesized that smoking deprivation would significantly moderate such relations. Participants in the current study included 36 (Mage= 49.25; SD=8.83; 54.1% male) daily cigarette smokers that reported past month fatigue. Results were partially consistent with prediction. Specifically, results suggest that fatigue severity statistically significantly predicted smoking withdrawal (b=0.16, p<.05). Smoking deprivation condition statistically significantly predicted number of cigarettes smoked (b=1.35, p<.05) and puff velocity (b=28.24, p<.05). Lastly, the interaction between fatigue severity and smoking deprivation condition statistically significantly predicted number of cigarettes smoked (b=-0.29, p<.05), such that individuals that were smoking deprived reported lower levels of fatigue and smoked more cigarettes. However, due to sample size limitations, more work is needed to better understand the role of severe fatigue in the context of smoking behavior. Future work would benefit from more directly manipulating fatigue among smokers, such as through behavioral tasks or sleep deprivation, to determine the impact of severe fatigue on smoking behavior.Item Fearful Temperament, Social Anxiety, And Depressive Symptoms In Clinically Anxious Youth: The Role Of Catastrophizing Cognitions(2021-08) Conroy, Haley Elizabeth; Viana, Andres G.; Storch, Eric Alan; Zvolensky, Michael J.Introduction: Fearful temperament—a proclivity to remain within reach of caregivers and to exhibit apprehension, heightened physiological reactivity, and/or avoidance in novel situations—is positively associated with youth social anxiety and depressive symptoms. However, there is little understanding of the cognitive mechanisms underlying this association. One potential candidate mechanism is catastrophizing cognitions, defined as the tendency to think that in any given situation the worst possible outcome is very likely to happen. The present investigation tested this hypothesis by examining the effect of fearful temperament on social anxiety and depressive symptoms via catastrophizing cognitions in a sample of clinically anxious youth. Method: A total of 105 children with anxiety disorders (Mage = 10.09 years, SD = 1.22; 56.7% female; 49% ethnic minority) completed a diagnostic interview and self-report measures of temperament, catastrophizing cognitions, and social anxiety and depressive symptoms. Children also completed behaviorally-indexed assessments of catastrophizing cognitions and social anxiety symptoms. Results: Significant indirect effects were found for fearful temperament on child self-reported social anxiety symptoms by way of self-reported (b = 1.96, PM = 0.29, SE = 0.73; 95% CI [0.64, 3.52]) and behaviorally-indexed (b = 0.72, PM = 0.12, SE = 0.50; 95% CI [0.16, 1.96]) catastrophizing cognitions. Significant indirect effects were also found for fearful temperament on child self-reported depressive symptoms by way of self-reported (but not behaviorally-indexed) catastrophizing cognitions (b = 2.82, PM = 0.38, SE = 0.83; 95% CI [1.02, 4.27]). Models predicting behaviorally-indexed child social anxiety severity were not significant. Discussion: Findings suggest that targeting fearful temperament before catastrophizing cognitive responses develop may have clinical utility. Likewise, among youth temperamentally at-risk for emotional disorders, addressing catastrophic cognitions may be warranted to prevent subsequent problems with social anxiety and depression.
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