Browsing by Author "Zvolensky, Michael J."
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Item A longitudinal examination of the associations between shyness, drinking motives, alcohol use, and alcohol-related problems(Alcoholism: Clinical, and Experimental Research, 2015-09) Young, Chelsie M.; DiBello, Angelo M.; Traylor, Zachary K.; Zvolensky, Michael J.; Neighbors, ClaytonBackground: The current study evaluated the roles of drinking motives and shyness in predicting problem alcohol use over two years. Methods: First-year college student drinkers (N=818) completed assessments of alcohol use and related problems, shyness, and drinking motives every six months over a two year period. Results: Generalized linear mixed models indicated that shyness was associated with less drinking, but more alcohol-related problems. Further, shyness was associated with coping, conformity, and enhancement drinking motives, but was not associated with social drinking motives. However, when examining coping motives, moderation analyses revealed that social drinking motives were more strongly associated with coping motives among individuals higher in shyness. In addition, coping, conformity, and enhancement motives, but not social motives, mediated associations between shyness and alcohol-related problems over time. Finally, coping motives mediated the association between the interaction of shyness and social motives and alcohol-related problems. Conclusions: Together, the results suggest that shy individuals may drink to reduce negative affect, increase positive affect, and fit in with others in social situations, which may then contribute to greater risk for subsequent alcohol-related problems.Item A TEST OF WHETHER DIFFICULTIES IN EMOTION REGULATION EXPLAIN THE RELATION OF ATTACHMENT WITH RISKY SEXUAL BEHAVIORS, ATTITUDES, AND SELF-EFFICACY(2015-05) Jardin, Charles; Sharp, Carla; Zvolensky, Michael J.; Neighbors, Clayton; Sales, Jessica M.The incidence of human immunodeficiency virus (HIV) and other sexually transmitted infections (STI) has increased among adolescents and young adults due to the prevalence of risky sexual behaviors. Adolescents with severe psychopathology may be particularly at risk. Interventions based on decision-making models of risky sexual behaviors have shown inconsistent results. Recent research emphasis on attachment processes and difficulties in emotion regulation suggests these factors may influence risky sexual behaviors, yet the underlying mechanism connecting these variables has not been explored. The primary aim of the present study was to examine whether lower levels of difficulties in emotion regulation would explain the relation of greater attachment security to mother, father, and peers, independently, with fewer risky sexual behaviors among inpatient adolescents. A secondary aim was to examine whether difficulties in emotion regulation explained the relation of attachment with sexual attitudes and self-efficacy. Results showed that attachment to mother and to peers, but not attachment to father, exerted an indirect effect, via difficulties in emotion regulation, on number of sexual partners and alcohol/substance use concurrent with sex. However, the observed indirect effect showed that greater attachment security associated with more sexual partners and alcohol/substance use concurrent with sex. Greater attachment security to mother indirectly associated with greater self-efficacy to negotiate condom use via lower levels of difficulties in emotion regulation. However, no indirect effect was observed upon sexual attitudes or self-efficacy to refuse sex. Findings reflect the development of normative sexual behavior among adolescents, with greater attachment security facilitating fewer difficulties in emotion regulation and more sexual exploration. More research is needed to clarify the functions of attachment and emotion regulation in normative sexual development.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 An Ecological Momentary Assessment (Ema) Study of Affective Reactivity within an Interpersonal Context in Young Adults with Borderline (Bpd) Traits(2017-08) Kalpakci, Allison; Sharp, Carla; Pavlidis, Ioannis T.; Zvolensky, Michael J.; Knee, C. RaymondBorderline Personality Disorder (BPD) is a serious disorder associated with impairment across multiple domains of functioning and treatment refractory behavior. Affective reactivity is a particularly detrimental feature of BPD; however, there are limitations of using single time-point assessments to measure this symptom. Studies have therefore employed ecological momentary assessment (EMA) to measure real time affective reactivity in BPD, with findings pointing to greater affective reactivity in adults with BPD versus healthy controls. However, little is known regarding antecedents of within-person affect change in BPD. Moreover, while it has been suggested that affective reactivity in BPD occurs in reaction to interpersonal cues of rejection and abandonment, few studies have demonstrated this in the context of daily life. Interpersonal Theory, and the associated Interpersonal Circumplex, provides an empirically validated framework for this purpose. Using the Circumplex, it is possible to determine biases in person perception that may relate to affective reactivity. While Circumplex studies have examined the relation between biases in person perception and negative affect in BPD patients, Circumplex methodology has yet to be combined with electronic EMA methodology to elucidate antecedents or triggers of affective reactivity in healthy adults with BPD traits. Against this background, the overall goal of the proposed study was to examine the relation between perceptions of non-communal behavior and affective reactivity in a non-clinical sample of college students. To this end, N = 123 college students participated in twenty days of EMA during which they recorded their affective state, interpersonal perceptions, and their own interpersonal behavior six times a day. The aims for the current study were two-fold: Aim 1 was to examine whether perceptions of partner non-communal behavior and negative affect were related, and whether BPD symptoms moderated this relation. Aim 2 was to examine whether perceptions of partner non-communal behavior and participants’ self-reported non-communal behavior were related, and whether BPD symptoms moderated this relation. An ancillary aim was added to determine whether any of the PAI BOR subscales moderated the relation between perceptions of non-communality and negative affect or self-reported non-communal behavior. In partial support of our hypotheses for Aim 1, results showed that perceptions of partner non-communal behavior predicted higher ratings of negative affect at the within-person levels. However, at the between-person level these relations were not significant, and BPD symptoms had no moderating effect. In partial support of our hypotheses for Aim 2, at the within-person level, perceptions of partner non-communal behavior were associated with participants own non-communal (ie. cold) behavior. However, at the between-person level these relations were not significant, and BPD symptoms had no moderating effect. Secondary analyses revealed a trend of the PAI-BOR subscale of identity problems moderating the relation between perceptions of non-communal behavior and participants’ self-reported non-communal behavior; however, the moderating effect was not statistically significant (p = .09). Findings from this study provide support for the relation between interpersonal perceptions and affective and interpersonal behavioral reactivity. Moreover, a potential (though non-significant) moderating effect of the PAI-BOR subscale of Identity Problems suggests a greater understanding of the role of identity-related disturbance in interpersonal perceptions, affect, and behavior in BPD is warranted.Item An Interactive Model of Assault on Staff Members in Inpatient Treatment Facilities(2014-12) Pardee, Alicia L.; Mariotto, Marco J.; Vincent, John P.; Zvolensky, Michael J.; Menditto, Anthony A.Effectiveness of psychosocial treatment programming in inpatient treatment facilities is limited by violence against staff members perpetrated by seriously mentally ill residents. The goal of this study was to analyze a model in which characteristics of staff members interact with aversive staff-resident interactions to predict assault in inpatient treatment facilities. Data were analyzed from 541 staff members who worked at a forensic psychiatric hospital between 1997 and 2007. Bootstrapping analyses revealed that older staff members and nurses who engaged in higher rates of negative nonsocial responses to appropriate resident behavior were at increased risk of assault. Staff members who were younger, male, psychiatric aides, nurses, and less experienced and who also engaged in higher rates of negative nonsocial responses to inappropriate resident behavior were also at increased risk of assault. Finally, engaging in lower rates of negative verbal responses to resident behavior placed staff members who worked in the Rehabilitation Services department and staff members who were more experienced at increased risk of assault. Characteristics of staff members that have previously been found to predict assault, such as age and length of employment, did not do so in this study; however, the variance accounted for by each of the models tested was significant, ranging from 13 to 16 percent. These results suggest that staff training should focus on negative nonsocial and negative verbal responses to resident behavior, teaching staff members how to set limits and deny requests in a way that minimizes the potentially negative impact on residents. Staff members should be taught how to respond to inappropriate resident behavior in a way that is consistent with the treatment programs in which they work.Item An Investigation of The Structure and Phenomenology of Panic Attack Symptomatology Across DSM-IV-TR Anxiety Disorders(2013-05) Chamberlain, Lance David 1985-; Norton, Peter J.; Inman, Tonya; Kraus-Schuman, Cynthia Ann; Zvolensky, Michael J.Panic attacks are common to anxiety disorders and are a significant marker of risk for the development and manifestation of psychopathology more broadly (Barlow et al., 1985; Craske et al., 2010). Despite the fact that panic attacks frequently occur within the context of varying anxiety disorders, mood disorders, and general medical conditions (APA, 2000), there has been limited research to date investigating the diagnostic features and symptom profiles of panic attacks occurring within the context of anxiety disorders other than panic disorder (Craske et al., 2010). In order to provide greater diagnostic and descriptive clarity, the present study provided a thorough investigation of the diagnostic features and symptom profiles of panic attacks for 50 individuals seeking treatment for anxiety-related problems at an anxiety disorder specialty clinic. Broad diagnostic classifications were utilized to compare the diagnostic features and symptom profiles of panic attacks between participants with a diagnosis of panic disorder and participants with other anxiety disorder diagnoses. While individuals with a diagnosis of panic disorder tended to report more symptoms during panic attacks, and experience those symptoms as more severe, results broadly suggest that the diagnostic features and symptom profiles of panic attacks occurring within the context of varying anxiety disorders are far more similar than they are different. The findings of the present study are discussed in relation to past research regarding the nature of panic attacks as well as the current panic attack diagnostic criteria. Implications for future research, assessment, and treatment are also briefly discussed.Item Anxiety Sensitivity Across Four Ethnoracial Groups(2013-08) Talkovsky, Alexander M.; Norton, Peter J.; Zvolensky, Michael J.; Foss, Donald J.Anxiety sensitivity is an individual difference that represents the fear of fearful and/or anxious cognitive and physiological experiences. It is associated with several Axis I disorders, but it appears to be most specific to panic disorder and, to a lesser extent, posttraumatic stress disorder. Research has shown that anxiety sensitivity is multidimensional and these dimensions incrementally add to the prediction of relationships with anxiety-related phenomenology. There is mostly agreement about the content of the dimensions although it is not universal. There is less agreement about the factor structure of the Anxiety Sensitivity Index, a widely used measure of anxiety sensitivity, across cultural groups. There is also variation in the epidemiology and phenomenology of anxiety, as well as physiological health problems with similar symptoms to anxiety disorders, across ethnoracial groups. There are theories suggesting that these differences may be due to environmental factors and learning. This investigation seeks to add clarity to the cross-cultural research in the psychometric properties of the Anxiety Sensitivity Index across four cultural groups in both clinical and analog samples. The results from the clinical sample support a three-factor hierarchical model. Although the extracted factor structures observed in the analog sample are not as clear, results from a confirmatory factor analysis support invariance across groups. Clinical implications are discussed.Item Anxiety Sensitivity and Fast-Food Ordering Habits Among African-American Adults(2020-09-29) Nitturi, VijayBackground: African American adults experience high rates of overweight/obesity, which is linked to chronic diseases and is exacerbated by fast-food consumption. Anxiety sensitivity, a relatively stable fear of anxiety-related sensations, has been linked to high caloric intake. Here, we examine whether anxiety sensitivity is associated with fast-food ordering habits within an African American convenience sample. Methods: Of 124 adults (79.4% women; Mage=49.3±11.6; 84.8% overweight/obese), 107 (86.3%) reported eating from a fast-food restaurant in the last month. Participants completed the Anxiety Sensitivity-Index 3, which has a total score and physical, cognitive, and social concerns subscales. Investigator-generated items were frequency of ordering “supersized” quantities of fast-food (e.g., cheeseburgers, fries), and healthy items (e.g., salads, oatmeal, yogurt), respectively, from “never” to “always.” Covariate-adjusted ordinal logistic regression models were used to assess relations between measures of interest. Results: Anxiety sensitivity (total and physical concerns) was associated with greater odds of more frequently ordering supersized unhealthy fast-food; and anxiety sensitivity (total and cognitive concerns) was associated with lower odds of more frequently ordering healthy items from fast-food restaurants. Conclusions: Results suggest that adults with greater anxiety sensitivity may engage in fast-food ordering habits that may contribute to the overweight/obesity epidemic. Future studies should replicate results and determine the potential for anxiety sensitivity-reduction interventions to affect dietary choices that contribute to overweight/obesity. This project was completed with contributions from Lorna H. McNeill from The University of Texas MD Anderson Cancer Center.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 Anxiety Sensitivity and Sleep Problems among Homeless Adults(2017-10-12) Bhavsar, Shaili; Okamoto, Hiroe; Kendzor, Darla E.; Zvolensky, Michael J.Anxiety sensitivity (AS) is a transdiagnostic individual difference factor, reflecting amplified fear about the negative consequences of anxiety-related autonomic arousal. AS has been linked to sleep problems and serious mental/physical health conditions in the domiciled population. No previous research has examined how AS affects sleep among homeless adults who are vulnerable to health disparities and living in harsh environments that may, by their nature, compromise sleep integrity. The purpose of this study was to investigate the association between AS and sleep-related problems among homeless adults. AS was significantly associated with more days of inadequate sleep (p < 0.001), fewer hours of sleep per day (p < 0.01), unintentionally falling asleep (p ≤ 0.01) in this convenience sample of predominately male homeless adults. See Tables 1 and 2. Results suggest that AS may be a risk factor conferring additional vulnerability to sleep- related problems among homeless adults. This project was completed with contributions from Michael S. Businelle from the Oklahoma Tobacco Research Center, University of Oklahoma Health Sciences Center.Item Anxiety Sensitivity and Smoking Behavior Among Trauma-Exposed Daily Smokers: The Explanatory Role of Smoking-Related Avoidance and Inflexibility(2017-10-12) Jones, Jenna; Mayorga, Angelina; Bakhshaie, JafarWork suggests anxiety sensitivity (AS) plays an important role in understanding the smoking-trauma association. AS is thought to serve as a transdiagnostic risk factor in both smoking and trauma, resulting in poorer outcomes in both domains. Cognitive inflexibility reflects a lack of ability to disengage attention from one task to another. In relation to smoking, a decrease in smoking-specific avoidance and inflexibility is associated with increased likelihood of smoking abstinence after treatment. Our aim was to examine whether smoking-specific avoidance and inflexibility explains the relation of AS and smoking severity among trauma-exposed smokers. It was hypothesized AS would have a significant indirect effect within this relation. The findings show empirical evidence of the explanatory effect of smoking-specific avoidance and inflexibility in the relation between AS and smoking severity among trauma-exposed smokers. This relation impacted number of cigarettes per day, years of being a daily smoker, number of failed quit attempts, and even heaviness of smoking index.Item Anxiety Sensitivity and Smoking Topography: A Multi-Method Experimental Investigation(2016-05) Farris, Samantha G.; Zvolensky, Michael J.; Blalock, Janice A.; Neighbors, Clayton; Lu, QianIntroduction: Anxiety sensitivity, the tendency to catastrophically interpret the meaning of anxiety-relevant interoceptive sensations, is implicated in the acquisition and maintenance of anxiety symptoms/disorders and aspects of cigarette smoking. Smokers who tend to perceive interoceptive sensations as harmful or dangerous may be more likely to smoke for affect-regulatory purposes. The present study tested an experimental model of negative reinforcement-based smoking motivation by examining the extent to which laboratory-induced physiological arousal impacts smoking urges, craving, smoking topography (puff style), and the moderating role of anxiety sensitivity. Method: Adult daily smokers (n = 90; Mage = 43.6 [SD = 9.7]; average 15.8 cigarettes per day) were recruited to participate in a single-session experimental study. Participants were randomly assigned to complete a biological challenge procedure, used as an experimental emotion-provocation task that consisted of a single vital capacity inhalation of 35% CO2-enriched air mixture or compressed room air (control condition). Smoking urges and smoking topography (puff behavior) were assessed before and after the challenge. Results: Exposure to the 35% CO2-enriched air experimental condition, relative to room air, elicited significantly higher levels of subjective distress (b = 0.72, p = .013), panic attack symptoms (b = 1.13, p < .0001), heart rate (b = 0.14, p = .002), and respiration rate (b = 0.47, p < .038). All effects were medium to large in size (Cohen’s d range = 0.53 – 1.13). Results revealed a main effect of experimental condition in terms of self-report smoking urges post-challenge (b = -81.26, p = .048; d = -0.45), such that smokers exposed to the 35% CO2-enriched air reported significantly lower smoking urges post-challenge, relative to the room air condition. There was a significant interaction between anxiety sensitivity and experimental condition (b = -9.96, p = .014; d = -.56), such that high anxiety sensitive smokers exposed to 35% CO2-enriched air reported significantly lower levels of smoking urges, relative to low anxiety sensitive smokers, and anxiety sensitivity did not differentially impact smoking urges for those exposed to room air. Regarding smoking topography, results revealed a non-significant main effect of experimental condition in terms of latency to smoking initiation or average inter-puff interval post-challenge. There was a significant condition effect for average puff volume (b = -8.11, p = .048) and puff duration (b = -144.39, p = .050), such that exposure to 35% CO2-enriched air relative to room air, resulted in significantly smaller and shorter puff inhalations while smoking (Cohen’s d = -0.43). There were no significant interaction effects of experimental condition by anxiety sensitivity for any of the smoking topography outcomes. Discussion: The experience of abrupt physiological distress may immediately result in decreased subjective smoking urges and changes in puff behavior (smaller volume; shorter duration), likely due to intensity of the cardiorespiratory distress experienced from the 35% CO2-enriched air manipulation. This appeared to be particularly true for smokers high in anxiety sensitivity, at least in the case of subjective smoking urges. Findings are contextualized with the existing literature examining mechanistic factors linking panic attacks and smoking.Item Assessing the Efficacy of an App-Delivered Intervention Amongst Daily Smokers(2018-10-18) Chavez, JeanFelixThe purpose of this pilot study was to assess the feasibility and user engagement of an app tailored to help daily smokers reduce or quit cigarette smoking. All participants received a preliminary version of the application on a phone. We hypothesized that participants would use all the features available on the application, complete more than 70 percent of the Ecological Momentary Assessments (EMA’s), expect videos to be utilized by over 80 percent of the sample, and post-intervention feedback will result as generally positive. We recruited 15 daily smokers (40.0 percent female; mean age; 46.5; SD: 13.3; age range 18-65 years) who were screened using a web-based system. Those eligible were scheduled for a baseline visit at The Anxiety and Health Research Lab/Substance Use Treatment Clinic. Participants returned the phone at the 4-week post quit follow-up, totaling 6 weeks of use. Interactions with the application were recorded for descriptive analysis. The results of the study reflect that participants had completed over 73.5 percent of EMA’s, all videos were utilized by over 80 percent of the sample, every participant utilized available features, and self-reports indicates a positive experience regarding EMA’s utility and overall experience with the application.Item Brief Guided Mindfulness Meditation for Women Undergoing Stereotactic Breast Biopsy: Effects on Patient Self-Report, EEG Activity, and Physiological Measures(2015-05) Ratcliff, Chelsea Gilts; Norton, Peter J.; Cohen, Lorenzo; Zvolensky, Michael J.; Lu, QianBackground: Stereotactic breast biopsies (SBB) are associated with significant anxiety. As anxiolytic medication is not a viable option for many patients, nonpharmacologic methods to manage acute anxiety in this setting are needed. Method: In this single-blind trial, we examined feasibility and acceptability, as well as the efficacy of guided meditation (GM) compared to guided focused breathing (FB), both delivered for 10 min before and throughout SBB, and standard care (SC), on anxiety and pain ratings, blood pressure, pulse, and brain activity in women undergoing SBB. Patients were recruited prior to SBB and randomized in a 2:2:1 ratio to GM (n=30), FB (n=30), or SC (n=16). Anxiety, pain, blood pressure, and pulse activity were assessed at baseline, after a 10-min pre-SBB group-specific activity (GM, FB, or SC (listening to neutral audio clips)), and post-SBB. Anxiety and pain were also assessed every 4 min during SBB, and electroencephalogram (EEG) activity was collected throughout the study. Baseline trait mindfulness was examined as a moderator of the intervention. Results: Fifty-four percent (84/157) of eligible patients provided consent for the present study, and 90% (76/84) of consented patients were evaluable. Linear multilevel modeling covarying for baseline anxiety ratings revealed a significant group by time interaction on change in anxiety ratings during the procedure (p < 0.001). Women in GM reported a steeper reduction in anxiety during the biopsy compared to FB (β = -0.09, p = 0.001) and SC (β = -0.12, p = 0.001), while FB and SC reported similar reductions in anxiety during biopsy (p = 0.65). There were no group differences in pain ratings during the biopsy, and no group differences on any measure after the 10-min group-specific activity or after the biopsy. Moderation analyses indicated that participating in GM buffered the effect of low trait mindfulness on anxiety before and during biopsy and pain after biopsy. During biopsy, GM had greater delta wave activity in the left primary somatosensory cortex (S1), medial prefrontal cortex (PFC), insula, and bilateral precuneus compared to SC. FB had greater delta activity than both GM and SC in the bilateral S1, anterior PFC, insula, and precuneus, and left medial PFC during biopsy. Further, delta wave activity in the left medial PFC negatively correlated with anxiety, and delta wave activity in the left S1, insula, and precuneus negatively correlated with pain ratings reported during biopsy. Additionally, GM had greater theta wave activity in the right medial and anterior PFC compared to SC. Similarly, FB had greater theta wave activity in the bilateral anterior PFC, right medial PFC, and right insula and compared to SC. Theta activity in these regions was not associated with anxiety or pain ratings during biopsy. Groups did not differ in any other bandwidth during biopsy. Conclusion: Results indicate GM is a feasible and accepted intervention. Additionally, GM relieves anxiety during biopsy more effectively than FB and SC. Compared to SC, both GM and FB were associated with neuronal quieting (i.e., greater slow-wave activity) in regions associated with pain processing, emotional and cognitive engagement, and self-awareness. Lastly, participation in GM appears to be particularly useful for individuals who report low trait mindfulness, suggesting even transient increases in mindfulness may be beneficial in acutely stressful settings.Item Cannabis Beliefs: Extending The Discussion On Cannabis Motives, Cannabis Expectancies, And Cannabis Social Norms To Never Users And Non-Current Users(2023-05-22) Weinstein, Andrew P.; Neighbors, Clayton; Zvolensky, Michael J.; Knee, C. RaymondCannabis has routinely been identified as one of the most frequently used illicit substances among adolescents, young adults, and the general adult population in the United States by large epidemiological studies. Recent policy changes in the legal status of cannabis have inspired calls for the replication of research and further exploration of the biopsychosocial relationships between cannabis use and outcomes. Theoretical psychological perspectives of behavior, such as outcome expectancies, social norms, and motivation, have found success in explaining why substance use occurs. Previous studies have suggested that there are underlying motivations, expectancies, and social norms for the discontinuing of cannabis use and maintenance of abstinence-oriented behaviors; presumably, these also exist within the population of lifetime abstinent individuals as well. The proposed study will seek to identify beliefs about cannabis in a process to construct a measure of cannabis-related beliefs. Two important types of validity for new assessment measure(s) are their unique content area, distinguishing them from existing measures (i.e. discriminant validity), and their ability to predict scores on other assessment measures (i.e. predictive validity). We will examine the relationships among cannabis-related beliefs in the context of social norms, expectancies, and motivation as well as their association with indicators of psychosocial well-being and cannabis-related consequences. Thus, results will indicate if the proposed cannabis belief scale(s) possesses construct and predictive validity. Future studies may identify unique associations between cannabis beliefs, psychosocial factors, or evidence of protective and risk factors for cannabis use and outcomes with prospective designs.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 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.