Anxiety Sensitivity and Negative Urgency

Abstract

Objectives Anxiety sensitivity—fear of anxiety symptoms—may increase motivation to smoke by influencing the development of cognitive expectations regarding smoking’s negative reinforcing effects; yet, the nature and mechanisms of this pathway are unclear. We hypothesized that relations between anxiety sensitivity and negative reinforcement-related smoking expectancies would be mediated by negative urgency, i.e., a trait tendency to act impulsively during negative affect. Methods In a cross-sectional design, we administered self-report measures of anxiety sensitivity, negative urgency, and negative reinforcement-related smoking outcome and abstinence expectancies to 205 smokers (≥10 cig/day, 34% female, M age = 44.4 years). Results Anxiety sensitivity was associated with stronger expectancies that smoking alleviates negative affect (β = .30, p < .0001) and smoking abstinence exacerbates aversive withdrawal symptoms (β = .24, p = .0004). Negative urgency partially mediated the relation between anxiety sensitivity and both types of negative reinforcement-related smoking expectancies (βs ≥ .057, ps ≤ .007). Results remained significant after statistically controlling for anxiety and nicotine dependence symptoms. Conclusions Smokers high in anxiety sensitivity tend to display negative urgency, which in turn is related to greater expectations of negative reinforcement consequences of smoking and smoking abstinence. Treatments which mitigate fear of anxiety symptoms and the tendency to act impulsively in response to negative affect (e.g., interoceptive exposure, distress tolerance skills training, and mindfulness training) may be particularly useful in assisting with smoking cessation for high-anxiety sensitivity smokers.

Anxiety sensitivity facets in relation to tobacco use, abstinence-related problems, and cognitions in treatment-seeking smokers

“…[22,23] A prominent theory is that high-AS individuals may be more likely to smoke for the negative affect (NA) alleviating (i.e., negative reinforcing) effects of smoking. [24,25] High-AS smokers report experiencing more severe withdrawal symptoms [26–28] and stronger motives and expectations in regard to reducing NA by smoking, [17–20] and AS associations with smoking-related variables have persisted when controlling for anxiety, depression, NA, daily cigarette use, and tobacco dependence severity. [29–31] Additionally, two experimental studies have shown that high-AS individuals report greater NA reduction from smoking subsequent to laboratory-induced social stress.…”

Transdiagnostic processes linking anxiety symptoms and substance use problems among adolescents

“…28 NU correlates with anxiety symptoms in children and adults 29, 30 and alcohol and cannabis use problems in adolescents and young adults, 25, 31 though scant research has investigated NU in relation to anxiety in adolescence. Two studies in young adults found that the relation between NU and alcohol problems was statistically mediated by negative affect coping motives, 32, 33 suggesting that individuals with high NU may be prone to use substances to reduce negative affect.…”

Anxiety Sensitivity and Smoking Variability Among Treatment Seeking Smokers

“…For example, AS is positively correlated with smoking motives to reduce negative affect, 12, 13 beliefs (i.e., expectancies) that smoking will reduce negative affect, 14 negative urgency and smoking expectancies, 15 smoking inflexibly in response to negative affect states, 16 as well as increased expectations for adverse emotional distress during smoking deprivation. 17 Higher levels of AS also have been predictive of greater increase in positive affect, 18 and are associated with reductions in subjective anxiety during stressful situations 19,20 after cigarette smoking.…”