Anxiety sensitivity predicts increased perceived exertion during a 1-mile walk test among treatment-seeking smokers

Abstract

Smoking increases risk of early morbidity and mortality, and risk is compounded by physical inactivity. Anxiety sensitivity (fear of anxiety-relevant somatic sensations) is a cognitive factor that may amplify the subjective experience of exertion (effort) during exercise, subsequently resulting in lower engagement in physical activity. We examined the effect of anxiety sensitivity on ratings of perceived exertion (RPE) and physiological arousal (heart rate) during a bout of exercise among low-active treatment-seeking smokers. Adult daily smokers (n = 157; Mage = 44.9, SD = 11.13; 69.4% female) completed the Rockport 1.0 mile submaximal treadmill walk test. RPE and heart rate were assessed during the walk test. Multi-level modeling was used to examine the interactive effect of anxiety sensitivity x time on RPE and on heart rate at 5 time points during the walk test. There were significant linear and cubic time x anxiety sensitivity effects for RPE. High anxiety sensitivity was associated with greater initial increases in RPE during the walk test, with stabilized ratings towards the last five minutes, whereas low anxiety sensitivity was associated with lower initial increase in RPE which stabilized more quickly. The linear time x anxiety sensitivity effect for heart rate was not significant. Anxiety sensitivity is associated with increasing RPE during moderate-intensity exercise. Persistently rising RPE observed for smokers with high anxiety sensitivity may contribute to the negative experience of exercise, resulting in early termination of bouts of activity and/or decreased likelihood of future engagement in physical activity.

Anxiety Sensitivity is Associated with Lower Enjoyment and an Anxiogenic Response to Physical Activity in Smokers

“…However, anxiety sensitivity blunted the positive affective response to PA and instead predicted an anxiogenic response to PA (i.e., increased anxiety). Individuals with elevated anxiety sensitivity likely have increased attentional bias to and awareness of bodily sensations resulting from physical exertion during exercise (Farris et al 2017), which likely contributes to heightened anxiety during exercise (Smits et al 2010) and an anxiogenic response to submaximal exercise testing. These individual difference factors may have process-level influences (e.g., mediating, moderating effect) on this anxiogenic response to PA, which requires inquiry in future research (Ekkekakis et al 2005b;Ekkekakis and Lind 2006).…”

“…Second, future studies are needed to evaluate the generalizability of these findings across the type, duration, and intensity of PA performed. For example, anxiety sensitivity may show stronger negative associations with the affective experience surrounding PA of higher intensities (Moshier et al 2013), alternative forms of PA (e.g., running versus weight training; LeBouthillier and Asmundson 2017), or longer durations of PA (Farris et al 2017). Third, we assessed discrete negative affect states (i.e., anxiety, mood) before and after exercise.…”

“…Individuals with anxiety vulnerability may also benefit from carefully tailored PA prescriptions aimed at bolstering the affective experience of PA, including self-paced PA intensities (Williams 2008), which is particularly well-suited individuals with lower cardiorespiratory fitness (Baldwin et al 2016). In addition, shorter initial bouts of PA (e.g., 10 minutes) that may generate less anticipatory anxiety relative to longer bouts of PA and produce a more positive affective response (Farris et al 2017). These interventions would theoretically build tolerance and acceptance to PA-induced physical distress through repeated exposure (to decrease negative affect to PA), while also increasing the positive affective associations and responses to PA, which in combination could facilitate engagement in PA longer bouts of higher-intensity PA for ideal cardiorespiratory and health benefits.…”

“…Initial evidence also indicates that anxiety sensitivity is associated with increased negative affect (i.e., fear) during structured PA, particularly among individuals with higher body mass index (Smits et al 2010). Elevated anxiety sensitivity is linked to greater subjective feelings of exertion during prolonged bouts of PA, but not objective physiological arousal (Farris et al 2017). These findings suggest that anxiety sensitivity promotes biased cognitive processing of affective experiences during PA.…”

The potential role of anxiety sensitivity in the risk for and recovery from heart attacks: Comment on Edmondson et al. (2018).

“…In regard to CVD risk factors, AS is related to coping motives for alcohol and cigarette use, mood-related eating, and avoidance of physical activity (see Otto et al, 2016). AS is also associated with reduced exercise tolerance, particularly among those with the CVD risk factor of smoking (e.g., Farris et al, 2017) or high body mass (Smits, Tart, Presnell, Rosenfield, & Otto, 2010). Furthermore, in terms of direct evidence of a linkage between AS and CVD, a cross-sectional study of 635 participants (aged 10 -66 years) found that AS was associated with both carotid plaques and increased arterial stiffness, after statistical adjustment of demographic factors and specific CVD risk factors (low-density lipoprotein cholesterol and blood pressure; Seldenrijk et al, 2013).…”