Longitudinal course of anxiety sensitivity and PTSD symptoms in cognitive-behavioral therapies for PTSD

Abstract

Anxiety sensitivity (AS) has been conceptualized as trait-like vulnerability and maintenance factor for PTSD. Although recent literature has demonstrated its malleability during treatment, few have examined its influence on and effect from PTSD treatment. Using multilevel regression analyses we examined: a) changes in AS during treatment, and b) whether pre-treatment AS predicted PTSD treatment response, in sample of female victims of interpersonal trauma receiving one of three treatments (Cognitive Processing Therapy, Cognitive Processing Therapy-Cognitive, and Written Accounts). Participants exhibited reductions in total ASI scores from pre- to post-treatment. Growth curve modeling revealed slightly different trajectories of PTSD symptoms as a function of pre-treatment AS, and overall decreases in PTSD symptoms during treatment were not associated with pretreatment AS. Pretreatment AS dimensions impacted PTSD total scores and symptoms clusters differentially. Clinical and theoretical implications for these results are discussed.

Causal discovery identifies posttraumatic stress as a driver of internalizing symptoms across independent veteran and civilian populations

“…Consistent with our exploratory analysis of potential mechanisms, a study of Israeli veterans suggested centrality of the DSM-V NACM symptom cluster in bridging among PTSD, depressive symptoms, and moral injury (25). Similarly, consistent with our findings on the centrality of hyperarousal across PTSD and depressive symptom groups, other research suggests anxiety sensitivity and avoidance of inner experiences broadly may be transdiagnostic processes underlying PTSD and internalizing symptomatology (32,68,69). Further longitudinal research should consider the mechanisms connecting hyperarousal, NACM, and other internalizing symptoms that could play a transdiagnostic role in comorbidities.…”

Randomized Clinical Trial Investigating the Effects of an Anxiety Sensitivity Intervention on Posttraumatic Stress Symptoms: A Replication and Extension

“…Furthermore, initial evidence supports the efficacy of AS interventions for mitigating PTSS. For instance, reductions in AS during cognitive–behavioral therapy for PTSD were associated with decreased PTSS (Federoff et al., ; Gutner, Nillni, Suvak, Wiltsey‐Stirman, & Resick, ). Clinical case studies show that interoceptive‐exposure‐based interventions targeting AS (Wald & Taylor, ) and single‐session AS interventions (Vujanovic, Bernstein, Berenz, & Zvolensky, ) significantly improved PTSS.…”

Interactive Effects of Anxiety Sensitivity and Difficulties in Emotion Regulation: An Examination Among Individuals in Residential Substance Use Treatment with Comorbid Posttraumatic Stress Disorder

“…Interoceptive cues associated with AS and panic attacks are posited to exacerbate PTSD symptomatology (Hinton, Hofmann, Pitman, Pollack, & Barlow, 2008), and in fact there is strong evidence for an association between AS and severity of concurrent and prospective PTSD symptoms (Asmundson, Norton, Allerdings, Norton, & Larsen, 1998; Feldner, Lewis, Leen-Feldner, Schnurr, & Zvolensky, 2006; Feldner, Zvolensky, Schmidt, & Smith, 2008). Furthermore, PTSD treatment has been shown to reduce AS severity (Gutner, Nillni, Suvak, Wiltsey-Stirman, & Resick, 2013). Notably, more severe AS is related to increased substance use among individuals with PTSD (Gillihan, Farris, & Foa, 2011).…”