Distress Tolerance and Anxiety Sensitivity Cognitive Concerns: Testing the Incremental Contributions of Affect Dysregulation Constructs on Suicidal Ideation and Suicide Attempt

Empirical work has suggested relationships among suicide-related outcomes and several constructs related to affect dysregulation, notably anxiety sensitivity (AS) and distress tolerance (DT). However, important questions remain, including the relative contributions of these affect regulation variables as well as the direct contribution of DT on suicidal ideation and prior attempts. The current study sought to better elucidate the nature of these relationships by examining AS, DT, and suicidal ideation and attempt in a clinical sample (N = 192). Consistent with prior work and prediction, findings revealed a significant relationship between the AS cognitive concerns subfactor and suicidal ideation and suicide attempt history after accounting for the effects of DT, gender, and depressive symptoms. In addition, depressive symptoms significantly moderated the relationship between the AS cognitive concerns subfactor and suicidal ideation. After accounting for the influence of AS, analyses revealed that DT approached significance in predicting suicidal ideation, but did not significantly predict suicide attempt history. These results suggest that elevated AS cognitive concerns are particularly relevant to suicide in the context of depressive symptoms. Clinicians may benefit from implementing AS reduction strategies with individuals who endorse elevated suicide risk as well as elevated AS cognitive concerns.     

Distress Tolerance Scale: A Confirmatory Factor Analysis Among Daily Cigarette Smokers

The present investigation evaluated the factor structure of the Distress Tolerance Scale (DTS; Simons and Gaher 2005) among a sample of 173 (54.9% males) daily cigarette smokers (M = 16.64 cigarettes per day, SD = 7.83). Comparison of a single higher-order model and a hierarchical multidimensional model was conducted using confirmatory factor analyses (CFA). In addition, evaluation of the internal consistency and convergent and discriminant validity of the better-fitting model was completed. CFA of the DTS indicated a single second-order factor of distress tolerance, and four lower-order factors including Tolerance, Appraisal, Absorption, and Regulation; each factor demonstrated acceptable levels of internal consistency. In addition, the DTS displayed good convergent and discriminant validity with theoretically relevant smoking and affect variables. Results are discussed in terms of explicating the latent structure of distress tolerance, as measured by the DTS, within the context of smoking research.     

Laboratory Test of a Novel Structural Model of Anxiety Sensitivity and Panic Vulnerability

The current study evaluated a novel latent structural model of anxiety sensitivity (AS) in relation to panic vulnerability among a sample of young adults (N = 216). AS was measured using the 16-item Anxiety Sensitivity Index (ASI; Reiss, Peterson, Gursky, & McNally, 1986), and panic vulnerability was indexed by panic attack responding to a single administration of a 4-minute, 10% CO₂ challenge. As predicted, vulnerability for panic attack responding to biological challenge was associated with dichotomous individual differences between taxonic AS classes and continuous within-taxon class individual differences in AS physical concerns. Findings supported the AS taxonic-dimensional hypothesis of AS latent structure and panic vulnerability. These findings are discussed in terms of their theoretical and clinical implications.     

Does the social concerns component of the anxiety sensitivity index belong to the domain of anxiety sensitivity or the domain of negative evaluation sensitivity?

The present study utilized an exploratory factor-analytic approach (i.e. principal-components analysis; PCA) to investigate whether the Social Concerns component of the Anxiety Sensitivity Index (ASI [Peterson, R. A., & Reiss, S. (1992). Anxiety Sensitivity Index manual (2nd ed.). Worthington, OH: International Diagnostic Systems.]) is best conceptualized as belonging to the domain of anxiety sensitivity (AS) and/or the domain of negative evaluation sensitivity (NES). A sample of university students (N = 216) was administered measures of both NES (i.e. Brief Fear of Negative Evaluation scale; Leary, 1983) and AS (i.e. ASI). Participants' responses to the items comprising these measures were subjected to a PCA with oblique rotation. Factors representing the NES construct and the three lower-order AS constructs (i.e. AS Physical, Psychological and Social Concerns) were obtained. Subscales derived from these four factors were positively and significantly correlated with one another and loaded on a single higher-order factor labeled Threat Sensitivity. Thus, the present findings suggest that the AS Social Concerns factor is distinct from NES and the other lower-order components of AS. However, correlational analyses and higher-order PCA indicated that the AS Social Concerns factor taps a blend of AS and NES as well as something unique and distinct from both global AS and NES.     

A Bifactor Model of Anxiety Sensitivity: Analysis of the Anxiety Sensitivity Index-3

The purpose of the current study was to investigate the fit of a bifactor model of the Anxiety Sensitivity Index-3 (ASI-3; Taylor et al. Psychological Assessment, 19, 176–188, 2007) as well as to examine measurement invariance of the ASI-3 across gender. Participants were undergraduate students from the University of Cincinnati (n?=?954; 63 % female). Results indicated that the bifactor model was the best fit to the data, and that this model of AS is fully invariant in terms of gender. The current findings suggest that anxiety sensitivity consists of a general factor and three independent group factors (rather than a higher-order factor with three correlated lower-order factors). The ASI-3 subscales from the bifactor model however did not provide incremental predictive utility above and beyond the general AS factor with respect to an external anxiety criterion. Related research and clinical implications are discussed.     

The Anxiety Sensitivity Index - Revised: psychometric properties and factor structure in two nonclinical samples

Anxiety sensitivity (AS) is the fear of anxiety-related sensations based on beliefs about their harmful consequences. Despite its status as the most popular measure of AS, the anxiety sensitivity index is too abbreviated to adequately measure the somatic, cognitive, and social facets of the construct. The Anxiety Sensitivity Index - Revised (ASI-R) is a revised and expanded version of the ASI that was developed to improve the assessment of AS and its dimensions. The present study was conducted to examine the psychometric properties and factor structure of the ASI-R. Two large undergraduate samples completed a psychometric assessment package that included the ASI-R and measures of anxiety, depression, and related constructs. Exploratory factor analysis revealed four lower-order ASI-R factors: (1) beliefs about the harmful consequences of somatic sensations; (2) fear of publicly observable anxiety reactions; (3) fear of cognitive dyscontrol; and (4) fear of somatic sensations without explicit consequences. These factors loaded on a single, higher-order factor. Correlations between the ASI-R factors and related variables were consistent with AS theory. Results across both samples in the present study were highly similar. The strengths and limitations of the ASI-R are discussed, and the implications of our findings for the nature and measurement of AS are considered.     

Anxiety sensitivity and intolerance of uncertainty: Evidence of incremental specificity in relation to health anxiety

Anxiety sensitivity (AS) reflects the fear of arousal-related sensations and intolerance of uncertainty (IU) represents the dispositional fear of the unknown. Within cognitive–behavioral models, AS and IU are individual difference variables considered central to the phenomenology of health anxiety. However, prior studies have cast doubt on whether both variables incrementally contribute to our understanding of health anxiety. Addressing limitations of these prior studies, the present study examined the incremental specificity of AS and IU as these two variables relate to health anxiety in a large medically healthy sample of community adults (N = 474). Both AS and IU incrementally contributed to the concurrent prediction of health anxiety beyond both negative affect and one another. However, within these analyses, the physical dimension of AS and the inhibitory dimension of IU were the only AS and IU dimensions to evidence incremental specificity in relation to health anxiety.     

Factor Structure and Psychometric Properties of the Modified Childhood Anxiety Sensitivity Index in a Sample of Croatian Children and Adolescents

Anxiety sensitivity (AS) refers to a person’s tendency to fear anxiety-related symptoms due to the belief that they have harmful consequences. The Childhood Anxiety Sensitivity Index (CASI) is a well accepted operationalization of the AS construct in children and adolescents. This study evaluated the factor structure, gender stability and psychometric properties of the CASI, modified to a 5-point scale, in a sample of Croatian children and adolescents (N = 1,679). Exploratory and confirmatory analysis and a Schmid-Leiman solution confirmed the multidimensional and hierarchical structure of the CASI, which consisted of three lower-order factors and a single higher-order factor. Further, the modification of the CASI to a 5-point scale resulted in higher reliability, while maintaining acceptable levels of factor stability and validity.     

Motivation and engagement in diverse performance settings: Testing their generality across school,university/college,work, sport,music, and daily life

In the light of recent calls for more integrative approaches to theorizing and measurement in motivation and engagement research, the present study assesses the generality of key motivation and engagement constructs across seven performance domains: elementary school (N = 624), high school (N = 21,579), university/college (N = 420), work (N = 637), music (N = 224), sport (N = 204), and daily life (N = 249). Based on domain specific adaptations of the Motivation and Engagement Scale, multi-group confirmatory factor analyses (CFAs) tested invariance across the seven domains. First and higher order multi-group CFAs demonstrated broad invariance in factor loadings (in particular), factor correlations/variances, and uniquenesses across performance domains. Taken together, the present data support the hypothesized generality of key motivation and engagement constructs. Findings hold implications for pragmatic, statistical, substantive, and intervention considerations in motivation and engagement research and also for research into cognate constructs in personality psychology more generally.     

Interrelating Behavioral Measures of Distress Tolerance with Self-Reported Experiential Avoidance

Experiential avoidance and distress intolerance play a central role in novel behavior therapies, yet they appear to overlap considerably the REBT concept of low frustration tolerance. Using baseline data from 100 adult cigarette smokers enrolled in a clinical trial of smoking cessation therapies, the present study evaluated the convergent validity of common questionnaire measures of experiential avoidance (Acceptance and Action Questionnaire; AAQ; Hayes et al. 2004, and Avoidance and Inflexibility Scale: AIS; Gifford et al. 2004) and behavioral measures of distress tolerance (computerized Mirror Tracing Persistence Task: MTPT-C: Strong et al. 2003; computerized Paced Auditory Serial Addition Task; PASAT-C; Lejuez et al. 2003). The distress tolerance measures correlated significantly (r = .29) with one another. However, the questionnaire measures of experiential avoidance did not correlate with each other, nor with the behavioral measures. Further research is needed on the validity of measuring experiential avoidance by self-report and of the overlap versus distinctiveness of seemingly similar constructs such as experiential avoidance, distress tolerance, and frustration tolerance.     

The Interaction of Extraversion and Anxiety Sensitivity on Social Anxiety: Evidence of Specificity Relative to Depression

Neuroticism and extraversion have been linked to the etiologies and course of anxiety and mood disorders, such that neuroticism is broadly associated with numerous disorders and extraversion is most strongly associated with social anxiety and depression. While previous research has established the broad associations between temperament and emotional disorders, less is known about the specific, proximal factors that are associated with them, and very few studies have situated these risk factors into a larger etiological model that specifies how they may relate to one another. The current study examined the interaction of extraversion and anxiety sensitivity (AS) in predicting social anxiety symptoms in a large, diagnostically diverse clinical sample (N = 826). Symptoms were assessed with self-report and dimensional interview measures, and regression analyses were performed examining the main effects and interaction of extraversion and AS (examining both total and lower-order components) on social anxiety. Results showed that at higher levels of AS, the inverse relationship between extraversion and social anxiety was stronger, and the social concerns component of AS is responsible for this effect. This interaction was also observed with regard to depression symptoms, but the interaction was not present after accounting for shared variance (i.e., comorbidity) between depression and social anxiety symptoms. Clinical and theoretical implications of the results are discussed.     

A Multifaceted Assessment of Emotional Tolerance and Intensity in Hoarding

Hoarding is characterized by emotionally reinforced saving behaviors, which often combine with excessive acquisition to give rise to clutter, distress, and impairment. Despite the central role emotional processes are thought to play in hoarding, very little research has directly examined this topic. There is suggestive evidence linking hoarding with several facets of emotional intolerance and avoidance, though one key limitation of this past research has been the exclusive reliance on self-report questionnaires. The aim of the current study was to conduct a multimethod investigation of the relationship between hoarding and perceptions of, and cognitions about, negative emotional states. A large unselected sample of nonclinical young adults (N = 213) completed questionnaires, behavioral tasks, and a series of negative mood inductions to assess distress tolerance (DT), appraisals of negative emotions, and emotional intensity and tolerance. Hoarding symptoms were associated with lowered tolerance of negative emotions, as well as perceiving negative emotions as more threatening. Individuals high in hoarding symptoms also experienced more intense emotions during the mood inductions than individuals low in hoarding symptoms, though there was no association with poorer performance on a behavioral index of DT. Across measures, hoarding was consistently associated with experiencing negative emotions more intensely and reporting lower tolerance of them. This relationship was particularly pronounced for the difficulty discarding and acquiring facets of hoarding. Our results offer initial support for the important role of emotional processes in the cognitive-behavioral model of hoarding. A better understanding of emotional dysfunction may play a crucial role in developing more effective treatments for hoarding.     

Validation of Self-Report Measures of Emotional and Physical Distress Tolerance

The Distress Tolerance Scale (DTS) and Discomfort Intolerance Scale (DIS) are self-report measures developed for the assessment of emotional and physical distress tolerance, respectively. However, little evidence exists for their construct and specifically criterion-related validity. The current study examined the associations of these self-report measures with lab-based assessments of perceived emotional tolerance and physical discomfort tolerance. Undergraduate participants (N?=?166) were administered four film clips intended to induce sadness, disgust, fear, and anger, and a handgrip persistence task intended to elicit physical discomfort. The DTS, but not the DIS, was significantly associated with self-reported emotional tolerance and perceived threat associated with each film after controlling for emotional intensity. Among DTS subscales, the absorption subscale was the only subscale incrementally predictive of negative perceptions of the sad film, the appraisal subscale was incrementally predictive of negative perceptions of the other three films, and little support for the incremental validity of the tolerance and regulation subscales was found. The DTS also incrementally predicted tolerance and perceived threat of film-elicited emotions across films after controlling for anxiety sensitivity. The DIS was only marginally predictive of handgrip task persistence and was unrelated to emotional film perceptions. Overall, these findings uniquely add to the empirical literature on the construct and criterion-related validity of the DTS and DIS.     

Emotional Distress Intolerance,Experiential Avoidance,and Anxiety Sensitivity: The Buffering Effect of Attentional Control on Associations with Posttraumatic Stress Symptoms

A number of individual difference factors, including emotional distress intolerance (EDI), experiential avoidance (EA), and anxiety sensitivity (ASI), have been implicated in the development and maintenance of posttraumatic stress (PTS) symptomatology. Attentional control (AC) has been shown to serve as a protective factor against the development of maladaptive psychological outcomes across a number of studies, even among those with outcome-specific vulnerabilities. The purpose of the present study was to examine AC as a moderator of the relations between three constructs pertaining to the way that people relate to their internal experiences (i.e., EDI, EA, AS) and PTS symptoms among a trauma exposed community sample (N?=?903). As predicted, AC moderated the relations between each individual difference factor and PTS symptoms, such that as attentional control decreased, the strength of the association between each individual difference factor and PTS symptoms increased. Study results suggest that AC abilities may be one factor that differentiates those who recover from trauma from those who do not, even among those who may be vulnerable for developing PTS symptomatology. Clinical implications and results of a PTS cluster level analysis will be discussed.     

Verbal fluency and creativity: General and specific contributions of broad retrieval ability (Gr) factors to divergent thinking

The Cattell–Horn–Carroll (CHC) model of intelligence views creativity as a first-level factor within the second-level factor of broad retrieval ability (Gr), alongside other first-level abilities such as ideational fluency and word fluency. Traditional methods of measuring creativity, however, confound idea quality with idea quantity, which might exaggerate the relationship between creativity scores and verbal fluency factors. Participants (n = 131 adults) completed two divergent thinking tasks (unusual uses for a rope and a box), which were scored using newer methods that effectively separate creativity (scored via subjective ratings) and fluency (scored as number of responses). They then completed 16 verbal fluency tasks that assessed six lower-order Gr factors: word fluency, associational fluency, associative flexibility, ideational fluency, letter fluency, and dissociative ability. Viewed singly, many of the lower-order factors significantly predicted creative quality and fluency. General Gr had substantial effects on creative quality (standardized β = .443) and fluency (β = .339) in a higher-order model as well as in a bifactor model (quality β = .380, fluency β = .327). Moreover, general Gr was the only significant predictor in the bifactor model, suggesting that it, not the specific factors, was most important. All effects were essentially the same after controlling for typing speed and vocabulary knowledge. The findings thus support the CHC view of creativity/originality as a lower-order component of Gr, illuminate the relationships between creativity and first-level Gr factors, extend the study of creativity and intelligence beyond fluid intelligence, and further indicate that creativity is more closely tied to cognitive abilities than creativity research has yet recognized.     

Sixteen-item Anxiety Sensitivity Index: confirmatory factor analytic evidence, internal consistency, and construct validity in a young adult sample from the Netherlands

The present investigation examined the factor structure, internal consistency, and construct validity of the 16-item Anxiety Sensitivity Index (ASI; Reiss Peterson, Gursky, & McNally 1986) in a young adult sample (n = 420) from the Netherlands. Confirmatory factor analysis was used to comparatively evaluate two-factor, three-factor, and four-factor models of the anxiety sensitivity construct. Support was found for a hierarchical structure of anxiety sensitivity, with one global higher-order factor and four lower-order factors. Internal consistency for the global and lower-order factors of the 16-item ASI was adequate. Convergent and discriminant associations between the 16-item ASI and general mood and panic-specific variables were consistent with anxiety sensitivity theory. In addition, incremental validity of the anxiety sensitivity construct was established, relative to negative affectivity, for unexpected panic attacks and agoraphobic avoidance.     

Anxiety sensitivity and the five-factor model of personality.

Relations between anxiety sensitivity (AS) and the higher-order and lower-order dimensions of the 'Big Five' model of personality were examined in 317 university students. AS was significantly associated with a number of personality domains and facets of the NEO-PI-R. Regression analyses indicated that only the higher-order domains of neuroticism and extraversion (negatively) and the lower-order N facets of anxiety and self-consciousness, significantly predicted AS. Three lower-order factors within AS were identified and were also compared to NEO-PI-R domains and facets. In a hierarchical regression, the three AS factors significantly predicted variance in a measure of panic-related anxiety after the effects of the six N facets were statistically controlled. Results are discussed in the context of previous work with a Big Three taxonomy of personality and implications for understanding the nature and possible origins of AS are outlined.     

Distress Tolerance and Rational-Emotive Behavior Therapy: A New Role for Behavioral Analogue Tasks

Rational-emotive behavior therapy (REBT) is a widely utilized treatment approach for many mental disorders, but it has been “relatively neglected in the professional scientific literature” (Ellis 2003b). This neglect has been attributed in part to a lack of solid REBT outcome studies, which in turn stems from the difficulty of measuring constructs of interest in REBT, such as irrational beliefs, via self-report measures. In light of these concerns, the current paper aims to identify the potential utility of behavioral analogue laboratory tasks for advancing the understanding of mechanisms in REBT, as well as treatment outcome using this therapeutic approach. Specifically, we focus on the utilization of behavioral measures of distress tolerance and their application to the key REBT construct of frustration intolerance. In identifying the parallels across distress tolerance and frustration intolerance, we consider how the incorporation of distress tolerance tasks into REBT research can be useful in evaluating the role of frustration intolerance in the initiation, maintenance, and treatment of disordered behavior across a broad range of clinical disorders.

Experiential Avoidance as a Moderator of the Relationship Between Anxiety Sensitivity and Perceived Stress

Given the significant deleterious effects of stress on psychological and physical well-being, the present two-part study sought to clarify relations among putative vulnerability factors (i.e., anxiety sensitivity, experiential avoidance) for perceived stress. Relations among anxiety sensitivity, experiential avoidance, and perceived stress were examined using a large college student sample (N = 400) in Study 1 and were replicated using a large community sample (N = 838) in Study 2. As predicted, experiential avoidance moderated the relationship between anxiety sensitivity and perceived stress. Contrary to expectations, simple effects in both studies revealed that anxiety sensitivity shared a significant positive association with perceived stress at low, but not high, levels of experiential avoidance. The moderating role of experiential avoidance was found to be robust to the effects of general distress. Moreover, anxiety sensitivity and experiential avoidance evidenced a differential pattern of relations with perceived stress than was evidenced with related negative affective states (i.e., anxiety and depression). The present results suggest that experiential avoidance appears to be a vulnerability factor of particular importance for understanding the phenomenology of perceived stress. Conceptual and clinical implications are discussed.     

Factor structure and psychometric properties of the Anxiety Sensitivity Index in a sample of Croatian adults

Anxiety sensitivity (AS) refers to a person's tendency to fear anxiety-related symptoms due to the belief that these symptoms may have harmful consequences. The most widely used operationalization of AS in adults is the Anxiety Sensitivity Index (ASI). The factor structure, gender stability, and psychometric properties of the ASI in a sample of Croatian adults (N = 984) were evaluated. Results confirm the multidimensional and hierarchical structure of the ASI, which consisted of three lower-order factors (Physical Concerns, Psychological Concerns, and Social Concerns) and a single higher-order factor, AS. Furthermore, the achievement of normative scores for the ASI in a Croatian adult sample demonstrates the cross-national stability of the ASI. Reliability coefficients for the ASI, Physical Concerns, and Psychological Concerns are high and satisfactory in the total sample and for both genders. Overall, the results confirmed the cross-national stability, gender stability, reliability, and validity of the ASI in a sample of Croatian adults.