Top

Gepubliceerd in:

13-07-2018 | Original Article

The Role of Anxiety Sensitivity in the Relationship Between Emotion Dysregulation and Internalizing Psychopathology Among Trauma-Exposed Inpatient Adolescents

Auteurs: Emma C. Woodward, Andres G. Viana, Elizabeth M. Raines, Abigail E. Hanna, Michael J. Zvolensky

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 6/2018

Abstract

The present investigation examined the underlying role of anxiety sensitivity and its facets in the association between emotion dysregulation and three of the most prevalent and debilitating symptom classes among trauma-exposed psychiatric inpatient youth: posttraumatic stress disorder (PTSD), anxiety, and depression symptoms. Participants (N = 50; 52.0% female; M_age = 15.1 years, SD = .51, range 12–17 years) completed an assessment battery that included measures of emotion dysregulation anxiety sensitivity, PTSD, anxiety, and depression symptoms. Consistent with hypotheses, the global construct of anxiety sensitivity, as well as its mental incapacitation concerns and disease concerns facets, explained, in part, associations between emotion dysregulation and the three symptom classes. The study results provide novel and clinically meaningful findings regarding the potential mechanistic role of anxiety sensitivity in the relation of emotion dysregulation to PTSD and internalizing symptoms among trauma-exposed inpatient adolescents. As such, findings underscore the potential value of targeting anxiety sensitivity in general, and mental incapacitation and disease concerns specifically, as a means of reducing risk for internalizing psychopathology among trauma-exposed inpatient youth.

vorige artikel Self-Esteem Instability in Current, Remitted, Recovered, and Comorbid Depression and Anxiety

volgende artikel Training Less Threatening Interpretations Over the Internet: Impact of Priming Anxious Imagery and Using a Neutral Control Condition

Albano, A., & Silverman, W. (1996). Anxiety disorders interview schedule for DSM-IV-child version: Clinical manual. San Antonio: Psychological Corporation.

Carpenter, E. M., Frankel, F., Marina, M., Duan, N., & Smalley, S. L. (2004). Internet treatment delivery of parent-adolescent conflict training for families with an ADHD teen: A feasibility study. Child & Family Behavior Therapy, 26(3), 1–20.CrossRef

Cisler, J. M., Olatunji, B. O., Feldner, M. T., & Forsyth, J. P. (2010). Emotion regulation and the anxiety disorders: An integrative review. Journal of Psychopathology and Behavioral Assessment, 32(1), 68–82.CrossRef

Cloitre, M., Koenen, K. C., Cohen, L. R., & Han, H. (2002). Skills training in affective and interpersonal regulation followed by exposure: A phase-based treatment for PTSD related to childhood abuse. Journal of Consulting and Clinical Psychology, 70(5), 1067–1074. https://doi.org/10.1037//0022-006x.70.5.1067.CrossRefPubMed

Cloitre, M., Miranda, R., Stovall-McClough, K. C., & Han, H. (2005). Beyond PTSD: Emotion regulation and interpersonal problems as predictors of functional impairment in survivors of childhood abuse. Behavior Therapy, 36(2), 119–124. https://doi.org/10.1016/S0005-7894(05)80060-7.CrossRef

Cohen, J. A., Deblinger, E., Mannarino, A. P., & Steer, R. A. (2004). A multisite, randomized controlled trial for children with sexual abuse-related PTSD symptoms. Journal of the American Academy of Child & Adolescent Psychiatry, 43(4), 393–402.CrossRef

Cook, D. (2005). The role of maternal meta-emotion coaching in children’s self-regulation of negative emotion. 66, ProQuest Information & Learning, US.

Ditlevsen, S., Christensen, U., Lynch, J., Damsgaard, M. T., & Keiding, N. (2005). The mediation proportion: A structural equation approach for estimating the proportion of exposure effect on outcome explained by an intermediate variable. Epidemiology, 16(1), 114–120.CrossRef

Durlak, J. A., Weissberg, R. P., Dymnicki, A. B., Taylor, R. D., & Schellinger, K. B. (2011). The impact of enhancing students’ social and emotional learning: A meta-analysis of school-based universal interventions. Child Development, 82(1), 405–432. https://doi.org/10.1111/j.1467-8624.2010.01564.x.CrossRefPubMed

Feldner, M. T., Lewis, S. F., Leen-Feldner, E. W., Schnurr, P. P., & Zvolensky, M. J. (2006). Anxiety sensitivity as a moderator of the relation between trauma exposure frequency and posttraumatic stress symptomatology. Journal of Cognitive Psychotherapy, 20(2), 201–213.CrossRef

Foa, E. B., Johnson, K. M., Feeny, N. C., & Treadwell, K. R. H. (2001). The child PTSD symptom scale: Preliminary examination of its psychometric properties. Journal of Clinical Child Psychology, 30(3), 376–384. https://doi.org/10.1207/S15374424jccp3003_9.CrossRefPubMed

Fox, H. C., Axelrod, S. R., Paliwal, P., Sleeper, J., & Sinha, R. (2007). Difficulties in emotion regulation and impulse control during cocaine abstinence. Drug and Alcohol Dependence, 89(2–3), 298–301. https://doi.org/10.1016/j.drugalcdep.2006.12.026.CrossRefPubMed

Friedberg, R., & Sindeman, S. (2011). CDI scores in pediatric psychiatric inpatients: A brief retrospective static group comparison. Depression Research and Treatment, 2011, 1–5.CrossRef

Gardenswartz, C. A., & Craske, M. G. (2001). Prevention of panic disorder. Behavior Therapy, 32(4), 725–737. https://doi.org/10.1016/S0005-7894(01)80017-4.CrossRef

Garnefski, N., & Kraaij, V. (2006). Relationships between cognitive emotion regulation strategies and depressive symptoms: A comparative study of five specific samples. Personality and Individual Differences, 40(8), 1659–1669. https://doi.org/10.1016/j.paid.2005.12.009.CrossRef

Goenjian, A. K., Roussos, A., Steinberg, A. M., Sotiropoulou, C., Walling, D., Kakaki, M., & Karagianni, S. (2011). Longitudinal study of PTSD, depression, and quality of life among adolescents after the Parnitha earthquake. Journal of Affective Disorders, 133(3), 509–515. https://doi.org/10.1016/j.jad.2011.04.053.CrossRefPubMed

Gratz, K., & Roemer, L. (2004a). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54. https://doi.org/10.1023/B:JOBA.0000007455.08539.94.CrossRef

Gratz, K. L., & Roemer, L. (2004b). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54. https://doi.org/10.1023/B:JOBA.0000007455.08539.94.CrossRef

Gratz, K. L., Tull, M. T., Baruch, D. E., Bornovalova, M. A., & Lejuez, C. W. (2008). Factors associated with co-occurring borderline personality disorder among inner-city substance users: The roles of childhood maltreatment, negative affect intensity/reactivity, and emotion dysregulation. Comprehensive Psychiatry, 49(6), 603–615. https://doi.org/10.1016/j.comppsych.2008.04.005.CrossRefPubMed

Gus, L., Rose, J., & Gilbert, L. (2015). Emotion coaching: A universal strategy for supporting and promoting sustainable emotional and behavioural well-being. Educational and Child Psychology, 32(1), 31–41.

Havens, J. F., Gudiño, O. G., Biggs, E. A., Diamond, U. N., Weis, J. R., & Cloitre, M. (2012). Identification of trauma exposure and PTSD in adolescent psychiatric inpatients: An exploratory study. Journal of Traumatic Stress, 25(2), 171–178.CrossRef

Hayes, A. F. (2012). PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling [White paper]. Retrieved from http://www.afhayes.com/public/process2012.pdf.

Johnson, K. A., Zvolensky, M. J., Marshall, E. C., Gonzalez, A., Abrams, K., & Vujanovic, A. A. (2008). Linkages between cigarette smoking outcome expectancies and negative emotional vulnerability. Addictive Behaviors, 33(11), 1416–1424. https://doi.org/10.1016/j.addbeh.2008.05.001.CrossRefPubMedPubMedCentral

Joiner, T. E., Schmidt, N. B., Schmidt, K. L., Laurent, J., Catanzaro, S. J., Perez, M., & Pettit, J. W. (2002). Anxiety sensitivity as a specific and unique marker of anxious symptoms in youth psychiatric inpatients. Journal of Abnormal Child Psychology, 30(2), 167–175.CrossRef

Judd, C. M., & Kenny, D. A. (2010). Data analysis in social psychology: Recent and recurring issues. In S. T. Fiske, D. T. Gilbert, G. Lindzey, S. T. Fiske, D. T. Gilbert & G. Lindzey (Eds.), Handbook of social psychology (Vol. 1, 5th ed., pp. 115–139). Hoboken: Wiley.

Kashdan, T. B., Zvolensky, M. J., & McLeish, A. C. (2008). Anxiety sensitivity and affect regulatory strategies: Individual and interactive risk factors for anxiety-related symptoms. Journal of Anxiety Disorders, 22(3), 429–440. https://doi.org/10.1016/j.janxdis.2007.03.011.CrossRefPubMed

Keough, M. E., & Schmidt, N. B. (2012). Refinement of a brief anxiety sensitivity reduction intervention. Journal of Consulting and Clinical Psychology, 80(5), 766–772. https://doi.org/10.1037/a0027961.CrossRefPubMedPubMedCentral

Kilpatrick, D. G., Resnick, H. S., Milanak, M. E., Miller, M. W., Keyes, K. M., & Friedman, M. J. (2013). National estimates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM-5 criteria. Journal of Traumatic Stress, 26(5), 537–547. https://doi.org/10.1002/jts.21848.CrossRefPubMedPubMedCentral

Koltek, M., Wilkes, T. C. R., & Atkinson, M. (1998). The prevalence of posttraumatic stress disorder in an adolescent inpatient unit. Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie, 43(1), 64–68.CrossRef

Kovacs, M. (1985). The children’s depression, inventory (CDI). Psychopharmacology Bulletin, 21(4), 995–998. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/4089116.

Kovacs, M. (1992). Children’s depression inventory. North Tonawanda: Multi-Health System.

Lambert, S. F., McCreary, B. T., Preston, J. L., Schmidt, N. B., Joiner, T. E., & Ialongo, N. S. (2004). Anxiety sensitivity in African-American adolescents: Evidence of symptom specificity of anxiety sensitivity components. Journal of the American Academy of Child and Adolescent Psychiatry, 43(7), 887–895. https://doi.org/10.1097/01.chi.0000128799.99225.88.CrossRefPubMed

Leen-Feldner, E. W., Feldner, M. T., Reardon, L. E., Babson, K. A., & Dixon, L. (2008). Anxiety sensitivity and posttraumatic stress among traumatic event-exposed youth. Behaviour Research and Therapy, 46(4), 548–556. https://doi.org/10.1016/j.brat.2008.01.014.CrossRefPubMedPubMedCentral

Lipschitz, D. S., Winegar, R. K., Hartnick, E., Foote, B., & Southwick, S. M. (1999). Posttraumatic stress disorder in hospitalized adolescents: Psychiatric comorbidity and clinical correlates. Journal of the American Academy of Child and Adolescent Psychiatry, 38(4), 385–392. https://doi.org/10.1097/00004583-199904000-00010.CrossRefPubMed

Matthey, S., & Petrovski, P. (2002). The children’s depression inventory: Error in cutoff scores for screening purposes. Psychological Assessment, 14(2), 146–149. https://doi.org/10.1037/1040-3590.14.2.146.CrossRefPubMed

McLaughlin, K. A., Hatzenbuehler, M. L., Mennin, D. S., & Nolen-Hoeksema, S. (2011). Emotion dysregulation and adolescent psychopathology: A prospective study. Behaviour Research and Therapy, 49(9), 544–554.CrossRef

Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L. H., … Swendsen, J. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49(10), 980–989. https://doi.org/10.1016/j.jaac.2010.05.017.CrossRefPubMedPubMedCentral

Naragon-Gainey, K. (2010). Meta-analysis of the relations of anxiety sensitivity to the depressive and anxiety disorders. Psychological Bulletin, 136(1), 128–150. https://doi.org/10.1037/a0018055.CrossRefPubMed

Neumann, A., van Lier, P. A. C., Gratz, K. L., & Koot, H. M. (2010). Multidimensional assessment of emotion regulation difficulties in adolescents using the Difficulties in Emotion Regulation Scale. Assessment, 17(1), 138–149.CrossRef

Nixon, R. D. V., Meiser-Stedman, R., Dalgleish, T., Yule, W., Clark, D. M., Perrin, S., & Smith, P. (2013). The Child PTSD Symptom Scale: An update and replication of its psychometric properties. Psychological Assessment, 25(3), 1025–1031. https://doi.org/10.1037/a0033324.CrossRefPubMed

Olatunji, B. O., & Wolitzky-Taylor, K. B. (2009). Anxiety sensitivity and the anxiety disorders: A meta-analytic review and synthesis. Psychological Bulletin, 135(6), 974–999. https://doi.org/10.1037/a0017428.CrossRefPubMed

Pela, O. A., & Reynolds, C. R. (1982). Cross-cultural application of the Revised-Children’s Manifest Anxiety Scale: Normative and reliability data for Nigerian primary school children. Psychological Reports, 51(3 suppl), 1135–1138.CrossRef

Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879–891.CrossRef

Pynoos, R. S., Steinberg, A. M., & Piacentini, J. C. (1999). A developmental psychopathology model of childhood traumatic stress and intersection with anxiety disorders. Biological Psychiatry, 46(11), 1542–1554.CrossRef

Reiss, S. (1991). Expectancy model of fear, anxiety, and panic. Clinical Psychology Review, 11(2), 141–153. https://doi.org/10.1016/0272-7358(91)90092-9.CrossRef

Reynolds, C. R., & Richmond, B. O. (1978). What I think and feel: A revised measure of children’s manifest anxiety. Journal of Abnormal Child Psychology, 6(2), 271–280.CrossRef

Silk, J. S., Steinberg, L., & Morris, A. S. (2003). Adolescents’ emotion regulation in daily life: Links to depressive symptoms and problem behavior. Child Development, 74(6), 1869–1880.CrossRef

Silverman, W. K., Fleisig, W., Rabian, B., & Peterson, R. A. (1991). Childhood anxiety sensitivity index. Journal of Clinical Child Psychology, 20(2), 162–168. https://doi.org/10.1207/s15374424jccp2002_7.CrossRef

Silverman, W. K., Ginsburg, G. S., & Goedhart, A. W. (1999). Factor structure of the childhood anxiety sensitivity index. Behaviour Research and Therapy, 37(9), 903–917.CrossRef

Silverman, W. K., Goedhart, A. W., Barrett, P., & Turner, C. (2003). The facets of anxiety sensitivity represented in the Childhood Anxiety Sensitivity Index: Confirmatory analyses of factor models from past studies. Journal of Abnormal Psychology, 112(3), 364–374. https://doi.org/10.1037/0021-843X.112.3.364.CrossRefPubMed

Suliman, S., Mkabile, S. G., Fincham, D. S., Ahmed, R., Stein, D. J., & Seedat, S. (2009). Cumulative effect of multiple trauma on symptoms of posttraumatic stress disorder, anxiety, and depression in adolescents. Comprehensive Psychiatry, 50(2), 121–127.CrossRef

Suveg, C., & Zeman, J. (2004). Emotion regulation in children with anxiety disorders. Journal of Clinical Child & Adolescent Psychology, 33(4), 750–759. https://doi.org/10.1207/s15374424jccp3304_10.CrossRefPubMed

Taylor, S., Koch, W. J., & Mcnally, R. J. (1992). How does anxiety sensitivity vary across the anxiety disorders. Journal of Anxiety Disorders, 6(3), 249–259. https://doi.org/10.1016/0887-6185(92)90037-8.CrossRef

Tull, M. T., Stipelman, B. A., Salters-Pedneault, K., & Gratz, K. L. (2009). An examination of recent non-clinical panic attacks, panic disorder, anxiety sensitivity, and emotion regulation difficulties in the prediction of generalized anxiety disorder in an analogue sample. Journal of Anxiety Disorders, 23(2), 275–282.CrossRef

Viana, A. G., Dixon, L. J., Berenz, E. C., & Espil, F. M. (2017a). Trauma and deliberate self-harm among inpatient adolescents: The moderating role of anxiety sensitivity. Psychological Trauma: Theory, Research, Practice, and Policy, 9(5), 509–517.CrossRef

Viana, A. G., Hanna, A. E., Woodward, E. C., Raines, E. M., Paulus, D. J., Berenz, E. C., & Zvolensky, M. J. (2018a). Emotional clarity, anxiety sensitivity, and PTSD symptoms among trauma-exposed inpatient adolescents. Child Psychiatry & Human Development, 49, 146–154.CrossRef

Viana, A. G., Paulus, D. J., Bakhshaie, J., Garza, M., Valdivieso, J., Ochoa-Perez, M., … Zvolensky, M. J. (2017b). Emotional nonacceptance within the context of traumatic event exposure: The explanatory role of anxiety sensitivity for traumatic stress symptoms and disability among Latinos in a primary care setting. General Hospital Psychiatry, 44, 30–37.CrossRef

Viana, A. G., Woodward, E. C., Raines, E. M., Hanna, A. E., & Zvolensky, M. J. (2018b). The role of emotional clarity and distress tolerance in deliberate self-harm in a sample of trauma-exposed inpatient adolescents at risk for suicide. General Hospital Psychiatry, 50, 119–124.CrossRef

Wald, J., & Taylor, S. (2008). Responses to interoceptive exposure in people with posttraumatic stress disorder (PTSD): A preliminary analysis of induced anxiety reactions and trauma memories and their relationship to anxiety sensitivity and PTSD symptom severity. Cognitive Behavioral Therapy, 37(2), 90–100. https://doi.org/10.1080/16506070801969054.CrossRef

Weems, C. F., Costa, N. M., Watts, S. E., Taylor, L. K., & Cannon, M. F. (2007). Cognitive errors, anxiety sensitivity, and anxiety control beliefs: Their unique and specific associations with childhood anxiety symptoms. Behavior Modification, 31(2), 174–201.CrossRef

Wen, Z., & Fan, X. (2015). Monotonicity of effect sizes: Questioning kappa-squared as mediation effect size measure. Psychological Methods, 20(2), 193.CrossRef

Yap, M. B. H., Allen, N. B., & Sheeber, L. (2007). Using an emotion regulation framework to understand the role of temperament and family processes in risk for adolescent depressive disorders. Clinical Child and Family Psychology Review, 10(2), 180–196. https://doi.org/10.1007/s10567-006-0014-0.CrossRefPubMed

Titel: The Role of Anxiety Sensitivity in the Relationship Between Emotion Dysregulation and Internalizing Psychopathology Among Trauma-Exposed Inpatient Adolescents
Auteurs: Emma C. Woodward
Andres G. Viana
Elizabeth M. Raines
Abigail E. Hanna
Michael J. Zvolensky
Publicatiedatum: 13-07-2018
Uitgeverij: Springer US
Gepubliceerd in: Cognitive Therapy and Research / Uitgave 6/2018
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-018-9943-4

Bohn Stafleu van Loghum

Deel dit onderdeel of sectie (kopieer de link)

Abstract

Log in om toegang te krijgen

Andere artikelen Uitgave 6/2018

Reasons for Living Among U.S. Army Personnel Thinking About Suicide

Self-Esteem Instability in Current, Remitted, Recovered, and Comorbid Depression and Anxiety

Personalizing Affective Stimuli Using a Recommender Algorithm: An Example with Threatening Words for Trauma Exposed Populations

Training Less Threatening Interpretations Over the Internet: Impact of Priming Anxious Imagery and Using a Neutral Control Condition

Comparing Cognitive Defusion and Cognitive Restructuring Delivered Through a Mobile App for Individuals High in Self-Criticism

Understanding the Constellation of Adolescent Emotional Clarity and Cognitive Response Styles when Predicting Depression: A Latent Class Analysis