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Research on Child and Adolescent Psychopathology

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01-12-2006 | Original Article

The Interactive Role of Anxiety Sensitivity and Pubertal Status in Predicting Anxious Responding to Bodily Sensations among Adolescents

Auteurs: Ellen W. Leen-Feldner, Laura E. Reardon, Laura G. McKee, Matthew T. Feldner, Kimberly A. Babson, Michael J. J. Zvolensky

Gepubliceerd in: Research on Child and Adolescent Psychopathology | Uitgave 6/2006

Abstract

The present study examined the interaction between pubertal status and anxiety sensitivity (AS) in predicting anxious and fearful responding to a three-minute voluntary hyperventilation challenge among 124 (57 females) adolescents between the ages of 12 and 17 years (Mage = 15.04; SD = 1.49). As predicted, after controlling for baseline anxiety, age, and gender, there was a significant interaction between pubertal status and AS in predicting anxious responding to bodily sensations to the hyperventilation challenge. Specifically, adolescents reporting more advanced pubertal status and higher levels of AS reported the greatest post-challenge self-reported anxiety focused on bodily sensations, whereas pubertal status had relatively less of an effect on low AS adolescents. A test of specificity also was conducted; as expected, the interaction between AS and pubertal status was unrelated to generalized negative affectivity, suggesting the predictor variables interact to confer specific risk for anxious responding to bodily sensations. Finally, exploratory analyses of psychophysiological reactivity to the challenge indicated AS, but not pubertal status, moderated the relation between challenge-related change in heart-rate and post-challenge anxiety such that high AS youth who had experienced a relatively greater heart-rate change reported the most anxious reactivity to the challenge. Results are discussed in relation to theory regarding vulnerability to anxious responding to bodily sensations among adolescents.

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In light of the sensitive nature of questions on the Tanner stage questionnaire, participants were reminded before completing the questionnaire battery that they were free to skip any questions that made them feel uncomfortable. Of the 151 adolescents recruited, 124 completed the Tanner stage questionnaire. Analyses indicated that there were no significant differences between adolescents who completed the Tanner stage questionnaire and those who did not with respect to age, gender, anxiety sensitivity, or challenge responding.To delimit unnecessary participant burden, adolescents were apprised of exclusionary criteria upon contacting the laboratory. Specifically, it was explained that participants would be excluded for any of the six conditions described in the narrative (e.g., “if a doctor ever diagnosed you with a mental health problem or gave you medication for it” or “if you have a bad cold right now”). Thereafter, the participant was asked whether he/she was still interested in the study. Thirty-three adolescents (17 females) who contacted the laboratory reported that they did not meet the inclusionary criteria; specific reasons for ineligibility were not recorded and no additional information (e. g., age) was gathered. An additional nine participants (5 females) were excluded on the basis of ADIS-C responses (primary diagnoses: 6 past or current depression; 2 social phobia; 1 specific phobia).

The current study is the first direct test of the relation between puberty and panic-relevant responding among both male and female adolescents. Although the specific events of puberty differ across genders (e.g., differences in the amount and type of hormones released; Fechner, 2002), and the risk for internalizing-type problems is higher for post-pubertal girls (Hayward & Sanborn, 2002), the current model is predicated on the notion that the co-occurrence of bodily perturbation and fearful reactivity to such sensations may potentiate panic-type responding. These general features are characteristic of puberty across the sexes (Buchanan et al., 1992), and therefore, we contend that the role of puberty in panic attack development may be similar for males and females. Indeed, Craske (2003) points out that the frequency of prodromal panic symptomatology such as panic attacks does not differ as a function of gender; rather, girls are more likely to engage in avoidance-type behavior, increasing the likelihood of panic disorder development. Nonetheless, the role of gender is an important element of the model that merits empirical attention. In the present study, we were underpowered to test hypotheses in separate genders (a test of the triple interaction was non-significant). Instead, we elected to treat gender as a co-variate in this initial test of the model and highlight the issue of gender as paramount for future research in the area.

A reviewer made the interesting suggestion that observed findings may be due to the effects of age, rather than pubertal status. Specifically, compared to younger youth, older adolescents may evidence greater awareness of, and ability to report, interoceptive states and/or be more sensitive to the demand characteristics of the testing situation. To explore this alternative explanation, we examined the interaction between anxiety sensitivity (AS) and age in predicting post-challenge anxiety. After controlling for gender, pre-experimental anxiety, and the main effects of AS and age, the interaction was not predictive of SUDs anxiety ratings (ΔR² = .00, β = −.77, t = −.62, p = .56).

Post hoc exploration of the association between pubertal status and negative affectivity indicated that when pubertal status was entered by itself at level two of the model, it predicted negative affectivity above and beyond variance accounted for by age and gender. However, as can be seen in Table 2, when CASI scores were entered simultaneously with pubertal status at level two, pubertal status no longer predicted negative affectivity.

We also examined the study hypotheses in terms of heart rate variability (HRV). Specifically, the J & J Engineering software we use provides power values for the high frequency (HF) and low frequency (LF) components of the power spectra; consistent with extant research (e.g., Friedman & Thayer, 1998), HF power and the LF/HF ratio (as an index of cardiac autonomic balance) were employed as the index of HRV. Neither AS nor pubertal status moderated the association between challenge-related changes in HRV and anxious reactivity to the voluntary hyperventilation.

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Titel: The Interactive Role of Anxiety Sensitivity and Pubertal Status in Predicting Anxious Responding to Bodily Sensations among Adolescents
Auteurs: Ellen W. Leen-Feldner
Laura E. Reardon
Laura G. McKee
Matthew T. Feldner
Kimberly A. Babson
Michael J. J. Zvolensky
Publicatiedatum: 01-12-2006
Uitgeverij: Kluwer Academic Publishers-Plenum Publishers
Gepubliceerd in: Research on Child and Adolescent Psychopathology / Uitgave 6/2006
Print ISSN: 2730-7166
Elektronisch ISSN: 2730-7174
DOI: https://doi.org/10.1007/s10802-006-9079-y

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