Biomedical subjects

Michael J Zvolensky

Publications and source records attributed to Michael J Zvolensky.

At least 19 recordsLinked to original sources

PubMed2026

Relationships Between Risky Substance Use and Irritable Bowel Syndrome (IBS) Severity, Mental Health, and Smoking-Related Processes in Adults with IBS Who Smoke.

Objective: Irritable Bowel Syndrome (IBS) is a debilitating chronic pain condition that presents a major and growing public health burden. Combustible cigarette smoking plays a role in the maintenance of IBS, and the co-occurrence of these conditions warrants greater focus. Moreover, given that smoking co-occurs with other substance use behaviors, the impact of these comorbid behaviors on physical and mental health-related outcomes among individuals with IBS who smoke is warranted. The goal of the present cross-sectional study was to assess relationships of risky alcohol, cannabis, and opioid use with IBS severity, anxiety and depression, and smoking-related processes among adults with IBS who smoke. Methods: In total, 263 adults who met Rome IV criteria for IBS and who smoked combustible cigarettes were included in the study. Hierarchical regression analyses were conducted to examine the influence of risky substance uses on IBS symptom severity, IBS-related quality of life, anxiety, depression, perceived barriers for smoking cessation, and cigarette dependence. Results: Results indicated that opioid use was statistically related to all criterion variables, whereas alcohol use was specifically associated with depression and anxiety. Cannabis use showed a statistically significant association only with anxiety symptoms. Conclusions: The present investigation is among the first to explore the role of risky substance use in terms of a wide array of IBS, mental health, and smoking processes among adults with IBS who smoke. The findings suggest that substance use should be a focal point of screening and intervention for the IBS population to optimize outcomes beyond the reach of medical therapies.

Irritable bowel syndrome↗

PubMed2007

Anxiety sensitivity and CO2 challenge reactivity as unique and interactive prospective predictors of anxiety pathology.

Emerging evidence suggests that anxiety sensitivity (AS) and CO(2)-induced fear reactivity are associated with panic attacks and anxiety disorders. However, evidence regarding the unique and potentially synergistic effects of these variables is currently lacking. Our primary aims in this study were to determine whether AS and CO(2)-induced fear reactivity are unique and potentially interactive vulnerability factors involved in the pathogenesis of panic attacks and anxiety psychopathology. A large nonclinical sample of young adults (N=404) was prospectively followed over approximately 2 years. AS (i.e., 16-item Anxiety Sensitivity Index total scores) and biological challenge reactivity [i.e., fearful responding to pre- and postchallenge changes in subjective units of distress (SUDS) to a 20-s 20% CO(2) challenge] at study entry served as the primary predictor variables. Consistent with expectation, AS and challenge reactivity correlated only moderately with one another. Challenge reactivity was uniquely associated with the development of spontaneous panic attacks, whereas AS was uniquely associated with anxiety disorder diagnoses, including panic disorder. Moreover, the combination of both risk factors predicted spontaneous panic attacks beyond the effects of either risk factor individually. These data provide novel evidence for the unique and combined effects of AS and CO(2)-induced fear reactivity as risk factors in the development of anxiety and its disorders.

Anxiety Disorders↗

PubMed2007

Developmental course(s) of lifetime cigarette use and panic attack comorbidity: an equifinal phenomenon?

The present investigation examined the developmental course(s) of lifetime cigarette use and panic attack comorbidity. Participants included 4,409 adults, ages 15 to 54 years of age (M(Age) = 33.1, SD = 10.7, N (females) = 2,221) from the National Comorbidity Survey (NCS). The primary objective of the present investigation was to better understand the developmental course(s) of lifetime cigarette use and panic attacks. A second objective of the investigation was to evaluate the developmental features of smoking-panic comorbidity in relation to other comorbid psychiatric and substance outcomes. Results demonstrated two distinct and novel operative developmental patterns of smoking-panic attack co-occurrence. The theoretical and clinical implications of delineating course-related factors underlying smoking-panic attack comorbidity are discussed.

Adolescent↗

PubMed2007

Pubertal status and emotional reactivity to a voluntary hyperventilation challenge predicting panic symptoms and somatic complaints: a laboratory-based multi-informant test.

The main and interactive effects of pubertal status and emotional reactivity to bodily sensations elicited by a voluntary hyperventilation challenge were examined in relation to panic symptoms and self- and parent-reported somatic complaints among 123 (56 females) adolescents between the ages of 12 and 17 years (M(age) = 15.05; SD = 1.50). As expected, after controlling for baseline anxiety, age, and gender, there was a significant interaction between pubertal status and challenge response in predicting the outcome variables. Specifically, adolescents reporting more advanced pubertal status and greater reactivity to the challenge evidenced greater levels of panic symptoms and somatic complaints, whereas pubertal status had relatively less of an effect on these variables among adolescents who did not respond as fearfully to the challenge. Results are discussed in terms of extant theory and research on anxiety vulnerability among adolescents.

Adolescent↗

PubMed2007

Risk factor research and prevention for anxiety disorders: introduction to the special series on risk and prevention of anxiety pathology.

In relation to treatment-related research in the United States, there is relatively little systematic effort focused on the combination of risk and prevention for anxiety pathology. This article broadly discusses risk factor research and prevention program development for anxiety psychopathology. The authors also specifically discuss papers in this special issue that are focused on these topics. Risk factor research should be used by clinical researchers to inform prevention programs, and reciprocally, prevention knowledge should be effectively utilized to drive new, clinically focused risk factor research.

Anxiety Disorders↗

PubMed2006

Interaction between smoking rate and anxiety sensitivity: relation to anticipatory anxiety and panic-relevant avoidance among daily smokers.

The aim of the present investigation was to evaluate the moderating role of anxiety sensitivity (AS) in the relation between smoking rate and panic vulnerability variables, both concurrently and prospectively (3 months), among a community-based sample of 125 daily smokers (60 females; M(age) =26.02 years, S.D. =10.98). Consistent with prediction, the interaction between AS and smoking rate significantly predicted concurrent agoraphobic avoidance (3.2% of unique variance) and change in levels of anticipatory anxiety during the 3-month follow-up period (4.7% unique variance). Smokers high in AS who also smoked at greater rates reported the highest levels of avoidance and greatest increase in anticipatory anxiety. Overall, these data suggest that AS is an important individual difference factor that, when coupled with higher rates of smoking, is associated with greater levels of avoidance and anticipatory anxiety among daily smokers.

Adult↗

PubMed2006

Anxiety sensitivity as a moderator of association between smoking status and panic-related processes in a representative sample of adults.

The present investigation evaluated a moderational role of anxiety sensitivity (fear of anxiety and anxiety-related states; [McNally RJ. Anxiety sensitivity and panic disorder. Biological Psychiatry 2002; 52:938-946.]) in the relation between smoking status and anxiety/depressive symptoms in a Russian epidemiological sample (n = 390; 197 females, Mean age = 43.55). Consistent with prediction, anxiety sensitivity moderated the association of smoking status with indices of anxiety and depressive symptoms; the effects were evident after controlling for the variance accounted for by alcohol use problems, environmental stress (past month), and gender. These findings are discussed with regard to the role of anxiety sensitivity in etiologic connection between smoking and panic-related processes.

Adult↗

PubMed2006

Associations between psychedelic use, abuse, and dependence and lifetime panic attack history in a representative sample.

The present investigation evaluated the associations between lifetime psychedelic use, abuse, and dependence and panic attacks. The study consisted of a representative epidemiological sample from a state wide survey of the Colorado general adult population (n=4745; 52% female). Consistent with prediction, after controlling for theoretically relevant variables, psychedelic abuse and dependence, but not use, were significantly related to an increased lifetime risk of panic attacks. The results are discussed in terms of better understanding the role of psychedelic use in relation to the occurrence of panic attacks.

Adult↗

PubMed2006

Smoking, traumatic event exposure, and post-traumatic stress: a critical review of the empirical literature.

The current review critically examines the extant empirical literature focused on the associations among cigarette smoking, trauma, and post-traumatic stress. Inspection of the extant literature suggests that smoking rates are significantly higher among persons exposed to a traumatic event relative to those without such exposure. Moreover, smoking rates appear particularly high among persons with post-traumatic stress disorder (PTSD). In terms of the direction of this relation, evidence most clearly suggests that post-traumatic stress is involved in the development of smoking. Significantly less is known about the role of trauma and PTSD in terms of cessation outcome. Limitations of extant work, clinical implications, and key directions for future study are delineated.

Cross-Sectional Studies↗

PubMed2006

Anxiety sensitivity: prospective prediction of panic attacks and Axis I pathology.

Emerging evidence suggests that anxiety sensitivity (AS) predicts subsequent development of anxiety symptoms and panic attacks. However, evidence regarding whether AS serves as a premorbid risk factor for the development of clinical syndromes is lacking. The primary aim of the present study was to determine whether AS acts as a vulnerability factor in the pathogenesis of psychiatric diagnoses. A large nonclinical sample of young adults (N=404) was prospectively followed over two years. The Anxiety Sensitivity Index (ASI: Reiss S, Peterson RA, Gursky DM, McNally RJ. Anxiety sensitivity, anxiety frequency, and the prediction of fearfulness. Behaviour Research and Therapy 1986; 24: 1-8.) and trait anxiety served as predictors. Consistent with prior reports, AS predicted the development of spontaneous panic attacks in those with no history of panic. Importantly, AS was found to predict the incidence of anxiety disorder diagnoses and overall Axis I diagnoses in those with no history of Axis I diagnoses at study entry. These are the first data to provide strong prospective evidence for AS as a risk factor in the development of anxiety disorders.

Adult↗

PubMed2006

A test of the interactive effects of anxiety sensitivity and mindfulness in the prediction of anxious arousal, agoraphobic cognitions, and body vigilance.

The present investigation sought to examine the interactive effects of anxiety sensitivity [AS; Reiss, S., & McNally, R. J. (1985). Expectancy model of fear. In S. Reiss, & R. R. Bootzin (Eds.), Theoretical issues in behavior therapy (pp. 107-121). San Diego: Academic Press] and mindfulness [Brown, K. W., & Ryan, R. M. (2003). The benefit of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84, 822-848] in predicting panic-relevant processes. A community sample of 248 individuals participated in the study by completing a battery of self-report instruments. Consistent with prediction, the interaction between AS and mindfulness significantly predicted anxious arousal symptoms and agoraphobic cognitions, above and beyond the individual main effects, and did not significantly predict anhedonic depression symptoms. Contrary to prediction, the AS by mindfulness interaction did not significantly predict body vigilance. Theoretical implications are discussed and future directions are delineated.

Adolescent↗

PubMed2006

Mixed anxiety depression: taxometric exploration of the validity of a diagnostic category in youth.

BACKGROUND: Mixed anxiety depression (MAD) is a provisional diagnosis in the DSM-IV. This study determined whether MAD represents a discrete category thereby evaluating the validity of MAD as a diagnostic entity. METHODS: Taxometric analyses and mixture modeling were used to discern whether MAD indicators constitute a distinct psychopathological category (i.e., a taxon) in a large school-based sample of adolescents (N=706). RESULTS: Each taxometric procedure (MAXCOV, MAMBAC) identified a taxon with a prevalence of 13%+/-2%. A non-taxometric procedure (multivariate mixture modeling) also supported the existence of a taxon with a prevalence of 12%. Bootstrapping procedures were used to construct a measure of MAD (i.e., MAD-T). Scale construction suggested that MAD may be best represented by 12 criteria that largely overlap with the DSM-IV, though some modifications were suggested. Examination of the construct validity of the MAD taxon indicated that it is associated mood and anxiety symptoms. Taxon membership was predictive of the development of mood and anxiety disorders over a 14-month longitudinal follow-up. LIMITATIONS: This category should be studied in other populations including adult samples. CONCLUSIONS: MAD appears to be a viable diagnostic category for youth though it is recommended that future revisions of the DSM emphasize somewhat different criteria for this diagnosis.

Adolescent↗

PubMed2006

Smoking motives in the prediction of affective vulnerability among young adult daily smokers.

The primary aim of this study was to examine whether smoking to reduce negative affect was uniquely related to a range of affective vulnerability factors (e.g., anxiety sensitivity, anxious arousal, and negative affectivity) among daily smokers. Participants were 276 young adult daily smokers (124 females; M(age)=25.12, SD=10.37). Partially consistent with prediction, the motivation to smoke to reduce negative affect was significantly related to anxiety sensitivity and negative affectivity, but not anxious arousal; the observed significant effects were above and beyond other theoretically relevant factors (e.g., smoking rate, years smoked, age, gender). In contrast to prediction, habitual smoking motives demonstrated significant incremental associations with anxiety sensitivity and anxious arousal symptoms. These results suggest that there are important associations between certain smoking motives and negative affective states and that such relations are not attributable to other smoking factors (e.g., smoking rate).

Adolescent↗

PubMed2006

Marijuana use motives: concurrent relations to frequency of past 30-day use and anxiety sensitivity among young adult marijuana smokers.

The present investigation examined two theoretically relevant aspects of marijuana motives using the Marijuana Motives Measure (MMM) [Simons, J., Correia, C. J., Carey, K. B., & Borsari, B. E. (1998). Validating a five-factor marijuana motives measure: Relations with use, problems, and alcohol motives. Journal of Counseling Psychology 45, 265-273] among 141 (78 female) young adults (M(age)=20.17, S.D.=3.34). The first objective was to evaluate the incremental validity of marijuana motives in relation to frequency of past 30-day use after controlling for the theoretically relevant factors of the number of years using marijuana (lifetime), current levels of alcohol, as well as tobacco smoking use. As expected, coping, enhancement, social, and expansion motives each were uniquely and significantly associated with past 30-day marijuana use over and above the covariates; conformity motives were not a significant predictor. A second aim was to explore whether coping, but no other marijuana motive, was related to the emotional vulnerability individual difference factor of anxiety sensitivity (fear of anxiety). As hypothesized, after controlling for number of years using marijuana (lifetime), past 30-day marijuana use, current levels of alcohol consumption, and cigarettes smoked per day, anxiety sensitivity was incrementally and uniquely related to coping motives for marijuana use, but not other motives. These results are discussed in relation to the clinical implications of better understanding the role of motivation for marijuana use among emotionally vulnerable young adults.

Adaptation, Psychological↗

PubMed2006

Posttraumatic stress symptoms and smoking to reduce negative affect: an investigation of trauma-exposed daily smokers.

The present investigation examined the relations among posttraumatic stress symptoms and smoking motives. Participants included 100 daily smokers recruited from the community and university settings who reported exposure to at least one traumatic event that met criterion A for posttraumatic stress disorder. Consistent with prediction, higher levels of posttraumatic stress symptoms were associated with smoking to reduce negative affect; this relation was observed after controlling for variance accounted for by number of cigarettes smoked per day and gender. Results are discussed in terms of the implications of smoking to regulate affect among daily smokers who have been exposed to traumatic events.

Adolescent↗

PubMed2006

Associations between age of onset and lifetime history of panic attacks and alcohol use, abuse, and dependence in a representative sample.

OBJECTIVE: The present investigation evaluated associations between lifetime panic attacks and lifetime alcohol use, abuse, and dependence. Specifically, the relations between lifetime panic attacks and alcohol use, abuse, and dependence were examined after controlling for theoretically relevant variables of comorbid psychopathology and polysubstance use. DESIGN AND SETTING: Data for this study were obtained from a large statewide survey, the Colorado Social Health Survey. Participants were contacted using randomly sampled household addresses (response rate was 72%) and interviews took place in participants' homes. PARTICIPANTS: The study consisted of a representative sample of the Colorado general adult population (n = 4,745; 52% women). MAIN OUTCOME MEASURES: The Diagnostic Interview Schedule (American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders [3rd ed]. Washington [DC]: Author. 1980) was administered to obtain Axis I diagnoses. RESULTS: After controlling for theoretically relevant variables of comorbid psychopathology and polysubstance use, a lifetime history of panic attacks was significantly associated with alcohol dependence but not alcohol use or abuse. In addition, among participants reporting a lifetime history of both panic attacks and alcohol abuse or dependence, the number of participants for whom panic attacks developmentally preceded the onset of alcohol use problems was significantly greater (85.5%) than the number of participants for whom alcohol use problems preceded the onset of panic attacks (13.4%) or the number of participants for whom these problems developed at the same age (2.2%). CONCLUSIONS: These data suggest panic attacks, particularly of early onset, may serve as a risk marker for alcohol dependence.

Adult↗

PubMed2006

An examination of worry in relation to anxious responding to voluntary hyperventilation among adolescents.

This study examined the association between worry and fearful responding to a 3-min voluntary hyperventilation procedure. Participants were 160 adolescents (71 females) between the ages of 12 and 17 years (M=14.92 years). After accounting for the significant effects of state anxiety and anxiety sensitivity, results indicated that pre-challenge levels of worry indexed by the Penn State Worry Questionnaire-Child Version predicted post-challenge anxiety and intensity of panic symptoms. Results are discussed in terms of the role of worry in relation to panic-relevant emotional vulnerability among youth.

Adolescent↗

PubMed2006

Neuroticism moderates the effect of maximum smoking level on lifetime panic disorder: a test using an epidemiologically defined national sample of smokers.

The present study evaluated a moderational model of neuroticism on the relation between smoking level and panic disorder using data from the National Comorbidity Survey. Participants (n=924) included current regular smokers, as defined by a report of smoking regularly during the past month. Findings indicated that a generalized tendency to experience negative affect (neuroticism) moderated the effects of maximum smoking frequency (i.e., number of cigarettes smoked per day during the period when smoking the most) on lifetime history of panic disorder even after controlling for drug dependence, alcohol dependence, major depression, dysthymia, and gender. These effects were specific to panic disorder, as no such moderational effects were apparent for other anxiety disorders. Results are discussed in relation to refining recent panic-smoking conceptual models and elucidating different pathways to panic-related problems.

Adult↗