Emotion dysregulation and hazardous drinking in relation to suicidal ideation among Spanish-speaking Latinx daily-smokers.

OBJECTIVE: Suicidal ideation has increased among Latinx individuals in the last decade. Smoking increases the likelihood of suicidal ideation but work on Latinx smokers is minimal. Hazardous drinking and emotion dysregulation could be factors related to suicidal ideation among Latinx smokers, as has been evident in non-Latinx White samples. The current study sought to examine the main and interactive effects of emotion dysregulation and hazardous drinking in relation to suicidal ideation among Latinx daily-smokers. METHODS: Participants were 371 Spanish-speaking daily-smokers (58.8% female; Mage = 33.3; SDage = 9.8) recruited from the United States through Qualtrics. We used structural equation modeling (SEM) to test an interactive model of emotion dysregulation and hazardous alcohol consumption in relation to suicidal ideation; we also tested the effect of emotion dysregulation on suicidal ideation as a function of hazardous drinking status. RESULTS: Results indicated that latent emotional dysregulation was associated with greater suicidal ideation (p < 0.001); however, hazardous drinking was not related to suicidal ideation (p = 0.186). The interactive term of emotional dysregulation and hazardous drinking was significantly related to suicidal ideation (p = 0.017). Specifically, greater emotion dysregulation was significantly related to suicidal ideation among Latinx smokers who engaged in hazardous drinking (p < 0.001) but not those who did not engage in hazardous drinking (p = 0.123). CONCLUSIONS: The current findings suggest that smoking combined with hazardous drinking may be related to increased suicidal ideation among Latinx smokers. Findings are discussed in relation to the potential role of intervention strategies that focus on emotion dysregulation and hazardous drinking among Latinx current daily smokers to mitigate suicidal risk among this established health disparities population.

Pain severity as a predictor of negative affect following a self-guided quit attempt: An ecological momentary assessment study.

BACKGROUND: Past work has documented bidirectional associations between pain and cigarette smoking behaviors such that those who smoke evidence greater pain, and those in pain tend to smoke more. However, such work has not focused on the role of pain in relation to negative affect, which plays an important role during cessation attempts. OBJECTIVE: The current study evaluated pain as a predictor of negative affect as well as level of interference associated with negative affect among individuals undergoing a self-guided quit attempt. METHODS: Study variables were assessed via ecological momentary assessment (EMA) during the 2 weeks following a self-guided quit attempt. Participants included 54 daily smokers (33.3% female; Mage = 34.7, SD = 13.9). RESULTS: There were statistically significant within-person associations of pain ratings with negative affect and interference due to negative affect, such that greater pain was associated with higher levels of each dependent variable. Additionally, there was a within-person effect of smoking status (i.e., smoking vs. abstinence, measured via EMA) on negative affect, but not ratings of interference; smoking was associated with greater negative affect. CONCLUSION: These findings highlight the importance of bodily pain in relation to negative mood following a quit attempt. Clinically, the results suggest a greater focus on the experience of pain during quit attempts may be warranted.

Anxiety sensitivity and rumination: Transdiagnostic factors involved in the relation between subjective social status and anxiety and depressive symptoms and disorders among economically disadvantaged Latinos in primary care.

Latinos face striking physical and mental health disparities. One factor associated with such disparities is subjective social status, reflecting subjective ratings of social standing. Yet there is presently a lack of empirical information about the mechanisms underlying relations between subjective social status and anxiety and depressive symptoms and disorders among Latinos in community medical services that serve as focal catchment areas for assessment and intervention programming. The present investigation examined the unique explanatory roles of 2 transdiagnostic factors, rumination and anxiety sensitivity, in the relation between subjective social status and depressive, suicidal, social anxiety, and anxious arousal symptoms as well as anxiety/depressive disorders, among Latinos seeking health services at a primary health care facility. Participants included 253 Latino adults with annual incomes of less than $30,000 (M age = 39.1, SD = 11.1). Results indicated that rumination and anxiety sensitivity each significantly (independently) mediated associations between subjective social status and all dependent variables except suicidal symptoms. For suicidal symptoms, only rumination was a mediator. The present findings suggest that rumination and anxiety sensitivity may represent mechanisms for associations between subjective social status and anxiety and depressive symptoms and disorders among economically disadvantaged Latinos in primary care settings. (PsycINFO Database Record

Subjective social status and rumination in relation to anxiety and depressive symptoms and psychopathology among economically disadvantaged Latinos in primary care.

The present investigation examined the interactive effects of subjective social status and rumination in relation to anxiety/depressive symptoms and psychopathology among 276 Latinos (82% female; Mage = 39.2, SD = 11.1; 97.0% reported Spanish as first language) who attended a community-based primary health care clinic. Results indicated that the interaction between rumination and subjective social status was significantly associated with depression (B = -.04, t = -3.52, p < .001, 95% CI [-.06, -.02]), social anxiety (B = -.01, t = -3.84, p < .001, 95% CI [-.02, -.01]), and the number of mood and anxiety disorders (B = -.004, t = -2.80, p = .005, 95% CI [-.006, -.001]), after controlling for main effects of rumination and subjective social status. The form of the interactions suggested that the associations of rumination and the outcome variables were stronger for those with lower compared to higher subjective social status. For anxious arousal symptoms, however, there was not a statistically significant interaction. These findings underscore the potential importance of examining the interplay between rumination and subjective social status in regard to better understanding, and intervening to reduce, various forms of anxiety/depressive symptoms and disorders among Latinos in primary care settings. (PsycINFO Database Record

Anxiety Sensitivity and Age: Roles in Understanding Subjective Social Status among Low Income Adult Latinos in Primary Care.

One social determinant of health construct that is reliably related to health disparities among the Latino population is subjective social status, reflecting subjective ratings of social standing. Yet, little research has explored factors that may undergird variability in subjective social status among this population or in general. Accordingly, the present investigation examined one possible etiological model wherein age moderates the relation between individual differences in anxiety sensitivity (fear of the negative consequences of stress sensations) and subjective social status among a Latino primary care sample. Participants included Spanish-speaking Latino adults (n = 394; 86.5% female; average age = 39.0 years). Results demonstrated an interaction between the anxiety sensitivity and age for subjective social status among the Latino sample. Inspection of the form of the significant interaction indicated that the association between anxiety sensitivity and subjective social status was evident among older, but not younger, persons. The current findings suggest that decreasing anxiety sensitivity, especially among older Latinos, may be one possible viable therapeutic approach to change subjective social status in order to help offset health disparities among this group.

Anxiety sensitivity explains associations between anxious arousal symptoms and smoking abstinence expectancies, perceived barriers to cessation, and problems experienced during past quit attempts among low-income smokers.

Disproportionately more smokers report low-income and mental health problems relative to non-smokers. Low-income smokers may use smoking to alleviate negative emotional states resulting from exposure to multiple stressors. Yet, little work has been devoted to elucidating mechanisms that may explain the association between negative emotional states and smoking-related processes among low-income smokers. The present study sought to address this gap by examining anxiety sensitivity, a transdiagnostic factor related to both anxiety and smoking, as a potential mediator for the influence of anxiety symptoms on smoking-related processes, including threat-related smoking abstinence expectancies (somatic symptoms and harmful consequences), perceived barriers for cessation, and problems experienced during past quit attempts. Participants included treatment-seeking daily cigarette smokers (n=101; 68.3% male; Mage=47.1; SD=10.2). Results indicated that anxiety symptoms exerted a significant indirect effect through anxiety sensitivity for threat-related smoking abstinence expectancies (somatic symptoms and harmful consequences), perceived barriers for cessation, and problems experienced during past quit attempts. The present results provide empirical support that anxiety sensitivity may be an underlying mechanism that partially explains the relation between anxiety symptoms and smoking processes among low-income treatment-seeking smokers. Findings broaden current theoretical understanding of pathways through which anxiety symptoms contribute to maladaptive smoking processes and cognitions among socioeconomically disadvantaged smokers.

Transdiagnostic assessment of anxiety symptoms using the Anxiety Disorder Diagnostic Questionnaire - weekly version.

BACKGROUND: Norton and Robinson [2010. Development and evaluation of the anxiety disorder diagnostic questionnaire. Cognitive Behaviour Therapy, 39(2), 137-149. doi: 10.1080/16506070903140430 ] developed the Anxiety Disorder Diagnostic Questionnaire (ADDQ) as a transdiagnostic assessment of fear and anxiety to address problems in using diagnosis-specific measures as well as limitations with the extant transdiagnostic measures of anxiety. The present study validated a weekly version of the ADDQ, the Anxiety Disorder Diagnostic Questionnaire - Weekly (ADDQ-W) allowing session-by-session transdiagnostic assessment of anxiety. METHOD: Data were a secondary analysis of 49 treatment-seeking outpatient adults from a previous clinical trial. The ADDQ-W was administered weekly over the course of 12-group therapy sessions. RESULTS: The ADDQ-W was a valid weekly measure and neither scores, F(2, 37) = 2.70, p = .08, nor trajectories of change, F(2, 37) = 0.31, p = .73, differed by primary diagnosis, though power was limited. Rate of ADDQ-W change was predictive of change in both primary diagnosis severity, t = 2.40, p = .02, ß = 0.32, and overall severity, t = 3.01, p < .01, ß = 0.36, at post-treatment. CONCLUSIONS: This study has established initial support for the use of the brief, easily scored, ADDQ-W for repeated assessment over treatment using a diagnostically heterogeneous clinical sample of treatment-seeking individuals.

Synergistic effects of pain intensity and anxiety sensitivity in relation to anxiety and depressive symptoms and disorders among economically disadvantaged latinos in a community-based primary care setting.

The present investigation examined the interactive effects of anxiety sensitivity and pain intensity in relation to anxious arousal, social anxiety, and depressive symptoms and disorders among 203 Latino adults with an annual income of less than $30,000 (84.4% female; Mage=38.9, SD=11.3 and 98.6% used Spanish as their first language) who attended a community-based primary healthcare clinic. As expected, the interaction between anxiety sensitivity and pain intensity was significantly related to increased anxious arousal, social anxiety, and depressive symptoms as well as number of depressive/anxiety disorder diagnoses. The form of the significant interactions indicated that participants reporting co-occurring higher levels of anxiety sensitivity and pain intensity evinced the greatest levels of anxious arousal, social anxiety, and depressive symptoms as well as higher levels of depressive and anxiety disorders. These data provide novel empirical evidence suggesting that there is clinically-relevant interplay between anxiety sensitivity and pain intensity in regard to a relatively wide array of anxiety and depressive variables among Latinos in a primary care medical setting.

Interactive effect of negative affectivity and anxiety sensitivity in terms of mental health among Latinos in primary care.

From a public health perspective, primary care medical settings represent a strategic location to address mental health disapirty among Latinos. Yet, there is little empirical work that addresses affective vulnerability processes for mental health problems in such settings. To help address this gap in knowledge, the present investigation examined an interactive model of negative affectivity (tendency to experience negative mood states) and anxiety sensitivity (fear of the negative consequences of aversive sensations) among a Latino sample in primary care in terms of a relatively wide range of anxiety/depression indices. Participants included 390 Latino adults (Mage=38.7, SD=11.3; 86.9% female; 95.6% reported Spanish as first language) from a primary care health clinic. Primary dependent measures included depressive, suicidal, social anxiety, and anxious arousal symptoms, number of mood and anxiety disorders, and disability. Consistent with prediction, the interaction between negative affectivity and anxiety sensitivity was significantly related to suicidal, social anxiety, and anxious arousal symptoms, as well as number of mood/anxiety diagnoses and disability among the primary care Latino sample. The form of the interactions indicated a synergistic effect, such that the greatest levels of each outcome were found among those with high negative affectivity and high anxiety sensitivity. There was a trending interaction for depressive symptoms. Overall, these data provide novel empirical evidence suggesting that there is a clinically-relevant interplay between anxiety sensitivity and negative affectivity in regard to the expression of anxiety and depressive symptoms among a Latino primary care sample.

Interactive Effect of Negative Affectivity and Rumination in Terms of Mental Health Among Latinos in Primary Care.

The present investigation examined the interactive effects of rumination and negative affectivity in relation to anxiety and depressive symptoms and psychopathology among 245 Latino adults (M age = 39.7, SD = 11.4; 86.9 % female; 97.6 % reported Spanish as their first language) attending a community-based primary healthcare clinic. As expected, there was a significant interaction between rumination and negative affectivity for depressive, suicidal, social anxiety, anxious arousal symptoms, number of mood and anxiety disorders, and disability among the primary care Latino sample. Inspection of the interaction forms indicated a high degree of conceptual similarity. Specifically, rumination was related to greater levels of suicidal symptoms, social anxiety, anxious arousal, number of mood and anxiety disorders, and disability among individuals with higher, but not lower, levels of negative affectivity. The form of the interaction for depressive symptoms was in line with this pattern, but more extreme; rumination was related to greater levels of depressive symptoms among individuals with both higher and lower levels of negative affectivity. Together, these data provide novel empirical evidence suggesting that there is clinically relevant interplay between rumination and negative affectivity in regard to a relatively wide array of anxiety and depressive variables among Latinos in a primary care medical setting.