Objective: The suicide rate in the Unites States continues to increase suggesting novel intervention strategies are needed. Anxiety sensitivity (AS), or a fear of anxiety-related sensations, is a malleable suicide risk factor that can be substantially mitigated via a single-session, computerized intervention called the Cognitive Anxiety Sensitivity Treatment (CAST). Results from several randomized controlled trials have demonstrated that reductions in SI (SI) due to CAST were mediated by reductions in AS. However, a more detailed analysis of the mechanisms of SI reduction due to AS interventions is needed to further our understanding of the theoretical models of AS and suicide, as well as how AS treatment might be refined.
Methods: Participants (N = 74) with co-occurring anxiety pathology and active SI were randomized to a single session computerized treatment (CAST + cognitive bias modification for AS) or a control intervention. Assessments were conducted immediately post treatment, and at 1 month and 4 month follow-ups.
Results: There were no simple mediation effects through either AS or anxiety or depressive symptoms on SI. Chained mediation models revealed significant reductions in SI (month 4 follow-up) through AS (post treatment) and subsequently cognitive symptoms of anxiety and cognitive symptoms of depression (month 1 follow-up).
Conclusions: Results of the current study help to clarify the mechanistic pathways of SI reduction due to an AS intervention, and suggest that future work attempting to increase the efficacy of AS interventions should consider the potentially important role of downstream mechanisms that follow AS reduction to achieve SI reduction.
Aaron Norr– Psychology Intern, VA Puget Sound - Seattle Division, Seattle, Washington
Nicholas Allan– Assistant Professor, Ohio University
Greg Reger– Psychologist, VA Puget Sound Health Care System, Seattle, Washington
Norman Schmidt– Professor, Florida State University