Category: Adult Anxiety
Anxiety sensitivity (AS), or the fear of anxious arousal, is a widely recognized multidimensional construct composed of three lower-order dimensions: physical, social, and cognitive concerns. Prior work focusing on AS cognitive concerns has indicated that this risk factor is causally related to both anxiety and depression. However, it is unclear whether the pathways from AS cognitive concerns to anxiety and depression are direct, or whether these relations occur indirectly. The current study was designed to examine whether an intervention targeting AS cognitive concerns led to reductions in depression symptoms through immediate reductions in AS cognitive concerns followed by reductions in anxiety symptoms or reductions in anxiety symptoms through immediate reductions in AS followed by reductions in depression symptoms. The study sample contained 74 community participants (M age = 30.77; SD = 14.16) with a primary mood or anxiety disorder. Participants were randomized to a brief 1 hour intervention targeting AS cognitive concerns (Cognitive Anxiety Sensitivity Treatment [CAST]; N = 37) or a control condition (Physical Health Education Training [PHET]; N = 37; PHET coded as 0, CAST as 1). AS was measured post-intervention, and anxiety and depression symptoms were measured at months 1 and 4 follow-ups, allowing for temporal precedence in the chained mediation models. All analyses were conducted controlling for baseline levels of the corresponding variables. There was a significant chained mediation effect from treatment to month 4 depression symptoms through post-intervention AS and month 1 anxiety (B = - .50, 95% confidence interval [CI; -1.70, -.03]) favoring participants in the CAST condition. In contrast, the chained mediation effect from treatment to month 4 anxiety was only significant through post-intervention AS (B = - 2.19, 95% CI [-5.03, -.11]), again favoring participants in the CAST condition. Results of the current study indicate that the CAST intervention successfully reduces both depression and anxiety symptoms. Depression symptoms at the 4-month level diminished through reductions in post-intervention AS cognitive concerns and then 1-month anxiety, whereas anxiety symptoms at the 4-month level diminished through post-intervention AS cognitive concerns only. Thus, it may be presumed that the relation between AS cognitive concerns and depression is not directly related. That is, AS indirectly reduces depression through reductions in anxiety, revealing the presence of significant chained mediation. These findings clarify the impact of AS interventions on anxiety and depression symptoms.