Main and Interactive Effects of Anxiety Sensitivity and Physical Distress Intolerance with Regard to PTSD Symptoms Among Trauma-Exposed Smokers

Abstract

The present study examined the roles of anxiety sensitivity (AS; the tendency to misinterpret physical internal sensations of harmful) and distress tolerance (the capacity to tolerate aversive stimuli) in terms of the expression of posttraumatic stress disorder (PTSD) symptoms among a sample of trauma-exposed, treatment-seeking tobacco smokers (n = 137; M_age = 37.7 years, 48.2% female). It was hypothesized that higher AS and lower physical distress tolerance would interact to predict greater PTSD avoidance and hyperarousal symptoms. Results were partially consistent with this prediction. Specifically, there was a significant interactive effect of AS by physical distress tolerance in terms of PTSD hyperarousal symptom cluster severity. The form of the interaction was in the expected direction, with the highest levels of PTSD hyperarousal symptoms reported among smokers with higher levels of AS and a lower capacity to tolerate physical distress. Findings underscore the importance of considering AS and physical distress tolerance in terms of better understanding mechanisms underlying the expression of PTSD symptoms among trauma-exposed smokers.

• trauma
• PTSD
• smoking
• tobacco
• stress
• comorbidity

FUNDING

This work was supported by National Institutes of Health Grant No. R01 MH076629-01A1 awarded to Drs. Michael J. Zvolensky and Norman B. Schmidt. Ms. Farris was supported by a cancer prevention fellowship through the University of Texas MD Anderson Cancer Center, funded by National Cancer Institute Grant No. R25T-CA057730. The content of this article does not necessarily represent the official views of the National Cancer Institute or the National Institute of Mental Health. Please note that the funding sources had no other role other than to provide financial support.

Notes

1. 1. The current study uses the term PTSD symptom severity to refer to all levels of posttraumatic stress, including clinical and nonclinical (mild) symptomatology. It is important to note that 10% of the current sample met criteria for current PTSD.

2. 2. Exploratory analyses indicated that two subscales of the ASI-III (physical and cognitive concerns) interacted uniquely with breath holding to predict PDS–Hyperarousal symptoms.