Skip to main content
Log in

Anxiety Sensitivity and the Situational Antecedents to Drug and Alcohol Use: An Evaluation of Anxiety Patients with Substance Use Disorders

  • Published:
Cognitive Therapy and Research Aims and scope Submit manuscript

Abstract

Although anxiety and substance use disorders co-occur at a high rate, little is known about the cause of this association. Relations between anxiety sensitivity (AS), posited to play an important role in the development of anxiety disorders and some substance use problems, the situational antecedents of drug and alcohol use, and substance preference, were evaluated in inpatients with anxiety or mood disorders and concurrent substance use disorders. AS predicted substance use even after controlling for variance attributable to trait anxiety and diagnostic status. AS was more strongly associated with the use of depressants in situations involving negative reinforcement. If AS proves to be a reliable risk factor for anxiety disorders co-occurring with substance use disorders, interventions structured to reduce AS would become important components of treatment and prevention programs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

    Google Scholar 

  • Annis, H. M. (1982). Inventory of Drinking Situations. Toronto, ON: Addiction Research Foundation.

    Google Scholar 

  • Annis, H. M., Graham, J., & Davis, C. (1987). Inventory of Drinking Situations. Toronto, ON: Addiction Research Foundation.

    Google Scholar 

  • Annis, H. M., & Martin, G. (1985). Manual: The Inventory of Drug Taking Situations. Toronto, ON: Addiction Research Foundation.

    Google Scholar 

  • Annis, H. M., Turner, N. E., & Sklar, S. M. (1996). Inventory of Drug Taking Situations: User's guide. Toronto, ON: Addiction Research Foundation.

    Google Scholar 

  • Ball, S. G., Otto, M. W., Pollack, M. H., Uccello, R., & Rosenbaum, S. J. (1995). Differentiating social phobia and panic disorder: A test of core beliefs. Cognitive Therapy and Research, 19,473–482.

    Google Scholar 

  • Beck, A. T., Ward, C. H., Mendelsohn, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 564–571.

    Google Scholar 

  • Boyle, B. S. (1967). Shipley—Institute of Living Scale. Los Angeles, CA: Western Psychological Association.

    Google Scholar 

  • Blanchard, J. J. (2000). The co-occurrence of substance use in other mental disorders: Editor's introduction. Clinical Psychology Review, 20(2), 145–148.

    Google Scholar 

  • Bruce, T. J., Speigel, D. A., Gregg, S. F., & Nuzzarello, A. (1995). Predictors of aprazolam discontinuation with and without cognitive behavior therapy in panic disorder. American Journal of Psychiatry, 156, 1156–1160.

    Google Scholar 

  • Cannon, D. S., Leeka, J. K., Patterson, E. T., & Baker, T. B. (1990). Principal component analysis of the Inventory of Drinking Situations: Empirical categories of drinking by alcoholics. Addictive Behaviors, 15, 265–269.

    Google Scholar 

  • Cappell, H., & Greeley, J. (1987). Alcohol and tension reduction: An update of research and theory. In H. T. Blane & K. E. Leonard (Eds.), Psychological theories of drinking and alcoholism (pp. 15–54). New York: Guilford.

    Google Scholar 

  • Carrigan, G., Samoluk, S. B., & Stewart, S. H. (1998). Examination of a short form of the Inventory of Drinking Situations in a young adult university student sample. Behavior Research and Therapy, 36, 789–807.

    Google Scholar 

  • Conger, J. J. (1956). Alcoholism: Theory, problem and challenge: II. Reinforcement theory and the dynamics of alcoholism. Quarterly Journal of Studies on Alcohol, 12, 1–29.

    Google Scholar 

  • Conrod, P. J., Pihl, R. O., & Vassileva, J. (1998). Differential sensitivity to alcohol reinforcement in groups of men at risk for distinct alcoholic syndromes. Alcoholism: Clinical and Experimental Research, 22(3), 585–597.

    Google Scholar 

  • Cooper,M. L., Frone,M. R., Russell, M., & Mudlar, P. (1995). Drinking to regulate positive and negative emotions: A motivational model of alcohol use. Journal of Personality and Social Psychology, 69(5), 990–1005.

    Google Scholar 

  • Cox, B. J., Endler, N. S., Norton, G. R., & Swinson, R. P. (1991). Anxiety sensitivity and nonclinical panic attacks. Behaviour Research and Therapy, 29, 367–369.

    Google Scholar 

  • Cox, B. J., Norton,G. R., Swinson, R. P., & Endler, N. S. (1990). Substance abuse and panic related anxiety: A critical review. Behaviour Research and Therapy, 28, 385–393.

    Google Scholar 

  • Cox, B. J., Swinson, R. P., Shulman, I. D., Kuch, K., & Reichman, J. T. (1993). Gender effects and alcohol use in panic disorder with agoraphobia. Behaviour Research and Therapy, 31, 413–416.

    Google Scholar 

  • Donnell, C. D., & McNally, R. J. (1990). Anxiety sensitivity and panic attacks in a nonclinical population. Behaviour Research Therapy, 28, 83–85.

    Google Scholar 

  • First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1996). Users guide for the structured clinical interview for DSM-IV Axis I disorders—research version (SCID-I, Version 2.0, February 1996 final version). New York: Biometrics Research.

    Google Scholar 

  • Gunnarsdottir, D. E., Pingitore, R. A., Spring, B. J., Konopka, L. M., Cryton, J. W., Milo, T., et al. (2000). Individual differences among cocaine users. Addictive Behaviors, 25, 641–652.

    Google Scholar 

  • Jaccard, J., Turrisi, R., & Wan, C. K. (1990). Interaction effects in multiple regression. Newbury Park, CA: Sage.

    Google Scholar 

  • Karp, J. (1993). The interaction of alcohol expectancies, personality, and psychopathology among inpatient alcoholics [Summary]. Dissertation Abstracts International, 53, 4375-B.

  • Kessler,R.C., Crum, R. M., Warner, L. A., Nelson,C.B., Schulenberg, J., & Anthony, J.C. (1997). Lifetime co-occurrence of DSM-III-R alcohol abuse and dependence with other psychiatric disorders in the National Comorbidity Survey. Archives of General Psychiatry, 54, 313–321.

    Google Scholar 

  • Kushner, M. G., Abrams, K., & Borchardt, C. (2000). The relationship between anxiety disorders and alcohol use disorders: A review of major perspectives and findings. Clinical Psychology Review, 20(2), 149–171.

    Google Scholar 

  • Kushner, M. G., Sher, K. J., & Beitman, B. D. (1990). The relation between alcohol problems and anxiety disorders. The American Journal of Psychiatry, 147(6), 685–695.

    Google Scholar 

  • MacDonald, A. B., Baker, J. M., Stewart, S. H., & Skinner, M. (2000). Effects of alcohol on the response to hyperventilation of participants high and low in anxiety sensitivity. Alcoholism: Clinical and Experimental Research, 24, 1656–1665.

    Google Scholar 

  • Maller, R. G., & Reiss, S. (1992). Anxiety sensitivity in 1984 and panic attacks in 1987. Journal of Anxiety Disorders, 6, 241–247.

    Google Scholar 

  • Marlatt, G. A. (1978). Craving for alcohol, loss of control, and relapse: A cognitive- behavioral analysis. In P. E. Nathan, G. A. Marlatt, & T. Lober (Eds.), Alcoholism: New directions in behavioral research and treatment (pp. 319–355). New York: Academic Press.

    Google Scholar 

  • McNally, R. J. (1996). Anxiety sensitivity is distinguishable from trait anxiety. In R. M. Rapee (Ed.), Current controversies in anxiety disorder research. New York: Guilford.

    Google Scholar 

  • McNally, R. J. (1999). Theoretical approaches to the fear of anxiety. In S. Taylor (Ed.), Anxiety sensitivity: Theory, research and treatment of the fear of anxiety (pp. 3–16). Mahwah, NJ: Erlbaum.

    Google Scholar 

  • Norton, G. R., Rockman, G. E., Ediger, J., Pepe, C., Goldberg, S., Cox, B. J., et al. (1997). Anxiety sensitivity and drug choice in individuals seeking treatment for substance abuse. Behaviour Research and Therapy, 35(9), 859–862.

    Google Scholar 

  • Otto,M.W., Pollack, M. H., Fava, M., Uccello, R., & Rosenbaum, J. F. (1995). Elevated anxiety sensitivity index scores in major depression: Correlates and changes with antidepressant treatment. Journal of Anxiety Disorders, 9, 117–123.

    Google Scholar 

  • Otto, M.W., & Reily-Harrington, N. A. (1999). The impact of treatment on anxiety sensitivity. In S. Taylor (Ed.), Anxiety sensitivity: Theory, research and treatment of the fear of anxiety (pp. 321–339). Mahwah, NJ: Erlbaum.

    Google Scholar 

  • Regier, D. A., Farmer, M. E., Rae, D. S., Locke, B. Z., Keith, S. J., Judd, L. L., et al. (1990). Comorbidity of mental disorders with alcohol and other drug abuse: Results from the Epidemiologic Catchment Area (ECA) Study. Journal of the American Medical Association, 264, 2511–2518.

    Google Scholar 

  • Reiss, S. (1987). Theoretical perspectives on the fear of anxiety. Clinical Psychology Review, 7, 585–596.

    Google Scholar 

  • Reiss, S. (1991). Expectancy model of fear, anxiety, and panic. Clinical Psychology Review, 11, 141–153.

    Google Scholar 

  • 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, CA: Academic Press.

    Google Scholar 

  • Reiss, S., Peterson, R. A., Gursky, D. M., & McNally, R. J. (1986). Anxiety sensitivity, anxiety frequency, and the prediction of fearfulness. Behavior, Research, and Therapy, 24, 1–8.

    Google Scholar 

  • Riemann, B. C., McNally, R. J., & Cox, W. M. (1992). The comorbidity of obsessive- compulsive disorder and alcoholism. Journal of Anxiety Disorders, 6, 105–110.

    Google Scholar 

  • Samoluk, S. B., & Stewart, S. H. (1998). Anxiety sensitivity and situation-specific drinking Journal of Anxiety Disorders, 12, 407–419.

    Google Scholar 

  • Schmidt, N.B., Lerew, D. R., & Jackson, R. J. (1997). The Role of AS in the Pathogenesis of panic: Prospective evaluation of spontaneous panic attacks during acute stress. Journal of Abnormal Psychology, 106, 355–364.

    Google Scholar 

  • Schmidt, N. B., Lerew, D. R., & Jackson, R. J. (1999). Prospective evaluation of anxiety sensitivity in the pathogenesis of panic: Replication and extension. Journal of Abnormal Psychology, 108(3), 532- 538.

  • Schmidt, N. B., Lerew, D. R., & Joiner, T. E. (1998). Anxiety sensitivity and the pathogenesis of anxiety and depression: Evidence for symptom specificity. Behaviour Research and Therapy, 36, 165–177.

    Google Scholar 

  • Spielberger, C. D., Gorsuch, R. K., Luchene, R., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the State- Trait Anxiety Inventory (form Y). Palo Alto, CA: Consulting Psychologists Press.

    Google Scholar 

  • Stewart, S. H. (1996). Alcohol abuse in individuals exposed to trauma: A critical review. Psychological Bulletin, 120, 83–112.

    Google Scholar 

  • Stewart, S. H., Karp, J., Pihl, R.O., & Peterson, R. A. (1997). Anxiety sensitivity and self-reported reasons for drug use. Journal of Substance Use, 9, 223–240.

    Google Scholar 

  • Stewart, S. H., & Pihl, R. O. (1994). The effects of alcohol administration on psychophysiological and subjective-emotional responses to aversive stimulation in anxiety sensitive women. Psychology of Addictive Behaviors, 8, 29–42.

    Google Scholar 

  • Stewart, S. H., Samoluk, S. B., & MacDonald, A. B. (1999). Anxiety sensitivity and substance use/abuse. In S. Taylor (Ed.), Anxiety sensitivity: Theory, research, and treatment of the fear of anxiety. Mahwah, NJ: Erlbaum.

    Google Scholar 

  • Stewart, S. H., Taylor, S., & Baker, J. M. (1997). Gender differences in dimensions of anxiety sensitivity. Journal of Anxiety Disorders, 11, 179–200.

    Google Scholar 

  • Stewart, S. H., & Zeitlin, S. B. (1995). Anxiety sensitivity and alcohol use motives. Journal of Anxiety Disorders, 9, 229–240.

    Google Scholar 

  • Swendsen, J. D., & Merikangas, K. R. (2000). The comorbidity of depression and substance use disorders. Clinical Psychology Review, 20(2), 173–189.

    Google Scholar 

  • Taylor, S., Koch, W. J., & McNally, R. J. (1992). How does anxiety sensitivity vary across the anxiety disorders? Journal of Anxiety Disorders, 6, 249–259.

    Google Scholar 

  • Telch, M. J., Lucas, J. A., & Nelson, P. (1989). Non-clinical panic in college students: An investigation of prevalence and symptomatology. Journal of Abnormal Psychology, 98, 300–306.

    Google Scholar 

  • Turner, N. E., Annis H. M., & Sklar, S. M. (1997). Measurement of antecedents to drug and alcohol use: Psychometric properties of the Inventory of Drug Taking Situations (IDTS). Behaviour Research and Therapy, 35(5), 465–483.

    Google Scholar 

  • Wilson, G. T. (1988). Alcohol and anxiety. Behaviour Research and Therapy, 26, 369–381.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

DeHaas, R.A.B., Calamari, J.E. & Bair, J.P. Anxiety Sensitivity and the Situational Antecedents to Drug and Alcohol Use: An Evaluation of Anxiety Patients with Substance Use Disorders. Cognitive Therapy and Research 26, 335–353 (2002). https://doi.org/10.1023/A:1016076911164

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1016076911164

Navigation