Effects of anxiety sensitivity on cannabis, alcohol, and nicotine use among adolescents: evaluating pathways through anx
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Effects of anxiety sensitivity on cannabis, alcohol, and nicotine use among adolescents: evaluating pathways through anxiety, withdrawal symptoms, and coping motives Ashley A. Knapp1,2 · Nicholas P. Allan3 · Renee Cloutier4 · Heidemarie Blumenthal4 · Shahrzad Moradi3 · Alan J. Budney2 · Sarah E. Lord2
Received: 17 December 2019 / Accepted: 5 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Anxiety sensitivity (AS) is a promising intervention target due to its relevance to negative health behaviors broadly, and substance use specifically. The aim of the current study was to evaluate the direct and indirect pathways through which elevated AS could relate to recent substance use among a national adolescent sample recruited via social-media. As predicted, AS was indirectly associated with greater likelihood of using alcohol, cigarettes, and electronic nicotine delivery systems in the past-month through anxiety symptoms. Regarding cannabis, AS was directly related to increased likelihood of past-month cannabis use; however, the indirect relation between AS and likelihood of past-month use via anxiety symptoms was not significant. Through chained indirect effects, AS was related positively to past-month alcohol and cannabis use via anxiety symptoms and coping-related motives, and through withdrawal symptoms and coping-related motives. Study findings can be used to generate hypotheses on potential pathways through which AS could prospectively relate to substance use among youth.
Keywords Anxiety sensitivity · Anxiety · Cannabis · Marijuana · Alcohol · Nicotine · Youth · Adolescents
Introduction Substance use is common among adolescents, and problematic use often co-occurs with other psychopathology (Brewer et al., 2017; Centers for Disease Control and Prevention, 2016). Indeed, co-occurring disorders consistently increase the risk for problematic substance use (e.g., earlier age of initiation, heavier use, and dependence) and are linked to poorer treatment outcomes (Rowe et al., 2004; Shane et al., 2003). Examination of transdiagnostic mechanisms that have the potential to reduce incidence and prevalence of substance use disorders along with co-occurring disorders is thus an important public health priority (Leventhal & Zvolensky, 2015). Anxiety sensitivity (AS) is a malleable, cognitive vulnerability factor concerning the fear of the negative 1
Department of Preventive Medicine, Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, 750 N. Lake Shore Dr. 10th Floor, Chicago, IL 60611, USA
2
Heidemarie Blumenthal [email protected]
Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, 46 Centerra Parkway, Lebanon, NH 03766, USA
3
Shahrzad Moradi [email protected]
Department of Psychology, Ohio University, Porter Hall 209, Athens, OH 45701, USA
4
Teen Stress and Alcohol Research Laboratory, Department of Psychology, University of North Texas, 1155 Union Circle
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