The Role of Distress Tolerance as a Potential Mechanism Between Anxiety Sensitivity and Gut-Specific Anxiety
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The Role of Distress Tolerance as a Potential Mechanism Between Anxiety Sensitivity and Gut-Specific Anxiety Casey D. Wright 1
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Cecelia I. Nelson 1
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Jamey T. Brumbaugh 1 & Daniel W. McNeil 1,2
# International Society of Behavioral Medicine 2020
Abstract Background The link between anxiety/fear and gut dysfunction has been robustly documented in both physical and mental health literatures. The current study explored distress tolerance as a potential mechanism in the relation between anxiety sensitivity and gut-specific anxiety. Method A cross-sectional sample of 828 adults completed measures of distress tolerance, gut-specific anxiety, and anxiety sensitivity. Multiple linear regression analyses were conducted to determine variable associations, including potential mediating factors. Results The results demonstrated a bidirectional relation between anxiety sensitivity and gut-specific anxiety (ß = 0.23, p < 0.001; ß = 0.22, p < 0.001). Findings suggest distress tolerance is a significant mediator that may partially explain the relation between gut-specific anxiety and anxiety sensitivity more broadly (ß = 0.11, CI [0.07–0.14]). Mediation results were consistent when individual subscales of distress tolerance or anxiety sensitivity were incorporated. Conclusion The outcome of the present study merits additional examination of the psychosomatic nature of distress tolerance as a potential clinical target for individuals with both anxiety and gut-related disorders. Keywords Distress tolerance . Anxiety . Psychogastroenterology . Gut-specific anxiety . Health psychology
Introduction Digestive diseases affect more than 60 million individuals in the USA, with an annual cost burden of over $141 billion [1]. Abdominal pain is the leading gastrointestinal complaint in outpatient visits, followed closely by diarrhea, constipation, vomiting, nausea, and heartburn or indigestion [2]. Such maladaptive digestive symptomatology has demonstrated associations with psychosocial factors such as anxiety, fear, Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12529-020-09912-6) contains supplementary material, which is available to authorized users. * Casey D. Wright [email protected] * Daniel W. McNeil [email protected] 1
Department of Psychology, Eberly College of Arts and Sciences, West Virginia University, 53 Campus Drive, PO Box 6040, Morgantown, WV 26505, USA
2
Department of Dental and Rural Practice, School of Dentistry, West Virginia University, Morgantown, WV, USA
depression, and stress [3–5]. While these aversive emotional experiences interact with biological factors in digestive diseases [3, 6], these relations are not yet well-understood.
Anxiety and Gastrointestinal Distress Individuals with elevated anxiety1 have been shown to have exacerbated symptoms related to digestive disease [8]. On the other hand, anxiety and gut-specific anxiety often are comorbid results of functional [or other] gastrointestinal disorders [9, 10]. This distinct bidi
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