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. 2021 Apr;44(2):187-201.
doi: 10.1007/s10865-020-00182-x. Epub 2020 Sep 27.

Effects of anxiety sensitivity on cannabis, alcohol, and nicotine use among adolescents: evaluating pathways through anxiety, withdrawal symptoms, and coping motives

Ashley A Knapp  1   2 , Nicholas P Allan  3 , Renee Cloutier  4 , Heidemarie Blumenthal  4 , Shahrzad Moradi  3 , Alan J Budney  5 , Sarah E Lord  5
Affiliations

Effects of anxiety sensitivity on cannabis, alcohol, and nicotine use among adolescents: evaluating pathways through anxiety, withdrawal symptoms, and coping motives

Ashley A Knapp et al. J Behav Med. 2021 Apr.

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: Adolescents; Alcohol; Anxiety; Anxiety sensitivity; Cannabis; Marijuana; Nicotine; Youth.

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Figures

Figures 1a-1b.
Figures 1a-1b.
Conceptualized indirect relations between AS and substance use outcomes. Conceptual model demonstrating the tested indirect pathways from AS to the substance use outcomes (alcohol, cannabis, cigarettes, electronic nicotine delivery systems). AS = Anxiety sensitivity.
Figures 2a-2b.
Figures 2a-2b.
Indirect relations between AS and alcohol use likelihood and log-transformed days using alcohol. Item-level indicators, error terms, and residual covariances are omitted from the figures for clarity. Solid lines indicate significant paths (p < .05). Dashed lines indicate nonsignificant paths (p > .05). Unstandardized B’s are reported for alcohol use likelihood and standardized βs are reported for log-transformed days using alcohol. AU = Alcohol use. DU = Days using.
Figures 3a-3b.
Figures 3a-3b.
Note. Indirect relations between AS and cannabis use likelihood and log-transformed days using cannabis. Item-level indicators, error terms, and residual covariances are omitted from the figures for clarity. Solid lines indicate significant paths (p < .05). Dashed lines indicate nonsignificant paths (p > .05). Unstandardized B’s are reported for cannabis use likelihood and standardized βs are reported for log-transformed days using cannabis. DU = Days using.
Figure 4.
Figure 4.
Indirect relations between AS and cigarette use likelihood. Item-level indicators, error terms, and residual covariances are omitted from the figures for clarity. Solid lines indicate significant paths (p < .05). Dashed lines indicate nonsignificant paths (p > .05). Unstandardized B’s are reported. CU = Cigarette use.
Figure 5.
Figure 5.
Indirect relations between AS and electronic nicotine delivery systems (ENDS) use likelihood. Item-level indicators, error terms, and residual covariances are omitted from the figures for clarity. Solid lines indicate significant paths (p < .05). Dashed lines indicate nonsignificant paths (p > .05). Unstandardized B’s are reported. eCU = ENDS use.
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