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. 2023 Jul;84(4):535-545.
doi: 10.15288/jsad.22-00257. Epub 2023 Apr 19.

Prospective Associations Between Anxiety Sensitivity, Distress Intolerance, Depressive Symptoms, and Indices of Alcohol and Cannabis Use Among Veterans

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Prospective Associations Between Anxiety Sensitivity, Distress Intolerance, Depressive Symptoms, and Indices of Alcohol and Cannabis Use Among Veterans

Kayleigh N McCarty et al. J Stud Alcohol Drugs. 2023 Jul.

Abstract

Objective: There is substantial evidence linking anxiety sensitivity and distress intolerance to depressive symptoms, and further evidence linking depressive symptoms to alcohol and cannabis use. However, the prospective indirect associations of anxiety sensitivity and distress intolerance with alcohol and cannabis use through depressive symptoms remain uncertain. Thus, the current study examined whether depressive symptoms mediated the associations between anxiety sensitivity and distress intolerance with alcohol and cannabis use frequency, quantity, and problems in a longitudinal sample of veterans.

Method: Participants (N = 361; 93% male; 80% White) were military veterans with lifetime cannabis use recruited from a Veterans Health Administration in the Northeastern United States. Eligible veterans completed three semi-annual assessments. Prospective mediation models were used to test for the effects of baseline anxiety sensitivity and distress intolerance on alcohol and cannabis use quantity, frequency and problems at 12 months via depressive symptoms at 6 months.

Results: Baseline anxiety sensitivity was positively associated with 12-month alcohol problems. Baseline distress intolerance was positively associated with 12-month cannabis use frequency and quantity. Baseline anxiety sensitivity and distress intolerance significantly predicted increased alcohol problems and cannabis use frequency at 12 months through depressive symptoms at 6 months. There were no significant indirect effects of anxiety sensitivity and distress intolerance on alcohol use frequency or quantity, cannabis use quantity, or cannabis problems.

Conclusions: Anxiety sensitivity and distress intolerance share a common pathway to alcohol problems and cannabis use frequency through depressive symptoms. Interventions focused on modulating negative affectivity may reduce cannabis use frequency and alcohol problems.

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Figures

Figure 1.
Figure 1.
Prospective mediation models. Mediation of the relation between anxiety sensitivity/distress intolerance and alcohol use frequency (Panel A), alcohol problems (Panel B), cannabis use frequency (Panel C), number of cannabis problems (Panel D), alcohol use quantity (Panel E), and cannabis use quantity (Panel F). a-path = arrow from anxiety sensitivity/distress intolerance to depressive symptoms; b-path = arrow from depressive symptoms to substance use outcome (e.g., alcohol problems); c-path = dotted line from anxiety sensitivity/distress intolerance to substance use outcome;ć-path = arrow from anxiety sensitivity/distress intolerance to substance use outcome. All models included baseline alcohol and cannabis use as covariates. BL = baseline; Mon. = months. *p < .05; **p < .01; ***p < .001.

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