Prospective relations between anxiety sensitivity and transdiagnostic anxiety following cognitive-behavioral therapy: Evidence from the Coordinated Anxiety Learning management trial. (August 2022)

• Record Type: Journal Article
• Authors: Hunt, Christopher; Campbell-Sills, Laura; Chavira, Denise; Craske, Michelle; Sherbourne, Cathy; Sullivan, Greer; Roy-Byrne, Peter; Stein, Murray B.; Bomyea, Jessica
• Is Part Of: Behaviour research and therapy. Volume 155(2022)
• Publication Date: 2022-08
• Subjects: Anxiety disorders -- Anxiety sensitivity -- Cognitive-behavioral therapy -- Longitudinal design -- Transdiagnostic; Cognitive therapy -- Periodicals; Psychotherapy -- Periodicals; 616.891
• DOI: 10.1016/j.brat.2022.104119
• Languages: English
• ISSNs: 0005-7967

Abstract

Abstract: Previous research has implicated reductions in anxiety sensitivity (AS) – the dispositional tendency to fear anxiety-related sensations – as critical to change during cognitive behavioral therapy (CBT) for anxiety. However, the relationship of AS to anxiety symptom remittance following CBT remains largely unknown. To address this gap, the current study evaluated prospective associations between AS and symptoms of various anxiety disorders following completion of the Coordinated Anxiety Learning and Management (CALM) study– a large clinical trial evaluating the efficacy of a brief, computer-facilitated CBT intervention for transdiagnostic anxiety within primary care. Participants were randomized to CALM ( n = 460) or a control treatment ( n = 501) and completed self-report measures of general and disorder-specific anxiety symptoms at pretreatment and at 6-month, 12-month, and 18-month follow-up. Longitudinal relations between AS and each anxiety measure across timepoints and within each treatment group were assessed using cross-lagged panel models. Results indicated that higher AS following CALM predicted greater anxiety symptoms at the subsequent timepoint for all anxiety symptoms except social anxiety symptoms. Higher anxiety following treatment also predicted later AS. These findings implicate AS as an indicator of transdiagnostic anxiety remittance and suggest that targeting AS could be useful for reducing clinical anxiety relapse following CBT. Highlights: Tested prospective relations between anxiety sensitivity (AS) and anxiety symptoms following CBT. Examined general anxiety and specific anxiety disorder symptoms as outcomes. Higher posttreatment AS predicted higher anxiety symptoms at later follow-up. Higher posttreatment anxiety symptoms also predicted higher AS at later follow-up. Predictive effects were less robust among those who received typical care.