Fear and avoidance of internal experiences among patients with substance use disorders and PTSD: the centrality of anxiety sensitivity.
This study evaluated anxiety sensitivity, cognitive avoidance, and alexithymia and their relationship to posttraumatic stress disorder (PTSD) and alcohol use indices concurrently and prospectively in an outpatient substance abuse treatment sample that screened positive for PTSD (N=58). Anxiety sensitivity accounted for substantial variance in the PTSD clusters, reexperiencing, avoidance, and hyperarousal, both concurrently and prospectively. Cognitive avoidance accounted for additional variance with concurrent PTSD avoidance symptoms. Anxiety sensitivity and cognitive avoidance were largely not associated with alcohol use indices. Alexithymia was largely redundant with cognitive avoidance and was, therefore, not included in the regression analyses. Theoretical and treatment implications of these findings are discussed in the context of individuals with dually diagnosed PTSD and substance abuse disorders.
Simpson
Tracy
T
VA Puget Sound Health Care System, Seattle Division, and the Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98108, USA. Tracy.Simpson@va.gov
Jakupcak
Matthew
M
Luterek
Jane A
JA
D000328:Adult; D000342:Affective Symptoms / Q000523:psychology*; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology*; D001007:Anxiety / Q000523:psychology*; D001362:Avoidance Learning; D015897:Comorbidity; D003674:Defense Mechanisms; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology*; D014728:Veterans / Q000523:psychology; D014861:Washington / Q000453:epidemiology