title: Anxiety sensitivity and negative urgency: a pathway to negative reinforcement-related smoking expectancies.
abstract: OBJECTIVE
  Anxiety sensitivity--fear of anxiety symptoms--may increase motivation to smoke by influencing the development of cognitive expectations regarding smoking's negative reinforcing effects; yet, the nature and mechanisms of this pathway are unclear. We hypothesized that relations between anxiety sensitivity and negative reinforcement-related smoking expectancies would be mediated by negative urgency, that is, a trait tendency to act impulsively during negative affect.
  
  
  METHODS
  In a cross-sectional design, we administered self-report measures of anxiety sensitivity, negative urgency, and negative reinforcement-related smoking outcome and abstinence expectancies to 205 smokers (≥10 cigarettes/d, 34% female, M age = 44.4 years).
  
  
  RESULTS
  Anxiety sensitivity was associated with stronger expectancies that smoking alleviates negative affect (β = 0.30; P < 0.0001) and smoking abstinence exacerbates aversive withdrawal symptoms (β = 0.24; P = 0.0004). Negative urgency partially mediated the relation between anxiety sensitivity and both types of negative reinforcement-related smoking expectancies (βs ≥ 0.057; Ps ≤ 0.007). Results remained significant after statistically controlling for anxiety and nicotine dependence symptoms.
  
  
  CONCLUSIONS
  Smokers high in anxiety sensitivity tend to display negative urgency, which in turn is related to greater expectations of negative reinforcement consequences of smoking and smoking abstinence. Treatments that mitigate fear of anxiety symptoms and the tendency to act impulsively in response to negative affect (eg, interoceptive exposure, distress tolerance skills training, and mindfulness training) may be particularly useful in assisting with smoking cessation for high-anxiety sensitivity smokers.
authors.affiliation: From the Department of Preventive Medicine (CRG, RDP, AML), University of Southern California Keck School of Medicine, Los Angeles; and Department of Psychology (AML), University of Southern California, Los Angeles.
authors.forename: Casey R
authors.initials: CR
authors.lastname: Guillot
authors.forename: Raina D
authors.initials: RD
authors.lastname: Pang
authors.forename: Adam M
authors.initials: AM
authors.lastname: Leventhal
mesh_terms: D000328:Adult; D059031:Anticipation, Psychological; D001007:Anxiety / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007175:Impulsive Behavior; D008297:Male; D008875:Middle Aged; D011581:Psychological Tests; D012054:Reinforcement, Psychology; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology; D013375:Substance Withdrawal Syndrome / Q000523:psychology; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000523:psychology; D055815:Young Adult