title: Anxiety sensitivity mediates the association between post-traumatic stress symptom severity and interoceptive threat-related smoking abstinence expectancies among World Trade Center disaster-exposed smokers.
abstract: BACKGROUND
  Anxiety sensitivity (fear of internal anxiety-relevant bodily sensations) is an individual difference variable that is associated with the development and maintenance of posttraumatic stress disorder (PTSD) and is also involved in the maintenance/relapse of smoking. Abstinence expectancies are crucial to smoking maintenance, yet, past work has not explored how PTSD symptom severity and anxiety sensitivity contribute to them.
  
  
  METHODS
  Participants were 122 treatment-seeking daily smokers (36.1% female; Mage=49.2, SD=9.7; cigarettes per day: M=18.3, SD=15.2) who were exposed to the World Trade Center disaster on September 11, 2001 and responded to an advertisement for a clinical smoking cessation trial. The indirect effect of anxiety sensitivity was tested in terms of the effect of PTSD symptom severity on smoking abstinence expectancies (i.e., anxiety sensitivity as a statistical mediator).
  
  
  RESULTS
  PTSD symptom severity was positively associated with interoceptive threat-related smoking abstinence expectancies: expecting harmful consequences (β=.33, p<.001) and somatic symptoms (β=.26, p=.007). PTSD symptom severity was also significantly associated with anxiety sensitivity (β=.27, p=.003). Anxiety sensitivity mediated the association between PTSD symptom severity and expectancies about the harmful consequences (β=.09, CI95%=.02-.21; ΔR(2)=.076) and somatic symptoms (β=.11, CI95%=.02-.24; ΔR(2)=.123) from smoking abstinence, with medium effect sizes (Κ(2)=.08 and .10, respectively).
  
  
  CONCLUSIONS
  These data document the role of PTSD symptoms in threat-based expectancies about smoking abstinence and suggest anxiety sensitivity may underlie the associations between PTSD symptom severity and abstinence expectancies.
authors: University of Houston, Department of Psychology, Houston, TX 77024, United States. Electronic address: sgfarris@uh.edu.
authors: Samantha G
authors: SG
authors: Farris
authors: University of Houston, Department of Psychology, Houston, TX 77024, United States.
authors: Daniel J
authors: DJ
authors: Paulus
authors: Stony Brook University, Department of Psychiatry, Stony Brook, NY 11794, United States.
authors: Adam
authors: A
authors: Gonzalez
authors: Stony Brook University, Department of Psychiatry, Stony Brook, NY 11794, United States.
authors: Brittain L
authors: BL
authors: Mahaffey
authors: Stony Brook University, Department of Psychiatry, Stony Brook, NY 11794, United States.
authors: Evelyn J
authors: EJ
authors: Bromet
authors: Stony Brook University, Department of Medicine, Stony Brook, NY 11794, United States.
authors: Benjamin J
authors: BJ
authors: Luft
authors: Stony Brook University, Department of Psychiatry, Stony Brook, NY 11794, United States.
authors: Roman
authors: R
authors: Kotov
authors: University of Houston, Department of Psychology, Houston, TX 77024, United States; The University of Texas MD Anderson Cancer Center, Department of Behavioral Science, Houston, TX 77030, United States.
authors: Michael J
authors: MJ
authors: Zvolensky
mesh_terms: D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D012720:Severity of Illness Index; D012907:Smoking; D016540:Smoking Cessation / Q000523:psychology* / Q000706:statistics & numerical data; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D023481:Terrorism / Q000523:psychology*; D014029:Tobacco Use Disorder / Q000523:psychology* / Q000534:rehabilitation
keywords: 9/11; Abstinence; Anxiety vulnerability; Expectancies; Nicotine dependence; Trauma