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International Journal of Behavioral Medicine

Erschienen in:

24.06.2020 | Full length manuscript

The Role of Distress Tolerance as a Potential Mechanism Between Anxiety Sensitivity and Gut-Specific Anxiety

verfasst von: Casey D. Wright, Cecelia I. Nelson, Jamey T. Brumbaugh, Daniel W. McNeil

Erschienen in: International Journal of Behavioral Medicine | Ausgabe 6/2020

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Abstract

Background

The link between anxiety/fear and gut dysfunction has been robustly documented in both physical and mental health literatures. The current study explored distress tolerance as a potential mechanism in the relation between anxiety sensitivity and gut-specific anxiety.

Method

A cross-sectional sample of 828 adults completed measures of distress tolerance, gut-specific anxiety, and anxiety sensitivity. Multiple linear regression analyses were conducted to determine variable associations, including potential mediating factors.

Results

The results demonstrated a bidirectional relation between anxiety sensitivity and gut-specific anxiety (ß = 0.23, p < 0.001; ß = 0.22, p < 0.001). Findings suggest distress tolerance is a significant mediator that may partially explain the relation between gut-specific anxiety and anxiety sensitivity more broadly (ß = 0.11, CI [0.07–0.14]). Mediation results were consistent when individual subscales of distress tolerance or anxiety sensitivity were incorporated.

Conclusion

The outcome of the present study merits additional examination of the psychosomatic nature of distress tolerance as a potential clinical target for individuals with both anxiety and gut-related disorders.

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Fear and stress also are likely involved; the terminology in describing these states is inexact, so “anxiety” will be used as an omnibus term for the purposes of this paper (see Felicione et al. [7]).

Moderation models also were conducted. Distress tolerance was not a statistically significant moderator in the relation between anxiety sensitivity and gut-specific anxiety while accounting for covariates.

Everhart JE. The burden of digestive diseases in the United States. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Washington, DC: US Government Printing Office, 2008; NIH Publication No. 09–6443.

Peery AF, Dellon ES, Lund J, Crockett SD, McGowan CE, Bulsiewicz WJ, et al. Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology. 2012;143(5):1179–87.CrossRefPubMed

Jones MP, Maganti K. Symptoms, gastric function, and psychosocial factors in functional dyspepsia. J Clin Gastroenterol. 2004;38(10):866–72.CrossRefPubMed

Martin CR, Osadchiy V, Kalani A, Mayer EA. The brain-gut-microbiome axis. Cellular and Molecular Gastroenterology and Hepatology. 2018;6(2):133–48.CrossRefPubMedPubMedCentral

Windgassen S, Moss-Morris R, Chilcot J, Sibelli A, Goldsmith K, Chalder T. The journey between brain and gut: a systematic review of psychological mechanisms of treatment effect in irritable bowel syndrome. Br J Health Psychol. 2017;22(4):701–36.CrossRefPubMed

Rieder R, Wisniewski PJ, Alderman BL, Campbell SC. Microbes and mental health: a review. Brain Behav Immun. 2017;66:9–17.CrossRefPubMed

Felicione NJ, Blank MD, Wright CD, McNeil DW. Pain, fear, anxiety, and stress: relation to beta-endorphins. In: Kerr P, Sirbu C, editors. Opioids from inside out: scientific foundations and clinical innovations of endogenous opioid research. Springer; in press.

Bouchoucha M, Hejnar M, Devroede G, Babba T, Bon C, Benamouzig R. Anxiety and depression as markers of multiplicity of sites of functional gastrointestinal disorders: a gender issue? Clinics and Research in Hepatology and Gastroenterology. 2013;37(4):422–30.CrossRefPubMed

Fond G, Loundou A, Hamdani N, Boukouaci W, Dargel A, Oliveira J, et al. Anxiety and depression comorbidities in irritable bowel syndrome (IBS): a systematic review and meta-analysis. Eur Arch Psychiatry Clin Neurosci. 2014;264(8):651–60.CrossRefPubMed

10.

Hazlett-Stevens H, Craske MG, Mayer EA, Chang L, Naliboff BD. Prevalence of irritable bowel syndrome among university students: the roles of worry, neuroticism, anxiety sensitivity and visceral anxiety. J Psychosom Res. 2003;55(6):501–5.CrossRefPubMed

11.

Gros DF, Antony MM, McCabe RE, Lydiard RB. A preliminary investigation of the effects of cognitive behavioral therapy for panic disorder on gastrointestinal distress in patients with comorbid panic disorder and irritable bowel syndrome. Depression and Anxiety. 2011;28(11):1027–33.CrossRefPubMed

12.

Reigada LC, Polokowski AR, Walder DJ, Szigethy EM, Benkov KJ, Bruzzese JM, et al. Treatment for comorbid pediatric gastrointestinal and anxiety disorders: a pilot study of a flexible health sensitive cognitive-behavioral therapy program. Clinical Practice in Pediatric Psychology. 2015;3(4):314–26.CrossRef

13.

Labus JS, Bolus R, Chang L, Wiklund I, Naesdal J, Mayer EA, et al. The Visceral Sensitivity Index: development and validation of a gastrointestinal symptom-specific anxiety scale. Aliment Pharmacol Ther. 2004;20(1):89–97.CrossRefPubMed

14.

Reiss S, Peterson RA, Gursky DM, McNally RJ. Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behav Res Ther. 1986;24(1):1–8.CrossRefPubMed

15.

Labus JS, Mayer EA, Chang L, Bolus R, Naliboff BD. The central role of gastrointestinal-specific anxiety in irritable bowel syndrome: further validation of the visceral sensitivity index. Psychosom Med. 2007;69(1):89–98.CrossRefPubMed

16.

Foster JA, Neufeld KA. Gut–brain axis: how the microbiome influences anxiety and depression. Trends Neurosci. 2013;36(5):305–12.CrossRefPubMed

17.

Drossman DA, Toner BB, Whitehead WE, Diamant NE, Dalton CB, Duncan S, et al. Cognitive-behavioral therapy versus education and desipramine versus placebo for moderate to severe functional bowel disorders. Gastroenterology. 2003;125(1):19–31.CrossRefPubMed

18.

Gaylord SA, Palsson OS, Garland EL, Faurot KR, Coble RS, Mann JD, et al. Mindfulness training reduces the severity of irritable bowel syndrome in women: results of a randomized controlled trial. Am J Gastroenterol. 2011;106(9):1678–88.CrossRefPubMedPubMedCentral

19.

Simons JS, Gaher RM. The Distress Tolerance Scale: development and validation of a self-report measure. Motiv Emot. 2005;29(2):83–102.CrossRef

20.

Brown RA, Lejuez CW, Kahler CW, Strong DR, Zvolensky MJ. Distress tolerance and early smoking lapse. Clin Psychol Rev. 2005;25(6):713–33.CrossRefPubMedPubMedCentral

21.

Buckner JD, Keough ME, Schmidt NB. Problematic alcohol and cannabis use among young adults: the roles of depression and discomfort and distress tolerance. Addict Behav. 2007;32(9):1957–63.CrossRefPubMed

22.

Bornovalova MA, Gratz KL, Daughters SB, Hunt ED, Lejuez CW. Initial RCT of a distress tolerance treatment for individuals with substance use disorders. Drug Alcohol Depend. 2012;122(1–2):70–6.CrossRefPubMed

23.

Brown TA, Chorpita BF, Barlow DH. Structural relationships among dimensions of the DSM-IV anxiety and mood disorders and dimensions of negative affect, positive affect, and autonomic arousal. J Abnorm Psychol. 1998;107(2):179–92.CrossRefPubMed

24.

Schmidt NB, Mitchell M, Keough M, Riccardi C. Anxiety and its disorders. Distress tolerance: theory, research, and clinical applications 2011:105–125.

25.

Keough ME, Riccardi CJ, Timpano KR, Mitchell MA, Schmidt NB. Anxiety symptomatology: the association with distress tolerance and anxiety sensitivity. Behav Ther. 2010;41(4):567–74.CrossRefPubMedPubMedCentral

26.

Zvolensky MJ, Bernstein A, Vujanovic AA, editors. Distress tolerance: theory, research, and clinical applications. Guilford Press; 2011.

27.

Bannaga AS, Selinger CP. Inflammatory bowel disease and anxiety: links, risks, and challenges faced. Clin Exp Gastroenterol. 2015;8:111–7.PubMedPubMedCentral

28.

Shah E, Rezaie A, Riddle M, Pimentel M. Psychological disorders in gastrointestinal disease: epiphenomenon, cause or consequence? Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology. 2014;27(3):224–30.

29.

Zvolensky MJ, Vujanovic AA, Bernstein A, Leyro T. Distress tolerance: theory, measurement, and relations to psychopathology. Curr Dir Psychol Sci. 2010;19(6):406–10.CrossRefPubMedPubMedCentral

30.

Wright CD. Fear of pain across the adult lifespan. West Virginia University Research Repository 2018.

31.

Buhrmester M, Kwang T, Gosling SD. Amazon’s Mechanical Turk: a new source of inexpensive, yet high-quality data? Perspect Psychol Sci. 2016;6(1):3–5.CrossRef

32.

Taylor S, Zvolensky MJ, Cox BJ, Deacon B, Heimberg RG, Ledley DR, et al. Robust dimensions of anxiety sensitivity: development and initial validation of the Anxiety Sensitivity Index-3. Psychol Assess. 2007;19(2):176–88.CrossRefPubMed

33.

Hayes AF. Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. Guilford Publications; 2017.

34.

Dunsmoor JE, Paz R. Fear generalization and anxiety: behavioral and neural mechanisms. Biol Psychiatry. 2015;78(5):336–43.CrossRefPubMed

35.

Rende R, Plomin R. Diathesis-stress models of psychopathology: a quantitative genetic perspective. Appl Prev Psychol. 1992;1(4):177–82.CrossRef

36.

Wright CD, Tiani AG, Billingsley AL, Steinman SA, Larkin KT, McNeil DW. A framework for understanding the role of psychological processes in disease development, maintenance, and treatment: the 3P-disease model. Front Psychol. 2019;10:2498.CrossRefPubMedPubMedCentral

37.

Dimeff L, Linehan MM. Dialectical behavior therapy in a nutshell. The California Psychologist. 2001;34(3):10–3.

38.

Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and commitment therapy: model, processes and outcomes. Behav Res Ther. 2006;44(1):1–25.CrossRefPubMed

Titel: The Role of Distress Tolerance as a Potential Mechanism Between Anxiety Sensitivity and Gut-Specific Anxiety
verfasst von: Casey D. Wright
Cecelia I. Nelson
Jamey T. Brumbaugh
Daniel W. McNeil
Publikationsdatum: 24.06.2020
Verlag: Springer US
Erschienen in: International Journal of Behavioral Medicine / Ausgabe 6/2020
Print ISSN: 1070-5503
Elektronische ISSN: 1532-7558
DOI: https://doi.org/10.1007/s12529-020-09912-6

Springer Medizin

Abstract

Background

Method

Results

Conclusion

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