Anxiety sensitivity, controllability, and experiential avoidance and their relation to drug of choice and addiction severity in a residential sample of substance-abusing veterans

The aim of the present study was to evaluate anxiety-related psychological risk factors (e.g., anxiety sensitivity, perceived uncontrollability, emotional avoidance) and their relation to drug of choice and addiction severity in an inpatient residential substance abuse population. Fully detoxified veterans (N= 94) meeting criteria for Axis I substance abuse disorders were enrolled in a 28-day residential substance abuse treatment program and completed the following measures at intake and discharge : Anxiety Sensitivity Index, Body Sensations Questionnaire (BSQ), Acceptance and Action Questionnaire (AAQ), Beck Depression Inventory (BDI ; intake only), and the Anxiety Control Questionnaire (ACQ). Consistent with the expectation, veterans who reported more distress over bodily sensations (anxiety sensitivity, BSQ) and depressive symptoms (BDIJ were more likely to avoid experiencing negative affect (AAQ) and perceived themselves as lacking in control (ACQ). Further, extent of avoidance, and to a lesser extent, controllability, discriminated between participants as a function of primary and comorbid diagnostic status, whereas anxiety sensitivity did not. No relation was found between anxiety sensitivity and drug of choice, and relations between assessed psychological factors and domains of addiction severity were mixed. Findings suggest that heightened bodily sensitivity, emotional avoidance, and perceived uncontrollability are common sequelae of patients seeking residential substance abuse treatment, but they do not contribute uniquely to drug of choice and measures of addiction severity. Theoretical and treatment implications are discussed with particular emphasis on approaches that may increase coping with untoward bodily cues, decrease avoidance of negative affect, and improve patient's sense of personal control over their responses and the environment. (Editor's abstract.)