Anxiety sensitivity as a transdiagnostic risk factor for trajectories of adverse posttraumatic neuropsychiatric sequelae in the AURORA study

J Psychiatr Res, 2022 · DOI: 10.1016/j.jpsychires.2022.09.027 · Published: December 1, 2022

Simple Explanation

This study examines how anxiety sensitivity, or fear of anxious arousal, affects the development of neuropsychiatric issues after trauma. The research followed trauma survivors presenting to emergency departments to see if higher anxiety sensitivity led to more severe and persistent symptoms like PTSD, depression, and sleep problems. The findings suggest that anxiety sensitivity may be a useful indicator to identify individuals at risk for developing adverse posttraumatic neuropsychiatric sequelae.

Study Duration

8 weeks

Participants

2,269 trauma survivors

Evidence Level

Not specified

Key Findings

1
Elevated anxiety sensitivity in the immediate posttrauma period was associated with more severe and persistent trajectories of PTSD, depression, anxiety, pain, insomnia, and somatic symptoms.
2
The associations between anxiety sensitivity and adverse outcomes persisted even after accounting for various demographic, trauma-related, pre-trauma mental health-related, and personality-related factors.
3
There was no evidence for specificity or a qualitatively stronger relationship between AS and hyperarousal or anxiety-related constructs.

Research Summary

The study investigated the role of anxiety sensitivity (AS) as a predictor of adverse posttraumatic neuropsychiatric sequelae (APNS) in trauma survivors. Growth mixture modeling revealed distinct trajectories of APNS, including PTSD, pain, depression, anxiety, sleep disturbance, and somatic symptoms. The results suggest that AS is a transdiagnostic predictor of negative outcomes posttrauma, including PTSD, pain, depression, sleep disturbance, anxiety, and somatic symptoms.

Practical Implications

Risk Identification

Anxiety sensitivity can be used to identify individuals at higher risk of developing adverse posttraumatic neuropsychiatric sequelae after experiencing trauma.

Secondary Prevention

Since anxiety sensitivity is malleable, it can be targeted with brief interventions to potentially prevent or reduce the severity of posttraumatic symptoms.

Clinical Intervention

Targeting anxiety sensitivity with brief interventions in the immediate aftermath of trauma could mitigate the development of various impairing and distressing APNS ranging from PTSD to depression to pain.

Study Limitations

1
The study used a brief, 3-item measure of AS to accommodate the need to measure many constructs in this large study.
2
AS was measured in the two weeks posttrauma, rather than prior to trauma exposure.
3
Many trauma survivors do not present to emergency care, particularly those who have experienced traumas placing them at high risk for PTSD such as sexual assault

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