ANXIETY SENSITIVITY AS MODERATOR OF THE ASSOCIATION BETWEEN NICOTINE WITHDRAWAL AND PANIC-RELEVANT RESPONDING TO A CARBON DIOXIDE-ENRICHED AIR LABORATORY CHALLENGE A Dissertation Presented by Anka

Individuals high in anxiety sensitivity (AS), a cognitive risk factor denoting a fear of anxiety-related sensations (Reiss & McNally, 1985), may be at increased risk of misinterpreting nicotine withdrawal-relevant interoceptive cues as harmful, thus amplifying their risk for panic problems. This study tested the moderating role of AS on the association between nicotine withdrawal and panic-relevant responding to a carbon dioxide-enriched air laboratory challenge. Specifically, it was hypothesized that AS moderates the relation between nicotine withdrawal (group status) and responding to a carbon dioxide-enriched air procedure (controlling for anticipatory anxiety, gender, negative affectivity, number of axis I diagnoses, and average daily smoking rate), as indexed by: (1) level of anxiety focused on bodily sensations and intensity of panic attack symptoms; (2) skin conductance reactivity; and (3) level of behavioral avoidance of a future challenge. To test this hypothesis, 90 daily smokers (35 women; Mage = 28.87, SD = 12.12, Range = 18-60 years) were enrolled and enlisted to attend two study sessions. At the conclusion of the first session, participants were randomly assigned to one of two groups (12-hour nicotine deprivation or smoking ̳as usual‘). At the second scheduled session, participants in both groups underwent a 10% carbon dioxide-enriched air laboratory challenge to assess panic-relevant responding. Contrary to hypothesis, the AS by nicotine withdrawal (group status) interactive effect was not significantly predictive of post-challenge anxiety, panic attack symptoms, skin conductance reactivity, or behavioral avoidance. However, post hoc tests indicated that the AS by nicotine withdrawal (group status) interaction was significantly predictive of peri-challenge anxiety ratings. Furthermore, post hoc tests demonstrated that between-group (significant) differences in withdrawal symptoms diminished after the first assessment of the challenge session. Results are discussed in the context of the theoretical and clinical implications of the current work, limitations of the current study, and future directions for work relevant to this line of inquiry.