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Published in: International Journal of Behavioral Medicine 5/2020

01-10-2020 | Mood Disorders | Full length manuscript

Anxiety Sensitivity and Physical Inactivity in a National Sample of Adults with a History of Myocardial Infarction

Authors: Carmela Alcántara, Min Qian, Laura Meli, Ipek Ensari, Siqin Ye, Karina W. Davidson, Keith M. Diaz

Published in: International Journal of Behavioral Medicine | Issue 5/2020

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Abstract

Background

The psychological factors underlying physical inactivity in vulnerable cardiac adult populations remain understudied. Anxiety sensitivity, a cognitive vulnerability defined as fear of the physical, cognitive, and social consequences of anxiety, may be an important modifiable determinant of physical inactivity. We examined the association of anxiety sensitivity, and each anxiety sensitivity subscale (physical, cognitive, and social concerns), with physical inactivity in adults with a history of myocardial infarction (MI).

Methods

Using cross-sectional data from a nationally representative survey of adults (N = 1417) in the USA who reported a health professional diagnosis of MI, we used weighted logistic regression models to evaluate the association between anxiety sensitivity (overall, and each subscale) and physical inactivity (self-reported exercise 0–1 day/week), with adjustment for age, gender, race, education, number of MIs, and depression.

Results

Overall, 34.3% reported physical inactivity. Anxiety sensitivity was associated with greater odds of physical inactivity (OR = 1.01; 95% CI = 1.00, 1.02; p = .026). Of the subscales, only physical concerns were associated with physical inactivity (OR = 1.02; 95% CI = 1.01, 1.04; p = .008) in the final model. High vs. low fear of shortness of breath was most consistently associated with physical inactivity (OR = 1.49; 95% CI = 1.08, 2.06; p < .021).

Conclusion

Anxiety sensitivity, generally, and fear of the physical sensations of anxiety (i.e., “fear of shortness of breath”), specifically, are important correlates of physical inactivity in adults with a history of MI. Future research should replicate these findings and experimentally test whether cardiac rehabilitation interventions that include an adjunctive component targeting reduction of anxiety sensitivity overall, or specific somatic symptoms, improve physical activity in this population.
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Literature
1.
go back to reference Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics—2016 update: a report from the American Heart Association. Circulation. 2016;133(4):e38–360. Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics—2016 update: a report from the American Heart Association. Circulation. 2016;133(4):e38–360.
2.
go back to reference Virani SS, Alonso, A., Benjamin EJ, et al., Heart Disease and Stroke Statistics-2020 Update: A Report From the American Heart Association. Circulation. 2020;141(9):e139‐e596. Virani SS, Alonso, A.,  Benjamin EJ, et al., Heart Disease and Stroke Statistics-2020 Update: A Report From the American Heart Association. Circulation. 2020;141(9):e139‐e596. 
3.
go back to reference Mora S, Cook N, Buring JE, Ridker PM, Lee IM. Physical activity and reduced risk of cardiovascular events: potential mediating mechanisms. Circulation. 2007;116(19):2110–8.CrossRef Mora S, Cook N, Buring JE, Ridker PM, Lee IM. Physical activity and reduced risk of cardiovascular events: potential mediating mechanisms. Circulation. 2007;116(19):2110–8.CrossRef
4.
go back to reference Sesso HD, Paffenbarger RS Jr, Lee IM. Physical activity and coronary heart disease in men: the Harvard Alumni Health Study. Circulation. 2000;102(9):975–80.CrossRef Sesso HD, Paffenbarger RS Jr, Lee IM. Physical activity and coronary heart disease in men: the Harvard Alumni Health Study. Circulation. 2000;102(9):975–80.CrossRef
5.
go back to reference Kronish IM, Diaz KM, Goldsmith J, Moise N, Schwartz JE. Objectively measured adherence to physical activity guidelines after acute coronary syndrome. J Am Coll Cardiol. 2017;69(9):1205–7.CrossRef Kronish IM, Diaz KM, Goldsmith J, Moise N, Schwartz JE. Objectively measured adherence to physical activity guidelines after acute coronary syndrome. J Am Coll Cardiol. 2017;69(9):1205–7.CrossRef
6.
go back to reference Daly J, Sindone AP, Thompson DR, Hancock K, Chang E, Davidson P. Barriers to participation in and adherence to cardiac rehabilitation programs: a critical literature review. Prog Cardiovasc Nurs. 2002;17(1):8–17.CrossRef Daly J, Sindone AP, Thompson DR, Hancock K, Chang E, Davidson P. Barriers to participation in and adherence to cardiac rehabilitation programs: a critical literature review. Prog Cardiovasc Nurs. 2002;17(1):8–17.CrossRef
7.
go back to reference Salmon J, Owen N, Crawford D, Bauman A, Sallis JF. Physical activity and sedentary behavior: a population-based study of barriers, enjoyment, and preference. Health Psychol. 2003;22(2):178–88.CrossRef Salmon J, Owen N, Crawford D, Bauman A, Sallis JF. Physical activity and sedentary behavior: a population-based study of barriers, enjoyment, and preference. Health Psychol. 2003;22(2):178–88.CrossRef
8.
go back to reference Farris S.G., Abrantes AM, Bond DS, Stabile LM, Wu WC. Anxiety and fear of exercise in cardiopulmonary rehabilitation: patient and practitioner perspectives. J Cardiopulm Rehabil Prev. 2019;39(2):E9‐E13. Farris S.G., Abrantes AM, Bond DS, Stabile LM, Wu WC.  Anxiety and fear of exercise in cardiopulmonary rehabilitation: patient and practitioner perspectives.  J Cardiopulm Rehabil Prev. 2019;39(2):E9‐E13.
9.
go back to reference Farris SG, Bond DS, Wu WC, Stabile LM, Abrantes AM. Anxiety sensitivity and fear of exercise in patients attending cardiac rehabilitation. Ment Health Phys Act. 2018;15:22–6.CrossRef Farris SG, Bond DS, Wu WC, Stabile LM, Abrantes AM. Anxiety sensitivity and fear of exercise in patients attending cardiac rehabilitation. Ment Health Phys Act. 2018;15:22–6.CrossRef
10.
go back to reference Olatunji BO, Wolitzky-Taylor KB. Anxiety sensitivity and the anxiety disorders: a meta-analytic review and synthesis. Psychol Bull. 2009;135(6):974–99.CrossRef Olatunji BO, Wolitzky-Taylor KB. Anxiety sensitivity and the anxiety disorders: a meta-analytic review and synthesis. Psychol Bull. 2009;135(6):974–99.CrossRef
11.
go back to reference Reiss S, Peterson RA, Gursky DM, McNally RJ. Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behav Res Ther. 1986;24:1–8.CrossRef Reiss S, Peterson RA, Gursky DM, McNally RJ. Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behav Res Ther. 1986;24:1–8.CrossRef
12.
go back to reference McHugh RK. Domain-general and domain-specific strategies for the assessment of distress intolerance. Psychol Addict Behav. 2011;25(4):745–9.CrossRef McHugh RK. Domain-general and domain-specific strategies for the assessment of distress intolerance. Psychol Addict Behav. 2011;25(4):745–9.CrossRef
13.
go back to reference Smits JAJ, Otto MW, Powers MB, Baird SO. Anxiety sensitivity as a transdiagnostic treatment target. In Smits JAJ, Otto MW, Powers MB, Baird SO, editors. The Clinician's Guide to Anxiety Sensitivity Treatment and Assessment. London, United Kingdom: Academic Press; 2019. pp 1-8. . Smits JAJ, Otto MW, Powers MB, Baird SO. Anxiety sensitivity as a transdiagnostic treatment target. In  Smits JAJ, Otto MW, Powers MB, Baird SO, editors. The Clinician's Guide to Anxiety Sensitivity Treatment and Assessment. London, United Kingdom: Academic Press; 2019. pp 1-8. .
14.
go back to reference Horenstein A, Potter CM, Heimberg RG. How does anxiety sensitivity increase risk of chronic medical conditions? Clin Psychol Sci Pract. 2018;25(3):e12248.CrossRef Horenstein A, Potter CM, Heimberg RG. How does anxiety sensitivity increase risk of chronic medical conditions? Clin Psychol Sci Pract. 2018;25(3):e12248.CrossRef
15.
go back to reference Taylor S, Rabian B, Fedoroff IC, Anxiety sensitivity: progress, prospects, and challenges. In Taylor S, editor. Anxiety sensitivity: theory, research, and treatment of the fear of anxiety. Mahwah, NJ: L. Erlbaum Associates; 1999: pp. 339–353. Taylor S, Rabian B, Fedoroff IC, Anxiety sensitivity: progress, prospects, and challenges. In Taylor S, editor. Anxiety sensitivity: theory, research, and treatment of the fear of anxiety. Mahwah, NJ:  L. Erlbaum Associates; 1999: pp. 339–353.
16.
go back to reference Moshier SJ, Szuhany KL, Hearon BA, Smits JAJ, Otto MW. Anxiety sensitivity uniquely predicts exercise behaviors in young adults seeking to increase physical activity. Behav Modif. 2016;40(1–2):178–98.CrossRef Moshier SJ, Szuhany KL, Hearon BA, Smits JAJ, Otto MW. Anxiety sensitivity uniquely predicts exercise behaviors in young adults seeking to increase physical activity. Behav Modif. 2016;40(1–2):178–98.CrossRef
17.
go back to reference Smits JA, Tart CD, Presnell K, Rosenfield D, Otto MW. Identifying potential barriers to physical activity adherence: anxiety sensitivity and body mass as predictors of fear during exercise. Cogn Behav Ther. 2010;39(1):28–36. Smits JA, Tart CD, Presnell K, Rosenfield D, Otto MW. Identifying potential barriers to physical activity adherence: anxiety sensitivity and body mass as predictors of fear during exercise. Cogn Behav Ther. 2010;39(1):28–36. 
18.
go back to reference DeHaas R, Calamari JE, Bair JP, Martin ED. Anxiety sensitivity and drug or alcohol use in individuals with anxiety and substance use disorders. Addict Behav. 2001;26(6):787–801. DeHaas R, Calamari JE, Bair JP, Martin ED. Anxiety sensitivity and drug or alcohol use in individuals with anxiety and substance use disorders. Addict Behav. 2001;26(6):787–801. 
19.
go back to reference Alcantara C, Edmondson D, Moise N, Oyola D, Hiti D, Kronish IM. Anxiety sensitivity and medication nonadherence in patients with uncontrolled hypertension. J Psychosom Res. 2014;77(4):283–6. Alcantara C, Edmondson D, Moise N, Oyola D, Hiti D,  Kronish IM. Anxiety sensitivity and medication nonadherence in patients with uncontrolled hypertension. J Psychosom Res. 2014;77(4):283–6.
20.
go back to reference Frasure-Smith N, Lespérance F, Talajic M, Khairy P, Dorian P, O’Meara E, et al. Anxiety sensitivity moderates prognostic importance of rhythm-control versus rate-control strategies in patients with atrial fibrillation and congestive heart failure: insights from the Atrial Fibrillation and Congestive Heart Failure Trial. Circ Heart Fail. 2012;5(3):322–30.CrossRef Frasure-Smith N, Lespérance F, Talajic M, Khairy P, Dorian P, O’Meara E, et al. Anxiety sensitivity moderates prognostic importance of rhythm-control versus rate-control strategies in patients with atrial fibrillation and congestive heart failure: insights from the Atrial Fibrillation and Congestive Heart Failure Trial. Circ Heart Fail. 2012;5(3):322–30.CrossRef
21.
go back to reference Taylor S, Koch WJ, Woody S, McLean P. Anxiety sensitivity and depression: how are they related? J Abnorm Psychol. 1996;105(3):474–9.CrossRef Taylor S, Koch WJ, Woody S, McLean P. Anxiety sensitivity and depression: how are they related? J Abnorm Psychol. 1996;105(3):474–9.CrossRef
22.
go back to reference Otto MW, Eastman A, Lo S, et al. Anxiety sensitivity and working memory capacity: Risk factors and targets for health behavior promotion. Clin Psychol Rev. 2016;49:67‐78. Otto MW, Eastman A, Lo S, et al. Anxiety sensitivity and working memory capacity: Risk factors and targets for health behavior promotion. Clin Psychol Rev. 2016;49:67‐78. 
23.
go back to reference Farris SG, Abrantes AM. Anxiety sensitivity in smokers with indicators of cardiovascular disease. Psychol Health Med. 2017;22(8):961‐968. Farris SG, Abrantes AM. Anxiety sensitivity in smokers with indicators of cardiovascular disease. Psychol Health Med. 2017;22(8):961‐968. 
24.
go back to reference Roshanaei-Moghaddam B, Katon WJ, Russo J. The longitudinal effects of depression on physical activity. Gen Hosp Psychiatry. 2009;31(4):306–15.CrossRef Roshanaei-Moghaddam B, Katon WJ, Russo J. The longitudinal effects of depression on physical activity. Gen Hosp Psychiatry. 2009;31(4):306–15.CrossRef
25.
go back to reference Salmon P. Effects of physical exercise on anxiety, depression, and sensitivity to stress: a unifying theory. Clin Psychol Rev. 2001;21(1):33–61.CrossRef Salmon P. Effects of physical exercise on anxiety, depression, and sensitivity to stress: a unifying theory. Clin Psychol Rev. 2001;21(1):33–61.CrossRef
26.
go back to reference Eifert GH. Cardiophobia: a paradigmatic behavioural model of heart-focused anxiety and non-anginal chest pain [published correction appears in Behav Res Ther 1993 Sep;31(7):711]. Behav Res Ther. 1992;30(4):329‐345. Eifert GH. Cardiophobia: a paradigmatic behavioural model of heart-focused anxiety and non-anginal chest pain [published correction appears in Behav Res Ther 1993 Sep;31(7):711]. Behav Res Ther. 1992;30(4):329‐345.
27.
go back to reference Alcantara C, Giorgio Cosenzo LA, Fan W, Doyle DM, Shaffer JA. Anxiety sensitivity and racial differences in sleep duration: results from a national survey of adults with cardiovascular disease. J Anxiety Disord. 2017;48:102–8. Alcantara C, Giorgio Cosenzo LA, Fan W, Doyle DM, Shaffer JA. Anxiety sensitivity and racial differences in sleep duration: results from a national survey of adults with cardiovascular disease. J Anxiety Disord. 2017;48:102–8.
28.
go back to reference Schiller JS, Lucas JW, Ward BW, Peregoy JA. Summary health statistics for U.S. adults: National Health Interview Survey. Vital Health Stat 10. 2010;2012(252):1–207. Schiller JS, Lucas JW, Ward BW, Peregoy JA. Summary health statistics for U.S. adults: National Health Interview Survey. Vital Health Stat 10. 2010;2012(252):1–207.
29.
go back to reference Rivers, D. Sampling for web surveys. in Joint Statistical Meetings. 2007. Rivers, D. Sampling for web surveys. in Joint Statistical Meetings. 2007.
30.
go back to reference Peterson RA, Reiss S. Anxiety Sensitivity Index, 2nd ed. Worthington, OH: International Diagnostic Systems; 1992. Peterson RA, Reiss S. Anxiety Sensitivity Index, 2nd ed. Worthington, OH: International Diagnostic Systems; 1992.
31.
go back to reference Milton K, Bull FC, Bauman A. Reliability and validity testing of a single-item physical activity measure. Br J Sports Med. 2011;45(3):203–8.CrossRef Milton K, Bull FC, Bauman A. Reliability and validity testing of a single-item physical activity measure. Br J Sports Med. 2011;45(3):203–8.CrossRef
32.
go back to reference Kroenke K, Strine TW, Spitzer RL, Williams JBW, Berry JT, Mokdad AH. The PHQ-8 as a measure of current depression in the general population. J Affect Disord. 2009;114(1–3):163–73.CrossRef Kroenke K, Strine TW, Spitzer RL, Williams JBW, Berry JT, Mokdad AH. The PHQ-8 as a measure of current depression in the general population. J Affect Disord. 2009;114(1–3):163–73.CrossRef
33.
go back to reference Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13.CrossRef Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13.CrossRef
34.
go back to reference Dong Y, Peng CY. Principled missing data methods for researchers. Springerplus. 2013;2(1):222. Dong Y, Peng CY. Principled missing data methods for researchers. Springerplus. 2013;2(1):222.
35.
go back to reference Peterson, R.A. and K. Plehn, Measuring anxiety sensitivity. In Taylor S, editor. Anxiety sensitivity: theory, research, and treatment of the fear of anxiety. Mahwah, NJ: L. Erlbaum Associates; 1999: pp. 61–81. Peterson, R.A. and K. Plehn, Measuring anxiety sensitivity. In Taylor S, editor. Anxiety sensitivity: theory, research, and treatment of the fear of anxiety. Mahwah, NJ:  L. Erlbaum Associates; 1999: pp. 61–81.
36.
go back to reference Rector NA, Szacun-Shimizu K, Leybman M. Anxiety sensitivity within the anxiety disorders: disorder-specific sensitivities and depression comorbidity. Behav Res Ther. 2007;45(8):1967‐1975. Rector NA, Szacun-Shimizu K, Leybman M. Anxiety sensitivity within the anxiety disorders: disorder-specific sensitivities and depression comorbidity. Behav Res Ther. 2007;45(8):1967‐1975.
37.
go back to reference Tully PJ, Sardinha A, Nardi AE. A new CBT model of panic attack treatment in comorbid heart diseases (PATCHD): how to calm an anxious heart and mind. Cogn Behav Pract. 2017;24(3):329–41.CrossRef Tully PJ, Sardinha A, Nardi AE. A new CBT model of panic attack treatment in comorbid heart diseases (PATCHD): how to calm an anxious heart and mind. Cogn Behav Pract. 2017;24(3):329–41.CrossRef
Metadata
Title
Anxiety Sensitivity and Physical Inactivity in a National Sample of Adults with a History of Myocardial Infarction
Authors
Carmela Alcántara
Min Qian
Laura Meli
Ipek Ensari
Siqin Ye
Karina W. Davidson
Keith M. Diaz
Publication date
01-10-2020
Publisher
Springer US
Published in
International Journal of Behavioral Medicine / Issue 5/2020
Print ISSN: 1070-5503
Electronic ISSN: 1532-7558
DOI
https://doi.org/10.1007/s12529-020-09881-w

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