Development of an Anxiety Sensitivity (AS) Intervention for High-AS Individuals in Substance Use Disorders Treatment

Substance use disorders (SUDs) and anxiety disorders commonly co-occur, yet to date no empirically-supported treatments for this combination of disorders has been developed. One potential way of treating these issues simultaneously may be to target anxiety sensitivity (AS), which is a risk factor for development of both SUDs and problematic anxiety. The objectives of the current study were to develop and pilot test a brief treatment aimed at reducing AS and substance use. Twenty-one individuals concurrently participating in a community-based intensive outpatient SUD treatment program received six 1.5-h sessions of an AS-targeted intervention, primarily utilizing interoceptive exposures, cognitive challenging, and psychoeducation about the relationship between substance use and anxiety. At post-treatment, participants had significant reductions in AS as measured by the Anxiety Sensitivity Index ( d = 1.62; ASI; Reiss et al. in Behav Res Ther 24(1):1–8, 1986 ), and significant decreases in percent days abstinent from substances (Cohen’s d = 1.35). Average scores on the ASI at pre-treatment were in the clinical range ( M = 41.5, SD = 9.97) but had moved to the nonclinical range on the ASI at 3 months follow-up ( M = 20.8, SD = 9.39; intent to treat analysis). Participants had large reductions in the Depression–Anxiety–Stress Scale (Lovibond and Lovibond in Manual for the Depression Anxiety Stress Scales. Psychology Foundation Monograph, Sydney, 1995 ) anxiety subscale scores but remained in the moderate range on this subscale at follow-up. Subjective reports of both participants and therapists described the intervention as tolerable, effective, and desired. Results of the current open trial suggest that a relatively brief (<9 h) anxiety sensitivity intervention may be promising for reducing both anxiety sensitivity and in turn, frequency of substance use and anxiety symptoms.