Browsing by Author "Asmundson, Gordon J.G."

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Open Access
An investigation of the factor structure and validity of a revised Pain Anxiety Symptoms Scale (PASS-R) in a university sample.
(Faculty of Graduate Studies and Research, University of Regina, 1998) McWilliams, Lachlan A.; Hadjistavropoulos, Thomas; Asmundson, Gordon J.G.
Open Access
Anxiety-related psychopathology and chronic pain comorbidity among public safety personnel
(Elsevier, 2018-03-28) Carleton, R. Nicholas; Afifi, Tracie O.; Taillieu, Tamara L.; Turner, Sarah; El-Gabalawy, Renée; Sareen, Jitender; Asmundson, Gordon J.G.
Canadian Public Safety Personnel (PSP; e.g., correctional service officers, dispatchers, firefighters, paramedics, police officers) regularly experience potentially traumatic, painful, and injurious events. Such exposures increase risk for developing mental disorders and chronic pain, which both involve substantial personal and social costs. The interrelationship between mental disorders and chronic pain is well-established, and both can be mutually maintaining; accordingly, understanding the relationship between mental health and chronic pain among PSP is important for improving health care. Unfortunately, the available research on such comorbidity for PSP is sparse. The current study was designed to provide initial estimates of comorbidities between mental disorders and chronic pain across diverse PSP. Participants included 5093 PSP (32% women) in six categories (i.e., Call Center Operators/Dispatchers, Correctional Workers, Firefighters, Municipal/Provincial Police, Paramedics, Royal Canadian Mounted Police) who participated in a large PSP mental health survey. The survey included established self-report measures for mental disorders and chronic pain. In the total sample, 23.1% of respondents self-reported clinically significant comorbid concerns with both mental disorders and chronic pain. The results indicated PSP who reported chronic pain were significantly more likely to screen positive for posttraumatic stress disorder (PTSD), major depressive disorder, generalized anxiety disorder, social anxiety disorder, and alcohol use disorder. There were differences between PSP categories; but, the most consistent indications of comorbidity were for chronic pain, PTSD, and major depressive disorder. Comorbidity between chronic pain and mental disorders among PSP is prevalent. Health care providers should regularly assess PSP for both symptom domains.
Open Access
Assessing the impact of the Royal Canadian Mounted Police (RCMP) protocol and Emotional Resilience Skills Training (ERST) among diverse public safety personnel
(BMC, 2022-12-09) Carleton, R. Nicholas; McCarron, Michelle; Krätzig, Gregory P.; Sauer-Zavala, Shannon; Neary, J. Patrick; Lix, Lisa M.; Fletcher, Amber J.; Camp, Ronald D.; Shields, Robyn, E.; Jamshidi, Laleh; Nisbet, Jolan; Maguire, Kirby Q.; MacPhee, Renée, S.; Afifi, Tracie O.; Jones, Nicholas A.; Martin, Ronald, R.; Sareen, Jitender; Brunet, Alain; Beshai, Shadi; Anderson, Gregory S.; Cramm, Heidi; MacDermid, Joy C.; Ricciardelli, Rosemary; Rabbani, Rasheda; Teckchandani, Taylor A.; Asmundson, Gordon J.G.
Public safety personnel (PSP; e.g., border services personnel, correctional workers, firefighters, paramedics, police, public safety communicators) are frequently exposed to potentially psychologically traumatic events. Such events contribute to substantial and growing challenges from posttraumatic stress injuries (PTSIs), including but not limited to posttraumatic stress disorder.
Open Access
Automatic versus strategic processing in chronic pain: An investigation of attentional bias.
(Faculty of Graduate Studies and Research, University of Regina, 1998) Snider, Bonnie Sue; Hadjistavropoulos, Thomas; Asmundson, Gordon J.G.
Open Access
Can a Single Bout of Aerobic Exercise Reduce Anxiety Sensitivity? A Randomized Controlled Trial
(Faculty of Graduate Studies and Research, University of Regina, 2014-07) LeBouthillier, Daniel Marc; Asmundson, Gordon J.G.; Carleton, R. Nicholas; Klest, Bridget; Watt, Margo C.
A growing body of research supports the benefits of exercise for a variety of mental disorders, including anxiety. Several mechanisms have been posited for the anxiolytic effects of exercise, including reductions in anxiety sensitivity (i.e., fear of arousalrelated sensations, based on the beliefs that these sensations may have harmful or negative consequences) through exposure to these feared bodily sensations. Studies on aerobic exercise lend support to this hypothesis; however, research comparing exercise to placebo controls and evidence for the dose-response relationship between exercise and reductions in anxiety sensitivity are lacking. The present trial was designed to investigate reductions in anxiety sensitivity following a single session of exercise. A total of 41 participants were randomized to complete either a 20-minute session of aerobic exercise or a placebo stretching control. Anxiety sensitivity was measured at baseline, immediately post-intervention, and at approximately 3-day and 7-day followup using the Anxiety Sensitivity Index-3 (ASI-3). Individuals in the aerobic exercise group experienced significant decreases in ASI-3 Total and on the Cognitive Concerns and Social Concerns dimensions from baseline to 3-day follow-up and on all four dimensions of anxiety sensitivity at 7-day follow-up. Individuals in the control group had increases in ASI-3 Total and Social Concerns scores from baseline to posttreatment, 3-day follow-up, and 7-day follow-up. Clinically significant change in ASI-3 Total scores was observed in several individuals in the aerobic exercise group, but not in the control group. The present trial included individuals with a wide range of anxiety sensitivity severity and the results suggest that reductions in anxiety sensitivity following aerobic exercise are not exclusive to individuals with high levels of the trait. Additionally, the magnitude of reduction in anxiety sensitivity did not vary according to individuals’ level of the trait at baseline. The results of the present trial have important implications for aerobic exercise as a potential adjunct to or temporary substitute for psychotherapy aimed at reducing anxiety.
Open Access
Can Cognitive Behavioural Techniques Reduce Exercise Anxiety and Improve Adherence to a Resistance Training Program for People with Anxiety-Related Disorders?
(Faculty of Graduate Studies and Research, University of Regina, 2021-04) Mason, Julia Elizabeth; Asmundson, Gordon J.G.; Hadjistavropoulos, Heather; Wright, Kristi; Neary, Patrick; Stewart, Sherry
Anxiety-related disorders (ARDs) are highly prevalent and associated with substantial functional impairment, including poor health outcomes and economic burden. Exercise is a cost-efficient alternative to other treatments for ARDs (e.g., psychotherapy, pharmaceutical) that is also associated with health benefits. Several exercise modalities, including resistance training (RT), have demonstrated efficacy at reducing symptoms of ARDs; however, there are challenges associated with effectively implementing such protocols, most notably, exercise avoidance or early discontinuation. Researchers have identified exercise anxiety (i.e., exercise-related worries, fear of exercise-related physical sensations, and anxiety-driven exercise-related behaviours) as a contributor to exercise avoidance for people with ARDs. Consequently, exercise-based interventions for people with ARDs may need to include strategies for helping these individuals cope with exercise anxiety to facilitate long-term exercise engagement. Cognitive-behavioural techniques (CBT), such as cognitive restructuring and exposure, can alter maladaptive thinking and behavioural patterns associated with ARDs. Teaching people how to apply CBT techniques to manage their exercise anxiety could improve both the efficacy and effectiveness of exercise-based interventions; however, research has not been conducted to test this hypothesis. The primary purpose of this randomized controlled trial (RCT) was to examine the effects of combining select modules from a transdiagnostic iteration of CBT with a RT program for people with ARDs. Primary outcomes included changes in exercise anxiety, disorder-specific anxiety-symptoms, exercise behaviour, physical activity, and general psychological distress. This RCT also evaluated potential predictors of exercise frequency. A total of 59 physically inactive (i.e., not meeting Canada’s Physical Activity Guidelines) participants who met Diagnostic and Statistical Manual of Mental Disorders 5th Edition criteria for at least one anxiety disorder, obsessivecompulsive disorder, or posttraumatic stress disorder were recruited. Participants were randomized into either RT + CBT, RT, or waitlist (WL). Each condition consisted of a month-long active phase and a three-month-long follow-up phase. During the active phase, participants in both RT groups received and followed a program supported by a certified personal trainer. This program consisted of three weekly RT sessions. During the active phase, participants in the RT + CBT group also met weekly with a clinical psychology doctoral student to learn CBT techniques. Primary measures were assessed at baseline, weekly during active phase, and at 1-week, 1-month, and 3-month follow-ups. Multilevel modelling was used for all analyses. Findings showed that as compared to both WL and RT, RT + CBT was associated with significantly greater reductions in disorderspecific symptoms, increased exercise behaviour and vigorous physical activity, and improved exercise self-efficacy. Comparable improvements in exercise anxiety and exercise motivation were noted for both RT and RT + CBT participants. In addition, exercise anxiety was identified as the best predictor of exercise frequency. This RCT is the first to evaluate strategies for helping people with ARDs exercise. Findings indicate both RT and RT + CBT can reduce exercise anxiety; however, the addition of CBT techniques may help facilitate improvements in exercise self-efficacy, reductions in disorder-specific anxiety, and increases in long-term exercise behaviour and vigorous physical activity. These techniques may be useful for researchers and clinicians alike in supporting individuals with ARDs interested in using exercise to cope with anxiety. Keywords: randomized controlled trial, anxiety-related disorders, resistance training, cognitive behavioural techniques, Unified Protocol, exercise adherence, physical activity.
Open Access
The Center for Epidemiologic Studies Depression Scale: A Review with a Theoretical and Empirical Examination of Item Content and Factor Structure
(Public Library of Science, 2013-03-01) Carleton, R. Nicholas; Thibodeau, Michel A.; Teale-Sapach, Michelle; Welch, Patrick G.; Abrams, Murray P.; Robinson, Thomas; Asmundson, Gordon J.G.
The Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977) is a commonly used freely available self-report measure of depressive symptoms. Despite its popularity, several recent investigations have called into question the robustness and suitability of the commonly used 4-factor 20-item CES-D model. The goal of the current study was to address these concerns by confirming the factorial validity of the CES-D.
Open Access
Chronic pain among public safety personnel in Canada
(Taylor and Francis Group, 2017-12-18) Carleton, R. Nicholas; Afifi, Tracie O.; Turner, Sarah; Taillieu, Tamara L.; El-Gabalawy, Renée; Sareen, Jitender; Asmundson, Gordon J.G.
Chronic pain is highly prevalent in the general population and may be even higheramong public safety personnel (PSP; e.g., correctional officers, dispatchers, firefighters, paramedics,police). Comprehensive data on chronic pain among diverse Canadian PSP are relatively sparse.Aims: The current study was designed to provide initial estimates of chronic pain frequencyand severity among Canadian PSP.
Open Access
Clarifying the Nature of Pain-Related Anxiety: Implications for Assessment and Treatment of Chronic Musculoskeletal Pain
(Faculty of Graduate Studies and Research, University of Regina, 2014-10) Abrams, Murray Peter; Asmundson, Gordon J.G.; Candow, Darren; Oriet, Christopher; Wright, Kristi; Keogh, Edmund
Pain-related anxiety and anxiety sensitivity (AS) are important constructs in fearanxiety- avoidance models of chronic pain (Asmundson, P. J. Norton, & Vlaeyen, 2004). Pain-related anxiety (McCracken & Gross, 1998) includes dimensions of cognitive anxiety (e.g., concentration difficulties as result of pain), behavioural avoidance, fearful thinking about pain, and physiological reactivity to pain (e.g., autonomic arousal, nausea). AS (Reiss, Peterson, Gursky, & McNally, 1986) is the trait tendency to fear the physiological sensations of anxiety due to the belief such sensations signal imminent harm. Evidence suggests an association between AS and pain-related anxiety (e.g., Muris, Schmidt, Merckelbach, & Schouten, 2001; P. J. Norton & Asmundson, 2003); however, the nature of this relationship remains unclear. An overlapping but empirically distinct relationship has been suggested (Carleton, Abrams, Asmundson, Antony, & McCabe, 2009) but there is also evidence pain-related anxiety may be a manifestation of AS (Greenberg & Burns, 2003). The current study sought to assess the posited view that pain-related anxiety may be an expression of AS. An experimental design was used in an attempt to extend the findings of Greenberg and Burns (2003) with a non-clinical analogue sample. Participants were healthy adults (N = 61, 62% women, M age = 31, SD = 11.45) who completed measures of pain-related anxiety, AS, social anxiety, fear of negative evaluation, and general negative affectivity (i.e., depression, trait anxiety). They underwent a pain induction task intended to elicit pain-related anxiety and a mental arithmetic task intended to elicit social-evaluative anxiety. Data gathered at baseline, during, and post-experimental tasks included (a) cardiovascular variables to provide indices of anxious arousal; (b) self-report measures of pain-related anxiety, social evaluative anxiety, and general negative affectivity; and (c) behavioural performance measures (i.e., correct answers on the mental arithmetic task, pain tolerance). Two hypotheses were tested: 1. Consistent with the view that pain-related anxiety may be a manifestation of AS, it was hypothesized that a measure of pain-related anxiety (i.e., Pain Anxiety Symptoms Scale-20[PASS-20]; McCracken & Dhingra, 2002) would significantly and substantively predict scores on post-task dependent measures for both the pain-related anxiety and social-evaluative anxiety induction tasks in regression models while controlling for effects of general negative affectivity; 2. It was hypothesized that the predictive effects of pain-related anxiety (PASS-20) on dependent measure scores would be accounted for by scores on a measure of AS (Anxiety Sensitivity Index-3 [ASI-3]; Taylor et al., 2007) in regression models. Neither of these hypotheses was supported. For the first hypothesis, results revealed that PASS-20 scores predicted positive variance in only the pain induction post-task measure of current painanxiety. Contrary to prediction, the PASS-20 did not account for variance in any of the mental arithmetic task dependent measures. For the second hypothesis, the results similarly failed to reject the null hypothesis. Despite exhibiting a high degree of correlation with the PASS-20, ASI-3 scores failed to account for positive variance in either the pain induction or mental arithmetic post-task dependent measures. Results indicated that AS was not associated with pain-related anxiety in a sample of participants not reporting current pain. These findings may lend support to the view that the apparently robust relationship observed between AS and pain-related anxiety among persons with chronic pain, may, in part, be a consequence of a persistent pain experience.
Open Access
Cognitions in Non Life-Threatening Traumatic Events
(Faculty of Graduate Studies and Research, University of Regina, 2012-07) Peluso, Daniel; Asmundson, Gordon J.G.; Smythe, William; Wright, Kristi; Liechty, Toni; Feeny, Norah C.
Posttraumatic stress disorder (PTSD) is a debilitating condition associated with diffuse impairment and distress. The onset of PTSD requires a traumatic stressor, an event in which an individual experienced or was confronted with death, serious injury, or threat to bodily integrity. An emerging research literature has demonstrated that some stressors, while not necessarily life-threatening (e.g., divorce), may provoke intense posttraumatic stress reactions and hallmark PTSD symptoms (e.g., flashbacks, sleep disturbance, emotional numbing; Carleton, Peluso, Collimore, & Asmundson, 2011). Associations between experiencing PTSD-like symptoms in response to non lifethreatening stressors have been documented; however, this area remains both controversial and relatively understudied. The purpose of the current study was to contribute to this emerging area of inquiry by exploring characteristic cognitions in non life-threatening trauma. Given that posttrauma cognitions have been implicated in the development and maintenance of PTSD, this study sought to determine the dimensions along which cognitions in non life-threatening traumatic events are organized. Individuals exposed to trauma, both life-threatening and non life-threatening, were recruited for this study. Both quantitative and qualitative methods of inquiry were used to elucidate the research question, each carried out in two separate phases. The quantitative analyses were largely descriptive in nature, providing data on the nature and severity of posttrauma cognitions and symptoms. Planned t-tests and analyses of variance indicated that individuals meeting criteria for PTSD caseness in response to non life-threatening events (n = 53) did not differ in the severity or content of posttrauma cognitions as compared to those with PTSD caseness from life-threatening trauma (n = 75). Subsequent to the quantitative phase, six participants endorsing a non life-threatening event as the worst event ever experienced completed a qualitative interview in order to obtain rich descriptions of posttrauma cognitions. Grounded theory analyses revealed the presence of five themes: trust, low self-worth, needing to find meaning, perceptions of social interactions, and thoughts about traumatic recurrence. Together, the current data suggest that life-threatening trauma and non life-threatening distressing life events can produce very similar types and severity of cognitions. Comprehensive results, theoretical implications of trauma, and future research directions are discussed.
Open Access
Comorbidity of Posttraumatic Stress Disorder and Social Anxiety Disorder: Implications for Diagnosis and Treatment
(Faculty of Graduate Studies and Research, University of Regina, 2016-12) McMillan, Katherine; Asmundson, Gordon J.G.; Martin, Ronald; Sareen, Jitender; Wright, Kristi; Hadjistavropoulos, Heather; Keane, Terrence
Posttraumatic stress disorder (PTSD) and social anxiety disorder (SAD) demonstrate a high degree of comorbidity. Indeed, rates of past-year SAD among individuals with PTSD have been shown to range from 14.8 to 46.0% within treatment-seeking and veteran samples (Collimore, Carleton, Hofmann, & Asmundson, 2010). Although PTSD and SAD are individually associated with negative mental health outcomes, preliminary data suggests that the co-occurrence of these disorders can result in a significant increase in distress and impairment beyond the impact of either disorder alone (Zayfert, DeViva, Hofmann, 2005). Despite accumulating evidence that PTSD and SAD frequently co-occur, and growing interest into the nature and correlates of these disorders, little is known about the nature of this association. Contemporary research has largely been conducted using treatment-seeking or veteran samples which may not generalize to the population as a whole. In addition, studies of the impact of trauma type have largely focused on the impact of sexual abuse, ignoring large variability in the experience of trauma. Large-scale epidemiological studies are needed to fill existing gaps in the literature and to clarify the nature of this association within a representative sample of the general population. As such, the current dissertation examined the relationship between PTSD and SAD using Wave 2 of the National Epidemiological Survey of Alcohol and Related Conditions, a large, nationally-representative survey of American adults. A series of three thematically related studies were conducted in order to explore the nature and correlates of these frequently comorbid disorders. Study one examined patterns of trauma exposure among those with comorbid DSM-IV PTSD and SAD (PTSD-SAD). Compared to those with PTSD alone (PTSD-no SAD) or SAD alone (SAD-no PTSD), those in the comorbid PTSD-SAD group were significantly more likely to report specific types of traumas from within the assaultive violence, childhood maltreatment, or other shocking events categories. Associations between PTSD-SAD comorbidity and childhood maltreatment were significant for females only. Study two examined the impact of PTSD-SAD comorbidity on PTSD symptom expression. Compared to those with PTSD-no SAD, those with comorbid SAD demonstrated elevated rates of specific PTSD symptoms within each criterion cluster, suggesting that the presence of SAD is associated with differences in the expression of PTSD symptoms. Multiple between sex differences were noted. Finally, study three examined the impact of PTSD-SAD comorbidity on SF-12 quality of life indicators and lifetime suicide attempts. Those in the comorbid PTSD-SAD group demonstrated an elevated risk of lifetime suicide attempts and lower levels of physical and mental quality of life compared to those with PTSD-no SAD and SAD-no PTSD. Results demonstrate the adverse impact of PTSD-SAD comorbidity on psychosocial functioning and provide indicators to enhance differential diagnosis and treatment planning.
Open Access
Daily survey participation and positive changes in mental health symptom scores among Royal Canadian Mounted Police Cadets
(Frontiers, 2023-08-04) Shields, Robyn, E.; Teckchandani, Taylor A.; Asmundson, Gordon J.G.; Nisbet, Jolan; Krakauer, Rachel L.; Andrews, Katie L.; Maguire, Kirby Q.; Jamshidi, Laleh; Afifi, Tracie O.; Lix, Lisa M.; Brunet, Alain; Sauer-Zavala, Shannon; Krätzig, Gregory P.; Neary, J. Patrick; Sareen, Jitender; Carleton, R. Nicholas
Introduction: Royal Canadian Mounted Police (RCMP) officers self-report high levels of mental health disorder symptoms, such as alcohol use disorder, generalized anxiety disorder, major depressive disorder, panic disorder, and posttraumatic stress disorder. Participation in regular mental health monitoring has been associated with improved mental health disorder symptom reporting and may provide an accessible tool to support RCMP mental health. The current study assessed relationships between self-reported mental health disorder symptoms and the completion of daily surveys (i.e., daily mental health disorder symptom monitoring) by RCMP cadets during the Cadet Training Program (CTP). Methods: Participants were RCMP cadets (n = 394; 76.1% men) in the Standard Training Program who completed the 26-week CTP and daily self-monitoring surveys, as well as full mental health assessments at pre-training (i.e., starting the CTP) and pre-deployment (i.e., ~2 weeks prior to deployment to the field). Symptoms of alcohol use disorder, generalized anxiety disorder, major depressive disorder, panic disorder, and posttraumatic stress disorder were assessed. Changes in mental health disorder symptom reporting from pre-training to pre-deployment were calculated. Spearman’s rank correlations were estimated for number of daily surveys completed and change in mental health disorder symptom scores between pre-training and pre-deployment. Results: There were statistically significant inverse relationships between number of daily surveys completed and number of mental health disorder symptoms reported; specifically, cadets who completed more daily surveys during CTP reported fewer symptoms of alcohol use disorder, generalized anxiety disorder, major depressive disorder, panic disorder, and posttraumatic stress disorder. Conclusion: An inverse correlation between number of daily surveys completed and mental health disorder symptom scores indicated that participation in daily mental health monitoring was associated with improvements in self-reported mental health disorder symptoms between pre-training and pre-deployment. Regular self-monitoring of mental health disorder symptoms may help to mitigate mental health challenges among RCMP cadets and officers.
Open Access
Demographic and cognitive risk factors for police mental disorder symptoms
(SAGE Publications, 2019-12-17) Korol, Stephanie; Vig, Kelsey D.; Teale-Sapach, Michelle; Asmundson, Gordon J.G.; Carleton, R. Nicholas
The current study was designed to assess whether cognitive risk factors (i.e. anxiety sensitivity (AS), intolerance of uncertainty (IU)) explained variance in mental disorder symptoms in Canadian police officers beyond variance explained by demographic variables (i.e. sex, marital status, education, years of service). Police participants (708 men; 271 women) completed measures assessing posttraumatic stress disorder, panic disorder, social anxiety disorder, major depressive disorder, generalized anxiety disorder, IU and AS. Multivariate analysis of variance demonstrated that only main effects of sex were significant for all symptom variables, except SAD. Hierarchical multiple regressions demonstrated that AS and IU accounted for greater variance than sex on all mental disorder symptom measures, which suggests that cognitive risk factors explain more variance in mental disorder symptoms than sex. Efforts to reduce AS and IU may be beneficial for improving police mental health.
Open Access
Development of Scales that Measure Disorder Specific Intolerance of Uncertainty
(Faculty of Graduate Studies and Research, University of Regina, 2013-11) Thibodeau, Michel Albert; Asmundson, Gordon J.G.; Carleton, R. Nicholas; Wright, Kristi; Martin, Ronald R.; Radomsky, Adam
Evidence supports intolerance of uncertainty as an important feature of anxiety-based disorders and the construct may also play a role in major depressive disorder. Measures of intolerance of uncertainty have furthered understanding of the construct; however, existing questionnaires measure intolerance of uncertainty in a generalist fashion, not assessing the actual focus of uncertainty (e.g., what someone with panic disorder is uncertain about). This gap in research precludes conclusions regarding the nature of intolerance of uncertainty in anxiety-based disorders and major depressive disorder. The first objective of the study was to develop scales measuring disorder-specific intolerance of uncertainty (DSIU) for generalized anxiety disorder, social anxiety disorder, obsessivecompulsive disorder, posttraumatic stress disorder, health anxiety, panic disorder, specific phobia, and major depressive disorder. The second objective was to explore the relative contribution of DSIU to symptom severity beyond general (or non-specific) intolerance of uncertainty. The study included 920 university students from the University of Regina (n=360, 78% women, mean age=20.89) and the University of Houston (n=560, 86% women, mean age=22.94). Participants completed a bank of 137 items assessing DSIU and also completed symptom measures. Exploratory factor analyses and item characteristic curves highlighted items that warranted discard (addressing objective 1). Path analysis was conducted to explore the relationships between the constructs of interest (addressing objective 2). Exploratory factor analyses supported eight distinct factors across the DSIU items, reflecting the eight proposed scales. DSIU items generally did not crossload onto other DSIU scales or with items from symptom measures; however, items from the DSIU posttraumatic stress disorder scale overlapped substantially with the posttraumatic stress disorder symptoms measure. Examination of item characteristic curves demonstrated that most items measured the latent traits of interest along their full continuum; however, DSIU items for major depressive disorder and panic disorder did not discriminate between lower and medium levels of the latent traits. The finalized DSIU scales included an average of eight items and number of items ranged from 13 (social anxiety disorder) to six (specific phobia). The finalized scales exhibited excellent internal consistency in both samples (α.=86 to α.=95). Non-specific intolerance of uncertainty and DSIU predicted unique variance in symptoms of all disorders. DSIU and non-specific intolerance of uncertainty predicted symptoms of generalized anxiety disorder (β=31 vs. β=45), obsessive-compulsive disorder (β=40 vs. β=41), health anxiety (β=32 vs. β=45), specific phobia (β=22 vs. β=27), and major depressive disorder (β=32 vs. β=39) to a similar extent. DSIU predicted symptoms of social anxiety disorder (β=72 vs. β=18), panic disorder (β=60 vs. β=11) and posttraumatic stress disorder (β=61 vs. β=28) to a greater extent than non-specific intolerance of uncertainty. Individuals with social anxiety disorder, panic disorder, and posttraumatic stress disorder may be concerned primarily with uncertainty regarding situations specific to their symptoms (e.g., social situations in individuals with social anxiety disorder). Individuals with other disorders may also be relatively intolerant of uncertainty regarding other matters of every day life. Differences between these disorders related to DSIU may have implications for theories of how the disorders develop and how they are treated. Novel research using the DSIU scales is needed to further understanding of how DSIU and non-specific intolerance of uncertainty interact to underlie or exacerbate disorders.
Open Access
Does Exercise Prevent Exacerbation of Anxiety-Related Vulnerability Factors Following An Analogue Stressor: A Randomized Controlled Trial
(Faculty of Graduate Studies and Research, University of Regina, 2019-12) Krakauer, Rachel Lauren; Asmundson, Gordon J.G.; Carleton, R. Nicholas; Beshai, Shadi; Watt, Margo C.
The most common mental disorders are anxiety-related disorders (Andlin-Sobocki & Wittchen, 2005). The diathesis-stress model of psychopathology explains that stressors interact with vulnerability factors to influence the development of anxiety-related disorders (Monroe & Simmons, 1991); therefore, modifying vulnerability factors before a stressor occurs may reduce or prevent anxiety. Researchers have observed significant reductions in anxiety-related vulnerability factors following as little as a single session of exercise (Asmundson et al., 2013), suggesting exercise effectively targets vulnerability factors. Research is needed to investigate whether exercise interventions implemented prior to a stressful event can target anxiety-related vulnerability factors, thereby protecting against future anxiety or distress. The current randomized controlled trial assessed whether exercise could prevent elevations in measures of anxiety-related vulnerability factors following a stressful exposure. A nonclinical sample of community adults was randomly assigned to complete a 30-minute exercise protocol on a stationary bike (experimental condition) or lightly stretch for 30 minutes (placebo control condition). All participants subsequently watched a traumatic film clip used as an analogue stressor. Participants completed measures of anxiety-related vulnerability factors—state and trait anxiety, anxiety sensitivity (AS), distress tolerance (DT), and intolerance of uncertainty (IU)—at baseline, after exercise, after the analogue stressor, and at 3-day and 7-day follow-ups. Participants in the experimental group did not report statistically significantly lower scores on measures of vulnerability factors compared to the placebo control group. Overall, vulnerability factor scores were relatively stable across time. Effects of time were observed, demonstrating anxiolytic effects of physical activity that protected both groups against elevations in putative anxiety-related vulnerability factors. The results offer initial support for the efficacy of both exercise and stretching control to prevent elevations in AS, IU, state anxiety, trait anxiety, and reductions in DT, although analyses may have been underpowered. The current trial offers practical implications for individuals who regularly experience potentially traumatic events, as well as community adults who deal with minor daily stressors.
Open Access
The Efficacy of Aerobic Exercise and Resistance Training for Anxiety-Related Disorders and Constructs: A Randomized Controlled Trial
(Faculty of Graduate Studies and Research, University of Regina, 2017-07) LeBouthillier, Daniel Marc; Asmundson, Gordon J.G.; Wright, Kristi; Carleton, Nick; Candow, Darren; Stewart, Sherry
Anxiety-related disorders are highly prevalent and comorbid, affecting nearly one third of individuals over their lifetime. Evidence suggests that anxiety-related disorders share common etiology, latent structure, higher-order dimensions, and response to treatment. These similarities have fostered the development of transdiagnostic treatments that can effectively target a relatively wide array of anxiety-related psychopathological concerns and can also be widely and efficiently disseminated to individuals in need treatment. There is empirical evidence to support the use of physical activity, primarily aerobic exercise, as an effective intervention to treat a variety of mental health concerns; however, what effect exercise has on anxiety-related disorders and constructs (e.g., anxiety sensitivity) using an integrative, transdiagnostic approach is unknown. Therefore, the purposes of the current trial were: (1) to quantify the effects of aerobic exercise and resistance training on symptoms of anxiety-related disorders and constructs, (2) to evaluate whether both modalities of exercise were equally efficacious in reducing such symptoms, and (3) to determine whether exercise enjoyment and pre-intervention physical fitness were associated with symptom reduction. A total of 48 individuals with anxiety-related disorders were randomized to one of three conditions: aerobic exercise, resistance training, or a waitlist control. Symptoms of anxiety-related disorders, related constructs (i.e., general psychological distress, depression, anxiety, stress, anxiety sensitivity, distress tolerance, intolerance of uncertainty), and exercise enjoyment were assessed at pre-intervention and weekly during the 4-week intervention. Participants were further assessed 1-week and 1-month post-exercise. Both aerobic exercise and resistance training were efficacious in improving disorder status. Additionally, aerobic ii exercise was efficacious in improving general psychological distress and anxiety, while resistance training was efficacious in improving disorder-specific symptoms, anxiety sensitivity, distress tolerance, and intolerance of uncertainty. For both types of exercise, lower pre-intervention physical fitness was associated with greater reductions in general psychological distress. For aerobic exercise, lower physical fitness was also associated with greater reductions in stress. Scores at follow-up were generally not significantly different when compared to post-intervention. Results highlight the efficacy of aerobic exercise and resistance training in uniquely addressing anxiety-related disorder symptoms and constructs. Keywords: randomized controlled trial; transdiagnostic; anxiety disorders; aerobic exercise; resistance training
Open Access
An Examination of Attentional Bias for Threat in a Motor Vehicle Accident Survivors with Posttraumatic Stress Disorder
(Faculty of Graduate Studies and Research, University of Regina, 2014-07) Duranceau, Sophie; Carleton, R. Nicholas; Asmundson, Gordon J.G.; Oriet, Chris; Riemann, Bradley C.
Theoretical models of anxiety suggest that cognitive vulnerabilities are involved in the development and maintenance of posttraumatic stress disorder (PTSD; Elwood, Hahn, Olatunji, & Williams, 2009). Attentional bias for threat has been identified as a cognitive vulnerability which may facilitate the development and maintenance of PTSD (Bomyea, Risbrough, & Lang, 2012). Several cognitive tasks have previously been used to assess attentional bias for threat in anxiety pathologies (i.e., emotional Stroop task, visual search task, dot probe task). The proposed investigation was designed to assess the directionality (i.e., facilitated attention, difficulty in disengagement, avoidance) and time-course of attentional bias for threat in motor vehicle accident (MVA) survivors using a contemporary dot probe task. Participants included MVA survivors with high PTSD symptoms (n = 18), MVA survivors with low PTSD symptoms (n = 46), and a control group with no history of MVA or PTSD (n = 64) recruited across North America. Results suggest that MVA survivors reporting high PTSD symptoms display a different attentional pattern than individuals without such symptoms during the early stages of cognitive processing. Specifically, MVA survivors with high PTSD symptoms 1) easily disengage their attention from MVA-related threat and, contrary to individuals without PTSD symptoms, 2) fail to engage with generally threatening stimuli. A lack of engagement with threatening stimuli could interfere with the processing and re-appraisal of threat, in turn contributing to the exacerbation of PTSD symptoms. Attention bias modification programs could be useful for the treatment of PTSD. Comprehensive results, methodological considerations, implications, and future research are discussed.
Open Access
Examining Changes in Posttraumatic Stress Disorder Symptoms and Substance Use Among a Sample of Canadian Veterans Working with Service Dogs: An Exploratory Patient- Oriented Longitudinal Study
(VT Publishing, 2021-02-08) Williamson, Linzi; Dell, Colleen Anne; Osgood, Nathaniel; Charlmers, Darlene; Lohnes, Chris; Carleton, R. Nicholas; Asmundson, Gordon J.G.
Comorbid posttraumatic stress disorder (PTSD) and substance use (SU) is a growing health concern among Canadian veterans. Veterans are increasingly seeking symptom relief for PTSD and comorbid SU by engaging service dogs (SDs). Despite promising results, the efficacy of SDs in aiding veterans warrants further investigation. An exploratory patientoriented, longitudinal, time-series, mixed-methods research design was employed with a sample of five Canadian veterans matched with SDs from AUDEAMUS, Inc. PTSD and SU were measured at six time points over 1 year with the Posttraumatic Stress Disorder Checklist for the Diagnostic and Statistical Manual for Mental Disorders, 5th Edition (PCL-5), Drug Use Screening Inventory Revised Substance Use Subscale (DUSI-R SU), and one-onone semi-structured interviews. There were clinically significant decreases in the veterans’ PTSD scores with the PCL-5. Interview content complemented these results. Veterans offered accounts of ways in which their SDs directly supported and helped manage their PTSD and related symptoms. While DUSI-R SU scale changes were non-significant, during interviews each veteran reported a decrease in their use of opioids and alcohol, while some reported an increase in their use of medical cannabis. However, veterans also highlighted ways in which their SDs sometimes contributed to increases in their PTSD and related symptoms, as well as their SU. This was particularly evident during the early stages of training and bonding. This study makes an important contribution to the emerging field examining the potential benefit of SDs for veterans diagnosed with PTSD. Additionally, this study is novel in its identification of the SDs beneficial contributions to veterans’ comorbid problematic use of substances.
Open Access
Exploring item order in anxiety-related constructs: Practical impacts of serial position
(2012-04) Carleton, R. Nicholas; Thibodeau, Michel A.; Osborn, Jason A.; Asmundson, Gordon J.G.
The present study was designed to test for item order effects by measuring four distinct constructs that contribute substantively to anxiety-related psychopathology (i.e., anxiety sensitivity, fear of negative evaluation, injury/illness sensitivity, and intolerance of uncertainty). Participants (n = 999; 71% women) were randomly assigned to complete measures for each construct presented in one of two modalities: (a) items presented cohesively as measures or (b) items presented randomly interspersed with one another. The results suggested that item order had a relatively small impact on item endorsement, response patterns, and reliabilities. The small impact was such that item order appears unlikely to influence clinical decisions related to these measures. These findings not only have implications for these and other similar measures, but further inform a long-standing debate about whether item grouping is a substantial concern in measurement.
Open Access
Exploring Police Officers' Susceptibility to Posttraumatic Stress and Growth After Trauma
(Faculty of Graduate Studies and Research, University of Regina, 2017-06) Horswill, Samantha Christine; Asmundson, Gordon J.G.; Carleton, R. Nicholas; Klest, Bridget; Jones, Nicholas; Watt, Margo
Traumatic exposure is a frequently-occurring facet of policing, yet relatively little research has been done on posttraumatic outcomes in Canadian federal and municipal officers. Given that posttraumatic stress disorder (PTSD) in police populations represents a significant health concern and economic burden, clarifying risk and resilience factors for posttraumatic adversity or resilience would inform screening, training, assessment, and treatment for Canadian police. The current dissertation presents cross-sectional, mixed-methods data investigating the relationship between psychosocial variables (i.e., anxiety sensitivity, intolerance of uncertainty, childhood adversity, personality, work disengagement, hope, optimism, perceived social support) and trauma-related outcomes (i.e., PTSD, posttraumatic growth, anxiety, depression) in a sample of 500 RCMP and municipal officers deployed in Saskatchewan. Written feedback from a subset of the sample was analyzed using qualitative thematic network analysis to triangulate the quantitative findings. Within the sample, 25% of RCMP officers and 12% of municipal officers met criteria for probable PTSD. Mean comparisons with external samples indicated the RCMP participants reported greater PTSD severity than undergraduate or community samples, whereas the municipal participants reported lower or equivalent severity relative to undergraduate and community samples. Both groups reported lower PTSD severity than American military and veteran samples. Several psychosocial variables were statistically significantly (p<.05) associated with PTSD (i.e., high AS, high IU, low social support, low optimism) and posttraumatic growth (i.e., greater PTSD severity, low agreeableness, more adverse childhood experiences) for both RCMP and municipal participants. In addition, high neuroticism and high AS were associated with greater anxiety symptoms, whereas high AS, low optimism, and decreased work engagement were associated with greater depression symptoms. Unique relationships between psychosocial variables and the trauma-related outcome variables for either the RCMP participants or the municipal participants are described. Qualitative analysis identified three global themes: health is possible; trauma feels pervasive; and more work is needed. The current dissertation supports the importance of considering differences and similarities between various policing organizations even within the same provincial or national context. Comprehensive results, implications, and directions for future research are discussed.