Negative Urgency and Gender Moderate the Association between Anxiety Sensitivity and Alcohol-Related Problems

Tension reduction theory states that persons high in anxiety sensitivity (AS) are particularly sensitive to alcohol’s anxiolytic effects and thus may engage in problematic drinking to reduce distress. However, the literature is mixed, suggesting a complex AS pathway to problematic drinking. Elevated AS may promote drinking to alleviate anxiety, while alcohol’s initial aversive physiological effects (e.g., increased heart rate) and potentially negative outcomes may deter use among those high in AS. For anxiety sensitive persons to drink, they must temporarily disregard alcohol’s negative effects and instead focus on the immediate tension-reducing effects of drinking. Accordingly, anxiety sensitive individuals, who act impulsively when anxious (i.e., negative urgency), may be at risk for heavy drinking and experiencing alcohol-related problems. The goal of our study was to test this prediction. Given that gender differences have been consistently documented in the alcohol use literature, we also examined gender as a secondary moderator. Method: Undergraduates (N=346) completed self-reports of AS, negative urgency, and drinking habits. Results: Moderation analyses revealed that AS positively predicted alcohol-related problems, but only when negative urgency was elevated and this was true for men but not for women. Counter to predictions, the effect of AS on alcohol use was not moderated by negative urgency. However, gender did moderate the AS-alcohol use association, such that AS was negatively associated with alcohol use in men, but was unrelated in women. Conclusions: We found partial support for our hypotheses. Our findings place anxiety sensitive men, who are also high in negative urgency, at unique risk for alcohol-related problems. Clinical interventions may benefit from concurrently targeting negative urgency to reduce problematic drinking risk among anxiety sensitive men.