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Development and Initial Examination of a Brief Intervention for Heightened Anxiety Sensitivity Among Heroin Users

Center for Addictions, Personality, and Emotion Research and the University of Maryland at College Park, mtull{at}psyc.umd.edu

David Schulzinger

Center for Addictions, Personality, and Emotion Research and the University of Maryland at College Park

Norman B. Schmidt

Florida State University, Tallahassee

Michael J. Zvolensky

University of Vermont, Burlington

C. W. Lejuez

Center for Addictions, Personality, and Emotion Research and the University of Maryland at College Park

Anxiety sensitivity (AS) recently has been identified as a potential cognitive vulnerability underlying substance use problems, with some evidence specifically indicating its relevance to heroin. Focusing on the potential utility of interventions centered on increasing willingness to have anxiety-related sensations reduce vulnerability for relapse following substance use treatment, the current article describes the development of a brief (6 session) behavioral treatment for heightened AS among heroin users. The treatment consists of the following components: (a) psychoeducation about anxiety; (b) interoceptive exposure exercises; and (c) skills-training focused on heightening emotional acceptance, tolerance, and nonevaluative awareness (to facilitate willingness). Preliminary data on this treatment are provided in the form of a case study with a 46-year-old African American man in an inner-city residential substance use treatment facility. Results indicate reductions in AS (especially physical concerns), as well as corresponding decreases in heroin cravings and improvements in emotion regulation.

Key Words: anxiety sensitivity • distress tolerance • emotional acceptance • heroin • treatment • vulnerability

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