Examination of Anxiety Sensitivity and Distress Tolerance as Transdiagnostic Mechanisms Linking Multiple Anxiety Pathologies to Alcohol Use Problems in Adolescents

BACKGROUND: Multiple forms of anxiety psychopathology are associated with alcohol use problems in adolescents. Yet, the mechanisms underlying this association are unclear. Anxiety sensitivity (AS) and distress tolerance (DT) represent 2 distinct, conceptually relevant transdiagnostic constructs implicated in multiple manifestations of anxiety that may also underlie alcohol use problems and thereby explain why people with anxiety are more likely to have alcohol problems. METHODS: The current cross-sectional study examined whether AS and DT accounted for (i.e., statistically mediated) the relationship between manifest indicators of the 3 common anxiety phenotypes (generalized anxiety, social anxiety, and panic disorders) and alcohol problems in a sample of 534 high school students (14 to 15 years old). RESULTS: Multiple manifestations of anxiety were associated with greater alcohol use problems. AS statistically mediated multiple anxiety–alcohol associations, but DT did not. CONCLUSIONS: These findings provide preliminary evidence suggesting AS may be an important transdiagnostic target for alcohol prevention programs for those in early adolescence that experience elevated anxiety symptoms