Reductions in anxiety sensitivity cognitive concerns prospectively mitigate trauma symptom development

Identifying a malleable pre-trauma risk marker for posttraumatic stress is crucial to preventing symptom development among at-risk individuals. One such candidate is anxiety sensitivity cognitive concerns (ASCC), which represents the fear of psychological incapacitation due to anxious arousal. While the extant literature suggests that applying ASCC interventions prior to trauma exposure should mitigate development of posttraumatic stress symptoms (PTSS), this has not been formally tested. We examined whether individuals randomized to receive a Cognitive Anxiety Sensitivity Treatment (CAST; n = 44) prior to a trauma film paradigm would report lower film-specific PTSS after one week compared to individuals randomized to a physical health education training control condition (n = 47). Results revealed that post-intervention ASCC and week-one PTSS were both lower among the CAST condition, and reductions in ASCC mediated the relationship between intervention condition and follow-up PTSS. The current study demonstrated that reducing ASCC prior to an analog trauma can mitigate the development of PTSS. This is critical for establishing ASCC as a causal risk factor for PTSS and encourages the use of ASCC interventions in samples at-risk for trauma exposure.