1. Discussion & Future Directions
Reinforcement Sensitivity Moderates the Relationship Between Stressor Exposure & Anxiety Kelvin A. Adom, Nicholas W. Talisman, Sage K. Hess, Kara N. Meadows & Cynthia Rohrbeck, PhD
Introduction
Hypothesized Model
Discussion & Future Directions
Anxiety disorders are an extremely prevalent mental health illness, with the National Comorbidity Survey estimating that 28.8% of all Americans will have a diagnosable anxiety disorder in their lifetime (Kessler et al., 2005). Anxiety disorders have surpassed depression as the most prevalent mental health concern among college students (21.8%; American College Health Association, 2014). Exposure to stressful life events (SLE) can exacerbate the chances for the development of anxiety symptoms. The Reinforcement Sensitivity Theory of Personality (RST) provides one potential diathesis-stress explanation for understanding the underlying mechanisms of anxiety disorders. In the revised RST, individuals’ responses to threatening or aversive stimuli are facilitated by the Fight-Flight-Freeze system (FFFS; Gray & McNaughton, 2000). Activation in the FFFS is experienced subjectively as feelings of fear and panic. This study investigated the relationship between exposure to stressors common to college, FFFS sensitivity, and anxiety symptoms in a sample of undergraduate students.
The primary hypothesis was that FFFS will serve as a moderator such that there will be a stronger relationship between SLE and anxiety for individuals who are lower in FFFS sensitivity. The hypothesized moderation model is displayed in Figure 1 below.
These preliminary findings are consistent with the psychopathology literature on RST, providing further evidence that an individual’s sensitivity to punishment may confer risk towards the development of anxiety disorders. Though both main effects are replications of prior work, this is among the first empirical investigations into the interactive dynamic between individual RST sensitivity and stressful life event exposure. The observed interaction suggests that students who are especially prone to interpret experiences as threatening may develop anxiety following exposure to fewer stressful life events. These findings also may have implications for prevention of the development and progression of anxiety disorders, as lower FFFS sensitivity may confer resilience to the development of anxiety. Individuals with high FFFS will tend to report anxiety regardless of the number of SLEs they are experiencing. Should FFFS represent a malleable characteristic, preventive interventions may want to target FFFS sensitivity in order to reduce anxiety rates, particularly in college settings.
Future analyses will examine additional relationships between RST sensitivities, sociodemographic factors and anxiety outcomes. It will be important to explore whether the observed interaction behaves the same way when factoring in race, gender, and age, particularly for college students.
Results
Methods
Table 1- Bivariate Correlations Between Study Variables
Variable
(Mean, SD)
BAI
(39.73, 11.38)
CUSS
(23.75, 6.86)
FFFS
(31.63, 2.86) --
0.33** 
0.12* 
0.04  
0.12*
0.04
Participants
Undergraduates attending a private urban university (N=337) completed self-report measures through a secure online survey platform two times, one month apart.
Measures
Fight Flight Freeze System Subscale (FFFS)
The Revised Reinforcement Sensitivity Theory Questionnaire (rRST-Q; Reuter et al., 2015) is a 31-item self-report designed to measure individual’s sensitivities on each of the RST sub-systems. The FFFS scale of the rRST-Q is designed so that respondents rate their level of agreement on a Likert scale from 1 to 5. The scale includes items that address flight response tendencies such as “When faced with danger, I tend to flee,” fight response tendencies such as “Attack is the best form of defense,” and freeze response tendencies such as “I often feel paralyzed when in a dangerous situation.”
College Undergraduate Stress Scale (CUSS)
The CUSS (Renner & Mackin, 1998) provides participants with a list of 51 common stressful experiences in the college setting, and asks them to indicate whether or not they have experienced those stressors. Example stressors include: “difficulties with a roommate,” “flunking a class,” and “having a boyfriend/girlfriend cheat on you.”
Beck Anxiety Inventory (BAI)
The BAI is a self-report questionnaire (Beck et al., 1988) that asks participants to rate how often they have experienced 21 anxiety symptoms over the past month on a 4-point Likert scale. Example symptoms include: “numbness or tingling,” “hands trembling,” and “difficulty breathing.”
Note: N=337; **-p-value less than .001; *-p-value less than .05
References
American College Health Association. (2014). Spring 2014 Reference group executive summary. National College Health Assessment.
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of consulting and clinical psychology, 56(6), 893.
Gray, J. A., & McNaughton, N. (2000). The neuropsychology of anxiety: An enquiry into the function of the septo-hippocampal system. Oxford University Press.
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey replication. Archives of General Psychiatry, 62(6),
Renner, M. J., & Mackin, R. S. (1998). A life stress instrument for classroom use. Teaching of Psychology, 25(1),
Reuter, M., Cooper, A. J., Smillie, L. D., Markett, S., & Montag, C. (2015). A new measure for the revised reinforcement sensitivity theory: Psychometric criteria and genetic validation. Frontiers in Systems Neuroscience, 9, 1-12.
FFFS Sensitivity interacted with SLE when predicting change in anxiety (F=4.06, p<.05). Though the relationship between SLE and anxiety was positive at all levels of FFFS sensitivity, those with lower FFFS sensitivity reported lower levels of anxiety when they had less exposure to SLE. The interaction is displayed above in Figure 2 .