Pathways of psychological adjustment to physical health-related stressors

Acute medical events and health-related stressors are complex life events, impacting both body and mind, challenging one’s concept of physical safety, and requiring ongoing psychological adaptation and adjustment. Anxiety sensitivity is an established transdiagnostic risk factor for mental illness; in the context of health-related stressors, physical anxiety sensitivity, or the tendency to interpret somatic sensations as catastrophic and threatening cues, may represent a meaningful mechanism informing longitudinal psychological adjustment and clinical course. This dissertation examines physical anxiety sensitivity and other key mechanisms influencing psychological adjustment following acute health-related events with three empirical studies. Study 1 sheds light on the role of perceived threat and heightened interoceptive threat bias in the development of posttraumatic stress (PTS) symptoms following a suspected acute coronary syndrome (ACS). Studies 2 and 3 share a common computational approach, latent growth mixture modeling (LGMM), allowing for the mapping of trajectory classes of psychological adjustment and highlighting distinct symptom profiles. Using LGGM, Study 2 investigates the role of peritraumatic threat and ongoing cardiac-related anxiety sensitivity on the clinical course of PTS, identifying trajectories of psychological adjustment in the 12-months following a suspected ACS. Study 3 seeks to apply these findings within the context of the COVID-19 pandemic, exploring the impact of worry and physical anxiety sensitivity on trajectories of depression and anxiety during the first 12-months of the pandemic. Together, these studies provide valuable insights into the naturalistic, heterogeneous course of psychological adjustment to health-related stressors, with particular attention to physical anxiety sensitivity as a potent mechanism driving symptom patterns over time.