Pre-deployment trait anxiety, anxiety sensitivity and experiential avoidance predict war-zone stress-evoked psychopathology

Identifying modifiable risk factors is requisite for preventing stress-related psychopathology, but few prospective studies have examined their impact on the emergence of psychological dysfunction. Trait anxiety (TA), anxiety sensitivity (AS), and experiential avoidance (EA) were assessed in 161 soldiers awaiting deployment. Soldiers also completed repeated in-theater assessments of stressors, post-traumatic stress (PTSS), anxiety, and depression symptoms. Multilevel models tested predictions that each trait would independently and jointly amplify stressors' impact on symptoms. TA increased risk for anxiety (r = .19, p = .020), but not stressors' anxiogenic effects (r = .14, p = .080), whereas TA reduced stressors' impact on depression (r = .18, p = .038) and PTSS (r = .28, p = .001). AS increased risk across symptoms (r's = .26-.31, p's ≤ .002), but did not moderate stressors' anxiogenic effects (r = .15, p = .074). EA's stress-moderating effects depended on levels of TA and AS (r's = .22-.27, p's ≤ .010). Findings suggest TA and EA may interact in ways to enhance resilience, whereas AS may reliably potentiate the pathogenic effects of stress. Support is given for examining the contextualized influence of individual differences, and their dynamic interactions in predicting soldiers' reactions to war-zone stressors.