Relations between common and specific factors of anxiety sensitivity and distress tolerance and fear, distress, and alcohol and substance use disorders

• Anxiety sensitivity (AS) and distress tolerance (DT) were fit as a bifactor model.
• The common factor was related to distress/fear related mood and anxiety disorders.
• The common factor was also related to alcohol/substance use disorders (AUD/SUDs).
• A distinct DT factor was also related to AUD/SUDs and distress/fear disorders.
• Relations between specific AS factors and specific disorder clusters were found.

Whereas it has been speculated that the psychopathology risk factors anxiety sensitivity (AS) and distress tolerance (DT) are highly overlapping, no studies have examined whether a core affect sensitivity construct explains this relation. It was hypothesized that, in a sample of 808 treatment-seeking individuals (Mage = 35.11, SD = 14.94), the best-fitting confirmatory factor analysis model of AS and DT would comprise a common underlying affect sensitivity factor orthogonal to DT and lower-order AS factors (physical, cognitive, and social concerns). It was also hypothesized that specific relations between the factors and fear, distress, and alcohol/substance use disorders would emerge. The best-fitting model comprised a common affect sensitivity factor orthogonal to DT and lower-order AS factors. Whereas the affect sensitivity and DT factors were associated with fear, distress, and alcohol/substance use disorders, AS cognitive concerns was only related to distress disorders and AS social concerns was only related to fear disorders.