Cognitive Anxiety Sensitivity: Invariance, Longitudinal Course, and Associations With Suicide Risk in a Large Military Sample

This study examined cognitive anxiety sensitivity's invariance, longitudinal course, and associations with suicidal thoughts and attempts within a large military sample (N = 1,147). First, multiple group confirmatory factor analyses assessed the latent structure of cognitive subscale from the anxiety sensitivity index (ASI-C) by group (i.e., Active Military/Veterans and men/women). Second, free-loading latent growth curve modeling assessed the stability of cognitive anxiety sensitivity across each group over four time points. Third, multiple linear regressions tested if cognitive anxiety sensitivity at the previous time point predicted suicidal thoughts and number of attempts at the following study visit, above and beyond previous suicidal thoughts, generalized anxiety, and thwarted belongingness and beyond previous lifetime attempts, respectively. The ASI-C displayed a very well-fitting unifactorial structure and metric invariance across all groups. Overall, cognitive anxiety sensitivity appeared to significantly decrease over time across all groups, significantly more so for Active Military personnel than for Veterans and significantly more so for women than for men. Cognitive anxiety sensitivity predicted future suicidal thoughts at Time Point (T) 4 above and beyond control variables among Active Military and T2 and T3 among men but not for Veterans or women. Further, cognitive anxiety sensitivity predicted future suicide attempts at T3 beyond control variables among Active Military, Veterans, and men but was not for women. Findings suggest that cognitive anxiety sensitivity is worth including in suicide risk screening and, due to its malleability, may be a viable treatment target to reduce suicide risk among Active Military and Veteran men.