© 2020 Asia Pacifc Journal of Clinical Trials: Nervous System Diseases | Published by Wolters Kluwer - Medknow 37 REVIEW INTRODUCTION Substance-related disorders result from abnormal and unau- thorized consumption of substances such as alcohol, opioids, and cannabis, and cause one’s psychological or physiological substance dependency. These disorders are widespread among the general population and have imposed enormous economi- cal and psychological costs on society (Grant et al., 2004; Azad and Saed, 2012). In recent decades, there has been a signifcant tendency towards the prevention of such high-risk behaviors in adolescents and adults. To this end, understand- ing the etiology of this multifaceted phenomenon and its related factors seems necessary, and research in this area can help to increase our understanding of the psychopathology of substance-related disorders and prevent its occurrence. Some studies on the etiology of substance-related disorders have focused on factors involved in emotional and psychological vulnerabilities such as anxiety sensitivity. Overall, anxiety sensitivity refers to the fear of anxiety-related sensations that appear to arise from one’s beliefs about the adverse conse- quences of anxiety symptoms (Taylor, 1999; Deacon and Abramowitz, 2006). These perceived consequences include the three general categories of fear of body sensations, fear of cognitive dyscontrol, and fear of socially observable anxiety symptoms (Asmundson et al., 2011; Wheaton et al., 2012). Anxiety sensitivity constructs were initially raised in relation to panic disorder, but the results suggest that this vulnerability also plays a role in the pathology of other emotional disorders (Schmidt et al., 2008). In addition, Reiss (1991) suggested that anxiety sensitivity plays a role not only in the development and maintenance of anxiety disorders but also in substance-related disorders. This article aims to investigate the role of anxiety sensitivity as a moderating, mediating, and independent factor in substance-related disorders. SEARCH STRATEGY AND SELECTION CRITERIA Inclusion criteria for the current review were the following: a) articles had original and review formats b) anxiety sensitiv- ity, substance use and alcohol were one of the main variables in the title of articles and c) full text of the article should be available. To identify studies which were appropriate for surveying anxiety sensitivity and substance use disorders, we conducted systematic searches of the electronic databases American Psychological Association (PsychInfo), PubMed, Scopus, and Google Scholar up to 2018. In order to identify anxiety sensitivity and substance use disorders studies the following parameters were searched: anxiety sensitivity and substance use disorders or alcohol or cigarette or nicotine or marijuana or cannabis or tobacco and mediation or moderation and treatment or intervention. In addition, reference sections of all identifed papers were scrutinized for additional published papers in this area. We restricted searches to studies in English, relating to humans, published after January 1, 1990. The full electronic searches are shown in Table 1. THE MODERATING, MEDIATING AND INDEPENDENT ROLES OF ANXIETY SENSITIVITY IN SUBSTANCE-RELATED DISORDERS A review of the literature in this area shows that various studies have investigated the role of anxiety sensitivity in substance- related disorders. These studies can be categorized into three general groups in terms of their role in considering anxiety sen- sitivity. The frst group mainly emphasizes the moderating role of anxiety sensitivity in the relationship between anxiety and substance use. From this perspective, high anxiety sensitivity can increase the likelihood of drug use in anxious individuals (Stewart and Kushner, 2001). In Reiss’s view, high anticipa- tory anxiety increases avoidant behaviors such as substance Abstract Omid Saed, Sahel Khakpoor * Department of Clinical Psychology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran *Correspondence to: Sahel Khakpoor, MS, sahelkhakpoor@zums.ac.ir. orcid: 0000-0003-2536-3337 (Sahel Khakpoor) Anxiety sensitivity and substance-related disorders: a narrative review Anxiety sensitivity means fear of anxiety-related sensations which is one of the important factors in the development and maintenance of substance-related disorders. Studies support the underlying, mediating, and moderating role of this construct in the etiology of substance- related disorders. This review suggests that anxiety sensitivity can play a role in this group of disorders in different ways, such as fear of body sensations, fear of cognitive dyscontrol, and fear of socially observable anxiety symptoms. Finally, high anxiety sensitivity can interfere with the treatment of substance-related disorders as an underlying vulnerability and increase the likelihood of relapse in this group of people. Key words: alcohol use; anxiety sensitivity; review; substance-related disorders doi: 10.4103/2542-3932.295802 How to cite this article: Saed O, Khakpoor S (2020) Anxiety sensitivity and substance-related disorders: a narrative review. Asia Pac J Clin Trials Nerv Syst Dis 5(3):37-41. [Downloaded free from http://www.actnjournal.com on Wednesday, September 30, 2020, IP: 83.120.45.58]