Anxiety sensitivity, distress intolerance, and negative interpretation bias strengthen the relationship between trait anxiety and depersonalization

Background and Objectives Depersonalization is common in anxiety disorders, but little is known about factors that influence co-occurring anxiety and depersonalization. Design We investigated trait moderators of the relationships between state and trait anxiety and depersonalization to better understand their co-occurrence and to identify potential points of intervention. Methods Adults recruited on Amazon Mechanical Turk (N = 303) completed two computer tasks designed to increase variability in state anxiety and depersonalization as well as several self-report questionnaires. Results As hypothesized, anxiety positively predicted depersonalization at both a state level and trait level. Moreover, as hypothesized, the trait anxiety-trait depersonalization relationship was strengthened by greater anxiety sensitivity; distress intolerance; and negative interpretation bias for anxiety sensations, and for depersonalization sensations. None of these hypothesized trait moderators significantly strengthened the state anxiety-state depersonalization relationship. Conclusions These findings suggest that, on a trait level, anxiety and depersonalization more frequently co-occur when people catastrophically misinterpret their symptoms or have lower emotional distress tolerance.