Is anxiety sensitivity a predictor of PTSD in children and adolescents?

Department of Child Psychiatry, Medical School, Ankara University, Ankara, Turkey.
Journal of Psychosomatic Research (Impact Factor: 2.84). 08/2008; 65(1):81-6. DOI: 10.1016/j.jpsychores.2008.02.013
Source: PubMed

ABSTRACT Anxiety sensitivity (AS) is the fear of the physical symptoms of anxiety and related symptoms. Longitudinal studies support AS as a vulnerability factor for development of anxiety disorders. This study aimed to investigate AS as a vulnerability factor in the development of childhood posttraumatic stress disorder (PTSD) following traumatic experiences.
The study included 81 children 8-15 years of age who experienced the 1999 earthquake in Bolu, Turkey. The earthquake survivors were compared to a randomized group of age- and sex-matched controls 5 years after the earthquake. Both the subject and control groups were administered the Childhood Anxiety Sensitivity Index (CASI), State and Trait Anxiety Inventory for Children (STAI-C), and Child Depression Inventory (CDI), while the PTSD symptoms of the subjects were assessed using the Child Posttraumatic Stress Reaction Index (CPTS-RI).
Subjects and controls did not differ significantly in CASI, STAI-C, or CDI scores. Multiple regression analysis showed that both trait anxiety and CASI scores predicted CPTS-RI scores of the subjects; the prediction by CASI scores was over and above the effect of trait anxiety.
The results of this study support the hypothesis that AS may be a constitutional factor, which might increase the risk of PTSD following traumatic experiences.

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    • "Although individuals with greater levels of anxiety sensitivity are at a risk for developing severe posttraumatic stress response and the therapeutic role of this construct in treating PTSD has been well recognized [26] [27], relationships between anxiety sensitivity and posttraumatic syndrome in children and adolescents have been paid almost no attention. In a preliminary study, 5 years after the 1999 Bolu earthquake, Kilic et al. [28] examined the possible influence of anxiety sensitivity on PTSD symptom severity among 81 Turkish children, aged 8–15 years. The study demonstrated that children who reported high PTSD symptoms were more prone to greater levels of anxiety sensitivity as well as higher levels of trait anxiety. "
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    ABSTRACT: OBJECTIVE: Our aims were to investigate the prevalence of PTSD, depression, anxiety-related disorders, and dissociative symptomotology, and to assess the risk factors for development of psychopathology among children and adolescents after the 2011 Van earthquake in Turkey. METHODS: The screening was conducted among 738 participants at 6months post-earthquake using the CPTSD-Reaction Index, State and Trait Anxiety Inventory for Children, Screen for Child Anxiety Related Emotional Disorders, Child Depression Inventory, Childhood Anxiety Sensitivity Index, Metacognitions Questionnaire for Children, and Adolescent Dissociative Experiences Scale. RESULTS: Less than half (40.69% of) of the participants reported severe levels of PTSD symptoms, 53.04% were at greater risk for developing an anxiety-related disorder, 37.70% met the criteria for clinical depression, and 36.73% revealed pathological levels of dissociative symptomotology. State-trait anxiety, and anxiety sensitivity were significant antecedents of psychopathology. CONCLUSION: We concluded that anxiety sensitivity is a significant risk factor in various types of psychopathology, but metacognitions seem to have a limited utility in accounting for poor psychological outcomes in young survivors of earthquake.
    Comprehensive psychiatry 05/2013; DOI:10.1016/j.comppsych.2013.04.003 · 2.26 Impact Factor
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    • "Even though the bulk of research has focused on panic disorder (PD), AS has been found to be relevant to a range of mental disorders. AS measured by the Anxiety Sensitivity Index (ASI, Reiss et al., 1986) is associated cross-sectionally with depression (Rodriguez et al., 2004), posttraumatic stress disorder (Lang et al., 2002; Kilic et al., 2008; Marshall et al., 2010), social and generalized anxiety disorders (e.g., Deacon and Abramowitz, 2006), obsessive compulsive disorder (McWilliams et al., 2007), and several other disorders (Asmundson and Taylor, 1996; Joiner et al., 2008; Olatunji et al., 2009). Longitudinal studies support the role of AS as a precursor of panic attacks and a diagnosis of PD but also of other anxiety disorders (Hayward et al., 2000; Schmidt et al., 2006). "
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    ABSTRACT: Psychometric studies indicate that anxiety sensitivity (AS) is a risk factor for anxiety disorders such as panic disorder (PD). To better understand the psychophysiological basis of AS and its relation to clinical anxiety, we examined whether high-AS individuals show similarly elevated reactivity to inhalations of carbon dioxide (CO2) as previously reported for PD and social phobia in this task. Healthy individuals with high and low AS were exposed to eight standardized inhalations of 20% CO2-enriched air, preceded and followed by inhalations of room air. Anxiety and dyspnea, in addition to autonomic and respiratory responses were measured every 15s. Throughout the task, high AS participants showed a respiratory pattern of faster, shallower breathing and reduced inhalation of CO2 indicative of anticipatory or contextual anxiety. In addition, they showed elevated dyspnea responses to the second set of air inhalations accompanied by elevated heart rate, which could be due to sensitization or conditioning. Respiratory abnormalities seem to be common to high AS individuals and PD patients when considering previous findings with this task. Similarly, sensitization or conditioning of anxious and dyspneic symptoms might be common to high AS and clinical anxiety. Respiratory conditionability deserves greater attention in anxiety disorder research.
    Psychiatry Research 03/2013; DOI:10.1016/j.psychres.2013.02.010 · 2.68 Impact Factor
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    • "However, experiencing a traumatic event may not necessarily in and of itself elevate an individual's AS (Kiliç et al. 2008). For example, a recent study indicated that although a group of children surviving Hurricane Katrina did not display higher AS compared to children who had not experienced a traumatic event, the hurricane survivors who demonstrated moderate to very severe PTSD symptoms did display higher AS (Kiliç et al. 2008). Such findings are consistent with the relationship between AS and anxiety reported in the adult research (e.g., Lang et al. 2002). "
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    ABSTRACT: Conflicting findings exist regarding (1) whether anxiety sensitivity (AS) is a construct distinct from anxiety in children and (2) the specific nature of the role of AS in child anxiety. This study uses meta-analytic techniques to (1) determine whether youth (ages 6-18 years) have been reported to experience AS, (2) examine whether AS differentiates anxiety disordered youth from youth without diagnoses, and (3) ascertain whether AS distinguishes youth with panic disorder from those with other anxiety disorders. The weighted mean effect size analyses included 15 studies and 6,579 participants. Results suggested positive correlational relationships between AS and anxiety for children (r = 0.26) and adolescents (r = 0.36) and higher levels of AS for anxiety disordered youth than non-clinical youth (d = 0.64). Findings tentatively suggested higher levels of AS for youth with panic disorder than youth diagnosed with other anxiety disorders. Implications and future directions in the research of child AS are discussed.
    Journal of Abnormal Child Psychology 02/2011; 39(5):721-33. DOI:10.1007/s10802-011-9489-3 · 3.09 Impact Factor
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