Causal modeling of relations among learning history, anxiety sensitivity, and panic attacks

ArticleinBehaviour Research and Therapy 39(4):443-56 · May 2001with 127 Reads
DOI: 10.1016/S0005-7967(00)00023-1 · Source: PubMed
We used structural equation modeling (SEM) to test the hypothesis that childhood instrumental and vicarious learning experiences influence frequency of panic attacks in young adulthood both directly, and indirectly through their effects on anxiety sensitivity (AS). A total of 478 university students participated in a retrospective assessment of their childhood learning experiences for arousal-reactive sensations (e.g., nausea, racing heart, shortness of breath, dizziness) and arousal-non-reactive sensations (i.e., colds, aches and pains, and rashes). SEM revealed that learning history for arousal-reactive somatic symptoms directly influenced both AS levels and panic frequency; AS directly influenced panic frequency; and learning history for arousal-non-reactive symptoms directly influenced AS but did not directly influence panic frequency. These results are consistent with the findings of previous retrospective studies on the learning history origins of AS and panic attacks, and provide the first empirical evidence of a partial mediation effect of AS in explaining the relation between childhood learning experiences and panic attacks in young adulthood. Implications for understanding the etiology of panic disorder are discussed.

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  • Article
    Background The clinical relevance of Anxiety Sensitivity (AS) is well established, as well as the association between parents’ and children’s AS. However, there is little data data on the indirect relation between parents’ AS and children’s anxiety and somatic-hypochondriac symptoms through children’s AS, and the few findings available are inconsistent. Objective The study examined, in a community sample, whether children’s AS was associated to their anxiety and somatic-hypochondriac symptoms, and tested whether children’s AS mediated the link between parents’ AS and children’s anxiety and somatic-hypochondriac symptoms. MethodsA total of 392 children and one of their parents completed a battery of questionnaires. ResultsChildren’s AS mediated the links between parents’ AS and children’s anxiety and somatic-hypochondriac symptoms. These pathways were moderated by the child’s age, in that they were significant for older children (ages 11–17 years old), but not for younger ones (ages 8–10 years old). Conclusions The findings advance understanding of how parental AS might be implicated in children’s AS and clinical symptoms.
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  • ... Child's learning experiences: Learning Experience Index -second version (LEI-II) was based on the expanded version of Muris et al.'s (2001) Learning Experience Questionnaire, which itself was based upon the Learning History Questionnaire developed by Ehlers (1993) and used in previous studies (Stewart et al., 2001;Watt & Stewart, 2003;Watt et al., 1998). This scale is divided into three parts. ...
    ... The role of parental AS and learning experiences in child's AS Consistent with other studies ( Muris et al., 2001;Stewart et al., 2001;Watt et al., 1998), learning experiences following children's somatic sensations influenced their level of AS. More specifically, only learning experiences following pain symptoms were observed to have an impact. ...
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  • Article
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  • ... IIS has been shown to be a stronger predictor than AS of pain catastrophizing, pain-related fear, pain-related anxiety, and pain tolerance (Vancleef and Peters 2006b ; Vancleef et al. 2006 ). In contrast, heightened AS appears related to learning to catastrophize about the meaning of somatic sensations, rather than catastrophizing about the sensations themselves ( Stewart et al. 2001 ;Watt and Stewart 2000 ;Watt et al. 1998 ). In contrast, IIS appears linked to parental modelling and reinforcement of sick-role behaviour specifically related to aches and pains, which is in line with precedent research (Vancleef and Peters 2006b ;Vancleef et al. 2006 ) that IIS may be subsumed within a more general fear of somatic sensations. ...
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  • ... Given that environmental factors may vary across cultures, crosscultural studies in AS manifestations and in instruments devised to assess AS are recommended. Indeed, even though the influence of genetic factors in the etiology of AS has been confirmed (Stein et al., 1999; Taylor et al., 2008), both empirical (Taylor et al., 2008) and retrospective (Stewart et al., 2001; Scher and Stein, 2003) studies have bolstered the role of environmental factors in AS development. For example, although a few studies found that AS is associated in the same way with anxiety and related disorders across socio-cultural contexts (Zvolensky et al., 2001Zvolensky et al., , 2003 Bernstein et al., 2006; Taylor et al., 2007), symptom perception and expression may be affected by cultural variability (Kirmayer et al., 1995 ). ...
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    Preface. List of Figures. List of Tables. 1. The Scope of Genetic Analyses. 2. Data Summary. 3. Biometrical Genetics. 4. Matrix Algebra. 5. Path Analysis and Structural Equations. 6. LISREL Models and Methods. 7. Model Fitting Functions and Optimization. 8. Univariate Analysis. 9. Power and Sample Size. 10. Social Interaction. 11. Sex Limitation and GE Interaction. 12. Multivariate Analysis. 13. Direction of Causation. 14. Repeated Measures. 15. Longitudinal Mean Trends. 16. Observer Ratings. 17. Assortment and Cultural Transmission. 18. Future Directions. Appendices: A. List of Participants. B. The Greek Alphabet. C. LISREL Scripts for Univariate Models. D. LISREL Script for Power Calculation. E. LISREL Scripts for Multivariate Models. F. LISREL Script for Sibling Interaction Model. G. LISREL Scripts for Sex and GE Interaction. H. LISREL Script for Rater Bias Model. I. LISREL Scripts for Direction of Causation. J. LISREL Script and Data for Simplex Model. K. LISREL Scripts for Assortment Models. Bibliography. Index.
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  • Article
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  • Article
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