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Assessment of anxiety sensitivity in young American Indians and Alaska Natives

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Abstract

In the present study, the Anxiety Sensitivity Index [ASI; Behav. Res. Ther. 24 (1986) 1] was administered to 282 American Indian and Alaska Native college students in a preliminary effort to: (a) evaluate the factor structure and internal consistency of the ASI in a sample of Native Americans; (b) examine whether this group would report greater levels of anxiety sensitivity and gender and age-matched college students from the majority (Caucasian) culture lesser such levels; and (c) explore whether gender differences in anxiety sensitivity dimensions varied by cultural group (Native American vs. Caucasian). Consistent with existing research, results of this investigation indicated that, among Native peoples, the ASI and its subscales had high levels of internal consistency, and a factor structure consisting of three lower-order factors (i.e. Physical, Psychological, and Social Concerns) that all loaded on a single higher-order (global Anxiety Sensitivity) factor. We also found that these Native American college students reported significantly greater overall ASI scores as well as greater levels of Psychological and Social Concerns relative to counterparts from the majority (Caucasian) culture. There were no significant differences detected for ASI physical threat concerns. In regard to gender, we found significant differences between males and females in terms of total and Physical Threat ASI scores, with females reporting greater levels, and males lesser levels, of overall anxiety sensitivity and greater fear of physical sensations; no significant differences emerged between genders for the ASI Psychological and Social Concerns dimensions. These gender differences did not vary by cultural group, indicating they were evident among Caucasian and Native Americans alike. We discuss the results of this investigation in relation to the assessment of anxiety sensitivity in American Indians and Alaska Natives, and offer directions for future research with the ASI in Native peoples.

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... Investigations into gender differences in AS have repeatedly shown women to have higher levels of AS in both nonclinical (Deacon et al., 2003;Stewart et al., 1997;Zvolensky et al., 2001) and clinical samples (Schmidt and Koselka, 2000). For example, Deacon et al. (2003) found female college students to have significantly higher AS scores (d ¼ .23, ...
... In contrast to the evidence that women have higher overall AS, the extant work examining lower-order AS dimensions is less consistent. Studies utilizing undergraduate populations have shown women to have higher levels of AS physical concerns than men, but have shown no sex difference in AS cognitive concerns (Foot and Koszycki, 2004;Stewart et al., 1997;Zvolensky et al., 2001). With regard to AS social concerns, some data suggest no gender difference (Stewart et al., 1997), while other data suggest greater AS social concerns either among men (Foot and Koszycki, 2004) or among women (Zvolensky et al., 2001). ...
... Studies utilizing undergraduate populations have shown women to have higher levels of AS physical concerns than men, but have shown no sex difference in AS cognitive concerns (Foot and Koszycki, 2004;Stewart et al., 1997;Zvolensky et al., 2001). With regard to AS social concerns, some data suggest no gender difference (Stewart et al., 1997), while other data suggest greater AS social concerns either among men (Foot and Koszycki, 2004) or among women (Zvolensky et al., 2001). However, these findings are limited by the undergraduate, nonclinical populations from which the data were derived. ...
... Several studies in both clinical samples (Cox, Swinson, Shulman, Kuch, & Reichman, 1993; Foot & Koszycki, 2004; Goodin et al., 2009) and non-clinical samples (Feldner, Zvolensky, Schmidt, & Smith, 2008; Goodin et al., 2009; Katz, Martin, Pagé, & Calleri, 2009) have noted no sex differences in AS as a unidimensional construct. Yet other studies have found women to demonstrate higher levels of AS than men (O'Connor, Farrow, & Colder, 2008; Schmidt & Koselka, 2000; Telch, Lucas, & Nelson, 1989; Zvolensky, McNeil, Porter, & Stewart, 2001). Van Dam, Earleywine, and Forsyth (2009), who initially reported women to have higher AS than men, examined the item construction of the ASI. ...
... The aim of the present study is to examine the hierarchical and multidimensional model of AS illustrated by Olatunji and Wolitzky-Taylor (2009) among men and women. Given the equivocal findings that have been reported to date with respect to potential sex differences in levels of specific facets of AS (e.g., Foot & Koszycki, 2004; McLeish et al., 2011; Stewart et al., 1997; Zvolensky et al., 2001), this study took as a first step the task of examining the pattern of relationships that exist between anxiety and depression and specific AS factors in two separate groups of women and men participants. As such, the intent of this study was not simply to directly compare women and men with respect to specific AS factors, but rather to examine, within each sex group separately, how individual AS factors are related to symptoms of anxiety and depression. ...
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Anxiety sensitivity (AS) is most often described in its multidimensional and hierarchical form, consisting of three lower order factors: fear of physical symptoms, fear of publically observable symptoms, and fear of cognitive dyscontrol. The lower order factors of AS have been shown to be differentially predictive of panic disorder, social anxiety, generalized anxiety disorder, and depression. However, there is limited research exploring sex differences in these relationships. The present study examined three specific anxiety symptom clusters (i.e., physiological hyperarousal, worry, and social anxiety symptoms) and depressive symptoms and their relationship with measures of the three lower order factors of AS (i.e., physical concerns, social concerns, and mental incapacitation) in men and women. Sex differences were observed in the unique associations between the lower order factors and physiological hyperarousal and social anxiety symptoms; similar relationships between men and women, which were also consistent with the hierarchical structure of AS, were observed with worry and depressive symptoms.
... Research has suggested that the ASI has three lower order factors that all load on a single higher order factor (see Zinbarg, Mohlman, & Hong, 1999, for a review). The lower order factors represent physical, cognitive, and social concerns, and the higher order factor represents the global anxiety-sensitivity construct (Stewart et al., 1997;Zvolensky, McNeil, Porter, & Stewart, 2001). In the present investigation, we used the ASI total score as a general index of fear of anxiety-related bodily sensations. ...
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Although control over aversive events maintains a central role in contemporary models of anxiety pathology, particularly panic disorder, there is little understanding about the emotional consequences of specific types of control processes. In the present study, offset control over 8 20% carbon dioxide-enriched air administrations was experimentally manipulated in a large nonclinical population (n = 96) varying in anxiety sensitivity (high or low) and gender. Dependent measures included self-reported anxiety, affective reports of valence, arousal, emotional control, and physiological indices of heart rate and skin conductance. High anxiety-sensitive participants who lacked offset control reported significantly greater elevations in self-reported anxiety, emotional displeasure, arousal, and dyscontrol relative to their yoked counterparts with offset control. In contrast, low anxiety-sensitive individuals responded with similar levels of cognitive and affective distress regardless of the offset control manipulation. Although the provocation procedure reliably produced bodily arousal relative to baseline, at a physiological level of analysis, no significant differences emerged across conditions. These findings are discussed in relation to offset control during recurrent interoceptive arousal, with implications for better understanding anxiety about abrupt bodily sensations.
... On the other hand, women had higher scores in total, physical, and cognitive AS. Also in accordance with previous research, there is a clear sex difference in anxiety-related variables (Nakajima & al'Absi, 2012) and, in particular, in AS (Norr et al., 2015;Zvolensky et al., 2001). These differences emphasize the need to apply the gender perspective in future clinical trials addressing smoking cessation, since both the number of cigarettes per day and AS have shown to be powerful predictors (Martínez-Vispo et al., 2021;Pérez-Pareja et al., 2020). ...
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Background: In recent years, several studies have found a relationship between transdiagnostic variables, such as anxiety sensitivity (AS) and tobacco use and smoking cessation. Method: In this line, the aim was twofold: 1) to analyze sex differences in variables related to tobacco and AS and 2) to examine the mediating effect of AS. For this purpose, the sample consisted of 340 smokers (Mage = 33.59 years, SD = 11.98, 68.5% women). Results: The results showed that men smoked more cigarettes per day and women had higher levels of total, physical, and cognitive AS. The structural equation model confirmed that AS is a mediator variable between the number of cigarettes per day and nicotine dependence, and the number of previous cessation attempts. Conclusions: These findings suggest that transdiagnostic variables, such as AS, and sex differences, must be taken into account in smoking cessation interventions.
... Theoretical models posit that individuals with high AS are more likely to attend to bodily sensations that are associated with anxiety, such as respiratory symptoms, stomach distress, fatigue, and body aches, and to misinterpret these symptoms as dangerous or catastrophic [30,31]. These interpretations of bodily sensations can lead to increased anxiety and perpetuate a cycle of increased attention to and misinterpretation of bodily cues [31][32][33]. This process may eventually lead to avoidance and increased symptoms of anxiety, stress, and depression, with potential to exacerbate stress on the body systems, further compromising the immune system and placing certain individuals at greater risk for more severe psychopathology [34]. ...
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Background: Clear health disparities have emerged in rates of COVID-19 exposure, hospitalization, and death among Black, Hispanic, and American Indian (BHAI) individuals, relative to Non-Hispanic White (NHW) individuals. BHAI populations have been disproportionately affected by lower behavioral health access and heightened negative mental health outcomes during the pandemic. Objective: The current project directly addresses health disparities in access to behavioral health care during the COVID-19 pandemic among BHAI populations via an adaptation of the established, initially validated, low-cost, mobile application (i.e., Easing Anxiety Sensitivity for Everyone; EASE) among individuals with elevated anxiety and/or depression symptoms. Methods: The EASE trial is a 2-arm, prospective, randomized, blinded-assessor study with intention-to-treat analysis. Participants (N = 800; 200 Black, 200 Hispanic, 200 American Indian, and 200 NHW) are randomized to receive either EASE or an active comparison condition for anxiety and depression. Participants compete an online pre-screener, an enrollment call to provide informed consent, a baseline survey, a 6-month intervention period, and 3- and 6-month post-baseline assessments. Select participants also complete a 3- and 6-month post-baseline qualitative interview via phone or online platform (e.g., Zoom). Participants complete two scheduled daily ecological momentary assessments (EMAs) during the 6-month study period. These twice daily EMAs guide a just-in-time approach to immediate, personalized behavioral health care. Results: Outcomes include reductions in anxiety and depressive symptoms and functional impairment at 3- and 6-months post-randomization. We also will examine putative mechanisms (e.g., AS and COVID-19 specific stress and fear) of the intervention effects. Further, as treatment effects may differ across sociocultural factors, perceived discrimination, social support, and socioeconomic status will be evaluated as potential moderators of treatment effects on the primary outcomes. Process evaluation using data collected during the study, as well as individual interviews with participants will complement quantitative data. Conclusions: Data from the current efficacy trial will determine if EASE successfully improves symptoms of anxiety and depression, and if these improvements outperform an active comparison control app. If successful, findings from the present study have the potential to decrease anxiety and depression symptoms among vulnerable populations determined to be most at risk of exacerbated, long-lasting negative health sequelae. Data from the current study may be used to support an implementation and dissemination trial of EASE within "real-world" behavioral health and social service settings. International registered report: DERR1-10.2196/40713.
... High rates of SUD in AIAN youth, including lifetime opioid misuse, in both urban and rural areas have been linked to numerous risk factors, including poverty, poor social conditions, exposure to use in others, community norms, community stressors such as violence and discrimination, antisocial peer groups, lower school performance, trauma exposure, and significant life stress (Beauvais & LaBoueff, 1985;Dickerson et al., 2016;Fisher et al., 1998;LeMaster et al., 2002;Nalven et al., 2020;Oetting et al., 1988;Sarche & Spicer, 2008;Rutman et al., 2008), parental use, younger age at initiation of use, initiating use with another drug, adolescent conduct problems, sexual abuse, witnessing family trauma, or experience of a traumatic event (O'Connell et al., 2007), and psychological distress and high risk behavior (Hawkins et al., 2004). Mental health disparities may also demonstrate a significant contributor to risk for SUD; AIAN youth are at disproportionately high risk for depression, anxiety, trauma-related stress, attention deficit hyperactivity disorder (ADHD), conduct disorder, and suicide rates four times the national average (American Psychiatric Association, 2017; Beals et al., 1997Beals et al., , 2005Costello et al., 1997;Moncher et al., 1997;Sarche, 2011;Stiffman et al., 2003;Whitbeck et al., 2008;Yoder et al., 2006;Zvolensky et al., 2001). Further, research suggests that traumatic exposure is highly prevalent in AIAN communities and associated with increases in mental health issues and SUD (Ehlers et al., 2013). ...
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Objective: American Indian and Alaska Native (AIAN) youth demonstrate significant substance use and mental health disparities and represent a highly underserved population with regard to effective services. A community-based needs assessment study of urban and rural AIAN youth throughout California was conducted to inform the development of community-based, culturally relevant opioid and substance use services. This study examined AIAN youth experiences with opioid and other substance use disorders (OUD/SUD) in their communities, utilization of existing programs, and service system recommendations. Method: Fifteen focus groups were conducted in partnership with urban and rural/reservation health programs, and AIAN serving community-based organizations throughout California with youth ranging from 13 to 18 years of age. Focus groups were recorded and professionally transcribed, then coded using NVivo qualitative data analysis software. An a priori coding structure was refined through a data-informed, iterative process until a final coding structure was agreed upon to characterize data. Results: Findings demonstrate the need for OUD/SUD services that integrate cultural beliefs and practices, incorporate attention to family and community risk and resiliency factors, provide effective outreach and education, and focus on the development of holistic wellness and positive development for AIAN youth. This study also provides a model for conducting a needs assessment using community-based participatory methods to inform effective service development that more directly responds to community-identified needs. Conclusion: Findings indicate that future services and interventions should incorporate a focus on promoting overall wellness and positive youth development in order to prevent or promote recovery from opioid or other substance abuse. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... Also, the "open prison" metaphor, which was most frequently used by the male participants to compare with the COVID-19 pandemic, seems to be highly related to the concept of being restricted. Parallel to the finding of the current study, many other studies in the literature have found that anxiety level varies significantly depending on gender (Lewinsohn, Gotlib, Lewinsohn, Seeley, & Allen, 1998;Schneier, Johnson, Hornig, Liebowitz, & Weissman, 1992;Yonkers et al., 1998;Zvolensky, McNeil, Porter, & Stewart, 2001). Similar findings have also been reported by studies focusing on the COVID-19 pandemic. ...
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The main purpose of the current study is to investigate the perceptions of individuals’ living in Turkey during the COVID-19 pandemic through metaphor analysis. The current study employed the descriptive phenomenological design, one of the qualitative research methods. A total of 210 individuals living in Turkey (114 females (68.6%) and 66 males (31.4%)) participated in the current study through an online questionnaire on a voluntary basis. As the data collection tool, the online questionnaire form developed by the researchers was used. The collected data were analyzed within the framework of five-stage metaphor analysis. As a result of the analysis, a total of seven metaphor categories called being restricted, restlessness, uncertainty/obscurity, deadly/dangerous, struggling, faith/destiny, and supernatural were obtained. These categories were subsumed under three themes called “anxiety/concern, risk, and faith”.
... Women have increased their levels of tobacco consumption in recent years (Amos, Greaves, Nichter & Bloch, 2012; National Plan on Drugs, 2019), and being a female represents a risk factor for maintaining smoking behavior, since they show significantly fewer quit attempts and perceive more barriers to quit smoking (Allen, Oncken & Hatsukami 2014; Allen, Scheuermann, Nollen, Hatsukami & Ahluwalia 2016). In particular, previous studies have shown that female sex is positively related to high levels of anxiety (Nakajima & al'Absi, 2012) and AS (Norr, Albanese, Allan & Schmidt, 2015;Stewart, Taylor & Baker, 1997;Zvolensky, McNeil, Porter & Stewart, 2001). When analyzing lower-order AS dimensions (that is, physical, cognitive and social concerns), some authors have also found that women present higher physical sensations ) when compared to men. ...
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Tobacco smoking is the leading preventable cause of premature death worldwide and, despite the fact that many therapies are available for smoking cessation, additional efficacious interventions are needed since many quit attempts are unsuccessful and a high percentage of patients relapse within the months following a quit attempt. In particular, both cigarette consumption and relapse rates among smokers with comorbid mental health problems have shown to be higher than those without them. So far, smoking cessation treatments usually include different approaches aimed at treating specific mental health disorders, particularly anxiety and depression. However, this traditional approach is turning towards a transdiagnostic vulnerability model that includes a set of key clinical factors underlying tobacco use and different emotional conditions, being anxiety sensitivity (AS) increasingly becoming the focus of attention. Preceding research conducted in United States and Argentina has demonstrated that integrating AS reduction components into broader smoking cessation treatments leads to reduced AS levels as well as improved treatment retention and cessation rates. Nonetheless, there are no published behavioral treatment protocols addressing anxiety and smoking concurrently, or using a transdiagnostic approach for this population, in our country. So far, little is known about the mechanisms underlying the relationship between AS and smoking in Spain. Both clinicians and researchers should focus on explore the AS global construct among Spanish smokers, including the most clinically-relevant variables related to both smoking behavior and smoking cessation, with the purpose of developing novel treatment proposals for quitting.
... Specifically, drawing on the evidence reviewed above, we hypothesized that higher trait fear would be uniquely related with more enhanced inhibitory control, while higher trait anxiety would be uniquely associated with impaired inhibitory control. In addition, given that females are more anxiety-prone and susceptible to anxiety-related disorders than males (Bernstein, Zvolensky, Stewart, Nancy Comeau & Leen-Feldner, 2006;Chambless & Mason, 1986;Lake, Eaves, Maes, Heath & Martin, 2000;Lewinsohn, Gotlib, Lewinsohn, Seeley & Allen, 1998;Zvolensky, McNeil, Porter & Stewart, 2001), we inquired whether gender would moderate the unique relation of anxiety with inhibitory control. Notably, we conjectured that the specific effects of anxiety on inhibitory control may be more pronounced for females than for males. ...
Article
Given the dearth of research regarding the relations of trait fear and trait anxiety to cognitive control processes, we sought to investigate how trait fear and trait anxiety are uniquely related to inhibitory control, which is a crucial component of the regulatory processes that inhibit inappropriate responses that interfere with goal achievement. Given that inhibitory control tasks are often plagued by task-impurity issues, we employed a latent variable approach based on multiple measures of inhibitory control. We found that trait fear and trait anxiety are related but separable constructs that, when their shared variance was controlled for, predicted inhibitory control positively and negatively, respectively. Also, the unique negative relation between trait anxiety and inhibitory control was evident only for females. Our findings underscore distinct contributions of trait fear and trait anxiety to inhibitory control and the consideration of affective traits as multidimensional (e.g., valence and motivation) constructs to better understand the relation between negative affectivity and cognitive processes.
... In a 2003 study, Silverman and colleagues used CFA to compare two-, three-, and fourfactor models of 13 CASI items. In these analyses, five items were not classified (items 7, 13, 16, 14, and 18), given inconsistencies among previous studies with respect to which factors these items on the CASI (Chorpita and Daleiden 2000; Muris et al. 2001;Silverman et al. 1999;van Widenfelt et al. 2002) and ASI (Carter et al. 1999;Stewart et al. 1997;Zinbarg et al. 1997;Zvolensky et al. 2001) belonged. Results of these analyses indicated that the four-factor model provided the best fit for the data and that this model provided a significantly better fit than the three-factor model. ...
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Background Child anxiety sensitivity (AS) is measured almost exclusively using the Childhood Anxiety Sensitivity Index (CASI). Yet, in the context of significant discrepancies regarding the CASI factors and how they are scored and reported, it remains unclear whether the CASI reliably and validly assesses the purported multifactorial AS construct. Objective This paper will: (1) provide a comprehensive summary of previous CASI factor analyses by which these factor structures were identified, (2) evaluate evidence regarding the multifactorial nature of AS in youth, and (3) discuss potential directions for continued research in this area. Method In a PsycInfo search, peer-reviewed studies published between 1991 and 2018 were identified for inclusion if they examined the factor structure of the CASI or reported data on the CASI subscales as administered to child participants. Results Findings from the 50 studies reviewed suggested that (1) the 18-item CASI does not consistently yield internally reliable assessments of specific AS facets, (2) significant discrepancies exist regarding the CASI subscales identified, the items comprising these scales, and their predictive validity in terms of anxiety, and (3) alternatives to assess the multifactorial construct of AS in youth do exist, but they have not been systematically examined in the literature. Conclusions Directions for future study include further examining expanded scales for AS in youth, continued study of shorter scales assessing more consistently reliable AS content, and evaluating the utility of an expanded response scale for the CASI.
... Decades of research conducted largely among Caucasian samples has indicated that anxiety sensitivity is a relatively stable, yet malleable, cognitive vulnerability that predisposes individuals to the development and maintenance of anxiety and depressive psychopathology (Olatunji & Wolitzky-Taylor, 2009). Across a range of populations, anxiety sensitivity is unique from, and demonstrates incremental validity to, other factors, such as negative affectivity and perceived stress (Zvolensky et al., 2002;Zvolensky, Kotov, Antipova, & Schmidt, 2005;Zvolensky, McNeil, Porter, & Stewart, 2001). Research among Latinos has indicated that anxiety sensitivity maintains a similar latent structure and is related to more severe anxiety-depressive symptoms (Varela et al., 2007;Viana et al., 2017;Zvolensky et al., 2015aZvolensky et al., , 2015bZvolensky, Paulus, Bakhshaie, Garza, Valdivieso, et al., 2018). ...
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This investigation examined the explanatory role of anxiety sensitivity in the relationship between perceived racial discrimination and anxiety–depressive symptoms and disorders among Latinos seeking health services at a Federally Qualified Health Center (FQHC). Participants included 202 Spanish-speaking Latino adults (86.1% female; Mage = 38.99 years, SD = 12.43) who completed a structured interview and study measures. Results indicated perceived racial discrimination was indirectly related to depression, social anxiety, anxious arousal, and mood and anxiety disorders through anxiety sensitivity. Indirect effects were of medium-large size for all criterion variables. Observed effects were evident above and beyond variance accounted for by age, gender, marital status, and years in the United States. Comparative models revealed significant bidirectional effects from anxiety sensitivity via perceived racial discrimination in relation to anxiety–depressive symptoms and disorders. The current results suggest anxiety sensitivity may be an individual difference factor that serves as a mechanism between perceived racial discrimination and mental health among Latino adults, but these 2 constructs may also maintain bidirectional relations with 1 another.
... To date, a growing body of evidence implicates anxiety sensitivity as a risk factor for a variety of mental health difficulties, including anxiety symptoms and disorders (Naragon-Gainey, 2010;Olatunji and Wolitzky-Taylor, 2009), depression (Naragon-Gainey, 2010;Olatunji and Wolitzky-Taylor, 2009), suicidality (Capron et al., 2012), as well as substance use problems (Dixon et al., 2014), alcohol use problems (Schmidt et al., 2007), and tobacco use (Zvolensky et al., 2007). Although the majority of work on anxiety sensitivity has been conducted among non-Hispanic White samples, additional work suggests it may be a robust explanatory construct among Latino (Zvolensky et al., 2015), African-American (Arnau et al., 2009), Asian (Ebesutani et al., 2016), and American Indian adults (Zvolensky et al., 2001). ...
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The present study examined the factor structure, invariance properties, reliability, and validity of the Anxiety Sensitivity Index-3 (ASI-3, Taylor et al., 2007). Participants were recruited from a large, ethnically diverse southwestern university (n = 3651; 77.8% female; Mage = 22.06 years; 28% non-Hispanic White). Findings supported a bifactor structure for the ASI-3, which demonstrated measurement invariance across sex, race/ethnicity, age, and sexual minority status. Furthermore, the ASI-3 demonstrated strong reliability and validity, with the anxiety sensitivity general and specific factors (physical, cognitive, and social concerns) evidencing unique patterns of relations with symptoms of depression, suicidality, anxious arousal, and social anxiety. Clinically, these findings generally support the validity of the ASI-3 in measuring anxiety sensitivity across sex, age, race/ethnicity, and sexual minority status. Future work is needed to better understand the role anxiety sensitivity plays within specific demographic subgroups, particularly African-Americans, Asian Americans, and sexual minorities.
... t[1083] = -10.974, p < 0.001), although gender differences in the AS construct may in part account for these differences[48][49][50]. Finally, the average scores of SBQ-R suicide risk were also lower than those reported by Stanley et al.[17] among that same sample (M [SD] = 3.85 [1.79] vs. M [SD] = 5.83 [2.90], t[1083] = -13.135, ...
Article
Background: Firefighters represent an occupational group at increased suicide risk. How suicidality develops among firefighters is poorly understood. The depression-distress amplification model posits that the effects of depression symptoms on suicide risk will be intensified in the context of anxiety sensitivity (AS) cognitive concerns. The current study tested this model among firefighters. Methods: Overall, 831 firefighters participated (mean [SD] age = 38.37 y [8.53 y]; 94.5% male; 75.2% White). The Center for Epidemiologic Studies Depression Scale (CES-D), Anxiety Sensitivity Index-3 (ASI-3), and Suicidal Behaviors Questionnaire-Revised (SBQ-R) were utilized to assess for depression symptoms, AS concerns (cognitive, physical, social), and suicide risk, respectively. Linear regression interaction models were tested. Results: The effects of elevated depression symptoms on increased suicide risk were augmented when AS cognitive concerns were also elevated. Unexpectedly, depression symptoms also interacted with AS social concerns; however, consistent with expectations, depression symptoms did not interact with AS physical concerns in the prediction of suicide risk. Conclusions: In the context of elevated depression symptoms, suicide risk is potentiated among firefighters reporting elevated AS cognitive and AS social concerns. Findings support and extend the depression-distress amplification model of suicide risk within a sample of firefighters. Interventions that successfully impact AS concerns may, in turn, mitigate suicide risk among this at-risk population.
... Although there is still confusion regarding the number of lower-order factors, the majority of studies have reported three-factor solutions loaded onto a single higher-order factor. These factors describe physical concerns, psychological concerns, and social concerns (e.g., Jurin, Jokic-Begic, & Korajlija, 2012;Rodriguez et al., 2004;Zvolensky, McNeil, Porter, & Stewart, 2001). When testing the divergent validity of these dimensions, research demonstrates that only one AS dimension -physical concernsis predictive of panic disorder (e.g., Rector, Szacun-Shimizu, & Leybman, 2007;Rodriguez et al., 2004), while both physical and psychological concerns dimensions were found to be a predictors of panic attacks (Naragon-Gainey, 2010). ...
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Background and Objectives: Anxiety sensitivity (AS) is the fear of anxiety symptoms, a feature proven to be an important vulnerability factor for anxiety pathogenesis. The aim of this study was to examine whether AS (as well as its factors) predicts the onset of panic disorder symptoms when controlling for the contribution of trait anxiety. Design: We conducted a prospective 3 year follow up study. Methods: The participants, students at the Humanities and Social Sciences in Zagreb (N = 1087), completed an Anxiety Sensitivity Index and State-Trait Anxiety Inventory (Trait form) and, after a period of three years, were asked to self-assess criteria for panic disorder (according to the DSM-5). Results: The predictive validity of AS for the onset of panic disorder symptoms, regardless of trait anxiety, was confirmed. Furthermore, the physical concerns dimension of AS was the only significant predictor of panic disorder symptoms. The optimal cutoff score of 25 on the ASI provides poor to moderate accuracy indices in detecting participants who will manifest panic disorder symptoms in the next three years. Conclusion: This study contributes to our current understanding of AS as a prospective risk factor for panic disorder symptoms.
... Early studies examining this issue have found that the psychometric properties of some commonly used assessment instruments, such as the Anxiety Sensitivity Index (ASI) [5] , have been extensively evaluated across different ethnic groups [6][7][8]. These reports have highlighted that the psychometric characteristics of the ASI do vary considerably across groups. ...
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Background: Cultural awareness and its implications in assessment is becoming an important issue in mental health. Recent studies examining this issue have found that the psychometric properties of some commonly used assessment instruments may vary considerably, especially when administered to people who have English as a second language. Objective: To examine the factor structure of the Thai Depression Anxiety and Stress Scales (DASS-42) using internal consistency and confirmatory factor analysis. Methods: The Thai DASS-42 was administered to a non-clinical sample of Thai women (N = 300) residing in various metropolitan areas of Sydney. The findings were compared with the data of a Thai-speaking sample (N = 502) in Bangkok for validation compared with the English version by Lovibond and Lovibond. Results: Confirmatory factor analysis showed that the Thai DASS-42 discriminates between depression, anxiety and stress, but the extent of differentiation between these negative emotional disorders was less in comparison with the English DASS. Moreover, the Thai DASS-42 showed less discrimination between the three scales in an Australian Thai-speaking sample in comparison with a normal Thai-speaking sample in Bangkok (N = 502). In general, the factor loadings for all 42 DASS items in the Australian Thai-speaking sample were comparable with those in both the English-speaking and the Bangkok samples, and indicated that the items had been adequately and appropriately translated and adapted. The Thai DASS-42 demonstrated significant means and standard deviations (SD) 5.02 (7.37), 5.01 (6.51) and 7.52 (8.63) respectively for depression, anxiety and stress subscales with significant factor loading values. Conclusions: The Thai DASS-42 was found to have sound psychometric properties and to be a suitable tool for use among Thai women living in Sydney. The present findings will help guide further preventative research in examining indications of subclinical anxiety and depression.
... Empirical studies have demonstrated that anxiety sensitivity is an important risk factor people with anxiety problems. Among these studies, firstly, it is signified that anxiety sensitivity presents as fear feelings which impact on the functioning of the senses [19,20]. Secondly, anxiety sensitivity levels are higher for people who have anxiety disorders [21]. ...
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This study aims to examine the relationships between subdimensions of anxiety sensitivity and anxiety. The participants in the study were 841undergraduate students (411 females; 430 males) randomly selected from three different faculties -Faculties of Technical Education, Education, and Sport Sciences- at Mugla Sitki Kocman University. Data collection instruments included the Anxiety Sensitivity Index-Revised, (ASI-R), and also Beck Anxiety Inventory, (BAI). The data were analyzed using Pearson product-moment correlation analysis and structural equation modeling. The results indicate that there were significant positive associations between subdimensions of anxiety sensitivity and anxiety. The results also indicated that the fear of cognitive dyscontrol subdimension of anxiety sensitivity was the most important predictor of the anxiety for emerging adults. Further research examining the relationships between subdimensions of anxiety sensitivity and anxiety are necessary to strengthen the current study's findings.
... Des recherches empiriques concernant l'influence des contaminants environnementaux sur le développement émotionnel sont particulièrement importantes auprès des populations à risque d'être exposées aux contaminants telles que les populations autochtones. D'autant plus que la prévalence de symptômes anxieux et dépressifs est plus élevée dans les populations autochtones, par rapport aux caucasiens, particulièrement concernant les idées suicidaires (Zvolensky, McNeil, Porter, & Stewart, 2001). Ceci est particulièrement vrai chez les Inuits, dont le taux de suicide surpasse même celui des autres communautés autochtones d'Amérique du Nord (Haggarty, Cernovsky, Kermeen, & Merskey, 2000). ...
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L’objet de cet article est de présenter une revue des divers facteurs de risques et des corrélats neuronaux associés au développement des troubles intériorisés, soit les troubles anxieux et dépressifs. Un accent est mis sur la contribution de l’exposition aux contaminants environnementaux dans le développement de troubles intériorisés, en particulier le plomb, le méthylmercure et les biphényles polychlorés.
... Future research would benefit from replicating these findings in a more demographically diverse sample. However, because AS has been shown to be higher in females (Stewart et al. 1997; Zvolensky et al. 2001), it is not unreasonable to use a sample with a majority of female participants. Further, there was also a minimal difference in the duration of the MET condition and the psychoeducation control groups. ...
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Anxiety sensitivity (AS), the fear of anxiety and its potential consequences, places individuals at an increased risk for the development of anxiety disorders. While elevated AS is correctable, often through very brief interventions, individuals high in AS may be unaware of the risks associated with this risk factor and, therefore, may be unaware or unmotivated to address this potential risk. The purpose of the present investigation was to examine the use of motivation enhancement therapy (MET) to enhance motivation to utilize a preventive intervention in a non-intervention seeking population with elevated levels of AS. We examined this issue in a randomized controlled pilot study. Participants (N = 23) were randomized to one of two groups: (1) a MET group (n = 12) group or (2) a control group focused on healthy behaviors (n = 11). Those in the MET group received MET focused on enhancing motivation to reduce AS, whereas those in the control group received psychoeducation about health and general well being. At the end of the study, all of the participants were given the option to receive a computerized intervention previously found to be effective at reducing AS. Results revealed that the MET group had significant changes in motivation to change anxiety and motivation to attend the AS preventative intervention. Moreover, 50 % of individuals in the MET group completed the preventative intervention in comparison to 0 % in the control group. Implications of the findings are discussed.
... Outcome research may have limited generalizability when concepts are assumed to be universal across cultures. Research conducted by Zvolensky et al. (2001) demonstrated that the Anxiety Sensitivity Index Scale was applicable across a homogenous group of Native American university students and a Caucasian sample based on similar factor analytic structures. Researchers continue to encourage examinations of the applicability and appropriateness of psychological constructs, including the hope theory, and the Children's Hope Scale across cultures (Lopez et al. 2000). ...
Article
Child reports of hope continue to be utilized as predictors of positive adjustment; however, the utilization of the hope construct has not been assessed within the culturally diverse Native American child group. The present study investigated the applicability of the Hope theory among 96 Native American children in the Midwest. Measures included the Children’s Hope Scale and a Hope Interview. Native American children in the current sample appear to conceptualize hope as a way to reach goals as did the children in the normative sample. Results from the factor analysis demonstrate that the factor structure found in the current study was similar to the factor structure found in the standardization sample. Because of the similar Hope theory conceptualization and factor structure, interventions focused on the positive psychology construct of hope may be applicable within a Native American child population.
... One way to understand the concept of cultural vahdity is the degree to which members of a culture believe that a given intervention is consistent with their values and aspirations (Foster & Mash, 1999;Solano-Flores & Nelson-Barber, 2001 ;Wolf, 1978). Because ofthe differences in worldviews discussed earlier, it is crucial that culturally relevant assessment tools be used with Native clients (Zvolensky, McNeil, Porter, & Stewart, 2001). If assessment tools are perceived as inconsistent with the values and goals of Native Americans, then-at best-assessments will not be successfully completed, and-at worst-clients may be harmed (Foster & Mash, 1999;Napoli, 1999;Weaver, 2005). ...
Conference Paper
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Background and Purpose: The Joint Commissionthe nation's largest healthcare accrediting bodyrequires the administration of spiritual assessments in hospitals, agencies providing addiction services, and other organizations providing services to Native Americans. Although spirituality is linked to health and wellness in many tribal communities, little research has been conducted to ensure that such assessments are administered in a culturally relevant manner. This raises the possibility that helping relationships may be compromised as assessment approaches or tools are used that are incongruent with common Native values. Many conceptually distinct approaches to spiritual assessment have appeared in the literature. If healthcare professionals are required to conduct spiritual assessments with Native clients, it is critical that research be conducted to identify assessment tools that are congruent with common Native American cultural values. Drawing from the concept of social validity (Wolf, 1978), this mixed-method study determined which spirituality assessment approachesat a conceptual levelare most congruent with Native American values. Methods: In keeping with Pace et al.'s (2006) recommendations for assessing social validity, a hybrid purposive/snowball sampling strategy was used to identify individuals (N=50, 75% response rate) with specialized knowledge of Native American culture. The mean age of the sample was approximately 50, close to two-thirds were female, and the respondents reported a diverse array of tribal, geographic, and spiritual affiliations. The survey instrument described six conceptually unique approaches to spiritual assessment. Quantitative items asked respondents to rank the degree of cultural consistency of each approach on a 0 (no consistency) to 10 scale (complete consistency). Qualitative items explored the strengths and weakness of each approach. After pilot testing, the survey instrument was mailed to potential respondents. For the quantitative data, means, standard deviations, and modes were computed and reported. For the qualitative data, an inductively oriented constant comparative methodology was used to analyze the data (Padgett, 2008). Using this approach, data were examined across cases for similarities, patterns, and common concepts. In a recursive process, these commonalities were continually compared to similar phenomena across cases to identify, classify, and refine the emerging themes. Results: The quantitative findings indicated that the process of taking a spiritual history represented the approach that was perceived to be most congruent with common Native values (M=7.06). Conversely, genogramsalthough widely used with general European American populationwere perceived to be the least congruent with Native values (M=5.40). The qualitative responses helped illuminate these findings (e.g., genograms provide a poor cultural fit with the complex non-nuclear, family relationships common in many tribal communities). Conclusions and Implications: Although spirituality is a key variable in health and wellness for many Native clients, certain spiritual assessment approaches were perceived to be more congruent than others with common Native values. These results have distinct implications for practitioners required to administer spiritual assessments. Namely, assessments are likely to be perceived to be more culturally valid by Native clients if clinically salient information is gathered using a spiritual history.
... Thus, although there is research in several ethnoracial groups, there remains uncertainty in observed factor structures. In addition, only two studies directly compared minority and majority groups, and one included a small sample in the minority group (Hunter et al., 2012; Zvolensky et al., 2001). As such, there is a need to directly compare groups of a large size from a geographically similar location to demonstrate a stable factor structure in each ethnoracial group and to allow the observation of variance across groups while minimizing the effect of geography; geography may artificially mask or accentuate potential racial or ethnic effects. ...
Article
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Anxiety sensitivity (AS), the fear of anxious cognitive and physiological experiences, is multidimensional and adds incrementally to the prediction of relationships of panic and relevant phenomenology. Many agree upon the content of the dimensions, but there is less agreement about the factor structure of the anxiety sensitivity index (ASI), a widely used measure of AS, across cultural groups. Anxiety disorders vary in their epidemiology and phenomenology across ethnoracial groups. This investigation adds clarity to research in the psychometric properties of the ASI across four cultural groups. Results from a confirmatory factor analysis support invariance across groups with the exception of three psychometrically questionable items assessing fear of gastrointestinal symptoms. The convergent and divergent validity are consistent with cross-group invariance as well. Clinical implications are discussed.
... The first purpose was to create a Polish adaptation of the ASI-III in order to stimulate Polish research on the role of AS in the current etiological models of anxiety and related disorders and to make these research findings comparable with those obtained in other countries. Given psychological states and traits may show cultural differences (e.g., Arrindel et al., 1987;Iwawaki, Eysenck, & Eysenck, 1977) and the knowledge regarding the characteristics and the role of the AS in non-English speaking countries remains quite rudimentary (Kotov, Schmidt, Zvolensky, Vinogradov, & Antipova, 2005;Taylor et al., 2007;Zvolensky, McNeil, Porter, & Stewart, 2001), cross-cultural comparisons serve to test the applicability and generalizability of the ASI-III and the existing theories on the role of AS in the development and maintenance of anxiety and related disorders. If required, cross-cultural research may help to generate more universal etiological models of anxiety and related disorders and respect cultural specificity in the international classifications of mental disorder. ...
Article
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The present study sought to adapt and validate the psychometric properties of the Anxiety Sensitivity Index-III in Poland. The ASI-III consists of three subscales, each representing one of the three domains of fears of the negative consequences of anxiety-related physical, cognitive, or social sensations. The study included a total of 116 panic disorder patients and 411 controls who did not show the presence of mental disorders. The results indicated that the Polish-language version of the ASI-III is characterized by high content validity, internal consistency, and stability over a period of 28 days. Moreover, its factor structure was largely equivalent to that found on the original ASI-III. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
... Counter to hypotheses, exhibiting high levels of anxiety sensitivity was not significantly related to drinking to manage negative emotions. Zvolensky et al. (2001) found that American Indian and Alaskan Native college students reported significantly greater overall anxiety sensitivity than the majority (Caucasian) culture. It might be that coping motivated drinking for these groups is related to relieving physical tension. ...
Article
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This study tested the association between personality traits (i.e., anxiety sensitivity, sensation seeking, impulsivity, and hopelessness; as measured by the Substance Use Risk Profile Scale (Woicik et al. in Addictive Behaviors 34:1042–1055, 2009)), drinking motives (i.e., enhancement, social, coping, and conformity; as measured by the Drinking Motives Questionnaire—Revised (Cooper in Psychological Assessment 6:117–128, 1994)), and problematic patterns of alcohol use in 191 Canadian Aboriginal youth. Confirmatory factor analyses provided support for a three-factor model of drinking motives. Hierarchical regression analyses demonstrated that personality traits independently predicted motives for alcohol use: anxiety sensitivity predicted conformity motivated drinking; sensation seeking and impulsivity predicted enhancement motivated drinking; and hopelessness predicted coping motivated drinking. In addition, personality traits and drinking motives predicted problematic patterns of alcohol misuse: sensation seeking, hopelessness, and enhancement motives predicted heavy episodic drinking, while all personality traits and all drinking motives (save conformity) predicted alcohol-related problems. These findings suggest that specific personality traits in Canadian Aboriginal youth can explain specific reasons for drinking and may represent appropriate targets for intervention.
... Future research would benefit from replicating these findings in a more demographically diverse sample. Despite this limitation, AS has been shown to be higher in females (Stewart et al.,1997;Zvolensky et al., 2001), so it is not unreasonable to use predominately female samples. ...
Article
Mounting evidence suggests that specific psychological risk factors increase the likelihood for the development of anxiety psychopathology. Anxiety sensitivity (AS), the fear of the consequences of anxiety, is one such risk factor. However, very little is known about the consequences of having elevated AS prior to the development of diagnosable psychopathology. We hypothesized that elevated AS may create impairment among premorbid individuals. The aims of the present study were twofold. The first aim was to examine whether having elevated AS would be predictive of impairment in a nonclinical sample. The second aim was to examine whether subclinical anxiety symptoms would partially mediate the association between AS and impairment in daily life. These aims were examined in two studies utilizing samples of individuals with elevated levels of AS. Study 1 (N=387) and Study 2 (N=79) were comprised of participants with elevated AS. Participants completed a battery of questionnaires and a diagnostic interview to assess for risk status. Only participants without an anxiety disorder were eligible to participate in the study to ensure that they were in the premorbid stage. In Study 1, there was a direct effect of AS on impairment. Additionally, there was evidence for anxiety symptoms acting as a partial mediator in the relation between AS and impairment. Study 2 revealed the same pattern of results, with AS having a significant direct effect on impairment that was partially mediated by anxiety symptoms. The samples utilized in the present sample were primarily Caucasian females, thereby potentially limiting the generalizability of these findings. This study provides evidence that a premorbid risk factor is associated with impairment before the actual development of an anxiety disorder. Implications of the present investigation and future directions are discussed.
... Consistent with our hypothesis, those who scored higher on measures of AS also tended to endorse a greater expectancy that eating could be useful as an affect regulation strategy as well as lead to feeling out of control. In addition, higher AS was associated with greater self-reported urge to eat across all three domains encompassed in the EES, anger/frustration, anxiety and depression, providing support for the broad applicability of this construct as highlighted in previous research (Carter et al. 1999;McHugh and Otto 2011;Schmidt and Joiner 2002;Zvolensky et al. 2001). These results underscore the need to further examine the role of AS and eating expectancy in relation to actual eating behavior as well as to clarify whether such relationships are unique to overweight individuals or also occur in those in the normal BMI range. ...
Article
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Research has shown that anxiety sensitivity (AS), or the fear of somatic arousal, predicts distress and maladaptive coping in a range of psychiatric conditions. More recently, the role of AS has been examined in pathological eating. In the current investigation, a two-study design was employed to examine the role of AS and eating expectancies in both self-reported and actual eating behavior. For Study 1, 42 overweight/obese participants completed questionnaires assessing AS, as well as eating behaviors and attitudes. In Study 2, 60 participants representing all weight ranges completed the same questionnaire battery and underwent a negative mood induction task followed by food exposure. Results of this study revealed a 3-way interaction between Anxiety Sensitivity Index-mental concerns subscale, Eating Expectancy Inventory—eating leads to feeling out of control subscale, and BMI suggesting that those elevated on all 3 constructs consumed the most calories. Results are discussed in relation to better understanding the role of AS and eating expectancy and its utility in identifying a subset of overweight/obese individuals at risk for maladaptive eating behavior.
... For example, ethnic identity is associated with increased successful psychological functioning and well-being in adolescents (Markstrom et al. 2011;Martinez and Dukes 1997;Phinney 1990;Phinney and Chaviara 1992). This function of ethnic identity is especially important for American Indian youth given the heightened rates of mental health disorders in this population (Beals et al. 1997;West and Newman 2011), including anxiety (Zvolensky et al. 2001), depressive symptoms (Manson et al. 1990), and externalizing disorders (Whitbeck et al. 2008). However, little of the available literature has examined ethnic identity in the American Indian population (Markstrom et al. 2011). ...
Article
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Mental health functioning in American Indian youth is an understudied topic. Given the increased rates of depression and anxiety in this population, further research is needed. Using multiple group structural equation modeling, the current study illuminates the effect of ethnic identity on anxiety symptoms, depressive symptoms, and externalizing behavior in a group of Lumbee adolescents and a group of Caucasian, African American, and Latino/Hispanic adolescents. This study examined two possible pathways (i.e., future optimism and self-esteem) through which ethnic identity is associated with adolescent mental health. The sample (N = 4,714) is 28.53 % American Indian (Lumbee) and 51.38 % female. The study findings indicate that self-esteem significantly mediated the relationships between ethnic identity and anxiety symptoms, depressive symptoms, and externalizing behavior for all racial/ethnic groups (i.e., the total sample). Future optimism significantly mediated the relationship between ethnic identity and externalizing behavior for all racial/ethnic groups and was a significant mediator between ethnic identity and depressive symptoms for American Indian youth only. Fostering ethnic identity in all youth serves to enhance mental health functioning, but is especially important for American Indian youth due to the collective nature of their culture.
... The use of culturally competent assessment tools is essential with Native American clients (Zvolensky, McNeil, Porter, & Stewart, 2001). Assessment tools that have not been developed or modified for use with Native Americans can represent a form of institutional racism (Weaver, 2005). ...
Article
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Although spirituality plays a central role in health and wellness for many Native Americans, surprisingly few spiritual assessment tools have been validated with this population. This mixed-method study modifies an existing spiritual assessment tool—spiritual histories—that may be particularly congruent with Native American culture. Using a sample of recognized experts in Native culture (N = 50), the study identifies: (a) the degree of cultural consistency, strengths, and limitations of the tool, conceptually, and (b) a culturally valid question protocol to operationalize the concept for use with Native clients. The findings are discussed in light of recent accrediting requirements mandating the administration of spiritual assessments in numerous settings and suggestions are provided to administer the assessment in a culturally competent manner.
... Although it was reported that several AI-SUPERPF participants found some of the terms used in the depression scale difficult to appraise (e.g., concepts related to time) (), the pilot study conducted in Ontario did not identify these or similar issues, and the measure was deemed appropriate for this sample (MacMillan et al., 2008). Similarly, a scale measuring Anxiety Sensitivity, which functions as a vulnerability factor for anxiety disorders (Eifert et al., 1999), was found to be psychometrically sound and have the same factor structure in a university sample of American Indian, Alaska Native and Caucasian students (Zvolensky et al., 2001). However, the use of the Anxiety Sensitivity scale in a homogenous sample of American Indians living on or near a reservation in the Northern Plains did not produce the same factor structure. ...
Article
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... Future research would benefit from replicating these findings in a more demographically diverse sample. However, because AS has been shown to be higher in females (Stewart et al. 1997;Zvolensky et al. 2001), it is not unreasonable to use a sample with a majority of female participants. Further, there was also a minimal difference in the duration of the MET condition and the psychoeducation control groups. ...
Article
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Anxiety sensitivity (AS), the fear of the consequences of anxiety, is known to be a risk factor in the development and maintenance of anxiety psychopathology. In recent years, AS has been shown to be responsive to a variety of interventions aimed at reducing this malleable risk factor. Motivational interviewing (MI) and motivation enhancement treatment (MET) have been shown to be effective in enhancing the treatment of anxiety disorders. Thus, it was hypothesized that motivational interventions may also be effective in those with elevated AS. The aim of the present study was to examine whether the use of MI/ MET would be effective in reducing AS. Participants (N = 80) with elevated AS were randomized into an MET or health-focused psychoeducation control group. Results revealed that the MET condition showed a significant reduction in AS in comparison to the control group. These findings are comparable to reductions in AS observed in other AS interventions. Further, changes in motivation mediated the association between experimental group and post-intervention AS. This study is the first to demonstrate the efficacy of MI/MET strategies in the reduction of AS. Implications of the findings and directions for future research are discussed
... The low alpha for Factor 3 can be attributed to the fact that this factor contained only three items. These coefficients are somewhat higher than those obtained by other researchers (Essau et al. 2010;Muris et al. 2001;Silverman et al. 1999;van Widenfelt et al. 2002;Walsh et al. 2004) and more similar to reliability coefficients presented in research with adult samples (Zvolensky et al. 2001). For the purpose of comparison, Cronbach's alpha for the original CASI (3-points scale) obtained from the 3-5 group is .87. ...
Article
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Anxiety sensitivity (AS) refers to a person’s tendency to fear anxiety-related symptoms due to the belief that they have harmful consequences. The Childhood Anxiety Sensitivity Index (CASI) is a well accepted operationalization of the AS construct in children and adolescents. This study evaluated the factor structure, gender stability and psychometric properties of the CASI, modified to a 5-point scale, in a sample of Croatian children and adolescents (N = 1,679). Exploratory and confirmatory analysis and a Schmid-Leiman solution confirmed the multidimensional and hierarchical structure of the CASI, which consisted of three lower-order factors and a single higher-order factor. Further, the modification of the CASI to a 5-point scale resulted in higher reliability, while maintaining acceptable levels of factor stability and validity.
... for 3 years; Peterson & Reiss, 1992). The factor structure and psychometric properties of the ASI have been replicated across diverse populations, testifying to its broad-based applicability (e.g., Carter, Miller, Sbrocco, Suchday, & Lewis, 1999; Schmidt & Joiner, 2002; Zvolensky, McNeil, Porter, & Stewart, 2001). The ASI is unique from, and demonstrates incremental validity to, trait anxiety (Rapee & Medoro, 1994); thus, this construct is distinguishable from the frequency of anxiety symptoms (McNally, 1996). ...
Article
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The present study evaluated the association between the lower-order facets of anxiety sensitivity construct (physical, mental incapacitation, and social concerns) and positive (expectancies about negative affect reduction) and negative (expectancies about negative personal consequences) smoking outcome expectancies. Participants were 90 young adult regular smokers [37 females; M age = 23.4 years (SD = 8.9); mean number of cigarettes/day = 11.7 (SD = 6.1)] with no history of psychopathology or nonclinical panic attacks recruited from the general population. Anxiety sensitivity physical concerns and mental incapacitation concerns, as indexed by the Anxiety Sensitivity Index (ASI; S. Reiss, R. A. Peterson, M. Gursky, & R. J. McNally, 1986), were significantly and incrementally associated with smoking outcome expectancies, as indexed by the Smoking Consequences Questionnaire (SCQ; T. H. Brandon & T. B. Baker, 1991), for negative affect reduction as well as negative personal consequences; the observed effects were over and above the variance accounted for by theoretically relevant smoking history characteristics, gender, and negative affectivity. Results are discussed in relation to better understanding motivational processes for smoking among groups at heightened risk for developing panic psychopathology.
... The issue of validity is particularly important to nonmainstream populations such as Native Americans or American Indians (the two terms are used interchangeably in this paper; Zvolensky et al. 2001). Instruments tend to reflect the values of their designers (Gilligan 1993;Gone 2004). ...
Article
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The use of validated instruments is particularly important with populations of color such as Native Americans. Drawing upon the concept of social validity, this mixed method study validates an existing qualitative spiritual assessment instrument—spiritual eco-maps—using a sample of recognized experts in Native American culture (N=50). The study identifies: (1) the degree of cultural consistency, strengths, and limitations of the spiritual eco-map concept, and (2) how the questions designed to help operationalize the concept might be improved to be more valid, relevant and consistent with Native culture. The results suggest that spiritual eco-maps are relatively consistent with Native American culture as long as they are operationalized appropriately. The paper concludes by providing a more culturally valid question protocol along with suggestions for administering the instrument in a culturally competent manner.
Chapter
American Indians and Alaska Natives are incredibly diverse in terms of culture, tribal affiliations, and geographic dispersion. Unfortunately, they also share many commonalities including high rates of mental health conditions, remarkable health disparities, and difficulties accessing both care in general and evidence-based psychological treatments. Improving outcomes for Indigenous communities requires understanding the myriad of social inequities that increase risk for mental and physical health problems, tailoring and disseminating population-based models of mental health care to maximize efficiency of limited resources, and training a new culturally competent workforce.
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The current study evaluated the validity and reliability of the SCARED on a Native American child population. Results suggest excellent internal consistency for the total score. The hierarchical model best fit the data. Overall the SCARED is a valid tool for identifying Native American children at-risk for developing anxiety disorders.
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Traumatic brain injury (TBI) is both prevalent and potentially disabling. Extant literature has demonstrated women to report greater post-concussive symptoms (PCS) compared to men, highlighting the necessity of investigations into malleable, gender-linked risk factors for PCS that hold promise for reducing this gender disparity. Anxiety Sensitivity (AS) and Distress Tolerance (DT) are gender-linked risk factors that may be related to PCS. Despite a breadth of research supporting elevated AS and reduced DT in women, no study to date has investigated whether AS and DT mediate gender differences in PCS. The current sample was composed of 59 participants selected from a larger study based on their report of a past TBI. Findings indicated that AS, but not DT, significantly mediated gender differences in PCS. The present results suggest that AS is a cognitive risk factor that can partially account for the gender disparity in the expression of PCS. AS may influence an individual's interpretation of PCS as dangerous, thereby amplifying the perception of PCS severity. This suggests that efforts to reduce the burden of TBI may benefit from targeting AS in prevention and treatment paradigms, especially among women.
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Evidence from clinical and community studies reveals a two-fold higher rate of anxiety disorders among women than men. This risk is evident across the lifespan. Anxiety disorders are the most common class of mental disorder, with nearly one-third of women and one-fifth of men meeting lifetime criteria for one of the subtypes of anxiety. Women also experience a greater range of subtypes of anxiety than men. Anxiety disorders tend to co-occur with other classes of mental disorders, including mood disorders and substance use disorders across the lifespan. The onset of anxiety disorders typically occurs in childhood and the incidence rates remain fairly stable across adulthood. Anxiety disorders are highly familial, with both genetic vulnerability factors and environmental exposures contributing to the aggregation of these conditions. Furthermore, sex differences have been observed in various risk factors for anxiety disorders, ranging from psychosocial factors to temperament and biological factors. Although women are more likely than men to be affected by anxiety disorders, they may be less likely to obtain specialty mental health treatment for their conditions. This work highlights the need for more research that systematically examines sex differences in vulnerability, manifestation, causes and consequences of anxiety disorders.
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Anxiety sensitivity (AS) has been defined as the fear of symptoms of anxiety. AS is connected with psychological and demographic variables. The author of this study sought to examine the relationships among academic staffs' gender, age and AS with a sample of 355 practicing academic staff (female=133, male=222). Results showed that female academic staff have greater AS than their male colleagues. Results also revealed statistically significant relationships between age, moving away from social activities and AS. Implications for research and practice are discussed.
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Many studies have reported that Anxiety Sensitivity (AS) is positively associated with alcohol use or other alcohol-related variables. More recent mediator and moderator models have shown promise in elucidating mechanisms within this relationship; the literature to date suggests that the relationship between AS and alcohol is likely mediated by problematic coping motives. However, few studies have considered the effects of depression within the AS-alcohol use relationship, despite a strong body of evidence linking AS to subsequent depression and depression to subsequent alcohol use problems, independently. Therefore, the current study assessed depression as a potential mediator of this relationship. Participants were 418 sequential admissions to a substance abuse treatment facility. A mediation analysis using bootstrapping was utilized in order to estimate indirect effects of AS on alcohol dependence through depression. Results reveal an indirect effect suggesting that the effects of anxiety sensitivity on alcohol dependence are mediated by symptoms of depression. More specifically, the effects of AS total score and AS somatic sensations on alcohol dependence were mediated by symptoms of depression. Lastly, a dual mediator model demonstrated that both depression and problematic coping uniquely mediate the relationship between AS and alcohol dependence. While preliminary in nature, the current study provides evidence supporting the hypothesis that depression is an important factor to consider when examining the relationship between AS and alcohol dependence.
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The aim of the present study was to evaluate a factor mixture-based taxonic-dimensional model of anxiety sensitivity (AS) (Bernstein et al. Behavior Therapy 41:515-521, 2010), as measured by the ASI-3 (Taylor et al. Psychological Assessment 19:176-188, 2007), in regard to panic attacks, anxiety symptoms, and behavioral impairment among a university sample (N = 150, n females = 107, M age = 21.3 years, SD = 4.3) and a clinical sample (N = 150, n females = 102, M age = 39.0 years, SD = 12.0) from Mexico City, Mexico. Findings demonstrated cross-national support for the conceptual and operational utility of the AS taxonic-dimensional hypothesis (Bernstein et al. Journal of Anxiety Disorders 20:1-22, 2007b). Specifically, (1) the FMM-based AS taxon class base rate was significantly greater among the clinical relative to the university sample; (2) risk for panic attacks was significantly greater among the AS taxon class relative to the AS normative class; and (3) continuous individual differences in AS physical and psychological concerns, within the AS taxon class, were associated with level of risk for panic attacks, as well as panic attack severity and anxiety symptom levels. Similar AS taxonic-dimensional effects were observed in relation to degree of behavioral impairment across domains of functioning. The study results are discussed with respect to their implications for better understanding the nature of AS-related cognitive vulnerability for panic and related anxiety psychopathology.
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Ethnic group differences in affective, behavioral, and cognitive measures of anxiety were examined to better characterize the unique triggers and modes of anxious responding across different groups. Using an ethnically diverse sample (N = 112; 39 African Americans, 34 Asian Americans, and 39 European Americans), the study examined differences in anxious responding following three anxiety provocations (physical, social interpersonal, and social performance), each hypothesized to be a primary anxiety trigger for one of the groups. African Americans and European Americans demonstrated greater behavioral avoidance during a physical provocation designed to elicit shortness of breath sensations relative to Asian Americans. Asian Americans reported a higher number of anxious cognitions than African Americans during a social provocation designed to trigger performance concerns. These findings suggest ethnicity should be carefully considered when assessing the predominant triggers of anxiety and modes of anxious responding.
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We have provided a laboratory evaluation of emotional reactivity to physiological (hyperventilation), cognitive (mental arithmetic), and social (speech) challenge procedures, and investigated how preexperimental levels of perceived stress, anxiety sensitivity, and negative-evaluation sensitivity predicted anxious and fearful responding. Participants were 37 nonclinical individuals. Dependent measures included a multimethod assessment involving self-reported anxiety, frequency and intensity of bodily sensations, and heart rate and blood pressure responses to the challenges. Our results indicated that preexperimental levels of perceived stress were more predictive than other theoretically relevant variables of self-reported anxiety-related reactivity to cognitive and social challenges, whereas anxiety sensitivity was a better predictor of the emotional response to hyperventilation. Collectively, these findings are consistent with theoretical accounts of anxiety pathology, and suggest that perceived stress is an important process variable to consider in understanding the determinants of anxiety-related responding.
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The present investigation was aimed at developing a means to measure culturally re-lated anxiety in American Indians and Alaska Natives. Initial item selection and fac-tor structure for a self-report instrument, the Native American Cultural Involvement and Detachment Anxiety Questionnaire (CIDAQ), were derived from samples of Sincere appreciation is extended to the faculty, students, and staff of Haskell Indian Nations University for their enduring and strong support of this project. Similarly, the faculty, students, and staff of the Shiprock campus of Din6 College (formerly Navajo Community College) were very helpful in making Study 3 possible.
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The Icelandic version of the Anxiety Sensitivity Index was investigated in two studies of college students. A principal components analysis of ASI scores from both studies (N=718) yielded three components similar to what has been found previously: Psychological Concerns, Physical Concerns and Social Concerns. In the first study the relationship between the ASI and trait anxiety was investigated. It was analysed at the level of the total scales but also at the level of subscales of both instruments. Two subscales of the STAI, measuring respectively Anxiety-trait and Depression-trait, were used as well as the Psychological Concerns and Physical Concerns subscales of the ASI. In a second study the relationships between ASI and its subscales and two symptom measures of anxiety and depression were addressed. ASI was in both studies more strongly related to the anxiety than the depression scales. Also, in both studies the Physical Concerns subscale of the ASI was more strongly related to anxiety than to depression, whereas the Psychological Concerns subscale was equally related to anxiety and depression. Taken together the studies support the notion of different relationships between different aspects of anxiety sensitivity, and anxiety and depression as traits, cognitive symptoms and mood related symptoms.
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The present study explored psychological predictors of response to a series of three 25 second inhalations of 20% carbon dioxide-enriched air in 60 nonclinical participants. Multiple regression analyses indicated that only anxiety sensitivity physical concerns predicted self-reported fear, whereas both physical anxiety sensitivity concerns and behavioural inhibition sensitivity independently predicted affective ratings of emotional arousal. In contrast, the psychological concerns anxiety sensitivity dimension predicted ratings of emotional displeasure (valence), and both psychological anxiety sensitivity concerns and behavioural inhibition sensitivity independently predicted emotional dyscontrol. No variables significantly predicted heart rate. These data are in accord with current models of emotional reactivity that highlight the role of cognitive variables in the production of anxious and fearful responding to somatic perturbation, and help further clarify the particular predictors of anxiety-related responding to biological challenge.
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This article reviews the concept of heart-focused anxiety that may occur in response to cardiac-related stimuli and sensations. Our aim was to examine the relation between chest pain, panic, and heart-focused anxiety in persons with and without heart disease. We identify a preoccupation with the heart and its functioning based on the belief that it will lead to negative consequences (e.g., death, pain) as an important psychological variable in the production of anxious and fearful responding. We then discuss heart-focused anxiety in relation to other clinically relevant variables in anxiety-related problems such as hypochondriacal concerns, including physical symptoms, disease fear, disease conviction, and safety-seeking behavior. Finally, we briefly discuss the clinical importance of heart-focused anxiety in the assessment and treatment of certain anxiety and cardiac-related problems.
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The Cultural Involvement and Detachment Anxiety Questionnaire (D. W. McNeil, C. A. Porter, M. J. Zvolensky, & J. M. Chaney, 1998) and the Multigroup Ethnic Identity Measure (J. S. Phinney, 1992) were administered to 160 Navajo college students to explore the relation between ethnic identity and culturally related anxiety, compare level of ethnic identity in reference to standardized samples, and test for gender differences. Correlations indicated a notable lack of relation between ethnic identity and cultural anxiety. This particular Navajo sample evidenced significantly higher levels of ethnic identity in comparison to students of Caucasian, Asian, Hispanic, or mixed ethnicity. There were no significant gender differences in culturally related anxiety. Results are discussed in relation to culturally related anxiety and ethnic identity in the Navajo, with implications for better understanding the nature of cultural anxiety in other American Indians and Alaska Natives.
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Expectancy theory posits that anxiety sensitivity may serve as a premorbid risk factor for the development of anxiety pathology (S. Reiss, 1991). The principal aim of the present study was to determine whether anxiety sensitivity acts as a specific vulnerability factor in the pathogenesis of anxiety pathology. A large, nonclinical sample of young adults (N = 1,401) was prospectively followed over a 5-week highly stressful period of time (i.e., military basic training). Anxiety sensitivity was found to predict the development of spontaneous panic attacks after controlling for a history of panic attacks and trait anxiety. Approximately 20% of those scoring in the upper decile on the Anxiety Sensitivity Index (R. A. Peterson & S. Reiss, 1987) experienced a panic attack during the 5-week follow-up period compared with only 6% for the remainder of the sample. Anxiety sensitivity also predicted anxiety symptomatology, functional impairment created by anxiety, and disability. These data provide strong evidence for anxiety sensitivity as a risk factor in the development of panic attacks and other anxiety symptoms.
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The performance of five methods for determining the number of components to retain (Horn's parallel analysis, Velicer's minimum average partial [MAP], Cattell's scree test, Bartlett's chi-square test, and Kaiser's eigenvalue greater than 1.0 rule) was investigated across seven systematically varied conditions (sample size, number of variables, number of components, component saturation, equal or unequal numbers of variables per component, and the presence or absence of unique and complex variables). We generated five sample correlation matrices at each of two sample sizes from the 48 known population correlation matrices representing six levels of component pattern complexity. The performance of the parallel analysis and MAP methods was generally the best across all situations. The scree test was generally accurate but variable. Bartlett's chi-square test was less accurate and more variable than the scree test. Kaiser's method tended to severely overestimate the number of components. We discuss recommendations concerning the conditions under which each of the methods are accurate, along with the most effective and useful methods combinations.
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Two studies were designed to establish whether high anxiety sensitive (AS) university students selectively process threat cues pertaining to their feared catastrophic consequences of anxiety, and to examine potential gender differences in the selective processing of such threat cues among high versus low AS subjects. Forty students (20 M; 20 F) participated in Study 1. Half were high AS and half low AS, according to scores on the Anxiety Sensitivity Index (ASI). Subjects completed a computerised Stroop colournaming task involving social/psychological threat (e.g. EMBARRASS; CRAZY), physical threat (e.g. CORONARY; SUFFOCATED), and neutral (e.g. MOTEL; TOWEL) target words. High AS subjects demonstrated more threat-related interference in colour-naming than did low AS subjects, overall. High AS menevidencedgreater interference relative to low AS men only for the social/psychological threat stimuli; highAS women evidencedgreater interference relative to low AS women only for the physical threat stimuli. Study 2 was designed to replicate and extend the novel Study 1 finding of a cognitive bias favouring the processing of social/psychological threat cues among high AS men. Participants were 20 male university students (10 high AS; 10 low AS). In addition to social/psychological threat, physical threat, and neutral words, a category of positive emotional words (e.g. HAPPINESS; CELEBRATION) was included as a supplementary control on the Stroop. Consistent with Study 1, high AS males evidenced greater Stroop interference than did low AS males, but only for social/psychological threat words. No AS group differences in Stroop interference were revealed for the physical threat or positive words. Clinical implications, and potential theoretical explanations for the gender differences, are discussed.
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The goals of both exploratory and confirmatory factor analysis are described and procedural guidelines for each approach are summarized, emphasizing the use of factor analysis in developing and refining clinical measures. For exploratory factor analysis, a rationale is presented for selecting between principal components analysis and common factor analysis depending on whether the research goal involves either identification of latent constructs or data reduction. Confirmatory factor analysis using structural equation modeling is described for use in validating the dimensional structure of a measure. Additionally, the uses of confirmatory factor analysis for assessing the invariance of measures across samples and for evaluating multitrait-multimethod data are also briefly described. Suggestions are offered for handling common problems with item-level data, and examples illustrating potential difficulties with confirming dimensional structures from initial exploratory analyses are reviewed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Syndromal classification is a well-developed diagnostic system but has failed to deliver on its promise of the identification of functional pathological processes. Functional analysis is tightly connected to treatment but has failed to develop testable, replicable classification systems. Functional diagnostic dimensions are suggested as a way to develop the functional classification approach, and experiential avoidance is described as 1 such dimension. A wide range of research is reviewed showing that many forms of psychopathology can be conceptualized as unhealthy efforts to escape and avoid emotions, thoughts, memories, and other private experiences. It is argued that experiential avoidance, as a functional diagnostic dimension, has the potential to integrate the efforts and findings of researchers from a wide variety of theoretical paradigms, research interests, and clinical domains and to lead to testable new approaches to the analysis and treatment of behavioral disorders. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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The Anxiety Sensitivity Index (ASI) is one of the most widely used measures of the construct of anxiety sensitivity. Until the recent introduction of a hierarchical model of the ASI by S. O. Lilienfeld, S. M. Turner, and R. G. Jacob (1993), the factor structure of the ASI was the subject of debate, with some researchers advocating a unidimensional structure and others proposing multidimensional structures. In the present study, involving 432 outpatients seeking treatment at an anxiety disorders clinic and 32 participants with no mental disorder, the authors tested a hierarchical factor model. The results supported a hierarchical factor structure consisting of 3 lower order factors and 1 higher order factor. It is estimated that the higher order, general factor accounts for 60% of the variance in ASI total scores. The implications of these findings for the conceptualization and assessment of anxiety sensitivity are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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This study examined the factor structure of the Anxiety Sensitivity Index (ASI) among African American college students. Confirmatory factor analysis indicated the 3-factor solution commonly found among other populations did not fit the data for African Americans. Although an exploratory factor analysis indicated the presence of a Mental Incapacitation factor, the Physical Concerns factor was divided into unsteady and cardiovascular concerns. Items typically comprising the Social factor were reflective of emotional controllability among African Americans. The ASI was also moderately correlated with measures of anxiety and depression providing only weak evidence of convergent and discriminate validity of the ASI for African Americans. Although support for the multidimensional nature of AS was found, the factor composition differs for African Americans.
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Studies on race bias, social class bias, and gender bias are reviewed. Topics include psychodiagnosis and rating level of adjustment, the description of personality traits and psychiatric symptoms, the prediction of behavior, and treatment planning. Replicated findings include race bias in the differential diagnosis of schizophrenia and psychotic affective disorders, gender bias in the differential diagnosis of histrionic and antisocial personality disorders, race bias and gender bias in the prediction of violence, and social class bias in the referral of clients to psychotherapy. Recommendations for decreasing bias include (a) being aware of when biases are likely to occur, (b) adhering to diagnostic criteria, and (c) using statistical prediction rules to predict behavior.
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Investigated the performance of 5 methods for determining the number of components to retain—J. L. Horn's (see record 1965-13273-001 ) parallel analysis, W. F. Velicer's (see record 1977-00166-001 ) minimum average partial (MAP), R. B. Cattell's (see PA, Vol 41:969) scree test, M. S. Bartlett's (1950) chi-square test, and H. F. Kaiser's (see record 1960-06772-001 ) eigenvalue greater than 1 rule—across 7 systematically varied conditions (sample size, number of variables, number of components, component saturation, equal or unequal numbers of variables for each component, and the presence or absence of unique and complex variables). Five sample correlation matrices were generated at each of 2 sample sizes from the 48 known population correlation matrices representing 6 levels of component pattern complexity. Results indicate that the performance of the parallel analysis and MAP methods was generally the best across all situations; the scree test was generally accurate but variable; and Bartlett's chi-square test was less accurate and more variable than the scree test. Kaiser's method tended to severely overestimate the number of components. (65 ref)
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Control over the offset of repeated administrations of 20% carbon-dioxide-enriched air was assessed in nonclinical participants (n = 30) reporting elevated levels of anxiety sensitivity--a population at an increased risk for experiencing panic attacks and possibly developing panic disorder. In Phase I, participants were randomly assigned to 1 of 2 conditions: one that permitted offset control over gas inhalation and one that did not. These conditions were reversed in Phase II. Across phases, a lack of offset control resulted in greater self-reported anxiety compared with having control, although no significant differences were observed for heart rate. Whereas all participants demonstrated a Stroop interference effect for general (e.g., coffin) compared with specific (e.g., dizzy) physical threat word types prior to the first experimental phase, this effect persisted only for participants who had offset control in Phase I. We discuss these results in relation to the differential effects of offset control, with implications for better understanding anxious responding during elevated bodily arousal.
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The psychological and anthropological literature on cultural variations in emotions is reviewed. The literature has been interpreted within the framework of a cognitive-process model of emotions. Both cross-cultural differences and similarities were identified in each phase of the emotion process; similarities in 1 phase do not necessarily imply similarities in other phases. Whether cross-cultural differences or similarities are found depends to an important degree on the level of description of the emotional phenomena. Cultural differences in emotions appear to be due to differences in event types or schemas, in culture-specific appraisal propensities, in behavior repertoires, or in regulation processes. Differences in taxonomies of emotion words sometimes reflect true emotion differences like those just mentioned, but they may also just result from differences in which emotion-process phase serves as the basis for categorization.
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Many clinical and social psychologists need to develop scales to carry out their research. Without adequate training in psychometric methods, they can easily run into difficulty. This article is designed to address some of the more common pitfalls in homogeneous scale construction. Empirical scale development by the criterion-group method is not considered. Suggestions are offered about item writing, answer scale formats, data analysis procedures, and overall scale development strategy. Particular emphasis is placed on the effective use of factor-analytic methods to select items for the scale and to determine its proper location in the hierarchy of factor constructs.
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The study reported here was undertaken to analyze patterns of mental health conditions as reflected in visits to outpatient care facilities of the Indian Health Service (IHS). Quantitative information about the mental health of American Indians obviously must come from the IHS. Diagnoses made in IHS clinics and hospitals are entered into a computer for subsequent tabulation and analysis; these diagnoses are classified as 'problems' or 'clinical impressions'. In addition, problem checklists completed in the Mental Health or Social Services Branches of IHS also provide useful information about Indians' reasons for seeking care. Data for this study were obtained from the Office of Program Statistics of IHS. These data are contained in computer printouts showing the number of visits for various problems to IHS and contract facilities. Using these data, we constructed tables to compare the numbers and rates of visits for various diagnoses between different age groups for fiscal year 1975. The authors also similarly analyzed certain data relating to visits to Mental Health Branches. The IHS lists the following conditions under the heading 'Mental Disorders' for clinic visits: alcoholism, organic brain syndrome, schizophrenia and other psychoses, neurosis, personality disorders, and drug abuse and dependence. The IHS has 49 hospitals, 101 health centers, and more than 300 health stations. All of these facilities contribute reports to the computer center. During fiscal year 1975, a total of 2,759,000 outpatient visits were made, and 58,637 (2.1%) of these visits were for mental disorders.
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A prospective naturalistic 1-year follow-up study of 39 patients with current panic disorder, 17 remitted panic patients, 46 infrequent panickers, 22 patients with simple phobias, and 45 controls assessed clinical course and variables related to the maintenance of panic attacks. Nearly all panic disorder patients (92%) continued to experience panic attacks, and 41% of the initially remitted patients relapsed. No significant effects of treatments delivered in the community were found. Infrequent panickers tended to be more likely to develop panic disorder (15%) than controls (2%). Maintenance/relapse was most consistently linked with good heartbeat perception, anxiety sensitivity, and avoidance in the different subsamples. Patients with simple phobias or normal controls who experienced their first panic attack during follow-up had shown higher anxiety sensitivity at initial assessment than nonpanickers
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The Anxiety Sensitivity Index (ASI) is one of the most widely used measures of the construct of anxiety sensitivity. Until the recent introduction of a hierarchical model of the ASI by S. O. Lilienfeld, S. M. Turner, and R. G. Jacob (1993), the factor structure of the ASI was the subject of debate, with some researchers advocating a unidimensional structure and others proposing multidimensional structures. In the present study, involving 432 outpatients seeking treatment at an anxiety disorders clinic and 32 participants with no mental disorder, the authors tested a hierarchical factor model. The results supported a hierarchical factor structure consisting of 3 lower order factors and 1 higher order factor. It is estimated that the higher order, general factor accounts for 60% of the variance in ASI total scores. The implications of these findings for the conceptualization and assessment of anxiety sensitivity are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Control over the offset of repeated administrations of 20% carbon-dioxide-enriched air was assessed in nonclinical participants (n = 30) reporting elevated levels of anxiety sensitivity-a population at an increased risk for experiencing panic attacks and possibly developing panic disorder. In Phase I, participants were randomly assigned to 1 of 2 conditions: one that permitted offset control over gas inhalation and one that did not. These conditions were reversed in Phase II. Across phases, a lack of offset control resulted in greater self-reported anxiety compared with having control, although no significant differences were observed for heart rate. Whereas all participants demonstrated a Stroop interference effect for general (e.g., coffin) compared with specific (e.g., dizzy) physical threat word types prior to the first experimental phase, this effect persisted only for participants who had offset control in Phase I. We discuss these results in relation to the differential effects of offset control, with implications for better understanding anxious responding during elevated bodily arousal.
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A partir d'enquetes menees sur differentes populations (langues anglaise, espagnole, italienne, allemande ― Europe du Nord/du Sud ― Amerique du Nord/du Sud), l'article expose les donnees epidemiologiques obhtenues a propos des troubles de l'anxiete et de la panique
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The purpose of this study was to examine the extent to which anxiety-related individual difference variables predict anxious responding when individuals experience aversive bodily sensations. Thus, we explore several psychological and behavioral predictors of response to a single 25-sec inhalation of 20% carbon dioxide-enriched air in 70 nonclinical participants. Predictor variables included anxiety sensitivity, suffocation fear, heart-focused anxiety, and breath-holding duration. Multiple regression analyses indicated that only anxiety sensitivity significantly predicted postchallenge panic symptoms, whereas both anxiety sensitivity and suffocation fear predicted postchallenge anxiety. These data are in accord with current models of panic disorder that emphasize the role of “fear of fear” in producing heightened anxiety and panic symptoms and help clarify specific predictors of anxiety-related responding to biological challenge.
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Cognitive conceptualizations of panic disorder suggest that panic is produced and maintained by threatening beliefs associated with autonomic arousal. The present study tested the discriminant validity of the anxiety sensitivity model of panic by assessing the differential predictions of particular anxiety sensitivity domains. A factor analysis of the Body Sensations Questionnaire indicated four nested anxiety sensitivity factors assessing fears of cardiopulmonary, dissociation, numbness, and gastrointestinal sensations. The symptoms assessed by each factor possess varying levels of correspondence to the sensations typically produced during a 35% CO_2 inhalation (i.e., Cardiopulmonary Fears/High Correspondence, Dissociation Fears/Moderate Correspondence, Numbness Fears/Moderate Correspondence, Gastrointestinal Fears/Low Correspondence). It was hypothesized that anxiety sensitivity to the high-correspondence sensations, compared to anxiety sensitivity to moderate- and low-correspondence sensations, would predict greater fearful responding to a 35% CO_2 challenge. Fifty-six participants meeting DSM-IV criteria for panic disorder completed a single vital capacity 35% CO_2 challenge. Consistent with prediction, Cardiopulmonary Fears was the only index that predicted provocation-induced anxiety and symptoms. These findings suggest that specific anxiety sensitivities can provide a more powerful explanatory model for predicting emotional responding in panic disorder.
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Indian communities in Saskatchewan are undergoing social changes as a result of rapid growth in populations and a closer contact with the non-Indian communities. The effect of such changes may be reflected in the nature and extent of the mental health problems among the Indian populations. This paper is an attempt to understand such problems in Saskatchewan. Analysis of hospital first-admission statistics at the North Battleford psychiatric institution, for the period from 1961 to 1966, showed that the Indian sample contained significantly higher numbers of schizophrenics and epileptics. These findings prompted an active case-finding survey for the first time in Canada in an arbitrarily defined geographical area which contained 18 rural municipalities (non-Indian) and ten Indian reserves. Analysis of the data revealed that the prevalence of mental disorder was significantly higher in the Indian communities. Furthermore, the Indian sample contained significantly higher numbers of schizophrenics and mental retardates. Findings are discussed in terms of relevance to future cross-cultural psychiatric research and methodological problems.
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In recent years, the importance of including ethnically diverse populations in psychological research has been increasingly emphasized. The purpose of this survey was to examine the extent to which behavioral psychology has recognized issues of ethnic diversity in its published literature. Content analyses were conducted of all articles published in Behavioral Assessment from 1984 through 1992, BehaviorModification from 1977 through 1993, and Behavior Therapy from 1970 through 1993. Overall, only 1.31% of the articles published in the three journals focused on U.S. ethnic minority groups. Possible explanations for the lack of attention on ethnic minority groups are posited, and suggestions for ameliorating this problem are provided.
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"What does a manager do?" This question interested a few researchers on both sides of the Atlantic in the 1950s and 1960s, starting with Sune Carlson (1951) in Sweden in the early 1950s. They, like some other social scientists at the time, thought it important to explore what actually happened, whether in organizations, or in managerial activities, rather than to rely on the current theories about the principles of good organization or the nature of managerial functions. Joan Woodward (1965) and Tom Burns and George Stalker (1961) were the pioneers in exploring how organizations actually worked. Leonard Sayles was one of the early researchers to adopt a similar approach to managerial behavior.
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The present investigation was aimed at developing a means to measure culturally re-lated anxiety in American Indians and Alaska Natives. Initial item selection and fac-tor structure for a self-report instrument, the Native American Cultural Involvement and Detachment Anxiety Questionnaire (CIDAQ), were derived from samples of Sincere appreciation is extended to the faculty, students, and staff of Haskell Indian Nations University for their enduring and strong support of this project. Similarly, the faculty, students, and staff of the Shiprock campus of Din6 College (formerly Navajo Community College) were very helpful in making Study 3 possible.
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The purpose of the paper is to describe a more generally applicable method of factor analysis which has no restrictions as regards group factors and which does not restrict the number of general factors that are operative in producing the intercorrelation. Applications of the method to different types of correlation problems are suggested. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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present information . . . for counselors and therapists who become involved in the helping process with American Indians as well as for those scholars who may choose to investigate issues pertaining to mental health service provision or mental health in general for American Indian populations / this information includes a brief demographic description of the US American Indian/Alaska Native population, a rationale for the discussion of acculturation rather than racial identity, and an overview of historical and present-day acculturative influences / information about the effects of acculturation on some of the more prevalent mental health issues of American Indians and on help-seeking behavior is also presented / critically review existing models of acculturation and offer an alternative model that attempts to address some of the deficits of earlier models / include recommendations for counseling and research with American Indian individuals and groups (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Like its predecessor—which awakened the therapeutic community to the varying assumptions, needs, and biases of culturally different clients—this updated and revised "Second Edition" opens new doors and lays the groundwork for exciting new directions. While the overall approach has remained the same, there is heightened emphasis on the damaging effects of political and racial biases inherent in the mental health field and on the need for developing culture-specific communication/helping styles for culturally different clients. Also highlighted are the key issues of ethnic and racial identity formation and culturally specific concepts of the family and their relationship to counseling. "Counseling the Culturally Different" moves from the theoretical to the practical in three sections covering: Issues and Concepts—provides a conceptual framework with which to view the complex interplay of values, expectations, and social and political forces in the counselor-client relationship and the practice of cross-cultural counseling in public schools, mental health agencies, industries, and correctional institutions. Counseling Specific Populations—guidelines and detailed methods for counseling specific minority groups (including African Americans, Hispanics, American Indians and Asian Americans). Critical Incidents—a series of case vignettes portraying typical issues and dilemmas. Combining a sound conceptual framework for multicultural counseling with proven therapeutic methods for specific groups, "Counseling the Culturally Different, Second Edition" prepares students, like no other text in the field, for the rigors of counseling in the "real world." At the same time, as a source of enlightenment and guidance for professionals, it has been proven to make a difference in clients' lives. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
review what is known from cross-cultural studies that may indicate the dimensions and extent of cultural variation in anxiety disorders / recognizing that apparent universals may be artifacts of instruments and approaches employed, our aim is to provide a critical review of research methods used in cross-cultural research cross-cultural epidemiological studies of anxiety disorders / culture specific syndromes and anxiety disorders [fright disorders, shinkeishitsu ("neurasthenia") and taijin kyofu ("phobia of interpersonal relations") in Japan and agoraphobia in the West: culture specific forms of anxiety disorders, neurasthenia: the Chinese example] (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Evaluated a scale for measuring anxiety sensitivity (i.e., the belief that anxiety symptoms have negative consequences), the Child Anxiety Sensitivity Index (CASI), in 76 7th–9th graders and 33 emotionally disturbed children (aged 8–15 yrs). The CASI had sound psychometric properties for both samples. The view that anxiety sensitivity is a separate concept from that of anxiety frequency and that it is a concept applicable with children was supported. The CASI correlated with measures of fear and anxiety and accounted for variance on the Fear Survey Schedule for Children—Revised and the State-Trait Anxiety Inventory for Children (Trait form) that could not be explained by a measure of anxiety frequency. The possible role of anxiety sensitivity as a predisposing factor in the development of anxiety disorder in children is discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Guttman's classic lower bound for the number of common factors is extended to the completely general case where communalities may lie in the closed interval from zero to one.
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Sixteen American Indian women requesting counseling for domestic violence at an urban Indian health center were interviewed using standardized measures. The majority of the women were not married, had low family incomes, and both the women and their partners abused substances. All of the women experienced increased depression and stress as a result of the battering. A mental health needs assessment survey of 198 American Indian women is presented for comparison. Women who reported a history of domestic violence on the survey were more likely to be separated or divorced and reported more problems with alcohol than the women with no history of domestic violence. The results of the domestic violence program interviews are compared to the mental health needs assessment survey and studies of battered women in shelters.
Article
According to Reiss and McNally's expectancy theory, a high level of anxiety sensitivity (“fear of anxiety”) increases the risk for anxiety disorders, and plays a particularly important role in panic disorder (PD). There has yet to be a comprehensive comparison of anxiety sensitivity across the anxiety disorders. Using a measure of anxiety sensitivity known as the Anxiety Sensitivity Index (ASI), we assessed 313 patients, representing each of the six DSM-III-R anxiety disorders. ASI scores associated with each anxiety disorder were greater than those of normal controls, with the exception of simple phobia. The latter was in the normal range. The ASI scores associated with PD were significantly higher than those of the other anxiety disorders, with the exception of posttraumatic stress disorder (PTSD). There was a trend for the ASI scores associated with PD to be greater than those associated with PTSD. Analysis of the ASI item responses revealed that PD patients scored significantly higher than PTSD patients on items more central to the concept of anxiety sensitivity, as determined by principal components analysis. The pattern of results did not change when trait anxiety was used as a covariate. The implications for the expectancy theory are considered, and directions for further investigation are outlined.
Article
Laboratory-based experimental research has led to important breakthroughs in our understanding and treatment of anxiety disorders as well as other types of psychopathology. Despite the importance of this work, the relevance of laboratory-based research using clinical and nonclinical populations has been understated—particularly given concerns about the ecological and external validity of this research. Although some of these issues have been addressed elsewhere, there continues to be less emphasis on laboratory-based investigations compared to other types of research (e.g., treatment outcome). There also is continued misunderstanding regarding what questions can be examined and answered by experimental studies. As an introduction to this special series on the relevance of laboratory examinations of anxiety, we suggest that advances in laboratory preparations can make significant contributions to current behavior therapy. We also suggest that observations in clinical practice can spur innovations in laboratory research. One theme echoed by the articles in this miniseries is the need for a renewed commitment to reestablishing a link between laboratory-based research and clinical application as a means to further advance the science and practice of behavior therapy over the long-term.
Article
Anxiety sensitivity (AS) is the fear of anxiety-related sensations arising from beliefs that these sensations have harmful physical, psychological, or social consequences. AS is measured using the Anxiety Sensitivity Index (ASI), a 16-item self-report questionnaire. Little is known about the origins of AS, although social learning experiences (including sex-role socialization experiences) may be important. The present study examined whether there were gender differences in: (a) the lower- or higher-order factor structure of the ASI; and/or (b) pattern of ASI factor scores. The ASI was completed by 818 university students (290 males; 528 females). Separate principal components analyses on the ASI items of the total sample, males, and females revealed nearly identical lower-order three-factor structures for all groups, with factors pertaining to fears about the anticipated (a) physical, (b) psychological, and (c) social consequences of anxiety. Separate principal components analyses on the lower-order factor scores of the three samples revealed similar unidimensional higher-order solutions for all groups. Gender × AS dimension analyses on ASI lower-order factor scores showed that: females scored higher than males only on the physical concerns factor; females scored higher on the physical concerns factor relative to their scores on the social and psychological concerns factors; and males scored higher on the social and psychological concerns factors relative to their scores on the physical concerns factor. Finally, females scored higher than males on the higher-order factor representing the global AS construct. The present study provides further support for the empirical distinction of the three lower-order dimensions of AS, and additional evidence for the theoretical hierarchical structure of the ASI. Results also suggest that males and females differ on these various AS dimensions in ways consistent with sex role socialization practices.