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Anxiety sensitivity in 1984 and panic attacks in 1987. Journal of Anxiety Disorders, 6, 241-247
Abstract
151 college students to whom the Anxiety Sensitivity Index (ASI) was administered in 1984 were retested in 1987 for anxiety sensitivity and tested for panic attacks, state-trait anxiety, and anxiety disorder history. ASI scores in 1984 predicted the frequency and intensity of panic attacks in 1987. Compared to Ss with low 1984 ASI scores, Ss with high 1984 ASI scores were 5 times more likely to have an anxiety disorder during the period 1984 to 1987. Test-retest reliability for the ASI across 3 yrs was .71. Data provide evidence for the stability of anxiety sensitivity over time and that the concept of anxiety sensitivity should be considered a personality variable. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
... To date, there are only a few such prospective studies, which collectively suggest that AS prospectively predicts the onset of panic disorder. In two studies, AS was demonstrated to be a predictor of panic disorder specifically (Cox et al., 2008;Maller & Reiss, 1992) and of the clinical course of panic disorder (Pérez Benítez et al., 2009). In line with these results, recent findings also suggest that the reduction in AS achieved through cognitive behavioral treatment (CBT) predicts a decrease in panic disorder symptoms (Gallagher et al., 2013). ...
... Presently, there are only a few longitudinal studies assessing trait anxiety and the results are ambiguous. Although it has been hypothesized that AS would contribute to the explanation of panic disorder over and above trait anxiety, some studies have found that AS was a significant predictor of the incidence of anxiety disorders, panic disorder and panic attacks, while trait anxiety did not predict any major outcome variable (Maller & Reiss, 1992;Schmidt, Lerew, & Jackson, 1999;Schmidt et al., 2006). On the other hand, Plehn and Peterson (2002) demonstrated that AS was not a risk factor for the development of panic disorder when controlling for trait anxiety. ...
... Still others have used the mean plus or minus one standard deviation for dividing subjects into high and low AS groups, respectively (Kashdan, Zvolensky, & McLeish, 2008;. Maller and Reiss (1992) used a cut-off score of 23 on the ASI to define the high AS group but provided no statistical explanation. According to the mean results of a clinical population, Peterson and Plehn (1999) suggested that the cut-off score on the ASI for anxiety problems should be 25 and for panic disorder 30, although this was never statistically tested. ...
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.
... So anxiety disorders go up. Correlational [5,6] and longitudinal [7] research has been done with both adults and adolescents, which showed that anxiety sensitivity is higher for men than for women. The same result has also been observed for anxiety disorders although it has firstly been imagined as a risk cause only for panic. ...
... It was observed that there were individual differences in anxiety sensitivity, which were thought to derive from a combination of influences of genetic variation and certain previous experiences which cause a conventional belief regarding the potentially aversive outcomes of arousal and anxiety-related states [9,64]. The Anxiety Sensitivity Index was administered to nearly 50 college students by Maller and Reiss [7], and the students were followed in the future for evaluation of future diagnostic status. According to the findings, the students who had high Anxiety Sensitivity Index scores had five times greater risk for developing an anxiety disorder than another group with low baseline Anxiety Sensitivity Index scores in the three-year period. ...
... These explanations of bodily feelings may cause more anxiety and can cause to continue a vicious cycle by increasing. Finally, this process cause to avoidance, panic attacks, or raised anxiety symptoms [4,7]. People who have a high level of anxiety sensitivity suffer more from, for example, heart attacks after a fear with heart palpitations than the others who have a low level of anxiety sensitivity. ...
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.
... Anxiety sensitivity represents an individual's characteristic way of evaluating and responding to an emotional experience (specifically anxiety) when it occurs, distinct from the frequency or intensity of anxiety itself (Cox, Taylor, & Enns, 1999;Lilienfeld, 1999). Although anxiety sensitivity was originally introduced as a risk factor for panic disorder (Reiss, Peterson, Gursky, & McNally, 1986) and has predominantly been studied in the context of this disorder (e.g., Maller & Reiss, 1992;Plehn & Peterson, 2002;Rassovsky, Kushner, Schwarze, & Wangensteen, 2000), a large literature also has implicated anxiety sensitivity in the development of other anxiety disorders and depression (see Naragon-Gainey, 2010;Taylor, 1999). ...
... For example, prospective studies have demonstrated that anxiety sensitivity predicts the onset of anxiety and depressive disorders (Maller & Reiss, 1992;Schmidt, Keough, Timpano, & Richey, 2008) beyond the contributions of the tendency to experience anxiety (see McNally, 1996, for a review) and that reductions in anxiety sensitivity during treatment predict symptom improvement . In addition, anxiety sensitivity has demonstrated incremental validity above trait neuroticism in the prediction of most mood and anxiety disorders (Collimore, McCabe, Carelton, & Asmundson, 2008;Cox, Enns, Walker, Kjernisted, & Pidlubny, 2001;Kotov, Watson, Robles, & Schmidt, 2007;Norton et al., 1997;Reardon & Williams, 2007). ...
... AS and IU both appear to be specific risk factors associated with anxiety and mood symptoms for different mental disorders, including PTSD, MDD, PD, SAD and GAD (e.g. Boelen et al., 2016;Carleton et al., 2012;Hong and Cheung, 2015;Maller and Reiss, 1992;Schmidt et al., 2006;Taylor et al., 1992). In addition, AS and IU can both be reduced through cognitive and behavioural interventions that focus on addressing thoughts and behaviours related to uncertainty and overestimation of the dangerousness of physical anxiety symptoms (e.g. ...
... In addition, research on the importance of AS and IU as mental disorder risk factors are not limited to Canadian samples (e.g. Boelen et al., 2016;Hong and Cheung, 2015;Maller and Reiss, 1992;Schmidt et al., 2006;Taylor et al., 1992). Third, the current study used a crosssectional design (i.e. ...
The current study was designed to assess whether cognitive risk factors (i.e. anxiety sensitivity (AS), intolerance of uncertainty (IU)) explained variance in mental disorder symptoms in Canadian police officers beyond variance explained by demographic variables (i.e. sex, marital status, education, years of service). Police participants (708 men; 271 women) completed measures assessing posttraumatic stress disorder, panic disorder, social anxiety disorder, major depressive disorder, generalized anxiety disorder, IU and AS. Multivariate analysis of variance demonstrated that only main effects of sex were significant for all symptom variables, except SAD. Hierarchical multiple regressions demonstrated that AS and IU accounted for greater variance than sex on all mental disorder symptom measures, which suggests that cognitive risk factors explain more variance in mental disorder symptoms than sex. Efforts to reduce AS and IU may be beneficial for improving police mental health.
... The results of factorial analysis in a non-clinical sample in Croatia (N = 945) provide affirmation for a multidimensional hierarchical structure with three lower level factors and one higher order factor (Jurin, Jokić-Begić & Lauri Korajlija, 2011). Jurin and associates name factors in accordance with the results of the previous research: factor 1 -physical concerns (items 4, 6,7,8,9,10,11,14), factor 2psychological concerns (items 2, 3, 12, 13, 15, 16) and factor 3social concerns (items: 1, 5). The first factor explains 39.62% of variance, with Eigenvalue=6.2. ...
... In a study which involves twelve studies, a total of 4 517 respondents (Plehn & Peterson, 1999), showed that the mean value for the general population is 19.01 and the standard deviation is 9.11 (mean value varies from 14.2 to 22.5). Taylor's and associates (Taylor, Koch & McNally, 1992) Research of ASI scales reliability indicates that scale measures a stable personal construct for test retest with a reliability of r=0.75 (Reiss, Peterson, Gursky & McNally, 1986) for two weeks, and the value of r=0.71 for a period of 3 years (Maller & Reiss, 1992). Research of convergent validity confirms the validity of the ASI scale. ...
Anxiety sensitivity is an individual cognitive predisposition to arouse fear of anxiety and anxiety related symptoms. The aim of this study was to examine the psychometric properties of Anxiety Sensitivity Index (ASI) in Serbia, on the sample of a clinical and non clinical population (N=140). The sample engaged 70 participants diagnosed with anxiety disorder, and 70 of non clinical population, 27.14% male and 72.85% female, average age 40 years old. Descriptive statistics, Principal component analyisis, Cronbach's alpha, Pearson's coefficient of correlation (ASI with STAI-S and STAI-T) were used. The results confirmed three-factor structure of ASI (physical concern, psychological concern, social concern) with a higher-order factor. Mean value is 32.89 (SD=14.75) for participants with diagnosed anxiety disorder, and for non clinical sample is M=18.57 (SD=12.18). Cronbach's alpha is α=0.88 (physical concern, α=0.87; Psychological concern, α=0.77; Social concern, α=0.56). Correlation between ASI and STAI-S is r=0.567 and between ASI and STAI-T is r=0.668. There are no significant differences by gender. Three-factor structure and valid psychometric properties of Serbian version of ASI, in clinical and non-clinical population, are obtained in this research and confirm the results from other reasearches worldwide. The possibility of applying anxiety sensitivity concept and measurement in sport might be of great importance.
... AS also predicted the number of feared situations in individuals diagnosed with agoraphobia (McNally & Lorenz, 1987). A 3-year prospective study in which AS and anxiety symptoms were initially assessed in 1984 and then in 1987 demonstrated that AS level was significantly predictive of the risk for development of future anxiety disorders (Maller & Reiss, 1992). Specifically, results demonstrated that individuals who had scored most highly on the ASI were five times more likely than low scorers to be diagnosed with any anxiety disorder (Maller & Reiss, 1992). ...
... A 3-year prospective study in which AS and anxiety symptoms were initially assessed in 1984 and then in 1987 demonstrated that AS level was significantly predictive of the risk for development of future anxiety disorders (Maller & Reiss, 1992). Specifically, results demonstrated that individuals who had scored most highly on the ASI were five times more likely than low scorers to be diagnosed with any anxiety disorder (Maller & Reiss, 1992). Recent investigations using the ASI-3 have found that scores on the Social Concerns subscale are positively correlated with social phobia while high scores on the Physical Concerns subscale are associated with panic disorder (Olthuis et al., 2014;Wheaton et al., 2012). ...
As a group, anxiety disorders represent the most prevalent mental health condition. A hallmark feature of anxiety disorders is avoidant behavior. Along with this, anxious individuals have been shown to exhibit a risk aversion in decision making. However, anxiety disorders are simultaneously highly co-morbid with substance use disorders (e.g., Grant, Stinson, Dawson, & Chou, 2004), suggesting that certain individuals with anxiety disorders engage in particular forms of risk taking. However, much of the current literature on anxiety and risk taking has focused on risk aversion in anxiety, presupposing an inhibited model of anxious responding. In addition, there is little literature which explicitly differentiates between adaptive and maladaptive risk taking or the relevance of context in risk taking, variables which were predicted to be highly important when attempting to interpret risk taking behavior in anxious individuals. There were three overarching aims of the current study: 1) Investigate etiological and maintenance factors, particularly motivation and emotion regulation, hypothesized to play a role in risk taking behavior in individuals with heightened anxiety; 2) Differentiate between maladaptive (negative) and adaptive (positive) risk taking to examine if type of risk taking behavior is differentially influenced by anxiety; and 3) Investigate the relation between risk taking in the laboratory and naturalistic settings to identify the role of context. Participants included undergraduate college students enrolled in psychology courses (N = 143). Participants completed a laboratory portion of the study where they completed three computerized tasks to assess risk taking behavior and self-report inventories. The Anxiety Sensitivity Index-3 (ASI-3) was utilized due to its clinical relevance in anxiety disorders. Following the laboratory session, participants completed a naturalistic portion of the study where they completed a week-long diary of their engagement in and perception of different risk taking behaviors. Contrary to much of the literature on anxiety and risk taking, anxiety sensitivity was not found to be associated with reduced or heightened risk taking for either adaptive or maladaptive risk taking domains. Anxiety sensitivity also did not influence risk taking in laboratory or naturalistic settings. With regards to original aims, it was found that: 1) Anxiety did not interact with predicted moderating variables to influence risk taking behavior; 2) On laboratory tasks, positive risk taking was differentiated from negative risk taking; however, this distinction was not made in naturalistic settings; and 3) Risk taking in the laboratory was not associated with risk taking in real world settings, suggesting that it should not be assumed that findings from laboratory tasks will readily generalize to real world behavior.
... It is important to note that while anxiety sensitivity is predictive of certain anxiety disorders, such as panic disorder (Maller & Reiss, 1992;Naragon-Gainey, 2010;Olatunji & Wolitzky-Taylor, 2009), it is a distinct construct that reliably explains unique variance, separate from trait or clinical anxiety (Olatunji & Wolitzky-Taylor, 2009;Taylor et al., 1991). Anxiety sensitivity is a transdiagnostic vulnerability factor for internalizing mental health disorders in which individuals fearfully interpret or catastrophize the potential consequences of certain physiological sensations or cognitive experiences (Naragon-Gainey, 2010). ...
Alcohol use disorder (AUD) is a highly prevalent, yet heterogenous condition linked to anxiety, reward sensitivity, and cognitive biases. Understanding cognitive mechanisms of specific AUD symptoms is crucial for developing tailored, effective interventions. This pilot study sought to assess whether two potential cognitive correlates of AUD—intolerance of uncertainty and delay discounting—differentially influence the relationship between AUD, anxiety sensitivity, and drinking motives. Individuals with mild-to-moderate AUD (n = 31) and healthy control participants (n = 31) completed a single-session lab study in which they performed a decision making under uncertainty task as a behavioral measure of uncertainty tolerance, completed a delay discounting task as a measure of reward sensitivity, and responded to surveys related to anxiety sensitivity, state and trait anxiety, intolerance of uncertainty, and drinking motives. Hierarchical regression results demonstrated a significant interaction between AUD status (AUD vs. control) on both self-reported (β = 0.687, p = .020) and behavioral (β = 0.777, p = .012) intolerance of uncertainty. Greater anxiety sensitivity was associated with heightened intolerance of uncertainty in those with AUD but not controls. Correlations showed that the coping drinking motive was significantly positively associated with anxiety sensitivity (r = 0.462, p = .010), self-reported (r = 0.535, p = .002), and behavioral intolerance of uncertainty (r = 0.396, p < .027) in participants with AUD but not controls. No significant associations between anxiety sensitivity, drinking motives, and delay discounting were observed in either the AUD or the control group. Intolerance of uncertainty may therefore represent a cognitive bias in which individuals with AUD and anxiety sensitivity drink to cope with environmental and internal uncertainty.
... In contrast, decreased inhibitory input from the CeA to PACAP PBL→DR neurons under certain conditions may increase susceptibility to panic. Indeed, GABAergic dysfunction is associated strongly with depression and anxiety disorders 56,57 , and individuals with these conditions are more likely to experience panic attacks [58][59][60] . Therefore, we speculate that decreased GABAergic input from CeA to PACAP PBL→DR neurons in depression and anxiety disorders may increase the risk of panic attacks. ...
Panic disorder is characterized by uncontrollable fear accompanied by somatic symptoms that distinguish it from other anxiety disorders. Neural mechanisms underlying these unique symptoms are not completely understood. Here, we report that the pituitary adenylate cyclase-activating polypeptide (PACAP)-expressing neurons in the lateral parabrachial nucleus projecting to the dorsal raphe are crucial for panic-like behavioral and physiological alterations. These neurons are activated by panicogenic stimuli but inhibited in conditioned fear and anxiogenic conditions. Activating these neurons elicits strong defensive behaviors and rapid cardiorespiratory increase without creating aversive memory, whereas inhibiting them attenuates panic-associated symptoms. Chemogenetic or pharmacological inhibition of downstream PACAP receptor-expressing dorsal raphe neurons abolishes panic-like symptoms. The pontomesencephalic PACAPergic pathway is therefore a likely mediator of panicogenesis, and may be a promising therapeutic target for treating panic disorder.
... Anxiety sensitivity refers to beliefs that anxiety-related sensations (such as heartbeat awareness, increased heart rate, trembling, shortness of breath) have severe negative social, psychological, and/or physical consequences (Reiss, 1991;Taylor, 1999). Research indicates that anxiety sensitivity prospectively predicts the development of panic attacks (Maller & Reiss, 1992) and that anxiety sensitivity predicts panic beyond that predicted by trait anxiety in adult samples (e.g., Schmidt, Lerew, & Jackson, 1997, 1999. Research on anxiety sensitivity in childhood (e.g., Silverman, Fleisig, Rabian, & Peterson, 1991;Weems, Hammond-Laurence, Silverman, & Ginsburg, 1998) and its relation to panic in youth is also emerging (e.g., Kearney, Albano, Eisen, Allan, & Barlow, 1997;Lau, Calamari, Waraczynski, 1996). ...
This investigation sought to expand existing knowledge of anxiety sensitivity in a sample of high school students (N = 2,365) assessed over 4 years. The stability of anxiety sensitivity levels across assessment periods was examined, and cluster analyses were used to identify different developmental pathways in levels of anxiety sensitivity. Groups of adolescents with stable low, stable high, and escalating anxiety sensitivity levels were identified. Adolescents with stable high or escalating anxiety sensitivity were significantly more likely to report experiencing a panic attack than individuals with stable low anxiety sensitivity. Results also indicated that Asian and Hispanic adolescents tended to report higher anxiety sensitivity but that their anxiety sensitivity was less strongly associated with panic than that of Caucasian adolescents.
... Results from empirical studies have consistently highlighted the importance of AS in fearand anxiety-related pathology. Specifically, AS has been associated with the exacerbation and/or development of panic disorder (Kim et al., 2017;Maller & Reiss, 1992;Poletti et al., 2015;Rassovsky et al., 2000;Schmidt & Cook, 1999;Zvolensky et al., 2001), generalized anxiety disorder and worry (e.g., Floyd et al., 2005;Knapp et al., 2016;Ruiz, 2014), social anxiety (Allan et al., 2018;Laposa et al., 2015;Panayiotou et al., 2014), posttraumatic stress disorder (Bernstein & Zvolensky, 2007;Elwood et al., 2009;Feldner et al., 2007), and obsessive-compulsive disorder (e.g., Blakey et al., 2017;Wheaton et al., 2012). AS has also been implicated in conditions outside the strict anxiety domain, including substance abuse (e.g., Castellanos-Ryan et al., 2013) and depression (Allan et al., 2014(Allan et al., , 2018Rosellini et al., 2011). ...
Introduction: The present study examined the psychometric properties of a Greek adaptation of the Anxiety Sensitivity Index-3 (ASI-3; Taylor et al., 2007). Method: We translated the ASI-3 following a forward-backward method and then, in addition to measures of anxiety and depression (DASS-21; Lovibond & Lovibond, 1995; Lyrakos et al., 2011), we administered it to a nonclinical general population sample (N = 611) recruited online. Results: Confirmatory factor analysis revealed that a bifactor model with three orthogonal group factors best fit the data, followed by a correlated three-factor model. An examination of the dimensionality of the ASI-3 and the reliability of its dimensions suggested the presence of a reliable, strong AS general factor and comparatively weaker group factors. The ASI-3 appears to measure AS invariantly across gender. We report preliminary evidence for its convergent, discriminant, and divergent validity. Conclusion: The Greek adaption of the ASI-3 revealed adequate psychometric properties. Future studies should explore its criterion-related validity by administering the Greek adaptation of the ASI-3 to clinical samples and explore its relationship to other key constructs of anxiety sensitivity’s nomological network.
... thinking. Anxiety-sensitive youth exhibit an increased risk for anxiety disorders and tend to use alcohol as a coping, reduction, or avoidance strategy for negative emotions and social criticism (Maller et al., 1992;Stewart et al., 1997;Stewart et al., 2001;Conrod, 2007). Similarly, hopelessness/negative thinking personalities show a link to depressive disorders, with alcohol being used as a pain-reduction strategy to selfmedicate, specifically amongst Indigenous youth (Stewart et al., 2005). ...
Considering the growing prevalence of substance use amongst young people, prevention programs targeting children and adolescents are needed to protect against related cognitive, psychological, and behavioural issues. Preventative programs that have been adapted to Canadian Indigenous cultures in school and family settings are discussed. The first and second phase of the Life Skills Training (LST) program and the Maskwacis Life Skills Training (MLST) program are reviewed, as well as Bii-Zin-Da-De-Da (BZDDD; “Listening to One Another”) and a culturally sensitive smoking prevention program. Motivating factors, comorbid disorders, and at-risk personality types associated with substance use amongst Canadian children and adolescents, specifically Indigenous youth, are considered through the application of the biopsychosocial model. This paper aims to describe the requital efforts being made in Canada towards Indigenous communities, to compare substance use prevention programs targeting Indigenous children and adolescents, and to provide suggestions for future research on preventative interventions directed towards substance use within minority groups.
... These results are consistent with research that has shown that the strongest dispositional predictor of panic attacks is the tendency for hypersensitivity and fear of somatic arousal (Maller & Reiss, 1992;Schmidt et al., 1997;Schmidt et al., 2000). For example, a recent study (Lee et al., 2020) found that perceptions of physiological reactions corresponding to a "wave" of grief-related emotions as threatening was directly linked to grief-related dysfunction. ...
Grief-related panic attacks (GRPAs) are a relatively common yet debilitating psychological reaction to loss, the mechanisms of which remain poorly understood among scholars. The purpose of this study was to identify the personality traits that underlie GRPAs in a sample of 314 bereaved adults. The results indicate that GRPAs were relatively common (55.4%) and that anxiety sensitivity uniquely predicted both frequency and impairment associated with these kinds of attacks, while taking into account the effects of neuroticism, trait worry, grief, and gender. Findings suggest that anxiety sensitivity may be a risk factor for GRPAs and magnified grief for some mourners. Clinical implications and future directions are discussed.
... Anxiety sensitivity (AS) is often defined as the fear of experiencing anxiety-related sensations, especially those arising from within the body (e.g., heart palpitations or dyspnea) (Taylor, 2014, Taylor et al., 2007, although the most commonly used scale, the Anxiety Sensitivity Index-3 (Taylor, 2014) contains three subscales focused on physical, cognitive, and social stimuli (see Lapidus et al., 2020 for a recent application of this measure to the study of interoception). AS is considered to be a trait-like construct with good long-term stability (Maller & Reiss, 1992), and it shows consistently elevated scores across numerous anxiety disorders (Naragon-Gainey, 2010), suggesting utility as a transdiagnostic construct. Since the current study involved the delivery of physiologic substances (i.e., energy drinks) that were expected to perturb physical, as well as potentially affective and cognitive states, the AS construct seems to represent an ideal measure for evaluating the interaction between anxiety and interoception during energy drink consumption. ...
Background: The market for energy drinks has grown quickly over the past 20 years. While the physiological and psychological effects of different ingredients have been studied, the influence of energy drinks on interoceptive processes is unclear. Anxiety has been associated with amplified interoceptive functioning, suggesting potentially exaggerated reactions to energy drinks. Aims: Investigate the effect of energy drink consumption and anxiety sensitivity (AS) as well as their possible interactions on cardiorespiratory dimensions of interoception. Method: Thirty-nine healthy students consumed an energy drink via a placebo-controlled, counterbalanced, crossover design. Cardiac and respiratory interoceptive accuracy (IAcc), interoceptive sensibility (IS), and interoceptive evaluation (IE) were assessed. Heartbeat-evoked potentials (HEPs) were analyzed to evaluate neural processing of the heartbeat. Results: Consumption of one energy drink did not influence IAcc, IS, or IE. However, high AS subjects reported reduced interoceptive confidence after energy drink intake. While HEP amplitudes did not differ depending on the type of drink, high AS subjects showed reduced HEPs overall compared to low AS subjects. Heart rate was significantly lower following energy drink consumption as compared to the placebo condition. Limitations: The sample size was small, energy dosages low, and physiological parameters should be assessed in more detail. Conclusion: Energy drink consumption was associated with an interoceptive bias in high AS individuals suggesting possible interaction effects between changes in physical state, interoception, and anxiety.
... The studies conducted by Reiss and McNally (1985), Mantar et al. (2010) and Seçer (2014), and the other studies showing that individuals who have high anxiety sensitivity become immediately alert even in the case of a probable anxious situation appear to support this argument. Moreover, the findings obtained from Maller and Reiss (1992), a longitudinal research study indicating individuals with higher anxiety sensitivity tend to develop anxiety disorder five times more often than the individuals with lower anxiety sensitivity, and the study finding conducted by Ghasempour et al. (2012) and Grant et al. (2007) stating that the individuals with high anxiety sensitivity feel themselves under more threat and tend to much more avoid the situations which cause anxiety support this consideration. ...
The purpose of this study is to investigate the effects of anxiety sensitivity in adolescents on childhood depression and anxiety disorder. Mood disorders and anxiety disorders in children and adolescents can be given examples of important research topics in recent years. The participants of the study consist of 670 students in Erzurum city. The data were collected through anxiety sensitivity index and anxiety and depression index for children and adolescents. For data analysis, correlation analysis and structural equation model were used. The results revealed that anxiety sensitivity impacts anxiety disorder and childhood depression through direct and indirect effects in a positive way. The results are discussed in line with the relevant literature.
... 불안민감도 지표는 여러 임상 증상과 높은 관련성을 보이는데 불안장애, 특히 공황장애의 발생과 유지에 중요한 역할을 담당한다고 보고된다 (Reiss, 1991). 더불어, 공황장애 환자들은 불안민 감도의 하위 요인 중 심혈관 증상이나 호흡계 증상과 관련이 있는 신체적 염려 요인에서 매우 높은 점수를 보였으며 (Donnell et al., 1990), 이는 불안민감도가 공황발작과 같 은 불안증상 문제에 핵심이 되는 특질로서 작용할 수 있음을 시사한다 (Maller et al., 1992;Schmidt et al., 1997). ...
... The ASI has strong psychometric properties, with high internal consistency (alpha = 0.80-0.90) (Peterson & Reiss, 1992;Taylor, Koch, & McNally, 1992;Telch, Shermis, & Lucas, 1989), test-retest reliability (Maller & Reiss, 1992;Peterson & Reiss, 1992), and construct validity (McNally & Lorenz, 1987;Taylor, Koch, & Crockett, 1991). In the current sample, internal consistency was mostly good across time points (α Pre = 0.61; α Mid = 0.87 α Post = 0.89; α FU = 0.92). ...
Initial evidence suggests that experiential avoidance (EA) mediates the relation between anxiety sensitivity (AS) and depression. We examined the AS-EA-depression pathway, examining both concurrent, and prospective (cross-lag), mediation models. Utilizing data from a study that examined the effects of exercise on AS (N = 60), we modeled depressive symptoms, EA, and AS over four time points. Time-varying predictors were disaggregated into between-subjects (each person’s mean level of the predictor) and within-subjects change (each person’s deviations, at each time point, from their mean level on the predictor) components. Tests of the concurrent relations were partially consistent with predictions, with mean EA levels, but not within-subjects changes in EA, partially mediating the relation between AS and depression symptom severity. However, the prospective, cross-lag mediation model, in which AS predicted future EA controlling for previous EA, and EA predicted future depression, controlling for previous depression, yielded no significant effects. These results suggest that observed between-subjects mediation findings, found here and in previous studies, may not replicate using more stringent, quasi-causal, cross-lag mediation analyses. These results highlight the importance of estimating causal pathways in mediation analyses. Clinical implications and directions for future research are discussed.
... Furthermore, AS has been related to addictive behaviors, such as smoking , hazardous drinking (Schmidt et al., 2007), cannabis use problems (Johnson et al., 2010), and other forms of substance abuse (e.g., opiate addiction; Lejuez et al., 2008). The anxiety sensitivity findings have been observed across experimental, cross-sectional, and longitudinal designs (Hayward et al., 2000;Li and Zinbarg, 2007;Maller and Reiss, 1992;Marshall et al., 2010;Schmidt et al., 2010;Schmidt et al., 1997Schmidt et al., , 1999Schmidt et al., 2006b). ...
Anxiety sensitivity, defined as the fear of anxiety and arousal-related sensations, has been among the most influential cognitive-based transdiagnostic risk and maintenance factors in the study and treatment of emotional and related disorders. The currently available anxiety sensitivity measures are limited by their length. Specifically, the length of these instruments discourages the adoption of routine anxiety sensitivity assessment in clinical or medical settings (e.g., primary care). The goals of this study were to develop and assess the validity and reliability of a short version of the Anxiety Sensitivity Index-3 (ASI-3; Taylor et al., 2007), entitled the Short Scale Anxiety Sensitivity Index (SSASI), using three independent clinical samples. Results indicated that the abbreviated five-item version of the SSASI had good internal consistency and a robust association with the ASI-3. Further, across the samples, there was evidence of unidimensionality and excellent convergent and discriminant validity. There also was evidence of partial measurement invariance across sex and full measurement invariance across time. Overall, the five-item scale offers a single score that can be employed to measure anxiety sensitivity. Use of the SSASI may facilitate screening efforts and symptom tracking for anxiety sensitivity, particularly within clinical settings where practical demands necessitate the use of brief assessment instruments.
... Substantial evidence that anxiety sensitivity (Maller & Reiss, 1992;Plehn & Peterson, 2002;Schmidt, Lerew, & Jackson, 1999) and body vigilance (Schmidt, Lerew, & Trakowski, 1997;Schmidt & Trakowski, 1999) contribute to the pathogenesis of Panic Disorder has led to these constructs being investigated in the context of NCCP. For instance, fear of cardiac-related sensations has been associated with the chest pain reported by NCCP patients (Aikens et al., 1999;Eifert et al., 1996;Lipsitz et al., 2004), and anxiety sensitivity has been associated with both chest pain severity and interference caused by chest pain (White, McDonnell, Gervino, 2011). ...
The aim of this study was to investigate the role of disease conviction in the chest pain and life interference of patients with non-cardiac chest pain (NCCP), after controlling for anxiety sensitivity and body vigilance. While all three psychological constructs are theoretically implicated and empirically associated with the experience of NCCP, no research has examined the influence of disease conviction in the context of other relevant constructs. The sample included 229 participants with NCCP who were recruited after a medical evaluation failed to elicit an organic explanation for their chest pain. Hierarchical regression analyses revealed that while anxiety sensitivity significantly predicted chest pain severity and interference, only body vigilance contributed significant additional variance to chest pain severity, and only disease conviction contributed significant additional variance to chest pain interference. While anxiety sensitivity, body vigilance, and disease conviction all appear to affect those with NCCP, it seems that their impact is manifest in different domains (i.e., pain perception vs. psychosocial impairment).
... The ASI is comprised of three factors: social, physical, and mental concerns about bodily sensations of anxiety. Psychometrically, the ASI has good internal consistency and stable test-retest reliability (Maller & Reiss, 1992). In the present sample, the Cronbach's α was 0.87. ...
Objective:
Anxiety sensitivity and coping motives for substance use are processes implicated in anxiety and substance use disorder (SUD) comorbidity, and are malleable treatment targets. Little is known about whether changes in anxiety sensitivity or coping motives during cognitive behavioral therapy (CBT) for anxiety disorders (with or without CBT for SUD) mediate substance use outcomes among patients with comorbid anxiety disorders and SUD. We examined whether changes in anxiety sensitivity and coping motives during treatment for comorbid SUD and anxiety disorders (either CBT for SUD only or CBT for SUD and anxiety disorders) were associated with substance use outcomes.
Methods:
Repeated measurements of anxiety sensitivity and coping motives throughout treatment were examined from a randomized clinical trial comparing usual, CBT-based treatment at a substance use disorder specialty clinic (UC) to that usual care plus a brief CBT for anxiety program for patients with comorbid anxiety and substance use disorders (CALM ARC).
Results:
Anxiety sensitivity decline during treatment was significantly steeper among those who received CALM ARC than those in UC. Decreases in anxiety sensitivity mediated the effect of treatment group on alcohol use following treatment such that the greater reduction in anxiety sensitivity in CALM ARC explained the superior outcomes for alcohol use in CALM ARC compared to UC. Declines in substance use coping motives were not observed in either condition, and did not differ between CALM ARC and UC. Thus, declines in coping motives did not mediate substance use after treatment.
Conclusions:
These findings provide preliminary evidence suggesting alcohol use outcomes were related to decreasing anxiety sensitivity rather than decreasing coping motives. Implications and future directions are discussed.
... Anxiety Sensitivity Index (ASI) [46] is a 16-item questionnaire designed to assess fear of anxiety-related symptoms. The ASI displays a high internal consistency [46] and test-retest reliability [47] and is considered an evidence-based outcome measure [48]. ...
Background
Research increasingly supports a transdiagnostic conceptualization of emotional disorders (ie applying the same underlying treatment principles across mental disorders, without tailoring the protocol to specific diagnoses), and many international researchers are currently investigating this issue.
Objective
The aim of this study was to evaluate the efficacy and acceptability of a Web-based transdiagnostic program using a sample of Romanian adults diagnosed with anxiety and/or depression.
Methods
Volunteer participants registered for the study and completed a series of online self-report measures. Participants who fulfilled basic inclusion criteria on these measures were contacted for a telephone diagnostic interview using the Structural Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Axis I Disorders (SCID-I). Enrolled participants were randomized to either the active treatment group (N=69) or the wait-list control group (N=36) using a 2:1 ratio. The transdiagnostic treatment was based on the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP; Barlow et al, 2011) that addresses common underlying mechanisms of anxiety and depression. Participants randomized to the active treatment condition received 10 weeks of Web-based treatment based on the UP. Throughout treatment, graduate students in clinical psychology provided guidance that consisted of asynchronous written communication on a secure Web platform. After the intervention, participants in both study conditions were invited to complete a set of self-report measures and a postintervention SCID-I interview conducted by a different team of graduate students blinded to participants’ group and diagnostic status. Six months later, participants in the active treatment group were invited to complete an online follow-up assessment.
Results
During the intervention, active treatment participants completed on average 19 homework assignments (SD 12.10), and we collected data from 79.0% (83/105) at postintervention and 51% (35/69) at follow-up for self-report measures. Postintervention SCID-I interviews were collected from 77.1% (81/105) participants. Relative to the wait-list control group, the transdiagnostic intervention yielded overall medium to large effect sizes for the primary outcome measures (within-group Hedges g=0.52-1.34 and between-group g=0.39-0.86), and also for anxiety sensitivity (g=0.80), symptom interference (g=0.48), and quality of life (g=0.38). Significant within-groups effects only were reported for the active treatment group on Panic Disorder Severity Scale-Self Report (PDSS-SR, g=0.58-0.65) and Yale-Brown Obsessive Compulsive Scale (Y-BOCS, g=0.52-0.58).
Conclusions
Insignificant between-group differences for the Y-BOCS and PDSS-SR could be explained by the small number of participants with the associated primary diagnostic (eg, only 3 participants with obsessive compulsive disorder) by the choice of outcome measure (PDSS-SR was not rated among the evidence-based measures) and by the fact that these disorders may be more difficult to treat. However, the overall results suggest that the transdiagnostic intervention tested in this study represents an effective treatment option that may prove easier to disseminate through the use of Web-based delivery systems.
Trial Registration
ClinicalTrials.gov CT02739607; https://clinicaltrials.gov/ct2/show/study/NCT02739607 (Archived by WebCite at http://www.webcitation.org/6yY1VeYIZ)
... Anxiety Sensitivity Index (ASI) [46] is a 16-item questionnaire designed to assess fear of anxiety-related symptoms. The ASI displays a high internal consistency [46] and test-retest reliability [47] and is considered an evidence-based outcome measure [48]. ...
... AS has also been shown to reliably predict the future development of mood and anxiety disorders among nonclinical samples and the maintenance of anxiety disorders among those who have been previously diagnosed (e.g., Boffa et al., 2016;Maller & Reiss, 1992;Schmidt, Keough, Timpano, & Richey, 2008;Schmidt, Lerew, & Jackson, 1997;Schmidt, Zvolensky, & Maner, 2006). ...
The anxiolytic and antidepressant effects of regular physical exercise have been well documented, though the mechanisms through which exercise alleviates symptoms of emotion disorders require further investigation. Mounting research indicates that exercise reduces anxiety sensitivity, a known vulnerability factor for the development and maintenance of psychological disorders, presumably via repeated exposure to feared somatic sensations. The purpose of the present study was to examine whether anxiety sensitivity mediates the relation between exercise frequency and symptoms of anxiety and depression. A large community sample of 955 volunteers completed a demographic questionnaire, the Anxiety Sensitivity Index‐3, and the Brief Symptom Inventory‐18. Exercise frequency significantly predicted anxiety sensitivity, anxiety, depression, and somatization scores. Mediation analyses indicated that anxiety sensitivity mediated the association between exercise frequency and anxiety, depression, and somatization symptoms. The findings provide further support for the association between exercise and negative affective states and suggest that anxiety sensitivity may be one mechanism through which exercise reduces emotional disorder symptomology. The implications of these findings and recommendations for future research are discussed.
... Respondents are asked to indicate the degree to which they agree or disagree with each item on a five-point Likert scale (rated from 0, very little, to 4, very much). Elevated anxiety sensitivity has been shown to be closely associated with the development of panic attacks (20,21) and panic disorder (22). Moreover, reductions on the ASI are associated with a reduction in panic symptoms (23,24). ...
This article provides an overview of F-SET, a brief transdiagnostic treatment for anxiety disorders. The article focuses on the use of specific treatment techniques and follows a successful course of treatment using the F-SET protocol. The client's treatment progress is discussed session by session and at midtreatment, posttreatment, and 11-month follow-up.
... Recent evidence suggests that reducing AS may be important for the prevention and treatment of anxiety across diagnostic categories. Prospective studies have shown that AS is a strong predictor for the onset of mood and anxiety disorders and the development of spontaneous panic attacks (1,5,6), whereas longitudinal studies have shown that individuals with high AS have a propensity for greater chronicity of illness and a higher likelihood of experiencing future anxiety symptoms (3,7,8). Controlled studies have shown significant reductions in AS following successful treatment with psychotherapy (9) or pharmacotherapy (10), and several transdiagnostic treatments have been developed to specifically target AS using different forms of interoceptive exposure (11)(12)(13)(14). ...
Background
Floatation-REST (Reduced Environmental Stimulation Therapy), an intervention which attenuates exteroceptive sensory input to the nervous system, has recently been found to reduce state anxiety across a diverse clinical sample with high levels of anxiety sensitivity (AS). To further examine this anxiolytic effect, the present study investigated the affective and physiological changes induced by Floatation-REST, and assessed whether individuals with high AS experienced any alterations in their awareness for interoceptive sensation while immersed in an environment lacking exteroceptive sensation.
Methods
Using a within-subject crossover design, 31 participants with high AS were randomized to undergo a 90-minute session of Floatation-REST or an exteroceptive comparison condition. Measures of self-reported affect and interoceptive awareness were collected before and after each session, and blood pressure (BP) was collected during each session.
Results
Relative to the comparison condition, Floatation-REST generated a significant anxiolytic effect characterized by reductions in state anxiety and muscle tension, and increases in feelings of relaxation and serenity (p<.001 for all variables). Significant BP reductions were evident throughout the float session and reached the lowest point during the diastole phase (average reduction > 12 mmHg). The float environment also significantly enhanced awareness and attention for cardiorespiratory sensations.
Conclusions
Floatation-REST induced a state of relaxation and heightened interoceptive awareness in a clinical sample with high AS. The paradoxical nature of the anxiolytic effect in this sample is discussed in relation to Wolpe’s theory of reciprocal inhibition and the regulation of distress via sustained attention to present moment visceral sensations such as the breath.
... Initially conceptualised as relevant to internalising generally, anxiety sensitivity has since been shown to relate more strongly to anxiety than depression traits and symptoms (Joiner et al., 2002;Rabian, Embry, & MacIntyre, 1999;Smari, Erlendsdottir, Bjorgvinsdottir, & Agustsdottir, 2003;Weems, Hammond-Laurence, Silverman, & Ginsburg, 1998). It is also predictive of panic and anxiety in both clinical and nonclinical samples (Benitez et al., 2009;Maller & Reiss, 1992;Plehn & Peterson, 2002;Schmidt et al., 2010;Schmidt, Lerew, & Jackson, 1997). In summary, anxiety sensitivity is now considered a vulnerability factor for many anxiety subtypes. ...
Autism spectrum disorders (ASD) are characterised by social-communication difficulties and non-social symptoms such as restricted and repetitive behaviours and interests. ASD characteristics can be investigated at the subclinical trait level within the general population, and these quantitative autistic traits have been shown to have a smooth distribution. Adolescence is an important developmental stage, particularly for the emergence of internalising problems. However, few studies to date have investigated the causes of co-occurring autistic traits and internalising traits during adolescence. The aim of this thesis is to explore the aetiological causes of this trait association between the ages of 12 to 16 years using a quantitative genetic approach.
This thesis employs a classic twin design and the sample came from the Twins Early Development Study (TEDS). The causes of the association between autistic and internalising traits in early adolescence are the first focus of this thesis. The analyses in Chapter 4 explore this aetiological association at ages 12-14 years, revealing a moderate phenotypic trait association and at the aetiological level moderate genetic overlap, substantial shared environmental and modest nonshared environmental overlap. Teasing apart these associations further, Chapter 5 identifies specific autistic-like behaviours by means of factor analysis. Relating these factor-derived autistic trait subdomains to the internalising trait measure demonstrated distinguishable patterns of phenotypic and aetiological associations. A factor named autistic-like ‘Social Unease’ showed the most phenotypic and genetic overlap with internalising traits.
Secondly, this thesis investigates in Chapter 6 the role of childhood nonshared environment on internalising and autistic traits in early adolescence using the monozygotic twin differences design. Analyses showed that birth weight, childhood hyperactivity and peer problems played a role, via the nonshared environment, in influencing individual differences in internalising and autistic traits in early adolescence.
Finally, Chapter 7 presents findings on later adolescence, at age 16 years, exploring the association of autistic traits with anxiety traits and depression traits separately and drawing on both parent and self ratings. The implications of these findings, their limitations and their contribution to the current literature are considered in the Discussion (Chapter 8).
... Yet, growing work has demonstrated that intolerance of uncertainty may operate transdiagnostically, sharing relations with other forms of anxiety (Gentes & Ruscio, 2011;Paulus, Talkovsky et al., 2015). Likewise, anxiety sensitivity, often considered a central feature of panic (Maller & Reiss, 1992), is now widely accepted as a transdiagnostic anxiety vulnerability factor (Olatunji & Wolitzky-Taylor, 2009). Emotion regulation deficits, too, have been documented across anxiety, depression, and other emotional syndromes (Aldao, Nolen-Hoeksema, & Schweizer, 2010) with existing transdiagnostic models of anxiety/depression centered upon the etiological role of emotion dysregulation (e.g., Hofmann, Sawyer, Fang, & Asnaani, 2012). ...
... Despite the observed association between emotional nonacceptance and negative mood states and problems among non-Latino samples, there is little understanding of possible factors that may explain the association between this construct and anxiety/depressive symptoms in general and among Latinos in particular. Anxiety sensitivity (AS), reflecting the extent to which individuals believe anxiety and anxiety-related sensations have harmful consequences (McNally 2002;Reiss and McNally 1985), is a relatively stable, yet malleable, cognitive vulnerability that predisposes individuals to the development and maintenance of anxiety and depressive psychopathology (Hayward et al. 2000;Li and Zinbarg 2007;Maller and Reiss 1992;Marshall et al. 2010;Schmidt et al. 2010;Schmidt et al. 1997Schmidt et al. , 1999Schmidt et al. 2006). Such sensitivity to aversive internal cues may be one explanatory mechanism for emotional nonacceptance associations with depressive and anxiety symptoms. ...
The present investigation examined anxiety sensitivity (AS) in the relation between emotional nonacceptance (unwillingness to experience unwanted emotions) and mood and anxiety symptoms among Latinos seeking health services at a primary healthcare facility. Participants included 267 adult Latinos (85.4% female; Mage = 38.8 years, SD = 10.7, and 95.9% used Spanish as their first language). Results indicated that emotional nonacceptance was indirectly related to number of mood and anxiety disorders, anxious arousal, social anxiety, and depressive symptoms through AS. The observed effects were evident above and beyond the variance accounted for by gender, age, marital status, educational status, employment status, years living in the United States, and negative affectivity. Using a multiple mediation model revealed that the AS cognitive, physical, and social concerns demonstrated unique incremental explanatory effects (above and beyond the other two AS sub-scales) for depressive, anxious arousal, and social anxiety symptoms, respectively. Thus, specific sub-scales of AS were uniquely related with the expression of particular affective symptom domains. Overall, the present findings suggest that there is merit in focusing further scientific attention on the interplay between nonacceptance and AS in regard to better understanding and intervening to reduce anxiety/depressive vulnerability among Latinos in primary care.
... Consistent with the conceptualization of AS as a risk factor, studies have demonstrated that AS prospectively predicts the development of psychopathology. In one study, individuals with high AS were five times more likely to develop a future anxiety disorder than those with low AS (Maller and Reiss, 1992). Other studies have also shown that AS prospectively predicts symptoms of panic attacks, posttraumatic stress disorder (PTSD), eating disorders, and suicidal ideation (Anestis et al., 2008;Capron et al., 2012a;Schmidt et al., 1999Schmidt et al., , 1997Verreault et al., 2012). ...
Background:
Anxiety sensitivity (AS), or a fear of anxiety-related sensations, has become one of the most well researched risk factors for the development of psychopathology and comprises three subfactors: physical, cognitive, and social concerns. Fortunately, research has demonstrated brief protocols can successfully reduce AS, and in turn improve psychopathological symptoms. Computerized AS reduction protocols have combined psychoeducation with interoceptive exposure (IE), but they have not been dismantled to evaluate the effects of psychoeducation alone.
Method:
The current study sought to determine the efficacy of a brief single-session psychoeducation intervention for AS, compared to a control intervention, in a sample of at-risk individuals (N=54) with elevated AS cognitive concerns.
Results:
Individuals in the active condition displayed greater reductions in self-reported AS (β=.198, 95% CI [.065, .331]) and less fear reactivity (β=.278, 95% CI [.069, .487]) to the induction of AS cognitive-relevant sensations through a behavioral challenge compared to those in the control condition. Further, fear reactivity to the challenge was mediated by reductions in self-reported AS cognitive concerns.
Limitations:
Study limitations include use of an at-risk nonclinical student sample, lack of a long-term follow-up assessment, and inability to discern whether AS reductions due to CAST psychoeducation prevent future, or improve current, psychological symptoms.
Conclusions:
These results suggest that psychoeducation alone can produce significant AS reduction.
... (In press) that Suicidologists utilize EMA designs more actively to better understand suicide risk and reduce concerns of recall bias. However, it should be noted that anxiety sensitivity has been shown to be stable over time unless treated (Maller and Reiss, 1992). ...
The way individuals use humor to interact interpersonally has been associated with general personality, depression, and suicidality. Certain humor styles may moderate the risk for suicide ideation (SI) in individuals who are high in specific risk factors (e.g., thwarted belongingness, perceived burdensomeness). Previous research suggests a relationship between humor styles and borderline personality disorder (BPD) and an increased risk of suicidality and suicide completion in individuals with BPD. Participants (n = 176) completed measures of BPD traits, SI, and humor styles. It was hypothesized that BPD traits would be positively correlated with negative humor styles and negatively correlated with positive humor styles, and that humor styles would significantly moderate BPD traits and SI. Results showed that BPD traits were negatively correlated with self-enhancing humor styles and positively correlated with self-defeating humor styles, but that they were not significantly correlated with affiliative or aggressive humor styles. Bootstrapping analyses demonstrated that the affiliative, self-enhancing, and self-defeating humor styles significantly moderated BPD traits and SI, while the aggressive humor style did not.
... There is strong and consistent evidence, across cultures and distinct national groups that anxiety sensitivity predisposes individuals to the development and maintenance of anxiety and mood psychopathology (Hayward, Killen, Kraemer, & Taylor, 2000;Li & Zinbarg, 2007;Maller & Reiss, 1992;Marshall, Miles, & Stewart, 2010;Schmidt et al., 2010;Schmidt, Lerew, & Jackson, 1999;Schmidt, Zvolensky, & Maner, 2006a). Such effects are not better explained by the broad-based tendency to experience negative affect or trait anxiety (Taylor, 1999). ...
... The ASI has a high degree of internal consistency (alpha coefficients from .82 to .91; Peterson & Reiss, 1992) and stable test-retest reliability over a 3-year period (r=.71; Maller & Reiss, 1992). ...
The Acceptance and Action Questionnaire-II (AAQ-II) is a measure of experiential avoidance (EA), defined as the tendency to escape or avoid private psychological experiences, even when doing so is futile or interferes with valued actions (Hayes et al., 1996). Recent efforts have established the generalizability of this construct across different European cultures and languages and have established it as a deleterious psychopathological process. However, phenomenological differences of this construct between clinical vs. non-clinical samples have not yet been compared. The aim of the present study is to investigate the psychometrics of the Greek adaptation of the AAQ-II and examine measurement equivalence and scale invariance between different groups (sexes, clinical vs. nonclinical), before conclusions about the transdiagnosticity of this measure can be drawn. The total sample consisted of 274 (87 clinical outpatients; 75.8% female) Greek-speaking participants. Results suggest that the AAQ-II Greek translation has good psychometric properties, with high internal consistency, test-retest reliability, high correlations with similar constructs, and a unifactorial structure. Weak measurement invariance between clinical and non-clinical groups was established but scalar invariance failed. Regarding the sexes, invariance was established at all levels suggesting that EA can be considered a deleterious process irrespective of sex.
... (In press) that Suicidologists utilize EMA designs more actively to better understand suicide risk and reduce concerns of recall bias. However, it should be noted that anxiety sensitivity has been shown to be stable over time unless treated (Maller and Reiss, 1992). ...
The current study investigated the relationship between maladaptive Five-Factor Model (FFM) personality traits, anxiety sensitivity cognitive concerns, and suicide ideation in a sample of 131 undergraduate students who were selected based on their scores on a screening questionnaire regarding Borderline Personality Disorder (BPD) symptoms. Those who endorsed elevated BPD symptoms in a pre-screen analyses completed at the beginning of each semester were oversampled in comparison to those with low or moderate symptoms. Indirect effect (mediation) results indicated that the maladaptive personality traits of anxious/uncertainty, dysregulated anger, self-disturbance, behavioral dysregulation, dissociative tendencies, distrust, manipulativeness, oppositional, and rashness had indirect effects on suicide ideation through anxiety sensitivity cognitive concerns. All of these personality traits correlated to suicide ideation as well. The maladaptive personality traits of despondence, affective dysregulation, and fragility were positive correlates of suicide ideation and predicted suicide ideation when all traits were entered in one linear regression model, but were not indirectly related through anxiety sensitivity cognitive concerns. The implication for targeting anxiety sensitivity cognitive concerns in evidence-based practices for reducing suicide risk in those with BPD is discussed.
An array of measures of anxiety and related disorders (viz., Albany Panic and Phobia Questionnaire; Anxiety Sensitivity Index; Beck Anxiety Inventory; Beck Depression Inventory–II; Body Sensation Questionnaire; Fear Questionnaire; Padua Inventory; Penn State Worry Questionnaire; Post-Traumatic Stress Disorder Diagnostic Scale; Social Interaction Anxiety Inventory; and Worry Scale) was edited or translated from English into Spanish. Following an extensive edit and translation process, bilingual participants (n = 98) were assessed with the English and Spanish versions of these measures. Coefficient alphas were excellent and comparable across language versions. Means and standard deviations were also comparable across language versions. Evidence of convergent and discriminant validity was found for both language versions. The two language versions of each measure correlated highly with each other. This psychometric comparability adds confidence in using the newly edited or translated Spanish language measures in clinical practice and research.
Anxiety sensitivity (AS) has been defined as the fear of symptoms of anxiety and panic, and is most frequently assessed with the Anxiety Sensitivity Index (Peterson & Reiss, 1987). To investigate the nature and structure of AS in an older sample, data were collected from a sample of 322 adults aged 65 to 97, with mean age 75. Confirmatory factor analysis indicated a hierarchical structure with three group factors (physical concerns, mental incapacitation concerns, and social concerns), as well as a general factor, consistent with previous investigations. Results suggest that the nature and structure of the AS trait in older adults are highly similar to those of younger adults.
This study explored the validity of classifying a community-recruited sample of substance-abusing women (N = 293) according to 4 personality risk factors for substance abuse (anxiety sensitivity, introversion–hopelessness, sensation seeking, and impulsivity). Cluster analyses reliably identified 5 subtypes of women who demonstrated differential lifetime risk for various addictive and nonaddictive disorders. An anxiety-sensitive subtype demonstrated greater lifetime risk for anxiolytic dependence, somatization disorder, and simple phobia, whereas an introverted–hopeless subtype evidenced a greater lifetime risk for opioid dependence, social phobia, and panic and depressive disorders. Sensation seeking was associated with exclusive alcohol dependence, and impulsivity was associated with higher rates of antisocial personality disorder and cocaine and alcohol dependence. Finally, a low personality risk subtype demonstrated lower lifetime rates of substance dependence and psychopathology.
Background and Objectives
Anxiety sensitivity (AS) is the fear of consequences of anxiety-related sensations, and has been linked to the development of panic symptoms. Distress tolerance (DT) encompasses one’s behavioral or self-perceived ability to handle aversive states. We examined whether higher DT buffers the relationship between AS and changes in panic symptoms across two timepoints, spaced ∼three weeks apart.
Design and Methods
At Time 1, 208 participants completed questionnaires and a physical DT task (breath-holding duration), a cognitive DT task (anagram persistence), and a self-report measure of DT (perceived DT). Panic symptoms were assessed at both timepoints. Structural equation modeling was used to evaluate two models in which AS and DT predicted changes in panic.
Results
Contrary to hypotheses, for those with longer breath-holding duration (higher physical DT), higher fears of physical anxiety-related sensations (higher physical AS) were associated with worse panic outcomes over time.
Conclusions
Findings suggest that those with lower physical DT may have been less willing to engage with difficult tasks in the short-term. Although disengagement in the short-term may provide temporary relief, it is possible that averse psychopathological consequences stemming from rigid or habitual avoidance of distressing states may develop over longer periods of time.
Panic attacks are prevalent; almost one in three people will experience a panic attack in their lifetime. The occurrence of a panic attack is not sufficient for panic disorder diagnosis and can be added as a specifier to other disorders. DSM-5 separated the diagnoses panic disorder and agoraphobia. Various comorbidities with panic disorder and/or agoraphobia are summarized. Genes implicated in the etiology of PD are discussed including genes related to COMT, adenosine, MAO, GABA, and CRHR. Epigenetic factors such as methylation across different genes and G × E interactions are considered. Learning theory’s account of how panic disorder/agoraphobia develop is reviewed. The chapter offers a detailed explanation of the involvement of anxiety sensitivity trait in the development and maintenance of the disorder. Various cognitive models including Barlow’s, Clark’s, and Reiss’ expectancy model and integrative attempts are discussed. Gorman’s seminal neuroanatomical model of the disorder and its updates are examined considering functional connectivity, structural, and functional MRI studies. Finally, neurochemical hypotheses related to serotonergic and opioidergic deficits are explained.
Background:
Low- and moderate-intensity exercise training has been shown to be effective for reducing general anxiety and anxiety sensitivity among adults with asthma. Exercise frequency and intensity have been shown to play an integral role in reducing anxiety sensitivity; however, less is known about the impact of high-intensity interval training (HIIT) on anxiety in adults with asthma.
Methods:
A 6-week HIIT intervention was conducted with adults with asthma. Participants completed HIIT (10% peak power output for 1 min, 90% peak power output for 1 min, repeated 10 times) 3 times per week on a cycle ergometer. Preintervention and postintervention assessments included the Anxiety Sensitivity Index-3 and the Body Sensations Questionnaire.
Results:
Total Anxiety Sensitivity Index-3 (PRE: 17.9 [11.8]; POST 12.4 [13], P = .002, Cohen d = 0.4, n = 20) and Body Sensations Questionnaire (PRE: 2.4 [1.0]; POST: 2.0 [0.8], P = .007, Cohen d = 0.3) improved from preintervention to postintervention.
Conclusion:
A 6-week HIIT intervention leads to improved anxiety among adults with asthma. Future research should determine the impact of HIIT among adults with asthma with clinical anxiety.
У статті представлені результати перекладу та адаптації методики SURPS «Шкала ризику розвитку залежності від психоактивних речовин» російською мовою. Чотири субшкали методики, що відповідають чотирьом добре теоретично обґрунтованим конструктам — «депресивність», «тривожність», «імпульсивність», «пошук стимуляції». Вираженість цих рис на особистісному рівні асоційована з ризиком розвитку залежності від психоактивних речовин та прогнозує можливий вибір психоактивної речовини та етіологію залежності, спираючись на наявну особистісну мотивацію. Представлені кофіцієнти надійності для шкал за методами Альфа Кронбаха та Лямбда 2. За допомогою методу xi-квадрат на результатах вибірки проілюстрована можливість окремих питань-індикаторів передбачити приналежність досліджуваних до когорти без діагностованої залежності або до когорти з діагностованою залежністю. Відповідність оригінальної факторної моделі шкали SURPS емпірично виявленим на російськомовних досліджуваних закономірностям встановлена та модифікована за допомогою методу конфірматорного факторного аналізу.
Outcome measurement in intercultural psychotherapy is complex and lags behind standards of outcome measurement in Western populations. This chapter presents recommendations, challenges, and pitfalls related to the choice of assessment tools measuring outcome in intercultural psychotherapy, whether for clinical evaluation or research. Item response theory (IRT) is presented as a promising method for testing measure’s and item’s intercultural validity and reliability. IRT-validated measures are presently mostly available for disability and quality of life. Finally, with a renewed focus on personal recovery in mental health, the chapter also introduces patient-generated outcome measures, focusing on empowerment, and documentation of patient perspectives, which are particularly important in intercultural treatment settings.
Background:
Anxiety sensitivity (AS) refers to the tendency to fear physical sensations associated with anxiety due to concerns about potential physical, social, or cognitive consequences. Many previous studies were limited by the use of the anxiety sensitivity index (ASI) or the ASI-revised (ASI-R), which are both measurements with unitary or unstable structures. No recent study that has utilized the ASI-3 examined the relations between AS dimensions and depression. Thus, we examined multiple relationships between AS and anxiety disorders and depression using the ASI-3.
Methods:
The total sample consisted of 667 outpatients, diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders fourth text revision as assessed by a structured clinical interview. There were eight patient groups: multiple anxiety disorder, major depressive disorder (MDD), panic disorder (PD), social phobia (SP), obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), and anxiety disorder not otherwise specified (AD NOS). We conducted one-way analysis of variances and post hoc tests to compare the ASI-3 total and subscale scores across the groups.
Results:
The physical concern score was higher in patients with PD than patients with MDD, SP, OCD, or GAD. The social concern score was higher in the SP group than those with MDD, PD, GAD, and AD NOS. Patients with GAD and PTSD showed higher cognitive concern scores than the patients with PD.
Conclusion:
Results partially replicated the relationship between PD and physical concern, between SP and social concern, and between GAD and cognitive concern examining the relationships between AS dimensions and anxiety disorders.
Anxiety sensitivity (AS) is characterised by the fear of anxiety-related symptoms and is a risk factor for the development of anxiety-related disorders. We examined whether genetic variation in three stress response genes, CRHR1, NR3C1, and FKBP5, interact with childhood trauma (CT) to predict AS in South African adolescents. Xhosa (n = 634) and Coloured (n = 317) students completed self-report measures of AS and CT, and a total of eighteen polymorphisms within CRHR1, NR3C1, and FKBP5 were genotyped. Differences in AS based on genetic variation and CT were analysed within population and gender groups using multiple linear regression. Associations were found between AS and FKBP5 rs9296158 (p = 0.025) and rs737054 (p = 0.045) in Coloured males. Analysis of gene x CT interactions indicated that NR3C1 rs190488 CC-genotype, NR3C1 rs10482605 G-allele addition, and FKBP5 rs3800373 C-allele addition protect against AS with increasing CT in Xhosa females (p = 0.009), Xhosa males (p = 0.036) and Coloured males (p = 0.049), respectively. We identified two different protective single nucleotide polymorphism (SNP) combinations in a four-SNP CRHR1 haplotype in Coloured males. An analysis of the interaction between CT and a six-SNP FKBP5 haplotype in Coloured males revealed both protective and risk allelic combinations. Our results provide evidence for the influence of both genetic variation in CRHR1, NR3C1 and FKBP5, as well as CT x SNP interactions, on AS in South African adolescents. This study reinforces the importance of examining the influence of gene-environment (G X E) interactions within gender and population groups.
Background:
Anxiety sensitivity is a useful construct in explaining anxiety disorders. The Anxiety Sensitivity Index for Children (ASIC) is a brief self-report designed to assess anxiety sensitivity in youth.
Method:
Students (N = 1348; ages 10-17) completed a Spanish translation of the ASIC and measures of anxiety and depression.
Results:
Confirmatory factor analyses found that scores on the ASIC- Spanish version can be fitted to two factorial structures: A single factor and two first-order factors grouped into one higher-order factor. The two-factor structure was invariant between children and adolescents, and between boys and girls. The ASIC scales (Total Score, Mental Concerns, and Physical Concerns) demonstrated high internal consistency and test-retest reliability. ASIC scores were significantly related to measures of anxiety and, to a lesser extent, to a measure of depression.
Conclusions:
Results supported the factorial, convergent, and discriminant validity of ASIC scores in Spanish youth.
Generalized anxiety disorder (GAD), panic disorder with and without agoraphobia (PDA/PDWA), specific phobia, and social phobia are anxiety disorders that are commonly experienced among African Americans. Although burgeoning, the current empirical literature remains relatively sparse as it relates to culturally sensitive assessment of anxiety disorders. In some cases, cross-cultural comparisons denote differences between African Americans and non-Hispanic Whites (e.g., prevalence rates, mean differences on measures of anxiety) although other studies report mixed results. Along these lines, the goal of this chapter is to provide an overview of cultural considerations in the assessment of GAD, PD, and the phobias and summarize extant literature delineating culturally specific findings on “gold standard” assessments of the aforementioned anxiety disorders.
The present study explored the nature and extent of social anxiety and avoidance, anxiety sensitivity, and pain-related anxiety and avoidance in 46 clinic-referred chronic pain patients, compared with a community-based group reporting pain ( n = 66) and healthy controls ( n = 57). The chronic pain patients consistently reported higher levels of social distress, social avoidance, fear of negative evaluation, anxiety sensitivity, and pain-related anxiety and avoidance as compared with controls. Group differences in social distress, social avoidance, fear of negative evaluation, pain-related cognitive anxiety, and fear of cognitive and emotional dyscontrol, remained stable when pain severity was controlled for. Anxiety sensitivity was strongly related to both social and pain-related fears. The source of these social fears is examined in relation to the elevated pain-related fear and anxiety sensitivity also exhibited by chronic pain patients, and implications for treatment and rehabilitation are discussed.
Panic disorder has been the subject of considerable research and controversy. Though biological conceptualizations have been predominant, psychological theorists have recently advanced conditioning, personality, and cognitive hypotheses to explain the etiology of panic disorder. The purpose of this article is to provide an empirical and conceptual analysis of these psychological hypotheses. This review covers variants of the "fear-of-fear" construal of panic disorder (i.e., Pavlovian interoceptive conditioning, catastrophic misinterpretation of bodily sensations, anxiety sensitivity), research on predictability (i.e., expectancies) and controllability, and research on information-processing biases believed to underlie the phenomenology of panic. Suggestions for future research are made.
[review] a number of suggested dimensions of anxiety from various levels of analysis / [present] data on the core clinical dimensions that seem to run across the anxiety disorders, specifically the broad-based phenomena of panic, general anxiety, and the avoidance, cognitive, and somatic dimensions that characterize, in greater or lesser degree, the various anxiety disorders
the reliability of DSM-III [Diagnostic and Statistical Manual of Mental Disorders-III] / anxiety disorders categories / co-morbidity studies (PsycINFO Database Record (c) 2012 APA, all rights reserved)
A cognitive model of panic is described. Within this model panic attacks are said to result from the catastrophic misinterpretation of certain bodily sensations. The sensations which are misinterpreted are mainly those involved in normal anxiety responses (e.g. palpitations, breathlessness, dizziness etc.) but also include some other sensations. The catastrophic misinterpretation involves perceiving these sensations as much more dangerous than they really are (e.g. perceiving palpitations as evidence of an impending heart attack). A review of the literature indicates that the proposed model is consistent with the major features of panic. In particular, it is consistent with the nature of the cognitive disturbance in panic patients, the perceived sequence of events in an attack, the occurrence of ‘spontaneous’ attacks, the role of hyperventilation in attacks, the effects of sodium lactate and the literature on psychological and pharmacological treatments. Finally, a series of direct tests of the model are proposed.
The purpose of this study was to (a) compare people who experienced recent panic attacks (panickers) with nonpanickers and (b) determine, the factors associated with panic attacks in nonclinical subjects. Two hundred and fifty-six students completed the Panic Attack Questionnaire (PAQ), the State-Trait Anxiety Inventory (STAI), the Beck Depression, Inventory (BDI), the Profile of Mood States (POMS), and two measures of fear/avoidance. Over 22% of the subjects reported one or more panic attacks in the 3 weeks, prior to testing. Comparisons of panickers and nonpanickers showed that panickers (a) scored higher on measures of anxiety, depression, etc., and (b) reported more first-order relatives who have panic attacks. The panic attacks were characterized by (a) having a sudden onset, (b) an average of eight DSM-III symptoms, and (c) occurring in a wide variety of situations (especially social situations). Subjects who experienced unpredictable panic attacks differed, on several measures from subjects with only predictable attacks. Finally, panickers reported experiencing several symptoms not included in DSM-III. Similarities, between panickers and patients with Panic Disorder and Agoraphobia and the assessment of panic-related, disorders are discussed.
The purposes of this article are to summarize the author's expectancy model of fear, review the recent studies evaluating this model, and suggest directions for future research. Reiss' expectancy model holds that there are three fundamental fears (called sensitivities): the fear of injury, the fear of anxiety, and the fear of negative evaluation. Thus far, research on this model has focused on the fear of anxiety (anxiety sensitivity). The major research findings are as follows: simple phobias sometimes are motivated by expectations of panic attacks; the Anxiety Sensitivity Index (ASI) is a valid and unique measure of individual differences in the fear of anxiety sensations; the ASI is superior to measures of trait anxiety in the assessment of panic disorder; anxiety sensitivity is associated with agoraphobia, simple phobia, panic disorder, and substance abuse; and anxiety sensitivity is strongly associated with fearfulness. There is some preliminary support for the hypothesis that anxiety sensitivity is a risk factor for panic disorder. It is suggested that future researchers evaluate the hypotheses that anxiety and fear are distinct phenomena; that panic attacks are intense states of fear (not intense states of anxiety); and that anxiety sensitivity is a risk factor for both fearfulness and panic disorder.
The authors review the existing models for understanding agoraphobia and suggest a more complex behavioral model which includes a combination of necessary and sufficient factors for its formation. This model is presented as a framework allowing classification of agoraphobic-like symptoms with implications for treatment planning and research efforts.
Many people with anxiety disorders and phobias are afraid of experiencing anxiety. Psychoanalytic, existential, conditioning, and cognitive statements of the fear of anxiety are reviewed in this article. One conclusion is that there is a surprising degree of similarity among the various schools of thought. Another conclusion is that the fear of anxiety has been related theoretically to a much wider range of phenomena than is generally realized. The list includes agoraphobia, posttraumatic stress disorders, phobias, anxiety disorders, stress-related illnesses, anxiety incubation, placebo effects, anxious worrying, relaxation-induced anxiety, avoidance motivation, and fear exposure therapy. The concept of the fear of anxiety provides a theoretical basis for unifying a number of research areas. Empirical research is needed to evaluate the validity of these theoretical suggestions.
In the present study, we administered the Anxiety Sensitivity Index (ASI) and a modified version of the Panic Attack Questionnaire (PAQ) to 425 college students to determine whether high anxiety sensitivity ('fear of fear') occurs in the absence of a history of unpredictable ('spontaneous') panic attacks, or whether such attacks are a necessary precursor to high anxiety sensitivity. Based on their ASI scores, subjects were assigned to either the high, medium, or low anxiety sensitivity groups. High anxiety sensitivity subjects more frequently reported both a personal and family history of panic than did subjects in the other groups. Nevertheless, two-thirds of the high anxiety sensitivity subjects had never experienced an unpredictable panic attack. This suggests that the fear of anxiety can be acquired in ways other than through personal experience with panic.
We tested the hypothesis that anxiety sensitivity enhances responses to biological challenge by exposing college students who scored either high or low on the Anxiety Sensitivity Index (ASI) to 5 min of voluntary hyperventilation. The ASI is a validated self-report instrument that measures the fear of anxiety symptoms. Following hyperventilation, high-anxiety-sensitivity (HAS) subjects reported more frequent and more intense hyperventilation sensations and a higher level of subjective anxiety than did low-anxiety-sensitivity (LAS) subjects. Analyses of covariance controlling for baseline differences indicated that the magnitude of increase (i.e., reactivity) in hyperventilation symptoms remained greater in the HAS than in the LAS group, whereas the magnitude of increase in anxiety did not. HAS subjects also exhibited a bias for reporting bodily sensations in general. These findings parallel those obtained when panic patients and normal controls are biologically challenged with hyperventilation, lactate infusion, and other anxiogenic agents. Taken together, these results suggest that anxiety sensitivity may also enhance the anxiety responses of panic patients during biological challenge tests. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Diagnostic and Statistical Manual (Third edition, revised) Dimensions of anxiety disorders
- American Psychiatric
American Psychiatric Association (1987). Diagnostic and Statistical Manual (Third edition, revised). Washington, DC: American Psychiatric Association. Barlow, D. H. (1985). Dimensions of anxiety disorders. In A. H. Tuma & J. D. Maser (Eds.), Anxiety and the anxiety disorders (pp. 479-500). Hillsdale, NJ: Erlbaum.
The Anxiety Disorders Interview Schedule -Revised
- P A Diiardo
- D H Barlow
- J A Cemey
- B B Vermilyea
- J A Vermilyea
- W G Hhnaldi
- M T Waddell
Diiardo, P. A., Barlow, D. H., Cemey, J. A., Vermilyea, B. B., Vermilyea, J. A., Hhnaldi, W. G., & Waddell, M. T. (Unpublished manuscript). The Anxiety Disorders Interview Schedule -Revised (ADIS-R). Sme University of New York at Albany.
Anxieo Sensitivity index Manual
- R A Peterson
- S Reiss
Peterson, R. A., & Reiss, S. (1987). Anxieo Sensitivity index Manual. Worthington, OH: IDS Publishing.
Expectancy model of fear Theoretical issues in behavior therapy
- S Reiss
- R J Mcnally
Reiss, S., & McNally, R. J. (1985). Expectancy model of fear. In S. Reiss & R. R. Bootzin (I%.), Theoretical issues in behavior therapy. New York: Academic Press.
(in press) The childhood anxiety sen-sitivity index
- W K Silverman
- W Fleisig
- B Rabin
- R A C D 8~ Peterson
- R L Gorsuch
- R E Lushene
Silverman, W. K., Fleisig, W., Rabin, B., 8~ Peterson, R. A. (in press). The childhood anxiety sen-sitivity index. Journal Child Clinical Psychology. Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1970). Manual for the State Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologist Press.
The childhood anxiety sensitivity index
- W K Silverman
- W Fleisig
- B Rabin
- R A Peterson