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The role of anxiety sensitivity in the sexual functioning of young women
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High anxiety sensitivity (AS; fear of arousal-related bodily sensations) is a known risk factor for psychopathology and medical pathology. High AS individuals tend to avoid activities that induce feared arousal-related sensations; yet, few studies have examined AS and sexual activity, those that did have produced mixed results, and no study to date has examined AS and sexual avoidance. In Study 1, 296 young adult women completed the Anxiety Sensitivity Index-3 (ASI-3) and the Female Sexual Distress Scale-Revised, which were positively correlated, r = 0.34, p < .001. Women scoring in the highest and lowest quartiles on the ASI-3 were recruited for Study 2. As predicted, high (vs. low) AS women reported significantly more sexual distress, impairments in sexual functioning (including sexual pain), and avoidance of sexual activity, and less sexual satisfaction. Results suggest that high AS can limit the frequency and quality of sexual functioning in young adult women, or lead to avoidance of sexual activity altogether. Reducing AS via empirically validated cognitive-behavioural approaches could improve women's sexual and relationship well-being.
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... For some women, this association may form the basis of long-term difficulties with sexual pain (e.g., vaginismus, as reviewed by Cherner and Reissing (2013)). Indeed, some researchers have found that women who report more anxiety sensitivity also report more problems with sexual functioning (Gerrior et al., 2015;Tutino et al., 2017). ...
... sensitivity is that men and women have been shown to differ on these constructs. Women tend to score higher on anxiety sensitivity measures than men (Gerrior et al., 2015;Taylor et al., 2007). In contrast, men tend to score higher on positive beliefs about autonomic arousal sensations than women (See Supplementary Materials). ...
... These results may help explain why Fox et al. (2022) found only weak evidence that anxiety disorders are elevated in people with paraphilic disorders since anxiety sensitivity is an important correlate for these types of problems. Moreover, these results contrast with building evidence that anxiety sensitivity is a transdiagnostic factor for problems with sexual functioning in men and women (e.g., Gerrior et al., 2015;Tutino et al., 2017Tutino et al., , 2018. Overall, our results suggest that positive interpretations of bodily symptoms may be more robust correlates of paraphilic interests (total score and factor scores) than anxiety sensitivity. ...
We examined whether beliefs about autonomic arousal sensations and sexual sensation seeking explain some of the gender differences in self-reporting paraphilic sexual interests in 672 university students. A serial mediation model was used to test the direct association of gender and the indirect associations of positive interpretations of autonomic arousal sensations and sexual sensation seeking on paraphilic sexual interests. Anxiety sensitivity (e.g., the belief that anxiety sensations are dangerous) was included in the serial mediation model to evaluate the relationship between negative interpretations of autonomic arousal sensations and paraphilic interests. As predicted, men reported more paraphilic interests, sexual sensation seeking, positive beliefs about autonomic arousal sensations, and lower anxiety sensitivity than women. Participants' gender was indirectly related to paraphilic interests through positive beliefs about autonomic arousal sensations and sexual sensation seeking. Notably, positive interpretations of autonomic arousal sensations had a greater association with paraphilic sexual interests than anxiety sensitivity. When autonomic arousal sensations are interpreted positively, they may facilitate sexual sensation seeking, and people may endorse more paraphilic sexual interests. Future research on paraphilias should further examine positive interpretations of autonomic arousal sensations as they may relate to sexual sensation seeking and the endorsement of paraphilic interests.
... In the context of sexual activity, this fear might manifest as reduced sexual desire, less frequent sexual activity (Tutino et al., 2017), problems with sexual function, or less positive cognitive-affective responses to sexual activity (e.g. satisfaction; Gerrior et al., 2015). The association between anxiety sensitivity and sexual well-being, however, remains under investigated and methodological limitations of the research to date challenge the generalizability and interpretation of the findings. ...
... Recent studies have advanced research linking anxiety sensitivity with sexual well-being by considering sexual well-being outcomes beyond sexual function and using a more psychometrically sound measure of anxiety sensitivity, the ASI-3 (Taylor et al., 2007). In a study of 296 undergraduate women, Gerrior et al. (2015) found that higher anxiety sensitivity was associated with more sexual distress (e.g. unhappiness, guilt, frustration, worry about sex and sexual problems). ...
... Finally, although most studies have focused on sexual function, the associations of anxiety sensitivity with several domains of sexual well-being more broadly, including function, cognitive-affective responses, and behavior, remain under-explored. For instance, no studies have yet considered the association between anxiety sensitivity and sexual self-esteem even though there is a wealth of data indicating that esteem is consistently linked to indices of sexual health (Sakaluk et al., 2020), and only one study has examined the association between anxiety sensitivity and sexual avoidance (Gerrior et al., 2015). These sexual well-being outcomes warrant attention. ...
... ; physical health (Asmundson, Wright, & Hadjistavropoulos, 2000); and, pain (Olthuis & Asmundson, 2018). Higher anxiety sensitivity also has been linked to poorer sexual well-being (Burri, Spector, & Rahman, 2012;Gerrior, Watt, Weaver, & Gallagher, 2015;Meana & Lykins, 2009;Tutino, Ouimet, & Shaughnessy, 2017, Tutino, Shaughnessy, & Ouimet, 2018. Research exploring the association between anxiety sensitivity and sexual well-being has relied to date on the widely-adopted Anxiety Sensitivity Index-3 (ASI-3; Taylor et al., 2007). ...
... Tutino et al. (2017Tutino et al. ( , 2018 found that higher anxiety sensitivity among women (but not men) was associated with less frequent sexual activity with a partner. Gerrior et al. (2015) compared undergraduate women with high versus low anxiety sensitivity and found that high anxiety sensitivity women reported higher sexual aversion and sexual anxiety. Research also confirms associations between anxiety sensitivity and poorer sexual function including greater sexual pain (Burri et al., 2012;Gerrior et al., 2015;Meana & Lykins, 2009;Tutino et al., 2017Tutino et al., , 2018 but see Dèttore, Pucciarelli, &Santarnecchi, 2013 andBradford &Meston, 2006 for a null finding using the original ASI), greater sexual distress (Burri et al., 2012), and lower sex life quality (Tutino et al., 2017(Tutino et al., , 2018. ...
... Gerrior et al. (2015) compared undergraduate women with high versus low anxiety sensitivity and found that high anxiety sensitivity women reported higher sexual aversion and sexual anxiety. Research also confirms associations between anxiety sensitivity and poorer sexual function including greater sexual pain (Burri et al., 2012;Gerrior et al., 2015;Meana & Lykins, 2009;Tutino et al., 2017Tutino et al., , 2018 but see Dèttore, Pucciarelli, &Santarnecchi, 2013 andBradford &Meston, 2006 for a null finding using the original ASI), greater sexual distress (Burri et al., 2012), and lower sex life quality (Tutino et al., 2017(Tutino et al., , 2018. ...
Anxiety sensitivity, the fear of physiological arousal sensations, has been linked to lower sexual frequency, poorer sexual function, and greater sexual anxiety. The current study assessed whether anxiety sensitivity specific to the sexual context, termed sexual anxiety sensitivity, was linked to a wide range of indicators of sexual well-being over and above associations accounted for by general anxiety sensitivity. As a first step, we developed the Sexual Anxiety Sensitivity Inventory (SASI). Participants were 484 adults aged 19 to 60 years old who completed an on-line survey. To develop the SASI, we constructed parallel items to those on the Anxiety Sensitivity Scale-3 (ASI-3; Taylor et al., 2007 Taylor, S., Zvolensky, M. J., Cox, B. J., Deacon, B., Heimberg, R.G., Ledley, D.R., Abramowitz, J. S., Holaway, R. M., Sandin, B., Stewart, S. H., Coles, M., Eng, W., Daly, E. S., Arrindell, W. A., Bouvard, M., & Cardenas, S. J. (2007). Robust dimensions of anxiety sensitivity: Development and initial validation of the Anxiety Sensitivity Index—3. Psychological Assessment, 19(2), 176–188. doi:10.1037/1040-3590.19.2.176[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). The SASI demonstrated the same three-factor structure as the ASI-3 and showed high internal consistency providing evidence for its reliability. As predicted, sexual anxiety sensitivity was significantly associated with all ten of the markers of the behavioral, cognitive-affective, and functional domains of sexual well-being assessed and six of these associations remained significant after controlling for general anxiety sensitivity. The results provide evidence that sexual anxiety sensitivity is an important construct for understanding individuals’ sexual well-being and provide initial evidence that the specificity of the SASI has value as a reliable and valid measure for assessing sex-related anxiety sensitivity. Implications for clinicians and researchers are discussed.
... Among the biological factors, studies have highlighted that female sexual desire is notably influenced by age (Parish & Hahn, 2016;West et al., 2008;Worsley et al., 2017), gender (Graham et al., 2017;Mercer et al., 2003;Regan & Atkins, 2006), physical health (McCool-Myers et al., 2018;Parish & Hahn, 2016), medication (Goldstein et al., 2017;Parish & Hahn, 2016), and contraception (Warnock, 2002;Warnock et al, 2006). Among the psychological factors, studies have shown that female sexual desire is notably influenced by mental health (Thomas & Thurston, 2016), depression (Cyranowski et al., 2004;Frohlich & Meston, 2002;Hubin et al., 2011;McCool-Myers et al., 2018;Shifren et al., 2008), anxiety (Gerrior et al., 2015;Van Minnen & Kampman, 2000), stress (Géonet et al., 2018;Laumann et al., 1999;McCool-Myers et al., 2018;Parish & Hahn, 2016;Raisanen et al., 2018). Among the relational factors, studies have established the impact of marital status (Klusman, 2002;McNulty et al., 2019), relationship quality (Graham et al., 2017;McCool-Myers et al., 2018;Rosenkrantz & Mark, 2018;Sutherland et al., 2020), and the presence of children (Apt & Hurlbert, 1992;Friedmann et al., 1998;Trice-Black, 2010). ...
... The internal consistency coefficients of the three different subscales of the depression, anxiety, and stress scale of the French-language version of the DASS21 range from 0.89 to 0.94. We used the DASS21 (Henry & Crawford, 2005;Osman et al., 2012) to ensure that participants did not suffer from depression, anxiety, and stress problems that can disrupt sexual functioning (Gerrior et al., 2015;Kashdan et al., 2011;Laurent & Simons, 2009). ...
Numerous studies have described that women’s sexual desire is lower than men’s desire. Within a heterosexual couple, a sexual desire discrepancy can be associated with sexual and relationship dissatisfaction. The factors that negatively influence women’s sexual desire are biological, psychological, relational, cognitive and sociocultural. The present study aimed to determine the extent to which adherence to sexual norms predicted sexual desire in women engaged in a romantic relationship (min. 6 months). These norms were addressed by Simon and Gagnon’s (1984) notion of sexual scripts, which designate the sociocultural norms governing the sexual behaviors of men and women. A sample of women (N = 829, M age = 32 years, SD = 12.20, range = 18–72) completed a questionnaire about sexual desire and heterosexual scripts. The results showed that the more women in relationships say they felt desire, the less they subscribed to heterosexual scripts and particularly the conception that a man’s sex drive is higher than a woman’s. This conception seems to be the most determinant of women’s sexual desire in relationships. The results attest also to the persistence and strength of heterosexual scripts which, despite greater equality between men and women, continue to negatively influence women’s sexual desire. By becoming aware of these conditionings, women suffering from low sexual desire and sexual desire discrepancy within their couple can break free from them and experience a more fulfilling sexuality. Lastly, some interesting contradictory results are addressed in discussion.
... Previous research, which has largely focused on women, has been equivocal. Some studies found that high anxiety sensitivity was associated with impaired sexual functioning (Gerrior et al., 2015;Tutino et al., 2017Tutino et al., , 2018, no relationship (Dèttore et al., 2013), or a limited relationship in a laboratory study (Bradford & Meston, 2006). While the research is not conclusive, the hypothesized mechanism is that those with higher levels of anxiety sensitivity are more likely to misinterpret the physical symptoms of sexual arousal as symptoms of anxiety. ...
... Concerning anxiety sensitivity, the literature is equivocal. Increased anxiety sensitivity has been found to have no or a limited relationship with sexual functioning (Bradford & Meston, 2006;Dèttore et al., 2013) and to be associated with poorer sexual functioning (Gerrior et al., 2015;Tutino et al., 2017Tutino et al., , 2018. We found anxiety sensitivity to be associated with a higher risk of sexual dysfunction, higher associated distress, and lower sexual satisfaction among women only. ...
Although previous studies have established links between anxiety disorders, sexual dysfunctions, and sexual satisfaction, there is relatively little research on the specific factors associated with living with an anxiety disorder that might contribute to these sexual health disparities. This study assessed the associations between anxiety, cognitive distractions, biased expectancies, and 1) sexual dysfunction (DSM-5 diagnostic criteria) 2) associated distress, and 3) sexual satisfaction while considering the role of pharmacological treatment-related sexual side effects and comorbid depressive symptoms. A large clinical population (N = 207) of people with anxiety diagnoses seeking treatment at 11 outpatient anxiety clinics in Denmark participated. Higher cognitive distraction levels were linked with a greater risk of sexual dysfunction, more sexual dysfunction-associated distress, and lower sexual satisfaction. Higher sexuality and anxiety biased expectancies were associated with an increased risk of sexual dysfunctions and associated distress and decreased sexual satisfaction. Higher anxiety symptom severity was only associated with lower sexual satisfaction among female respondents. Higher anxiety sensitivity was linked to a higher risk of sexual dysfunction, associated distress, and lower sexual satisfaction among female participants only.
... Thus, we expect the use of sexual safety behaviors to differ significantly between the three groups. Given the high comorbidity between anxiety disorder, depression, and sexual dysfunction (Forbes, Baillie, & Schniering, 2015) as well as the existence of empirical results on shared cognitive processes and psychological vulnerabilities (e.g., anxiety sensitivity, Gerrior, Watt, Weaver, & Gallagher, 2015; internal, global, and stable attributional style, dysfunctional beliefs, and negative self-image, Nobre & Pinto-Gouveia, 2009, we expect sexual safety behaviors to be positively correlated with symptoms of anxiety and depression in women. Further, as sexual safety behaviors most prominently are characterized by self-conscious cognitive activities, we also hypothesize that sexual safety behaviors are positively associated with negative and repetitive thought processes, namely negative automatic thoughts (Nobre & Pinto-Gouveia, 2008), fear of negative evaluation (Pyke, 2019) and post-event-processing (Hofmann, 2007;Mitchell & Schmidt, 2014). ...
... For instance, SA was found to be associated with reduced sexual and relational satisfaction, 20,21 lower sexual self-efficacy, 22 as well as with other sexual difficulties (eg, low sexual desire, vaginismus), 12,20,23,24 and gynecologic conditions and procedures (eg, endometriosis, vulvectomy). 20,25 Developmental and psychological correlates of SA have also been documented, such as a history of child sexual abuse, 26,27 sexual assault in adulthood, 28 negative body image and self-disgust, 29-31 depression, 32 trait anxiety, 26,33 panic disorder, [34][35][36] and obsessive-compulsive disorder. 36 In their classic etiologic model of SA, Gold and Gold 37 described performance anxiety as a typical predictor, though this association is yet to be empirically tested. ...
Background: Sexual aversion (SA) is a chronic difficulty impacting sexual, relational and psychological wellbeing. Yet, there is a dearth of studies exploring its prevalence and associated factors.
Aims: To estimate the prevalence of SA and examine its correlates among a community sample of Canadian adults.
Methods: A large web-based sample of the Quebec (Canada) adult population (n = 1,935) completed an online survey on sexual wellbeing. Prevalence rates were estimated for SA and other sexual difficulties. Multivariate logistic regression analyses were used to identify correlates of SA.
Outcomes: Demographics (e.g., gender, employment status), self-reported experiences of sexual difficulties (low sexual desire and arousal, vaginal dryness, pain during sexual intercourse, erectile difficulties, premature or delayed ejaculation, and orgasm difficulties), and markers of psychosexual wellbeing (e.g., psychological distress, performance anxiety) according to the presence or absence of SA were assessed.
Results: The prevalence of SA was 9.7% (95% CI: 8.5-11.2) in the present sample (6.9% [95% CI: 5.1-8.9] in men, 11.3% [95% CI: 9.4-13.4] in women and 17.1% [95% CI: 9.4-27.4] in nonbinary/trans individuals). The multivariate logistic regression model explained 31% of the likelihood of experiencing SA. SA was related to psychological distress (aOR: 1.77, 95% CI: 1.33-2.38), sexual satisfaction (aOR: .59, 95% CI:.49-.70), sexual performance anxiety (aOR: 2.08, 95% CI: 1.45-2.98), and discomfort with sex-related information (aOR: 1.02, 95% CI: 1.01-1.04). Clinical implications: Several psychosexual correlates of SA were documented and could be targeted by practitioners during the assessment and treatment of individuals living with SA.
Strengths and limitations: The study’s strengths include its large, gender diverse sample and use of comprehensive diagnostic criteria for SA. Probability-based sampling methods and longitudinal studies should be conducted to address the current study’s limitations.
Conclusions: SA research is critical to document its prevalence in different sociodemographic groups, explore additional intrapersonal and interpersonal mechanisms involved in SA etiology, and ensure that the needs of people living with SA are met with tailored interventions.
... Furthermore, such evaluation often entails significant consequences for an individual, which may further intensify the anxiety [9] (Our focus is on anxiety related to performance, competition, and winning, and not anxiety associated with organizational or personal issues). For example, partnered sexual activity, particularly at the onset of a relationship, typically includes both evaluative and consequence components, with sexual impairment having long been associated with anxiety [10][11][12]. In sport, athletes are often under scrutiny not just by teammates and coaches but also by fans, and the consequences for failed or diminished athletic performance can be both personal (e.g., embarrassment, loss of confidence, etc.) and professional (e.g., loss of opportunities, contracts, income, etc.) [13]. ...
Strategies for addressing anxiety-related decrements in performance have been implemented across a variety of domains, including Sex, Sport, and Stage. In this review, we (1) iterate the dominant anxiety-related remediation strategies within each of these domains; (2) identify over-lapping and domain-specific strategies; and (3) attempt to unify the conceptualization of performance-related anxiety across these three areas under the information-processing framework of the Reflective/deliberative—Impulsive/automatic Model (RIM). Despite both diversity and similarity in remediation approaches across domains, we found that many strategies appear to share the common goal of maintaining a dominant automatic style of information processing in high performance demand situations. We then describe how various remediation strategies might hypothetically fit within the RIM framework and its subcomponents, identifying each intervention as falling into one or more broad categories related to achieving and/or maintaining dominance in automatic information processing. We conclude by affirming the benefit of adopting a unifying information-processing framework for the conceptualization of performance-related anxiety, as a way of both guiding future cross- and inter- disciplinary research and elucidating effective remediation models that share common pathways/mechanisms to improved performance.
... Autoři zjistili, že respondentky s vysokou citlivostí na úzkost měly skóre oblastí FSFI nižší oproti respondentkám s níz-kou citlivostí, jako je spokojenost (4,21 vs. 5,11), bolest (4,17 vs. 5,51) a celkové FSFI skóre (25,95 vs. 29,63). Ze studie vyplývá, že i mladé sexuálně aktivní ženy vykazují pocity úzkosti, které mají dopad na jejich sexuální fungování (6). Tyto dvě studie dokládají dopad psychického rozpoložení na psychickou pohodu v sexuálním životě. ...
Sexual anxiety can activate the stress response cycle during sex, compromising a woman's ability to experience sexual pleasure. Black women face additional cultural and contextual factors, such as hypersexualization, partner scarcity, and higher rates of sexual trauma that may increase the magnitude, frequency, and odds of experiencing sexual anxiety. However, limited research has explored this phenomenon among Black women. Thus, we sought to qualitatively explore how N = 25 premenopausal Black women living in the southern United States make meaning of experiences with sexual anxiety. We analyzed the interview data using an interpretive phenomenological approach. Three components of the phenomenon of sexual anxiety were gleaned: 1) causes of sexual anxiety, 2) characteristics of sexual anxiety, and 3) coping strategies. Each component included three to six elements of meaning making. For these Black women, causes of sexual anxiety included fears of sexual pain, partner unfamiliarity, previous traumas, mental health concerns, and intersecting socio-structural factors. Characteristics of sexual anxiety included mental, somatic, and emotional elements. Coping strategies included having a reassuring and supportive sex partner, supporting themselves with affirmations and mindfulness, attending therapy, and using substances. Through reflection about their perceived causes of, experienced characteristics of, and intentional coping with sexual anxiety, meanings were co-constructed through an intersectional frame. Implications for intersectionality-informed interventions and suggestions for mental health professionals and partners are discussed.
Classic and contemporary approaches to the assessment of female sexuality are discussed. General approaches, assessment strategies, and models of female sexuality are organized within the conceptual domains of sexual behaviors, sexual responses (desire, excitement, orgasm, and resolution), and individual differences, including general and sex-specific personality models. Where applicable, important trends and relationships are highlighted in the literature with both existing reports and previously unpublished data. The present conceptual overview highlights areas in sexual assessment and model building that are in need of further research and theoretical clarification.
Anxiety isn't all in your head. When you feel nervous, symptoms such as chills, sweating, heart palpitations, and shaking can affect your whole body. If you worry that others notice these anxiety symptoms or fear that they could be harmful to your health, you may have anxiety sensitivity. Anxiety sensitivity is the fear of anxiety-related sensations, a condition that affects approximately 16 percent of the population. People with high anxiety sensitivity often fear these bodily sensations even more than the situation that caused their anxiety in the first place. This fear of fear can lead them to avoid activities that might trigger their symptoms, and can cause other mental and physical problems down the road.
Overcoming the Fear of Fear provides you with all the tools you need to stop fearing your anxiety symptoms for good. You'll learn to use cognitive behavioral techniques that have been proven effective for people with anxiety sensitivity. These techniques can help you reduce your anxiety sensitivity, prevent recurrence of panic attacks, and start living without fear.
Reported sensations during sexual arousal and panic attacks were compared in women with panic disorder and in controls. Hypotheses: patients with panic disorders report: (1) similar sensations during sexual arousal and panic attacks, but (2) these sensations do not trigger panic during sexual activity, because (3) there is no sense of loss of control in sexual arousal. Thirty women with panic syndrome and 27 age-matched controls were included in this study. The two groups were compared using a self-developed questionnaire. The results do show a significant overlap of reported sensations (80% of sexual sensations identical with panic sensations), but with a different subjective perception for many women. Unexpectedly, most reported sensations during sex (masturbation and partner activity) were experienced as unpleasant. Contrary to our hypothesis, 30% of our sample did panic during sexual activity, 50% experienced a loss of control and 70% of the sample did not panic during sex, in spite of overlapping sensations. These results provide incentives for further studies on this topic.
A brief cognitive-behavioral treatment intervention that included an interoceptive exposure (IE) component was previously demonstrated effective in decreasing fear of anxiety-related sensations in high anxiety-sensitive (AS) women (see Watt, Stewart, Birch, & Bernier, 2006). The present process-based study explored the specific role of the IE component, consisting of 10 minutes of physical exercise (i.e., running) completed on 10 separate occasions, in explaining intervention efficacy. Affective and cognitive reactions and objective physiological reactivity to the running, recorded after each IE trial, were initially higher in the 20 high-AS participants relative to the 28 low-AS participants and decreased over IE trials in high-AS but not in low-AS participants. In contrast, self-reported somatic reactions, which were initially greater in the high-AS participants, decreased equally in both AS groups over IE trials. Findings were consistent with the theorized cognitive and/or habituation pathways to decreased AS.
Anxiety sensitivity (AS) is the fear of anxiety sensations which arises from beliefs that these sensations have harmful somatic, social, or psychological consequences. Over the past decade, AS has attracted a great deal of attention from researchers and clinicians with more than 100 peer-reviewed journal articles published. In addition, AS has been the subject of numerous symposia, papers, and posters at professional conventions.© 1999 by Lawrence Erlbaum Associates, Inc. Why this growing interest? Theory and research suggest that AS plays an important role in the etiology and maintenance of many forms of psychopathology, including anxiety disorders, depression, chronic pain, and substance abuse. Bringing together experts from a variety of different areas, this volume offers the first comprehensive state-of-the-art review of AS--its conceptual foundations, assessment, causes, consequences, and treatment--and points new directions for future work. It will prove to be an invaluable resource for clinicians, researchers, students, and trainees in all mental health professions. © 1999 by Lawrence Erlbaum Associates, Inc. All rights reserved.
Anxiety sensitivity (AS) is a construct that denotes an individual difference in fear of anxiety. Most research into the AS construct has focused on its association with panic attacks, panic disorder and several other psychiatric disorders. There has been growing interest recently in AS as an important factor in the maintenance and exacerbation of morbidity associated with some disabling chronic health conditions (e.g. gastrointestinal dysfunction, asthma, vestibular dysfunction and chronic pain). The purposes of this paper are (a) to provide a brief overview of the theoretical framework within which the AS and chronic health condition literature can be synthesized, (b) to review the existing literature regarding AS and chronic health conditions and (c) to offer recommendations for assessment and treatment. Theoretically and practically relevant directions for future investigation are provided throughout the review.
Tinnitus is the perception of sounds (often ringing or buzzing) in the absence of any external auditory stimulation, hence sometimes called a ''phantom auditory perception''. Although most people tend to ignore their tinnitus, a significant proportion will show marked annoyance and reduced quality of life as a result of this complaint. It is difficult to predict those who are likely to develop severe problems with tinnitus, but psychosocial aspects such as anxiety and depression have been proposed as mediators. In this study we investigated the role of anxiety sensitivity defined as a trait tendency to fear anxietyrelated sensations. The study sample included 146 tinnitus patients with moderate to severe tinnitus. Results showed that anxiety sensitivity correlated significantly with tinnitus distress, but the association was significantly stronger in female participants who also displayed more signs of anxiety sensitivity. A multiple regression analysis revealed that anxiety sensitivity contributed to explained variance in tinnitus distress beyond audiological measures of tinnitus maskability and hearing thresholds. These results are discussed in light of related investigations on the role of anxiety sensitivity in somatic conditions.
The purpose of the present article is to provide unification to a number of somewhat disparate themes in the chronic pain and phobia literature. First, we present a summary review of the early writings and current theoretical perspectives regarding the role of avoidance in the maintenance of chronic pain. Second, we present an integrative review of recent empirical investigations of fear and avoidance in patients with chronic musculoskeletal pain, relating the findings to existing cognitive-behavioral theoretical positions. We also discuss several new and emerging lines of investigation, specifically related to information processing and anxiety sensitivity, which appear to be closely linked to pain-related avoidance behavior. Finally, we discuss the implications of the recent empirical findings for the assessment and treatment of individuals who experience disabling chronic musculoskeletal pain and suggest possible avenues for future investigation.