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Anxiety sensitivity and emotional disorders: Psychometric studies and their theoretical implications
... 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. ...
... Furthermore, physical, psychological, and social concerns are usually mentioned for these three lower-order components. As a result, Cox, Borger, and Enns [5] and Moshier et al. [67] say that anxiety sensitivity plays an important role in anxiety. ...
... This study is coherent with prior research, and anxious patients misunderstand their anxiety symptoms in this research. They feel this sensation is a disorder of mental disturbance [5,46,54]. Deacon and Abramowitz [55] say that the fear of cognitive dyscontrol subdimension is associated with anxiety disorders strongly. These anxiety disorders can contain obsessive-compulsive disorder in addition to generalised anxiety disorder, and panic disorder. ...
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.
... AS is a vulnerability that amplifies preexisting anxiety and places individuals at risk for later developing anxiety-related problems, especially panic disorder (Cox, Borger, & Enns, 1999;Reiss, 1991;Gallagher et al., 2013). Researchers have consistently found evidence for a strong relationship between measures of AS and panic disorder symptoms (Deacon & Valentiner, 2001) and has been shown to predict panic attack frequency independent of negative affect (Schmidt, Mitchell, & Richey, 2008). ...
... Anxiety pathology has been separated into distinct anxiety disorders despite commonalities (i.e. maladaptive emotions, cognitions and dysfunctional avoidance behavior), which has resulted in a lot of research methodology designed to focus disorder-specific outcomes (Cox, Borger, & Enns, 1999;Olatunji & Wolitzky-Taylor, 2009;Reiss, 1991). While the strength between anxiety sensitivity and Panic Disorder is strong (Olatunji & Wolitzky-Taylor, 2009), anxiety sensitivity is also implicated as transdiagnostic factor across anxiety disorders (Calamari, et al., 2008;Rapee & Heimberg, 1997;Rodriguez et al., 2004;McNally & Steketee, 1985;Taylor, 2003). ...
Drinking behaviors among college students have become problematic as evidenced by 20% of students who endorse five or more problems associated with alcohol use. Alcohol use problems are associated with numerous anxiety problems and can begin as early as young adolescence. The period for risk of developing emotional problems peaks during the transition to college. Despite the relationship between anxiety and alcohol use problems, little is known about the cross-cutting mechanisms that explain their relationship and comorbidity. Researchers have proposed affective (i.e. anxiety sensitivity and distress tolerance) and alcohol-specific motivations (i.e. expectancies, valuations, peer influence, and drinking motives) as vulnerabilities for alcohol use and anxiety problems. To address the relationship gap,, the current study examined how changes in anxiety sensitivity, alcohol expectancies, valuations, peer resistance, and drinking motives contributed to changes in alcohol and anxiety interference across three waves of time. Key findings from 297 college students revealed expectancies predicted positive changes alcohol use problems across two phases of time. Anxiety sensitivity predicted alcohol use problems, drinking motives, expectancies, and valuations. Moreover, anxiety sensitivity predicted positive changes in anxiety interference and peer resistance. Drinking motives were associated with increased changes in alcohol useproblems. The relationship between anxiety sensitivity and alcohol use problems were serially mediated via expectancies and motives. These results highlight the importance of targeting specific cognitive- affective mechanisms among early college students to reduce the risk of alcohol use and anxiety-related problems. Adviser: Debra Hope
... Anxiety sensitivity is prospectively associated with the onset of anxiety disorders [21,22], as well as the experience of PTSD symptoms [23][24][25]. In addition, individuals with PTSD exhibit elevated levels of anxiety sensitivity [26], and higher anxiety sensitivity is linked to greater PTSD symptom severity and posttraumatic distress following trauma exposure [27,28]. Anxiety sensitivity is also associated with negative reinforcement expectancies (i.e., the belief that using substances will relieve distress) [29] and the use of substances to cope with negative affect [30,31], including among those with PTSD [32,33]. ...
... Anxiety sensitivity has been found to be associated with PTSD diagnosis, symptom severity, and the use of substances to cope with negative affect [24,26,27,33,77]. Among those with a SUD, both the presence of trauma exposure and a PTSD diagnosis are associated with greater SUD severity [7,9,15] and may contribute to ongoing substance use to relieve PTSD-related negative affect and somatic distress. ...
Background:
Exposure to traumatic events and posttraumatic stress disorder (PTSD) are common among individuals with substance use disorders (SUDs). Although the presence of trauma exposure and/or PTSD among those with SUDs is associated with a range of negative outcomes, much remains to be understood about the factors contributing to these outcomes. Anxiety sensitivity (the tendency to respond fearfully to the signs and symptoms of anxiety) has been linked to greater PTSD symptoms and the use of substances to cope with PTSD symptoms, and is a promising factor for understanding the negative outcomes associated with co-occurring PTSD and SUDs.
Methods:
This study examined the association between anxiety sensitivity and trauma cue reactivity among 194 trauma-exposed patients with SUDs (27.3% met criteria for current PTSD). Participants completed ratings of negative affect and substance cravings prior to and after exposure to a personally-relevant trauma cue.
Results:
Results indicated that anxiety sensitivity was associated with greater emotional reactivity (but not craving reactivity) to the trauma cue; neither PTSD symptom severity nor PTSD diagnosis moderated these associations. PTSD symptom severity was associated with greater emotional and craving reactivity to the trauma cue.
Conclusions:
Results highlight the potential utility of targeting anxiety sensitivity in treatments for trauma-exposed patients with SUDs with and without PTSD.
... Instead, particular bodily sensations (e.g., heart palpitations) are dreaded because they are associated with the onset of panic (not a heart attack), and a panic attack is considered highly aversive in and of itself (Reiss & McNally, 1985). This distinction is still somewhat controversial (see Cox, Borger & Enns, 1999). Further, anxiety sensitivity theory extends the theory of catastrophic misinterpretation by proposing that there is natural variation i the tendency to catastrophise in response to somatic symptoms. ...
... Clinical studies using the ASI have found that patients with panic disorder score about two standard deviations above the normative mean on the ASI, and significantly higher than those with generalized anxiety disorder, or social phobia (e.g., Taylor, Koch and McNally, 1992; see Cox, Borger & Enns, 1999 for a review). ...
... , which is comparable to the heritability coefficients of more well-established temperamental vulnerabilities for BPD (e.g., affective instability and impulsivity; see Jang et al., 1996). Furthermore, AS is considered to be distinct from trait anxiety (see Lilienfeld, 1999), reflecting an individual's characteristic way of evaluating and responding to the experience of anxiety, rather than the frequency or intensity of the anxiety experience per se (Cox et al., 1999). Research supports this distinction. ...
... Consistent with the conceptualization of AS as a vulnerability factor for the development of anxiety disorders, cross-sectional studies have found elevated AS among individuals with anxiety disorders compared to normal controls (Cox et al., 1999;Taylor and Cox, 1998;Taylor et al., 1992), and prospective studies have found that heightened AS predicts the development of spontaneous panic attacks (Schmidt et al., 1997(Schmidt et al., , 1999. Moreover, there is growing evidence for the role of AS in the development of psychopathology more broadly, as studies have found heightened AS in other clinical disorders as well (e.g., major depression; see Otto et al., 1995;Taylor et al., 1996). ...
Aunque la investigación sobre las vulnerabilidades temperamentales asociadas con el trastorno límite de la personalidad (TLP) se ha centrado principalmente en el papel de la agresividad impulsiva, la inestabilidad afectiva y la vulnerabilidad emocional, un número de pruebas cada vez mayor indica que la sensibilidad a la ansiedad (SA) también puede aumentar la vulnerabilidad al TLP. Este estudio proporciona datos preliminares sobre la relación entre la SA y el TLP, examinando si la SA distingue entre pacientes ambulatorios con TLP y pacientes sin un trastorno de la personalidad (TP) y si la relación entre SA y TLP está mediada por la evitación experiencial (es decir, tentativas de evitar las experiencias internas no deseadas, como la ansiedad). Los hallazgos indican que los pacientes ambulatorios con TLP refieren mayor SA que los sin TP y que la SA distinguió fiablemente entre estos dos grupos. Además, la relación entre la SA y el TLP estuvo mediada por la evitación experiencial. Por último, los resultados indican que la SA (y la evitación experiencial como mediador) explicó un grado significativo de la varianza adicional en el estado del TLP más allá tanto del afecto negativo como de las dos vulnerabilidades temperamentales establecidas para el TLP (intensidad/reactividad al afecto e impulsividad). Los hallazgos del presente estudio indican la necesidad de examinar con mayor detalle el papel de la SA en la patogenia del TLP.
... Reiss (1991) suggested that AS is a predisposing personality factor in the development of anxiety disorders. He also related AS to problems such as insomnia, some types of substance abuse, posttraumatic stress disorder, and other stress-related illnesses (Cox, Borger & Enns, 1999). In particular, AS has come to be treated by many investigators as a cognitive risk factor for panic disorder. ...
... Secondly, individuals in the sample group with high scores may be indicating the presence of an anxiety disorder, as elevated scores on the ASI are associated with anxiety disorders in general and panic disorder in particular. In addition to panic disorder, generalised anxiety disorder, social phobia, specific phobia as well as obsessivecompulsive disorder, the high scores may indicate a risk factor for alcohol or drug abuse as these substances are used to dampen the sensations of anxious arousal (Cox, Borger & Enns, 1999). ...
... Moreover, individuals with OCD did not have higher levels of anxiety sensitivity compared to individuals with mood disorders [29]. However, it is emphasised that the anxiety sensitivity dimension concerning fear of cognitive impairment is implicated explicitly in OCD, which is in line with cognitive-behavioural models [32]. ...
Background
Pregnancy and postpartum are considered vulnerable periods for new parents to develop obsessive-compulsive disorder (OCD). The aim of this study was threefold: (1) to establish the prevalence of OCD symptoms and its course in the peripartum period; (2) to examine comorbidity with depressive symptoms; and (3) to investigate which sociodemographic, obstetric, and individual characteristics are predictors of OCD symptoms.
Methods
A longitudinal study included 397 women during pregnancy (T1) and 6–12 weeks postpartum (T2). Participants filled out the obstetrical and demographic sheet, Anxiety Sensitivity Index (ASI), Emotional Stability subscale from the International Personality Item Pool-50 (IPIP-50), Brief Resilience Scale (BRS) all at T1, and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and Edinburgh Postpartum Depression Scale (EPDS) at T1 and T2.
Results
In this sample, 15.1% of women reported OCD symptoms during pregnancy and 15.1% in the postpartum, with 9.8% of women who had symptoms at both time points. However, the majority of women experienced symptoms of mild severity, according to the Y-BOCS. Of the women experiencing OCD symptoms, 33% and 43% had comorbid depressive symptoms in pregnancy and the postpartum period, respectively. The level of OCD symptoms significantly decreased after childbirth. None of the sociodemographic or obstetric variables were a significant predictor of OCD symptoms during pregnancy or postpartum. After controlling for current depression symptoms, higher psychological concerns of anxiety sensitivity (but not physical and social concerns) and higher neuroticism were significant predictors of higher levels of OCD symptoms both at T1 and T2. At the same time, higher resilience was a significant predictor of lower levels of OCD symptoms only at T1.
Conclusion
One in six women has OCD symptoms in the peripartum period, with substantial comorbidity with depression symptoms. Women who are high on neuroticism and anxiety sensitivity are prone to OCD symptoms, while resilience is a significant protective factor.
Clinical trial number
Not applicable.
... Prior research suggests that social concerns are uniquely associated with social anxiety symptoms (Olthuis et al., 2014) and that high social concerns differentiate individuals with SAD from those with other anxiety and depressive disorders or no diagnosis (Baek et al., 2019;Ölmez & Ataoğlu, 2019). Theoretically, the fear of negative evaluation due to observable arousal symptoms that is characteristic of those with high social concerns could increase risk for SAD (Cox et al., 1999). Indeed, social (vs. ...
Background/Purpose
Anxiety sensitivity (AS) is a transdiagnostic risk factor for mental health disorders. While its lower order factors – social, physical, and cognitive concerns – and their associations with emotional disorders have been examined independently of each other, research has not fully appreciated that these factors might appear to different degrees in individuals, with psychopathology implications.
Methods
We used cluster analysis to investigate how the lower order AS factors appear in treatment-seekers with high AS and how these manifestations of AS (i.e., the different clusters) are uniquely associated with psychopathology. Participants (N = 154; from two studies) were high AS treatment-seeking adults with anxiety and/or depressive disorders who completed a diagnostic interview and self-report measures of AS and anxiety and depression symptoms.
Results
A four-cluster solution emerged including a Multidimensional cluster (33.8% of the sample) and Social (28.6%), Physical (21.4%), and Cognitive (16.2%) clusters. Validation analyses revealed cross-cluster differences in age, gender, ethnicity, and psychopathology, the latter reflecting known associations between AS and mental health (e.g., depression symptoms were significantly highest in the Cognitive and Multidimensional clusters).
Conclusions
Results provide valuable insight into the heterogeneity of high AS as it appears clinically, with implications for best matching treatment approaches for this population.
... Thereby Anxiety Sensitivity functions as a continuum that is experienced by everyone to some degree. However high Anxiety Sensitivity is thought to amplify fearful reactions and thereby placing people at risk to develop anxiety, especially panic symptoms (Cox, 1999;Eley et al., 2004;Olatunji & Wolitzky-Taylor, 2009;Shipherd, Beck, & Ohtake, 2001). Adolescents with an elevated level of Anxiety Sensitivity show increased rates of PD and panic symptoms (Allan et al., 2014;Calamari et al., 2001;Schmidt et al., 2006;Weems, Hayward, Killen, & Taylor, 2002), even compared to patients with mood disorders or other forms of anxiety disorders (Noel & Francis, 2011;Olatunji & Wolitzky-Taylor, 2009). ...
Anxiety disorders are the most prevalent group of neuropsychiatric disorders and go along with high personal suffering. They often arise during childhood and show a progression across the life span, thus making this age a specific vulnerable period during development. Still most research about these disorders is done in adults. In light of this, it seems of utmost importance to identify predictive factors of anxiety disorders in children and adolescents. Temperament or personality traits have been proclaimed as risk markers for the development of subsequent anxiety disorders, but their exact interplay is not clear. In this dissertation an effort is made to contribute to the understanding of how risk markers of early temperamental traits, in this case Trait Anxiety, Anxiety Sensitivity and Separation Anxiety are interplaying. While Trait Anxiety is regarded as a more general tendency to react anxiously to threatening situations or stimuli (Unnewehr, Joormann, Schneider, & Margraf, 1992), Anxiety Sensitivity is the tendency to react with fear to one’s own anxious sensations (Allan et al., 2014; S. Reiss, Peterson, Gursky, & McNally, 1986), and Separation Anxiety is referring to the extent to which the child is avoiding certain situations because of the fear of being separated from primary care givers (In-Albon & Schneider, 2011). In addition, it will be addressed how these measurements are associated with negative life events, as well as brain functioning and if they are malleable by a prevention program in children and adolescents. In study 1 the aim was to extend the knowledge about the interrelations of this anxiety dimensions and negative life events. Results indicated positive correlations of all three anxiety traits as well as with negative life events. Thus, a close connection of all three anxiety measures as well as with negative life events could be indicated. The closest association was found between Anxiety Sensitivity and Trait Anxiety and between Separation Anxiety and Anxiety Sensitivity. Furthermore, negative life events functioned as mediator between Anxiety Sensitivity and Trait Anxiety, indicating that a part of the association was explained by negative life events. In study 2 we extended the findings from study 1 with neurobiological parameters and examined the influence of anxiety traits on emotional brain activation by administering the “emotional face matching task”. This task activated bilateral prefrontal regions as well as both hippocampi and the right amygdala. Further analyses indicated dimension-specific brain activations: Trait Anxiety was associated with a hyperactivation of the left inferior frontal gyrus (IFG) and Separation Anxiety with a lower activation bilaterally in the IFG and the right middle frontal gyrus (MFG). Furthermore, the association between Separation Anxiety and Anxiety Sensitivity was moderated by bi-hemispheric Separation-Anxiety-related IFG activation. Thus, we could identify distinct brain activation patterns for the anxiety dimensions (Trait Anxiety and Separation Anxiety) and their associations (Separation Anxiety and Anxiety Sensitivity). The aim of study 3 was to probe the selective malleability of the anxiety dimensions via a prevention program in an at-risk population. We could identify a reduction of all three anxiety traits from pre- to post-prevention-assessment and that this effect was significant in Anxiety Sensitivity and Trait Anxiety scores. Furthermore, we found that pre-intervention Separation Anxiety and Anxiety Sensitivity post-intervention were associated. In addition, pre-interventive scores were correlated with the intervention-induced change within the measure (i.e., the higher the score before the intervention the higher the prevention-induced change) and pre-intervention Anxiety Sensitivity correlated with the change in Separation Anxiety scores. All relations, seemed to be direct, as mediation/moderation analyses with negative life events did not reveal any significant effect. These results are very promising, because research about anxiety prevention in children and adolescents is still rare and our results are indicating that cognitive-behavioural-therapy based prevention is gilding significant results in an indicated sample even when samples sizes are small like in our study. In sum the present findings hint towards distinct mechanisms underlying the three different anxiety dimensions on a phenomenological and neurobiological level, though they are highly overlapping (Higa-McMillan, Francis, Rith-Najarian, & Chorpita, 2016; Taylor, 1998). Furthermore, the closest associations were found between Anxiety Sensitivity and Trait Anxiety, as well as between Separation Anxiety and Anxiety Sensitivity. Specifically, we were able to find a neuronal manifestation of the association between Separation Anxiety and Anxiety Sensitivity (Separation Anxiety-specific IFG activation) and a predictive potential on prevention influence. The results of these studies lead to a better understanding of the etiology of anxiety disorders and the interplay between different anxiety-related temperamental traits and could lead to further valuable knowledge about the intervention as well as further prevention strategies.
... Although originally conceived AS as a unitary construct (Reiss & McNally, 1985) it has proven to be a hierarchical and multidimensional and consisted of three lower-order factors (Physical Concerns, Psychological Concerns, and Social Concerns) and a single higher-order factor (global AS) (Zinbarg, Mohlman, & Hong, 1999). AS is related to a variety of anxiety disorders (particularly panic disorder) and non-anxiety psychopathology like depression, hypochondria, addictions and chronic pain disorders (Cox, Borger, & Enns, 1999;Deacon & Abramowitz, 2006;Reiss, 1987Reiss, , 1991. Recent studies suggest that AS might reflect a broader tendency to fear somatic symptoms more generally, rather than anxiety symptoms specifically (Horenstein, Potter, & Heimberg, 2018). ...
Dry eye disease (DED) represents a common health problem in the general population. Previous studies have demonstrated that the subjective symptoms of dry eye are associated with several psychological factors, including depression, anxiety and post-traumatic stress disorder. However, there is a lack of empirical information about the mechanisms underlying the relationships between DED and various psychological symptoms. In light of emerging evidence of its trans-diagnostic nature, anxiety sensitivity (i.e. AS) represents one promising factor for further understanding DED. The present study aimed to explore whether anxiety sensitivity plays a role in the perception of DED symptoms in a community-based sample of adults aged 20–89 years (N = 381; M = 39.72, SD = 12.6). A dry ocular surface was reported by 22.8% of the participants. As expected, women more often reported symptoms of dry eye that could be categorized as moderate to severe. The findings demonstrated that AS, and the AS-psychological concerns dimension in particular, predict the intensity of dry eye symptoms above and beyond depressive and anxiety symptoms. These findings add to a growing body of work underscoring the relevance of AS in increasing the risk of chronic medical conditions.
... Negative M-Es about negative Es can create self-perpetuating and paralizing conditions. Think for instance of "fear of fear", or "anxiety sensitivity" (Reiss, Peterson, Gursky, & McNally, 1986), that is likely to develop and maintain anxiety, especially panic disorder (Cox, Borger, & Enns, 1999). Another example is offered by shame of shame. ...
We suggest that meta-emotions – defined as emotions about one's own emotions – contribute to the complexity of people's psychic life by modifying the intensity and quality of their first-order emotions, and influencing their decisions and behaviour. After addressing similarities and differences between first-order and second-order emotions, and the role played on the latter by emotion goals and evaluations about emotions, we try to show how, by revealing the consequences of emotions, meta-emotions orient people towards, and turn them away from, certain first-order emotions. We also suggest a number of favouring conditions for the elicitation of meta-emotions: the “importance” of the first-order emotion; its perceived unexpectedness; the presence of other people; and the impact of the first-order emotion on the self-image. We finally consider the possible functions of meta-emotions, by pointing to their crucial role in emotion regulation and in fostering coherence with one's own values.
... 우울장애 환자들은 공황장애보다는 낮지만 범불안장애 혹은 사회공포증 환자들과 비슷한 수준의 불안민감도 점수를 가 진 것으로 나타났으며 (Otto et al., 1995), 특히 불안민감도 의 하위 요인 중 사회적 염려 요인과 인지적 통제 불능에 대 한 공포 요인에서 높은 점수를 보였다 (Taylor et al., 1996;Rodriguez et al., 2004;Rector et al., 2007;Kim YW et al., 2011). 이는 두 요인이 우울 증상을 고조시키는 변인들 과 높은 관련이 있기 때문인 것으로 보인다 (Schmidt et al., 1998;Cox et al., 1999a;Cox et al., 1999b;Cox et al., 2001;Zinbarg et al., 2001;Tull et al., 2006). 즉, 반추적 사고 혹은 통제불능한 인지적 파국화(mental catastrophe) 와 같은 우울의 대표 증상들이 불안민감도 지표를 통해 신뢰 롭게 측정될 수 있음을 나타낸다 (Rodriguez et al., 2004;Rector et al., 2007;Kim YW et al., 2011 ASI-R: ASI-R total score, PHQ-9: PHQ-9 total score. ...
... Finally, we wanted to examine the relations of the various anxiety sensitivity components (i.e., physical, cognitive, and social concerns; Stewart, Taylor, & Baker, 1997) to each lower-and higher-order MIHT dimension. We hypothesized that, of the three ASI subscales, the ASI Physical Concerns scale would be the strongest predictor of each of the MIHT dimensions in multiple regression analyses, given theory regarding the role of ASI Physical Concerns in hypochondriasis (Cox, Borger, & Enns, 1999). ...
The Multidimensional Inventory of Hypochondriacal Traits (MIHT; Longley, Watson, & Noyes, 2005) appears to address shortcomings of other common measures of health anxiety, but further research is required prior to using this measure in treatment planning and outcome assessment. This study was designed to explore the hierarchical structure of this health anxiety measure and relations of the various MIHT health anxiety components to anxiety sensitivity. A sample of 535 university students (362 women) was administered the 31-item MIHT and the 16-item Anxiety Sensitivity Index (ASI; Reiss, Peterson, Gursky, & McNally, 1986). Confirma-tory factor analyses of participants' responses on the MIHT showed that this measure may be conceptualized either as involving four correlated factors (i.e., Affective, Cognitive, Behavioral, and Perceptual) or as being hierarchical in nature, with the four lower-order factors loading on a single higher-order global health anxiety factor. Correlational analyses revealed significant relations of anxiety sensitivity to each of the four MIHT subscales and to the MIHT total score. Of the three established anxiety sensitivity components, ASI Physical Concerns were most strongly and consistently related to the various dimensions of health anxiety on the MIHT. Additional analyses revealed that the ASI and MIHT are better represented as two correlated but independent traits as opposed to common manifestations of a single underlying trait.
... Finally, we wanted to examine the relations of the various anxiety sensitivity components (i.e., physical, cognitive, and social concerns; Stewart, Taylor, & Baker, 1997) to each lower-and higher-order MIHT dimension. We hypothesized that, of the three ASI subscales, the ASI Physical Concerns scale would be the strongest predictor of each of the MIHT dimensions in multiple regression analyses, given theory regarding the role of ASI Physical Concerns in hypochondriasis (Cox, Borger, & Enns, 1999). ...
The Multidimensional Inventory of Hypochondriacal Traits (MIHT; Longley, Watson, & Noyes, 2005) appears to address shortcomings of other common measures of health anxiety, but further research is required prior to using this measure in treatment planning and outcome assessment. This study was designed to explore the hierarchical structure of this health anxiety measure and relations of the various MIHT health anxiety components to anxiety sensitivity. A sample of 535 university students (362 women) was administered the 31-item MIHT and the 16-item Anxiety Sensitivity Index (ASI; Reiss, Peterson, Gursky, & McNally, 1986). Confirma-tory factor analyses of participants' responses on the MIHT showed that this measure may be conceptualized either as involving four correlated factors (i.e., Affective, Cognitive, Behavioral, and Perceptual) or as being hierarchical in nature, with the four lower-order factors loading on a single higher-order global health anxiety factor. Correlational analyses revealed significant relations of anxiety sensitivity to each of the four MIHT subscales and to the MIHT total score. Of the three established anxiety sensitivity components, ASI Physical Concerns were most strongly and consistently related to the various dimensions of health anxiety on the MIHT. Additional analyses revealed that the ASI and MIHT are better represented as two correlated but independent traits as opposed to common manifestations of a single underlying trait. The
... The asterisk allows for multiple permutations of the root word to be searched: "anxiety sensitivit ء " returns results for "anxiety sensitivity" and "anxiety sensitivities;" and "suicid ء " returns results for "suicide;" "suicidal;" and "suicidality." Phrenophobia, the fear of cognitive incapacitation, is synonymous with the cognitive AS subfactor (see Cox, Borger, & Enns, 1999;Schmidt, Woolaway-Bickel, & Bates, 2001) and was included as a search term. No other synonyms of AS or its subfactors were identified after consulting a landmark textbook on AS (Taylor, 1999) as well as the relevant literature. ...
Objective:
Suicide is a global public health concern. To inform the prevention and treatment of suicidality, it is crucial to identify transdiagnostic vulnerability factors for suicide and suicide-related conditions. One candidate factor is anxiety sensitivity (AS)-the fear of anxiety-related sensations-which has been implicated in the pathogenesis of a host of mental health outcomes, including suicidal thoughts and behaviors. Importantly, AS is distinct from trait anxiety and negative affectivity, highlighting its potential incremental utility in the understanding of psychopathology. Despite a burgeoning body of literature demonstrating that AS is linked to suicidal thoughts and behaviors, this research has yet to be synthesized.
Method:
This meta-analysis includes 33 articles representing 34 nonredundant samples (N = 14,002) that examined at least one relationship between AS global or subfactor (i.e., cognitive, physical, social) scores and suicidal ideation and/or suicide risk.
Results:
Findings revealed small-to-moderate and moderate associations between global AS and suicidal ideation (r = .24, 95% confidence interval (CI): [.21, .26], p < .001) and suicide risk (r = .35, 95% CI [.31, .38], p < .001), respectively. All AS subfactors evinced significant associations with suicidal ideation (rs = .13-.24) and suicide risk (rs = .22-.32).
Conclusions:
AS is related to suicidal ideation and global suicide risk. Research is needed to disentangle AS from other indices of distress in the prediction of suicidal thoughts and behaviors. Theoretical and clinical implications of these findings are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
... [33] The ASI is a better predictor of response to biological challenges than are measures of general trait anxiety. [33][34][35] The strong association between elevated ASI scores and PDs has been replicated many times, [33,36] and ASI item analyses have indicated that fears of cardiorespiratory symptoms are especially prominent in PD. [33,37] These results supported the suggestion that physical concerns are most closely associated with PD, [30,38] specifically, ASI-R-fears of cardiovascular symptoms may be an important predictor of the clinical course of PD, but we could not find ASI-R-fears of respiratory symptoms predicting reduction in panic symptoms in this study. ...
Numerous studies have provided evidence for the effectiveness of cognitive behavioral therapy (CBT) on panic disorders (PDs). There has also been growing attention on brief CBT with regard to delivering intensive treatment efficiently. This study investigated the essential parts of mindfulness-based brief CBT to optimize treatment benefits.
A total of 37 patients were retrospectively enrolled in this study. They were recruited from the anxiety/panic/fear clinic of Seoul National University Hospital. The patients participated in group CBT once a week for a total of 4 sessions over a 4-week period, when they were assessed using the Panic Disorder Severity Scale (PDSS), Anxiety Sensitivity Index-Revised (ASI-R), Albany Panic and Phobia Questionnaire (APPQ), State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) before and after brief CBT. Twenty-nine patients completed the 1-month follow-up.
There were significant reductions in PDSS (P < .001), ASI-R-fear of respiratory symptoms (P = .006), ASI-R-fear of publicly observable anxiety reaction (P = .002), ASI-R-fear of cardiovascular symptoms (P < .001), ASI-R-fear of cognitive dyscontrol (P = .001), ASI-R-Total (P < .001), APPQ-Agoraphobia (P = .003), APPQ-Total (P = .028), STAI-State anxiety (P < .001), STAI-Trait anxiety (P = .002), BAI (P = .003), and BDI (P < .001) scores. We also found significant associations between ASI-R-fear of cardiovascular symptoms, ASI-R-Total, and changes in PDSS scores. A stepwise multiple linear regression analysis indicated that anxiety sensitivity for fear of cardiovascular symptoms predicted an improvement in panic severity (β = 0.513, P = .004).
Our findings suggested that behavioral aspects, especially physiological symptom control, needed to be considered in brief, intensive CBT for PD. The results also suggested that a mindfulness-based brief CBT approach might be particularly helpful for patients with PD who have severe cardiovascular symptoms.
... However, the influence of AS in the lonely group must not be underestimated. Mean ASI score for the lonely group is comparable to most clinical groups of social phobia patients [51]. It is probable that AS may function to motivate social avoidance in lonely individuals who are sensitive to physiological arousal associated specifically with social events, a proposed role of AS in social phobia patients [52]. ...
... Previous investigators have posited that the cognitive dimension of AS in particular is strongly related to OCD given that misappraisals of one's own thinking (e.g., overestimating the importance of thoughts) are a cardinal feature of OCD (Rachman, 1997(Rachman, , 1998. Although some research supports this hypothesis (e.g., Cox, Borger, & Enns, 1999;Sexton et al., 2003;, aggregate findings are inconsistent (Deacon & Abramowitz, 2006). Moreover, the cross-sectional nature of previous studies precludes investigators from determining whether AS predicts changes in OCD symptom severity over time (e.g., following treatment). ...
Background and objectives:
To address the fact that not all individuals who receive cognitive-behavioral therapy (CBT) for obsessive-compulsive disorder (OCD) exhibit complete symptom reduction, research has examined factors that predict outcome; however, no studies have examined anxiety sensitivity (AS) as a predictor of outcome of CBT for OCD. AS refers to the fear of anxious arousal that results from mistaken beliefs about the dangerousness of anxiety-related body sensations. It is important to understand whether AS influences OCD treatment outcome, considering that (a) some obsessions directly relate to AS, and (b) OCD patients with high AS may be reluctant to engage in anxiety-provoking components of CBT for OCD.
Methods:
Patients (N = 187) with a primary diagnosis of OCD who received residential CBT for OCD participated in this study, which involved completing a self-report battery at pre- and post-treatment.
Results:
Results supported study hypotheses, in that (a) baseline AS positively correlated with baseline OCD severity, and (b) greater baseline AS prospectively predicted higher posttreatment OCD symptom severity even after controlling for pretreatment OCD and depression severity.
Limitations:
The study was limited by its use of an older measure of AS, reliance on self-report measures, and nonstandardized treatment across participants.
Conclusions:
Findings highlight the importance of AS in the nature and treatment of OCD. Clinical implications and future directions are discussed.
... Although research examining the relationship between AS and OCD dimensions is mixed, emerging literature indicates relationships between specific domains of AS and OCD symptoms (e.g., Calamari et al., 2008;Wheaton, Mahaffey, et al., 2012). For example, it has been suggested that the AS-associated fear of cognitive dyscontrol is particularly pertinent to OC concerns related to the importance of (and need to control) thoughts (e.g., Cox, Borger, & Enns, 1999;Sexton et al., 2003;Wheaton, Mahaffey, et al., 2012). To illustrate, an OCD patient who believes that intrusive thoughts signal abnormality or forecast acting on an impulse to harm (OCCWG, 2005) may interpret racing thoughts as a sign that he or she is "going crazy" (Taylor et al., 2007). ...
Accumulated research implicates anxiety sensitivity (AS) as a transdiagnostic construct important to the maintenance of OCD. Yet despite the clinical implications of targeting fears of body-related sensations during treatment, interoceptive exposure (IE) is an often-overlooked therapeutic procedure in the cognitive-behavioral treatment of OCD. In this article, we discuss the rationale for—and procedures of—addressing AS during treatment for OCD. We provide two case examples, illustrating how a clinician might approach clinical assessment, case formulation, and treatment planning with each of these patients. We conclude by discussing future research directions to better understand if (and how) targeting AS during therapy might enhance OCD treatment outcome.
... Trait-like measures of anxiety, such as the anxiety sensitivity index (ASI) which assesses levels of anxiety sensitivity (AS), can help to identify individuals who may be at risk of developing clinically significant anxiety-related difficulties. AS is a known risk factor for the development of panic disorder (Schmidt, Lerew, & Jackson, 1999), and AS elevations are found across several anxiety disorders including PTSD, social phobia, and GAD (Cox, Borger, & Enns, 1999). AS will be discussed in depth as the current study will utilize ASI scores as an index of anxiety. ...
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 composed of three facets relating to fears stemming from the perceived negative physical, social, and cognitive consequences of anxiety (Zinbarg et al., 1997). Although AS was originally conceptualized as a risk factor for anxiety disorders (Cox et al., 1999), AS has also been found to be elevated among individuals with substance use disorders (Stewart et al., 1997;Lejuez et al., 2006). ...
... Among the cognitive-behavioral approaches, the most commonly adopted one about the development of PD is the 'anxiety sensitivity' theory, which has been shown to correlate positively with the personality disorders in cluster C (21). It has been suggested that the patients with PD misperceive harmless somatic sensitizations due to their high sensitivity to anxiety (22). This connection between PD and the personality structures within cluster C might also be the case in our samples. ...
Aim: We aimed to investigate the relationship between anxiety disorders and somatisation disorders described in ICD-10 within the title of neurotic disorders, and the personality characteristics related to both groups Method: Fifty-eight individuals who were either have DSM-IV panic disorder (PD) and or somatisation disorder (SD) completed the Minnesota Multiple Personality Inventory (MMPI). Intergroup differences of MMPI scores and personality disorders were analyzed. Result: The scores obtained from the clinical subscales of PD (n:28) and SD patients (n:30), and in the MMPI test were similar in comparison. The differences between the MMPI scores of PD and SD patients were statistically significant regarding the passive-aggressive personality disorder, avoidant personality disorder, borderline personality disorder and obsessive-compulsive personality disorder scores. The mean values of the study conducted in a Turkish population sample were used as cut-points, the results were greater than normal in the psychastenia and depression subtest scores in group PD, and in deny subtest in group SD (p<0.01). Conclusion: The findings were compatible with those in the literature. All of these personality disorders above-mentioned and found high in PD with an exception of the borderline personality disorder share high comorbidity with neuroticism. However, comparative studies following treatment are required whether these characteristics are related to the personality structure or the nature of PD.
... AS has been most closely implicated with the development and maintenance of panic disorder. Early clinical findings suggested a strong association between AS and the occurrence of panic attacks and panic disorder (e.g., Cox, Borger, & Enns, 1999;Cox, Fuentes, Borger, & Taylor, 2001;Taylor, Koch, & McNally, 1992). And now there is evidence that AS prospectively measured could be a risk factor for developing panic disorder; Maller and Reiss (1992) found that AS strongly predicted the frequency and intensity of later panic attacks, and Jackson (1997, 1999) demonstrated a link between scores on a measure of AS and subsequent spontaneous panic attacks in a nonclinical sample, after controlling for panic history and trait anxiety. ...
. The construct of anxiety sensitivity (AS) – the fear of anxiety-related symptoms – has been highly influential in current conceptualizations of anxiety disorders in general, and panic disorder specifically. However, given documented associations between AS and both non-anxiety psychological disorders as well as medical/health conditions, the extent to which measures of AS are assessing a specific fear or anxiety symptoms versus a broader fear of interoceptive or bodily sensations is unclear. Confirmatory factor analysis of data from 373 participants failed to suggest whether fears of anxiety-related symptoms were factorially distinct from fears of non-anxiety-related bodily sensations, although analyses indicated that while fears of anxiety-related symptoms were more closely associated with panic disorder severity than were fears of non-anxiety-related symptoms, both were similarly and strongly associated with hypochondriacal fears. Implications for the construct of AS, and the broader construct...
... Specifically, our findings suggest that AS may be relevant to PTSD only among individuals with the tendency to avoid negative emotional experiences. Together with evidence that both AS and negative emotional avoidance underlie numerous forms of anxiety-related pathology (Cox, Borger, & Enns, 1999;Salters-Pedneault et al., 2004), our results suggest that the combination of negative emotional avoidance and AS may have utility as a transdiagnostic model of risk for anxiety-related pathology. These results also provide additional support for the potential utility of interventions that target shared factors underlying anxiety-related pathology, such as the Unified Protocol (Barlow et al., 2010;Ellard, Fairholme, Boisseau, Farchione, & Barlow, 2010). ...
Anxiety sensitivity (AS) and the tendency to avoid emotions have both been identified as vulnerability factors for the development and maintenance of posttraumatic stress disorder (PTSD). Furthermore, both cross-sectional and prospective research have provided evidence that emotional avoidance and AS interact to predict anxiety symptoms, such that AS may only be associated with anxiety-related pathology among those who exhibit a tendency to avoid their emotions. The purpose of the present study was to determine if this moderator model extends to PTSD within a sample of substance dependent patients. Specifically, this study examined if AS is associated with PTSD only among individuals with high (vs. low) levels of negative emotional avoidance. As predicted, results of a logistic regression analysis revealed a significant interaction between negative emotional avoidance and AS in predicting PTSD status. Follow-up analyses revealed a significant positive association between AS and PTSD status for participants high in negative emotional avoidance; however, AS was not associated with PTSD for those low in negative emotional avoidance. This finding remained even when relevant covariates were included in the model. Results confirm hypotheses and are consistent with the extant anxiety-risk literature.
... Inclusion of this factor in hierarchical models of OCD agrees with cognitive (e.g., Salkovskis, 1999) and metacognitive models of OCD (e.g., Wells, 2000), both of which assume that the appraisal of obsessive thoughts plays a crucial role in the development of OCD symptoms. In OCD, anxiety sensitivity likely reflects a fear of cognitive dyscontrol, resulting from repeated experiences of intrusive, unwanted thoughts, coupled with an increased perceived responsibility for these thoughts (Cox, Borger, & Enns, 1999;Sexton et al., 2003). To date, no factors other than intolerance of uncertainty and anxiety sensitivity that might explain the association between neuroticism and OCD (Nishimura et al., 1998;Yorulmaz et al., 2010) have been examined. ...
Obsessive-compulsive disorder (OCD) is a severe anxiety disorder characterized by frequent obsessive thoughts and repetitive behaviors. Neuroticism is a vulnerability factor for OCD, yet the mechanisms by which this general vulnerability factor affects the development of OCD-related symptoms are unknown. The present study assessed a hierarchical model of the development of obsessive thoughts that includes neuroticism as a general, higher-order factor, and specific, potentially maladaptive thought processes (thought suppression, worry, and brooding) as second-order factors manifesting in the tendency toward obsessing. A total of 238 participants completed questionnaires assessing the examined constructs. The results of mediator analyses demonstrated the hypothesized relationships: A positive association between neuroticism and obsessing was mediated by thought suppression, worry, and brooding. Independent of the participant's sex, all three mediators contributed equally and substantially to the association between neuroticism and obsessing. These findings extend earlier research on hierarchical models of anxiety and provide a basis for further refinement of models of the development of obsessive thoughts.
... In addition, there is limited investigation of how DT relates to important cognitive risk factors in the anxiety disorders, namely AS and IU. AS is defined as the fear of anxiety-related sensations based on the belief that they have harmful consequences (Reiss & McNally, 1985), and is a well-established risk and maintaining factor in anxiety pathology (Cox, Borger, & Enns, 1999;McWilliams, Becker, Margraf, Clara, & Vriends, 2007;Naragon-Gainey, 2010;Schmidt, Mitchell, & Richey, 2008). While research on the role of AS in the anxiety disorders has flourished within the past two decades, there is now an increasing interest in emotional sensitivity in general, and not only sensitivity related to anxiety. ...
There is a growing interest in the role of distress tolerance (i.e., the capacity to withstand negative emotions) in the onset and maintenance of anxiety. However, both empirical and theoretical knowledge regarding the role of distress tolerance in the anxiety disorders is relatively under examined. Accumulating evidence supports the relationship between difficulties tolerating distress and anxiety in nonclinical populations; however, very few studies have investigated distress tolerance in participants with diagnosed anxiety disorders. Individuals with social anxiety disorder (SAD), generalized anxiety disorder (GAD), panic disorder with and without agoraphobia (PD/A) and obsessive-compulsive disorder (OCD) completed measures of distress tolerance (DT), conceptually related measures (i.e., anxiety sensitivity (AS), intolerance of uncertainty (IU)), and anxiety symptom severity. Results showed that DT was negatively associated with AS and IU. DT was correlated with GAD, SAD and OCD symptoms, but not PD/A symptoms, in individuals with those respective anxiety disorders. DT was no longer a significant predictor of OCD or anxiety disorder symptom severity when AS and IU were also taken into account. There were no between group differences on DT across OCD and the anxiety disorder groups. Implications for the role of distress tolerance in anxiety pathology are discussed.
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... La sensibilidad a la ansiedad es considerada una variable de diferencias individuales que predice eficazmente el riesgo hacia los trastornos de ansiedad, y especialmente hacia el trastorno de pánico (Chorot, Sandín, Valiente, Santed y Romero, 1997;Cox, Borger y Enns, 1999;McNally, 1994;Reiss, 1991;Sandín, Chorot y McNally, 1996;Taylor, 1995;Taylor, Koch y McNally, 1992). La sensibilidad a la ansiedad, por otra parte, ha sido considerada como un constructo diferente del rasgo de ansiedad (McNally, 1996;Sandín, Chorot y McNally, 2001;Taylor, 1995;Zinbarg, Mohlman y Hong, 1999). ...
Introduction: Anxiety sensitivity (AS) refers to the fear of anxiety-related sensa- tions due to beliefs that these sensations will lead to catastrophic outcomes. AS plays a central role in the etiology and maintenance of anxiety disorders. From a clinical perspective, it therefore seems important to possess a valid scale to assess AS in children. Objective, Method: This study examines the factor structure, reli- ability, and validity of the French translation of the Childhood Anxiety Sensitivity Index (CASI) in 353 Belgian children (9 to 13 years). Result: Results show that AS can be adequately measured using the French version of the CASI and conceptual- ized as a hierarchical factor structure with four lower-order factors – Physical Concerns, Mental Incapacity Concerns, Social Concerns, and Losing Control Con- cerns – loading on a single higher-order factor, Anxiety Sensitivity. The reliability was acceptable for the total scale. Hierarchical multiple regressions show that the CASI makes a significant contribution in predicting anxiety. Conclusion: The data support the relevance of the French CASI in the assessment of AS in nonclinical children.
... En suma, en adición al efecto sobre los síntomas hipocondríacos que ejercen la sensibilidad a la ansiedad y otras posibles variables (Chorot et al., 1997;Cox et al., 1999; López-Santiago y Belloch, 2012; Miaja y Moral, 2012) y la afectividad negativa (Chorot y Martínez-Narváez, 2009), los resultados del presente estudio indican, que la sensibilidad al asco predice estos síntomas de forma independiente a dichas variables personales, lo cual sugiere un posible efecto de vulnerabilidad específico, asociado a la tendencia personal a experimentar asco. En este sentido, si bien la sensibilidad general al asco parece amplificar las respuestas hipocondriacas, este efecto podría deberse específicamente a ciertas formas de asco, en particular el asco asociado a enfermedad/deterioro y trasgresión corporal. ...
En este artículo investigamos la asociación entre la sensibilidad al asco y los síntomas de hipocondría y ansiedad hacia la salud. Los participantes cumplimentaron la Escala Multi- dimensional de Sensibilidad al Asco (EMA; Sandín et al., 2013), la Illness Attitudes Scale (IAS; Kellner, 1986), las escalas PANAS (Watson et al., 1988), y el Índice de Sensibilidad a la Ansiedad (ASI-3; Taylor et al., 2007). Obtuvimos asociaciones significativas entre la sensibili- dad al asco y los síntomas hipocondríacos, incluso tras controlar el efecto de las variables demográficas (edad y sexo) y de vulnerabilidad individual (afecto negativo y sensibilidad a la ansiedad). Los resultados de los análisis de regresión múltiple indicaron, que ciertas dimensio- nes del asco (deterioro/enfermedad y trasgresión corporal), predecían los síntomas hipocondría- cos evaluados 10 meses después. Los autores discuten las implicaciones de estos resultados, res- pecto a un posible papel del asco en la etiopatogenia de la hipocondría.
... Thus, individuals with high anxiety sensitivity have a greater likelihood of misinterpreting or catastrophizing anxiety-related sensations. Anxiety sensitivity has been shown to play a role in the development and maintenance of a number of anxiety-related disorders, including panic disorder (McNally, 2002;Cox, Borger, & Enns, 1999) and social phobia (e.g., Rapee & Heimberg, 1997). Further, while GAD and OCD patients have been shown to have higher levels of anxiety sensitivity than individuals without an anxiety disorder (Zinbarg, Barlow, & Brown., 1997), elevations in anxiety sensitivity appear to be less pronounced in GAD and OCD than in other anxiety disorders (Zinbarg et al., 1997;Deacon & Abramowitz, 2006). ...
... For example, Feldner, Lewis, Leen-Feldner, Schnurr, and Zvolenksy (2006) found that among those high in anxiety sensitivity, greater frequencies of a variety of traumatic experiences were associated with greater PTSD symptom severity; however, trauma exposure frequency had little effect on those low in anxiety sensitivity. However, any protection conferred by anxiety sensitivity in relation to PTSD may be a curvilinear, with the presence of a moderate amount of anxiety sensitivity being more optimal than having very low levels of anxiety sensitivity (Cox, Borger, & Enns, 1999). Indeed, prior research suggests that those low in anxiety sensitivity represent an extreme group that may not be indicative of normal functioning (Shostak & Peterson, 1990). ...
Although anxiety sensitivity and disgust sensitivity have been shown to predict adverse reactions to traumatic events, it remains unclear whether these traits are best conceptualized as risk or resilience factors for posttraumatic stress disorder (PTSD). In the present study, veterans with PTSD (n = 21), trauma-exposed veterans without PTSD (n = 16), and healthy nonveteran controls (n = 22) completed measures of anxiety sensitivity, disgust sensitivity, and emotion regulation. The findings showed that veterans with PTSD reported significantly higher levels of anxiety sensitivity than veterans without PTSD and healthy nonveteran controls. However, veterans without PTSD and healthy nonveteran controls did not significantly differ in anxiety sensitivity. In contrast, veterans without PTSD reported significantly lower disgust sensitivity than veterans with PTSD and healthy nonveteran controls. Furthermore, veterans with PTSD and healthy nonveteran controls did not significantly differ from each other in disgust sensitivity. These distinct patterns of differences in anxiety sensitivity and disgust sensitivity remained significant when controlling for group differences in expressive emotion suppression. These preliminary findings suggest that anxiety sensitivity and disgust sensitivity may differ in the extent to which they represent risk or resilience factors for the development of PTSD. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
... En suma, en adición al efecto sobre los síntomas hipocondríacos que ejercen la sensibilidad a la ansiedad y otras posibles variables (Chorot et al., 1997;Cox et al., 1999; López-Santiago y Belloch, 2012; Miaja y Moral, 2012) y la afectividad negativa (Chorot y Martínez-Narváez, 2009), los resultados del presente estudio indican, que la sensibilidad al asco predice estos síntomas de forma independiente a dichas variables personales, lo cual sugiere un posible efecto de vulnerabilidad específico, asociado a la tendencia personal a experimentar asco. En este sentido, si bien la sensibilidad general al asco parece amplificar las respuestas hipocondriacas, este efecto podría deberse específicamente a ciertas formas de asco, en particular el asco asociado a enfermedad/deterioro y trasgresión corporal. ...
En este artículo investigamos la asociación entre la sensibilidad al asco y los síntomas de
hipocondría y ansiedad hacia la salud. Los participantes cumplimentaron la Escala Multi -
dimensional de Sensibilidad al Asco (EMA; Sandín et al., 2013), la Illness Attitudes Scale (IAS;
Kellner, 1986), las escalas PANAS (Watson et al., 1988), y el Índice de Sensibilidad a la
Ansiedad (ASI-3; Taylor et al., 2007). Obtuvimos asociaciones significativas entre la sensibilidad
al asco y los síntomas hipocondríacos, incluso tras controlar el efecto de las variables
demográficas (edad y sexo) y de vulnerabilidad individual (afecto negativo y sensibilidad a la
ansiedad). Los resultados de los análisis de regresión múltiple indicaron, que ciertas dimensiones
del asco (deterioro/enfermedad y trasgresión corporal), predecían los síntomas hipocondríacos
evaluados 10 meses después. Los autores discuten las implicaciones de estos resultados, respecto
a un posible papel del asco en la etiopatogenia de la hipocondría.
In this article we examine the association between domains of disgust and symptoms of hypochondriasis
in a nonclinical sample. Participants completed the Multidimensional Disgust Scale
(Escala Multidimensional de Sensibilidad al Asco, EMA; Sandín et al., 2013), the Illness Atti -
tudes Scale (IAS; Kellner, 1986), the PANAS scales (Watson et al., 1988) and the Anxiety
Sensitivity Index—3 (Taylor et al., 2007). Significant associations between disgust sensitivity
and hypochondriasis and health anxiety were found even when levels of demographics (age and
sex) and general risk factors (negative affect and anxiety sensitivity) were controlled for.
Further, a series of multiple regressions showed that, after controlling for demographics and
risk factors, specific dimensions of disgust (deterioration/disease, body envelope violations) predicted
hypochondriac and health anxiety symptoms assessed 10 months later. The authors discuss
implications of these findings concerning a possible role of disgust in hypochondriasis.
... It was predicted that the healthanxious group would report more anxiety in response to the BATs relative to the NAC group; however, this effect failed to emerge. The hypothesis was based on the assumption that health anxiety, as the term implies, is primarily a problem of fear and anxiety, as well as studies showing a tendency for elevated anxiety and intolerance of this emotional response (Abramowitz, Deacon, & Valentiner, 2007;Cox, Borger, & Enns, 1999). ...
Health anxiety is characterized by a preoccupation with the possibility of having a serious health condition or disease. Contemporary conceptualizations of health anxiety have improved in recent years to incorporate a fear of acquiring an illness; however, there is limited experimental data demonstrating the presence of fear of contamination among health anxious individuals.
The present study utilized behavior approach tasks (BATs) to examine the degree to which contamination fear is present in elevated health anxiety. Participants were 60 undergraduate students who reported elevated health anxiety, contamination fear, or no anxiety about either health or contamination. Participants completed four BATS from which avoidance, anxiety, and disgust ratings were derived.
Health anxious and contamination fearful individuals exhibited a similar degree of avoidance during the BATs. Contamination fearful participants reported significantly more anxiety and disgust relative to the non-anxious controls, but not the health anxious participants. Health anxious participants did not report more anxiety or disgust than the non-anxious participants.
The use of an analogue sample may limit the extension of these findings to clinical populations. Additionally, the role of general negative affect could not be reliably determined in the absence of an anxious control group.
These findings suggest that contamination fear may be a source of conceptual overlap between health anxiety and other disorders characterized by contamination fear. This highlights the importance of considering contamination fear in excessive health anxiety.
... Finally, although not necessarily a limitation, we only found evidence for the moderating role of low DT among male SUD patients with PTSD, suggesting the need to identify and evaluate other psychological variables that may influence treatment completion among female SUD patients with PTSD. One variable worth exploring may be anxiety sensitivity, given evidence that anxiety sensitivity is elevated among individuals with PTSD (Cox, Borger, & Enns, 1999) and has been found to predict residential SUD treatment dropout (Lejuez et al., 2008). Further, although related to DT, anxiety sensitivity and DT have been found to be uniquely associated with SUD-relevant outcomes (e.g., alcohol use problems; Howell, Leyro, Hogan, Buckner, & Zvolensky, 2010). ...
Reports an error in "Examining the Interactive Effect of Posttraumatic Stress Disorder, Distress Tolerance, and Gender on Residential Substance Use Disorder Treatment Retention" by Matthew T. Tull, Kim L. Gratz, Scott F. Coffey, Nicole H. Weiss and Michael J. McDermott ( Psychology of Addictive Behaviors , Advanced Online Publication, Sep 3, 2012, np). There was a copyediting error in Table 1. In the column Treatment completers, the value in parenthesis for Frequency of criminal behavior should have been (9.70). All versions of this article have been corrected. (The following abstract of the original article appeared in record 2012-23737-001 .) An extensive body of research has demonstrated that patients with a co-occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) diagnosis are at high risk for a wide range of negative clinical outcomes, including treatment noncompletion. However, no studies to date have explored the effect of a PTSD-SUD diagnosis on residential SUD treatment completion, as well as potential moderators of this effect. Consequently, the goal of this study was to examine the interactive effect of a PTSD diagnosis, distress tolerance (DT), and gender on residential SUD treatment retention. Participants were 214 substance-dependent patients consecutively admitted to a residential SUD treatment facility. Participants were administered diagnostic interviews, completed a laboratory-based measure of DT, and were followed throughout the course of treatment. Although no significant main effects were found, results did reveal a significant PTSD × gender × DT interaction. Post hoc analyses indicated that, among men, those with a current diagnosis of PTSD and low DT completed a significantly lower proportion of residential SUD treatment compared to all other groups. The implications of the study's findings for identifying ways to improve residential SUD treatment retention among patients with a PTSD-SUD diagnosis are discussed.
... Beyond PD, high levels of AS have also been associated with social phobia (SP; e.g., Ball, Otto, Pollack, Uccello, & Rosenbaum, 1995;Norton, Cox, Hewitt, & McLeod, 1997). This is likely due to the fear of negative evaluation resulting from a display of observable anxiety symptoms (Cox, Borger, & Enns, 1999). Research has also shown that lower AS levels predict recovery from SP (Vriends et al., 2007). ...
... Anxiety sensitivity, defi ned as the fear of anxiety and internal sensations (McNally, 2002; Reiss and McNally, 1985), is one promising candidate for better understanding the nature of depression-withdrawal symptom relations. Past non-smoking-oriented work has demonstrated that anxiety sensitivity is related to depressive symptoms and disorders (Cox et al., 1999; Otto et al., 1995; Schmidt et al., 2006). Furthermore, a limited, albeit growing, body of work suggests that anxiety sensitivity is retrospectively (Zvolensky et al., 2004) and prospectively (Marshall et al., 2009) associated with greater severity of acute nicotine withdrawal symptoms. ...
Objective:
The aim of the present investigation was to explore the main and interactive effects of anhedonic depressive symptoms and anxiety sensitivity in terms of the individual components of nicotine withdrawal symptoms experienced on quit day as well as throughout the initial 14 days of cessation.
Method:
Participants included 65 daily cigarette smokers (38 women; Mage = 46.08 years, SD = 9.12) undergoing psychosocial-pharmacological cessation treatment.
Results:
Results indicated that, after controlling for the effects of participant sex and nicotine dependence, anhedonic depression symptoms, but not anxiety sensitivity, significantly predicted quit day levels of mood-based nicotine withdrawal symptoms. Conversely, anxiety sensitivity, but not anhedonic depression symptoms, was significantly related to the change in most nicotine withdrawal symptoms over time. Finally, our results revealed a significant interaction between anxiety sensitivity and anhedonic depression symptoms related to the slope of certain withdrawal symptoms over time. Specifically, among participants with higher levels of anxiety sensitivity, greater levels of anhedonic depression symptoms were related to greater increases in withdrawal symptoms over time for two of the nine anxiety-relevant components of nicotine withdrawal (restlessness and frustration).
Conclusions:
Among high anxiety-sensitivity persons, compared with those low in anxiety sensitivity, anhedonic depression symptoms may be more relevant to the experience of some withdrawal symptoms being more intense and persistent during the early phases of quitting.
... Candidates for overlapping cognitive mediators of somatic focus and illness conviction in HC and PD include (a) the tendency to misinterpret harmless bodily sensations as physically harmful (i.e., anxiety sensitivity [AS]) and (b) the tendency to attend to and closely monitor internal sensations (i.e., body vigilance). Several studies indicate that AS is present in both HC and PD (e.g., Cox, Borger, & Enns, 1999) and that it is associated with HC and PD symptoms in various clinical and nonclinical populations (e.g., Bravo & Silverman, 2001;Deacon & Abramowitz, 2006;MacDonald, Baker, Stewart, & Skinner, 2000;Otto, Demopulos, McLean, Pollack, & Fava, 1998;Otto, Pollack, Sachs, & Rosenbaum, 1992;Stewart & Watt, 2000). Whereas there has been less work on body vigilance, preliminary evidence suggests that this phenomenon is also present in both HC and PD (Olatunji, Deacon, Abramowitz, & Valentiner, 2007) . ...
Although hypochondriasis (HC) is considered a somatoform disorder in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision), some authors have pointed out that the symptoms of HC overlap with certain anxiety disorders, namely, panic disorder (PD) and obsessive-compulsive disorder (OCD). Few studies have empirically addressed this overlap. In the present investigation, we used discriminant function analysis to explore how patients with a principal diagnosis of HC, OCD, or PD varied with respect to cardinal symptoms of these disorders (i.e., health anxiety, obsessions and compulsions, and panic-related anxiety and avoidance) and key cognitive biases (i.e., intolerance of uncertainty, anxiety sensitivity, and body vigilance). Fifty treatment-seeking individuals with PD, 21 with OCD, and 23 with HC completed self-report measures of symptoms and cognitions during their clinic visit. Results indicated that whereas individuals with HC experience panic attacks, obsessions, and compulsions, these symptoms are markedly less pronounced than among those with PD and OCD. Conversely, overlaps were found in terms of cognitive biases, with HC patients demonstrating elevated levels of intolerance of uncertainty, body vigilance, and fear of cardiovascular symptoms. Implications for the conceptualization and treatment of HC are discussed.
... Finally, although not necessarily a limitation, we only found evidence for the moderating role of low DT among male SUD patients with PTSD, suggesting the need to identify and evaluate other psychological variables that may influence treatment completion among female SUD patients with PTSD. One variable worth exploring may be anxiety sensitivity, given evidence that anxiety sensitivity is elevated among individuals with PTSD (Cox, Borger, & Enns, 1999) and has been found to predict residential SUD treatment dropout . Further, although related to DT, anxiety sensitivity and DT have been found to be uniquely associated with SUD-relevant outcomes (e.g., alcohol use problems; Howell, Leyro, Hogan, Buckner, & Zvolensky, 2010). ...
An extensive body of research has demonstrated that patients with a co-occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) diagnosis are at high risk for a wide range of negative clinical outcomes, including treatment noncompletion. However, no studies to date have explored the effect of a PTSD-SUD diagnosis on residential SUD treatment completion, as well as potential moderators of this effect. Consequently, the goal of this study was to examine the interactive effect of a PTSD diagnosis, distress tolerance (DT), and gender on residential SUD treatment retention. Participants were 214 substance-dependent patients consecutively admitted to a residential SUD treatment facility. Participants were administered diagnostic interviews, completed a laboratory-based measure of DT, and were followed throughout the course of treatment. Although no significant main effects were found, results did reveal a significant PTSD × gender × DT interaction. Post hoc analyses indicated that, among men, those with a current diagnosis of PTSD and low DT completed a significantly lower proportion of residential SUD treatment compared to all other groups. The implications of the study's findings for identifying ways to improve residential SUD treatment retention among patients with a PTSD-SUD diagnosis are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
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.
The relationship between nicotine abstinence and panic onset is still not well understood and the role of catastrophic misinterpretation, as possible moderator or mediator of this relationship, is unknown. We tested whether nicotine abstinence influences the response to a CO2 panic challenge and whether catastrophic misinterpretation (measured via the Anxiety Sensitivity [ASI] and the SomatoSensory Amplification Scale [SSAS]) exerts a moderating or mediating effect on the relationship between nicotine abstinence and panic. Eighty regular smokers underwent a 35% CO2 challenge after the transdermal administration of nicotine or placebo. Physiological and psychological variables were measured at baseline, directly before and after the challenge. Fear reactivity to the challenge was similar in both conditions. ASI (post-Test Visual Analogous Scale of Fear: ΔR2 = 0.043, p < .05) and SSAS (post-Test Visual Analogous Scale of Anxiety: ΔR2 = 0.036, p < .05; post-Test Panic Symptom List: ΔR2 = 0.035, p < .05) influenced anxiety as response to the challenge. We found no support for the moderational and the mediational hypotheses. The findings regarding fear reactivity when group status is considered partly confirm the literature. The positive findings observed for ASI and SSAS as factors influencing the response to the challenge, together with the lack of evidence for a moderational and a mediational hypothesis, confirm that anxiety sensitivity and somatosensory amplification are independent constructs and suggest that they directly influence the response to the challenge. (PsycINFO Database Record
(c) 2015 APA, all rights reserved).
Pharmacogenomics and the search for personalized medicine focus on the attainment of individualized pharmacotherapies that cover genetic variation and target groups of patients that present neurodevelopmental aspects of symptom profiles and biomarkers underlying the pathophysiology of mood disorders. The identification of genetic biomarkers facilitates choice of treatment, prediction of response, and prognosis of outcome over a wide spectrum of symptoms associated with affective states thereby optimizing clinical practice procedures. Several strategies, under development and refinement, show the propensity for derivation of essential elements in the etiopathogenesis of disorder affecting drug efficacy, drug metabolism, and drug adverse effects, e.g., with regard to SSRIs; these include the following: transporter gene expression and genes encoding receptor systems, hypothalamic-pituitary-adrenal axis factors, neurotrophic factors, and inflammatory factors affecting neuroimmune function. Nevertheless, procedural considerations of pharmacogenetics presume the parallel investment of policies and regulations to withstand eventual attempts at misuse thereby ensuring patient integrity.
En esta investigación hemos estudiado la estructura factorial de la sensibilidad a la ansiedad en una muestra de niños normales de 9-11 años de edad (N = 151). Los participantes completaron la versión española del Childhood Anxiety Sensitivity Index (CASI; Silverman, Fleisig, Rabian y Peterson, 1991). Se investigó la fiabilidad de los ítems de la CASI y su estructura factorial (análisis factoriales exploratorios y confirmatorios). Los resultados revelaron que la sensibilidad a la ansiedad, evaluada mediante la CASI, consistía fundamentalmente en una estructura multidimensional de dos (somático y mental) o tres (somático, mental y control/social) factores primarios correlacionados. Los datos también apoyaban una estructura jerárquica con un factor de segundo orden y dos o tres factores primarios. Estos resultados proporcionan apoyo empírico a la validez estructural de la versión española de la CASI.
The goal of this article is to advance understanding of borderline personality disorder (BPD) as an emotional disorder and to use this information as a heuristic for reconceptualizing targeted treatment approaches. The first section reviews evidence that BPD is characterized by the hallmark of emotional disorders, frequent intense negative emotions, and adverse reactions to them. Next, overlap between BPD and other emotional disorders is described, followed by a section delineating how these similarities can be largely accounted for by a shared underlying vulnerability, namely, high levels of neuroticism. Finally, we discuss the treatment implications of this conception of BPD in the context of recent transdiagnostic approaches to emotional disorders.
The psychometric properties of the Anxiety Sensitivity Index (ASI) have been criticized. Although it has been the gold standard in research and assessment, its reliability (i.e., internal consistency) has been questioned. There are doubts about its ability to identify accurately the underlying factors for anxiety sensitivity. To provide a more accurate description of the anxiety sensitivity construct, Taylor and Cox (1998) developed the Anxiety Sensitivity Profile (ASP) and performed analyses based on a sample of 349 university students. The current study utilized a clinical sample to test the hypotheses that the ASP would have convergent validity with the ASI and discriminant validity with the trait version of the State-Trait Anxiety Inventory (STAl). This correlational study was conducted with a clinical sample of 105 adults, 19 to 65 years old, who have an anxiety disorder. Each subject completed the ASP, ASI, STAl, and the computerized version of the SClD-I/P. Results supported the hypotheses. Large correlations at the .01 level were found for the ASP and ASI total scores and ASP subscale scores. Modest correlations were found for the ASI and ASP total and subscale scores and the trait version of the STAl at the .05 level. Reliability (internal consistency) for the ASI total scores and ASP subscales was high. Therefore this study provides evidence for convergent validity with the ASI. It also provides necessary, although not sufficient evidence for construct validity for the ASP subscales. Internal consistency reliability cannot be determined for all of the underlying domains of the ASI, because one of the domains consists of only one item. This evidence implies that the ASP is psychometrically superior to the ASI for research and treatment. Instead of the three underlying factors of the ASI, six factors are implied. Evidence is provided through convergent validity and internal consistency reliability found for the six ASP subscales. It is speculated that utilization of the ASP will support improved consistency in research through the use of congruence (i.e., matching the symptoms caused by a provocation task and the symptoms a person fears). Furthermore the ASP will support accurate identification of the domains underlying anxiety sensitivity that contribute to its association with all anxiety disorders. Finally, there are applied implications. These include the fact that those at risk can be identified and given brief cognitive-behavioral therapy as a preventive intervention. Also, treatment can target congruent cognitions, and elevated anxiety sensitivity at the end of treatment can be targeted for further interventions.
Comments on the article by E. T. Higgins (see record 1997-43865-002 ) regarding a regulatory focus theory of pleasure and pain. It is argued that although Higgins's concepts of promotion and prevention foci advance out understanding of approach and avoidance motivation, they leave some important questions unanswered. To address these questions, S. Reiss's sensitivity theory is offered as potentially useful in integration with Higgins's concepts to move beyond the Hedonic Principle. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Pandemic illnesses, such as the H1N1 influenza (swine flu) are often highly publicized in the mass media and can be associated with high levels of anxiety and compensatory behavior (e.g., using hand sanitizers). The present research sought to investigate the psychological processes associated with swine-flu related anxiety during the H1N1 influenza pandemic of 2009–2010. Participants were 315 college students who completed survey measures between September 25th 2009 and February 16th 2010, which encompassed the peak of flu season and a time of intense media attention to this particular outbreak. Data revealed that anxiety in response to the swine flu was common in the sample. Regression analysis indicated that health anxiety, contamination fears and disgust sensitivity were significant predictors of swine flu-related anxiety. Implications for how concerns over pandemic illnesses such as the swine flu can be conceptualized and clinically managed are discussed.
Anxiety sensitivity refers to the fear of anxiety-related physical sensations arising from beliefs that these sensations have harmful consequences (Reiss & McNally, 1985). The present study examined whether individuals with high (vs. low) anxiety sensitivity show stronger implicit associations in memory between anxiety-related symptoms, as opposed to neutral body parts, and harmful, as compared to harmless, consequences. A total of 22 undergraduate students (14 F, 8 M) completed the Extrinsic Affective Simon Task (EAST; De Houwer, 2003). Results indicated that high anxiety sensitive individuals (n = 10) tended to implicitly associate harmful consequences with anxiety-related symptoms. Their performance was significantly faster on trials where target words related to anxiety symptoms were mapped on to the same response key as harmful consequences. No significant difference in performance was found for low anxiety sensitive individuals (n = 12) or when target words were body parts unlikely related to diseases. Between-group differences persisted after controlling for trait anxiety and history of panic attacks, but not when illness-related beliefs were introduced as a covariate. Identifying this implicit association bias provides additional empirical support for the concept of anxiety sensitivity.
The Icelandic version of the Anxiety Sensitivity Index was investigated in two studies of college students. A principal components analysis of ASI scores from both studies (N=718) yielded three components similar to what has been found previously: Psychological Concerns, Physical Concerns and Social Concerns. In the first study the relationship between the ASI and trait anxiety was investigated. It was analysed at the level of the total scales but also at the level of subscales of both instruments. Two subscales of the STAI, measuring respectively Anxiety-trait and Depression-trait, were used as well as the Psychological Concerns and Physical Concerns subscales of the ASI. In a second study the relationships between ASI and its subscales and two symptom measures of anxiety and depression were addressed. ASI was in both studies more strongly related to the anxiety than the depression scales. Also, in both studies the Physical Concerns subscale of the ASI was more strongly related to anxiety than to depression, whereas the Psychological Concerns subscale was equally related to anxiety and depression. Taken together the studies support the notion of different relationships between different aspects of anxiety sensitivity, and anxiety and depression as traits, cognitive symptoms and mood related symptoms.
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