Is anxiety sensitivity a predictor of PTSD in children and adolescents?

Department of Child Psychiatry, Medical School, Ankara University, Ankara, Turkey.
Journal of Psychosomatic Research (Impact Factor: 2.74). 08/2008; 65(1):81-6. DOI: 10.1016/j.jpsychores.2008.02.013
Source: PubMed


Anxiety sensitivity (AS) is the fear of the physical symptoms of anxiety and related symptoms. Longitudinal studies support AS as a vulnerability factor for development of anxiety disorders. This study aimed to investigate AS as a vulnerability factor in the development of childhood posttraumatic stress disorder (PTSD) following traumatic experiences.
The study included 81 children 8-15 years of age who experienced the 1999 earthquake in Bolu, Turkey. The earthquake survivors were compared to a randomized group of age- and sex-matched controls 5 years after the earthquake. Both the subject and control groups were administered the Childhood Anxiety Sensitivity Index (CASI), State and Trait Anxiety Inventory for Children (STAI-C), and Child Depression Inventory (CDI), while the PTSD symptoms of the subjects were assessed using the Child Posttraumatic Stress Reaction Index (CPTS-RI).
Subjects and controls did not differ significantly in CASI, STAI-C, or CDI scores. Multiple regression analysis showed that both trait anxiety and CASI scores predicted CPTS-RI scores of the subjects; the prediction by CASI scores was over and above the effect of trait anxiety.
The results of this study support the hypothesis that AS may be a constitutional factor, which might increase the risk of PTSD following traumatic experiences.

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    • "Although individuals with greater levels of anxiety sensitivity are at a risk for developing severe posttraumatic stress response and the therapeutic role of this construct in treating PTSD has been well recognized [26] [27], relationships between anxiety sensitivity and posttraumatic syndrome in children and adolescents have been paid almost no attention. In a preliminary study, 5 years after the 1999 Bolu earthquake, Kilic et al. [28] examined the possible influence of anxiety sensitivity on PTSD symptom severity among 81 Turkish children, aged 8–15 years. The study demonstrated that children who reported high PTSD symptoms were more prone to greater levels of anxiety sensitivity as well as higher levels of trait anxiety. "
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    ABSTRACT: Objective: Our aims were to investigate the prevalence of PTSD, depression, anxiety-related disorders, and dissociative symptomotology, and to assess the risk factors for development of psychopathology among children and adolescents after the 2011 Van earthquake in Turkey. Methods: The screening was conducted among 738 participants at 6months post-earthquake using the CPTSD-Reaction Index, State and Trait Anxiety Inventory for Children, Screen for Child Anxiety Related Emotional Disorders, Child Depression Inventory, Childhood Anxiety Sensitivity Index, Metacognitions Questionnaire for Children, and Adolescent Dissociative Experiences Scale. Results: Less than half (40.69% of) of the participants reported severe levels of PTSD symptoms, 53.04% were at greater risk for developing an anxiety-related disorder, 37.70% met the criteria for clinical depression, and 36.73% revealed pathological levels of dissociative symptomotology. State-trait anxiety, and anxiety sensitivity were significant antecedents of psychopathology. Conclusion: We concluded that anxiety sensitivity is a significant risk factor in various types of psychopathology, but metacognitions seem to have a limited utility in accounting for poor psychological outcomes in young survivors of earthquake.
    Full-text · Article · May 2013 · Comprehensive psychiatry
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    • "Even though the bulk of research has focused on panic disorder (PD), AS has been found to be relevant to a range of mental disorders. AS measured by the Anxiety Sensitivity Index (ASI, Reiss et al., 1986) is associated cross-sectionally with depression (Rodriguez et al., 2004), posttraumatic stress disorder (Lang et al., 2002; Kilic et al., 2008; Marshall et al., 2010), social and generalized anxiety disorders (e.g., Deacon and Abramowitz, 2006), obsessive compulsive disorder (McWilliams et al., 2007), and several other disorders (Asmundson and Taylor, 1996; Joiner et al., 2008; Olatunji et al., 2009). Longitudinal studies support the role of AS as a precursor of panic attacks and a diagnosis of PD but also of other anxiety disorders (Hayward et al., 2000; Schmidt et al., 2006). "
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    ABSTRACT: Psychometric studies indicate that anxiety sensitivity (AS) is a risk factor for anxiety disorders such as panic disorder (PD). To better understand the psychophysiological basis of AS and its relation to clinical anxiety, we examined whether high-AS individuals show similarly elevated reactivity to inhalations of carbon dioxide (CO2) as previously reported for PD and social phobia in this task. Healthy individuals with high and low AS were exposed to eight standardized inhalations of 20% CO2-enriched air, preceded and followed by inhalations of room air. Anxiety and dyspnea, in addition to autonomic and respiratory responses were measured every 15s. Throughout the task, high AS participants showed a respiratory pattern of faster, shallower breathing and reduced inhalation of CO2 indicative of anticipatory or contextual anxiety. In addition, they showed elevated dyspnea responses to the second set of air inhalations accompanied by elevated heart rate, which could be due to sensitization or conditioning. Respiratory abnormalities seem to be common to high AS individuals and PD patients when considering previous findings with this task. Similarly, sensitization or conditioning of anxious and dyspneic symptoms might be common to high AS and clinical anxiety. Respiratory conditionability deserves greater attention in anxiety disorder research.
    Full-text · Article · Mar 2013 · Psychiatry Research
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    • "Activity of the heat-exposed rats (as determined by using open field test) was also found to be decreased. Depression-like behaviour has previously been reported in the immature rat2829. Thus, our findings provide further evidence that hypocorticosteronaemia is associated with behavioural deficits in pre-pubertal male rats. "
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    ABSTRACT: Heat stress related hyperthermia may cause damage to various organ systems. There are very few studies on the effects of hyperthermia on the endocrine system. We therefore, investigated effects of exogenously induced hyperthermia on adrenal, testicular and thyroid functions and behavioural alterations in pre-pubertal male Sprague-Dawley rats. Three groups of 30-day old rats (n=7 per group) were used. Body temperature was increased to 39 °C (Group I) and 41 °C (Group II) in a hyperthermia induction chamber for 30 min. The rats in the Group III served as control (36 °C). All animals received saline and were decapitated 48 h after the experiments. Serum free triiodothyronin (fT3), free thyroxine (fT4), total testosterone and dehydroepiandrosterone sulphate (DHEA-S) levels were determined by chemiluminescence assay, and corticosterone by enzyme immunoassay. Testes, pituitary and adrenal glands were dissected out and processed for histopathological examination. To assess activity and anxiety of the animals, the open field test and elevated-0-maze test, respectively, were used in all groups 24 h before (day 29) and after (day 31) hyperthermia induction. Serum corticosterone levels (3.22 ± 1.3) were significantly reduced in the 39 °C (1.3 ± 0.9) and 41 °C (1.09 ± 0.7) hyperthermia groups (P<0.01) compared to controls. Serum levels of thyroid hormones did not significantly differ among the groups. DHEA-S and testosterone values were below the limit of detection in all groups. Histopathological examination revealed that there was mild hydropic degeneration in the pituitary and adrenal glands. Apoptotic germ cells were seen in the seminiferous tubules of pre-pubertal male rats exposed to hyperthermia (41 °C). Progression time in the open field test was significantly decreased and anxiety test scores increased in animals exposed to 39 °C compared to the control group (P<0.01). These parameters were more pronounced in the 41 °C hyperthermia group. Our results show that heat exposure-induced stress may cause delayed reduction in serum corticosterone levels which may be associated with behavioural deficits in pre-pubertal male rats.
    Full-text · Article · Feb 2012 · The Indian Journal of Medical Research
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