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Taxometric and Factor Analytic Models of Anxiety Sensitivity Among Youth: Exploring the Latent Structure of Anxiety Psychopathology Vulnerability

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Abstract

This study represents an effort to better understand the latent structure of anxiety sensitivity (AS), a well-established affect-sensitivity individual difference factor, among youth by employing taxometric and factor analytic approaches in an integrative manner. Taxometric analyses indicated that AS, as indexed by the Child Anxiety Sensitivity Index (CASI; Silverman, Flesig, Rabian, & Peterson, 1991), demonstrates taxonic latent class structure in a large sample of youth from North America (N=4,462; M(age)=15.6 years; SD=1.3). Subsequent confirmatory factor analyses indicated that the latent continuous, multidimensional, 4-factor model of AS among youth (Silverman, Goedhart, Barrett, & Turner, 2003) provided good fit for the CASI data among the complement class ("normative form" of AS), but not among the taxon class ("high-risk form" of AS). EFAs supported the prediction that the AS taxon demonstrates a unique, heretofore unexplored latent continuous, unidimensional factor structure among youth. Findings are discussed in relation to refining our understanding of the latent structure of AS and the clinical implications that arise from it.

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... One is that it is potentially problematic to construct a model of AS amongst clinical youth and then test this model with non-clinical youth. Indeed, a subsequent study suggested that the factor structure of AS might vary depending upon whether the anxiety is at clinical or nonclinical levels (Bernstein et al. 2007). Secondly, the factor structure of AS in adults was used to guide the factor structure of this construct in children. ...
... Using the 13 items and factor structure suggested by Silverman et al. (2003), Bernstein et al. (2007) used CFA to find support for the same four-factor model of the CASI. However, this model demonstrated good fit only with individuals demonstrating normative levels of AS. ...
... Instead, EFA indicated that a single-factor model was supported in this group containing only seven items (three Mental Illness Concerns items, two Disease or Physical Concerns items, and two Social Concerns items). These authors concluded that the four-factor model proposed by Silverman et al. (2003) might represent the structure of childhood AS in its normative form, whereas a unidimensional factor structure is more representative of the high-risk form of childhood AS (Bernstein et al. 2007). ...
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Background Child anxiety sensitivity (AS) is measured almost exclusively using the Childhood Anxiety Sensitivity Index (CASI). Yet, in the context of significant discrepancies regarding the CASI factors and how they are scored and reported, it remains unclear whether the CASI reliably and validly assesses the purported multifactorial AS construct. Objective This paper will: (1) provide a comprehensive summary of previous CASI factor analyses by which these factor structures were identified, (2) evaluate evidence regarding the multifactorial nature of AS in youth, and (3) discuss potential directions for continued research in this area. Method In a PsycInfo search, peer-reviewed studies published between 1991 and 2018 were identified for inclusion if they examined the factor structure of the CASI or reported data on the CASI subscales as administered to child participants. Results Findings from the 50 studies reviewed suggested that (1) the 18-item CASI does not consistently yield internally reliable assessments of specific AS facets, (2) significant discrepancies exist regarding the CASI subscales identified, the items comprising these scales, and their predictive validity in terms of anxiety, and (3) alternatives to assess the multifactorial construct of AS in youth do exist, but they have not been systematically examined in the literature. Conclusions Directions for future study include further examining expanded scales for AS in youth, continued study of shorter scales assessing more consistently reliable AS content, and evaluating the utility of an expanded response scale for the CASI.
... The 16-item ASI total and subfactor scores have shown adequate internal consistency, test-retest reliability, and construct validity (McNally & Lorenz, 1987;Reiss et al., 1986;Rodriguez et al., 2004;Zinbarg et al., 1997). More recently, latent structural study integrating Coherent Cut Kinetic taxometric procedures and factor analysis has indicated that individual differences in anxiety sensitivity may best be characterized by first deciding whether individuals belong to a high or low anxiety sensitivity subgroup and then indexing variability within these latent classes (Bernstein, Zvolensky, Norton et al., 2007a;Bernstein, Zvolensky, Stewart, & Comeau, 2007b). Specifically, the distribution of anxiety sensitivity scores may demonstrate both a dichotomous latent class structure (taxonic) as well as continuous withinclass continuity (taxonic-dimensionality; Bernstein et al., 2007a). ...
... Specifically, the distribution of anxiety sensitivity scores may demonstrate both a dichotomous latent class structure (taxonic) as well as continuous withinclass continuity (taxonic-dimensionality; Bernstein et al., 2007a). Consequently, there may be taxonic group differences in anxiety sensitivity between individuals and continuous differences between individuals along a dimension(s) within each anxiety sensitivity group (Bernstein, Zvolensky et al., 2007b). ...
... These findings are in agreement with previous work suggesting that anxiety sensitivity physical and psychological concerns, rather than social concerns, demonstrate the most predictive power and utility in terms of anxiety psychopathology (e.g., Schmidt et al., 1999) and substancerelated problems . In light of these data, anxiety sensitivity social concerns items may possibly represent only normative anxiety sensitivity-relevant cognitions, as also indicated by taxometric research (e.g., Bernstein et al., 2007b). Alternatively, it is possible that these items, and perhaps the social concerns facet of the ASI, simply do not reflect the latent anxiety sensitivity variable as strongly as the others. ...
Article
The present investigation applied Item Response Theory (IRT) methodology to the 16-item Anxiety Sensitivity Index (ASI) [Reiss, S., Peterson, R. A., Gursky, M., & McNally, R. J. (1986). Anxiety sensitivity, anxiety frequency, and the prediction of fearfulness. Behaviour Research and Therapy, 24, 1–8] for a sample of 475 daily adult smokers (52% women; Mage = 26.9, S.D. = 11.1, range = 18–65). Using non-parametric item response analysis, all 16 ASI items were evaluated. Evaluation of the option characteristic curves for each item revealed 4 poorly discriminating ASI items (1: “It is important not to appear nervous;” 5: “It is important to me to stay in control of my emotions;” 7: “It embarrasses me when my stomach growls;” 9: “When I notice my heart beating rapidly, I worry that I might be having a heart attack”), which were dropped from analysis. Upon repeat analysis, the remaining items appeared to make adequate separations within levels of anxiety sensitivity in this sample. Graded response modeling data indicated important differences in ASI items’ capacity to discriminate between, and provide information about, latent levels of anxiety sensitivity. Specifically, three items best discriminated and provided the most information regarding latent levels of AS—items 3, 15, and 16. Items 1, 5, 7, and 9 were omitted due to their limited capacity to discriminate between latent levels of anxiety sensitivity; items 8, 12, and 13 also performed poorly. Overall, current findings suggest that evaluation of anxiety sensitivity among adult smokers using the 16-item ASI may usefully choose to focus on items that performed well in these IRT analyses (items: 2, 3, 4, 6, 10, 11, 14, 15, and 16).
... The observed FMM findings help illuminate the latent structure of AS and the nature of categorical and continuous individual differences in AS. These findings also help to resolve extant latent structural study of AS, using CCK taxometric procedures, that yielded mixed taxonic and dimensional findings (e.g., Bernstein, Zvolensky, Stewart, et al., 2007; Broman-Fulks et al., 2008). Importantly, in the event that AS was indeed a 1-class dimensional variable, alternative FMM findings would have been observed, but were not. ...
... These FMM data also may be interpreted to mean that: (a) the AS taxon indeed demonstrates a unique (partially invariant) 3-factor solution relative to the " normative " AS class, but that within the taxon, dimensional individual differences on one factor do not relate to dimensional individual differences on the other factors in a manner similar to the " normative " AS class; (b) a unidimensional or other multidimensional solution may better reflect the within-class dimensional variability of the AS taxon (e.g., 1-factor, 2-factor, 3-factor, 4- factor), and that in the event of a different multidimensional solution, these alternative factors may or may not covary; (c) certain facets of AS may vary dimensionally within the AS taxon whereas other facets may not; or (d) individual differences within the AS taxon are not dimensional, such that unlike the AS " normative " class, it could be that categorical membership to the AS taxon or " highrisk " class is not further characterized by withinclass continuous levels of AS. These FMM findings pertaining to differences in the factor structure of the latent taxonic AS classes are consistent with previous confirmatory and exploratory factor analyses of taxometrically derived AS classes (e.g., Bernstein, Zvolensky, Norton et al., 2007; Bernstein, Zvolensky, Stewart, & Comeau, 2007). In light of the fact that distinctly different data analytic strategies were employed between this and previous studies, the convergence between these studies' findings is noteworthy. ...
... It is noteworthy that items from each of the putatively AS lower-order factors loaded significantly on the AS taxon factor solution, consistent with previous factor analytic findings of taxometrically derived AS classes (Bernstein, Zvolensky, Norton, et al., 2007). These within-taxon factor analytic data indicate that dimensional variability within the AS taxon is likely characterized by various facets of AS (see also Bernstein, Zvolensky, Norton, et al., 2007; Bernstein, Zvolensky, Stewart, et al., 2007). Furthermore, in an exploratory and descriptive follow-up test, Physical and Psychological Concerns each uniquely predicted latent class membership derived via FMM, consistent with previous taxometric findings (e.g., Zvolensky, Forsyth et al., 2007). ...
Article
The present study tested multiple, competing latent structural models of anxiety sensitivity (AS), as measured by the Anxiety Sensitivity Index-3 (ASI-3; Taylor et al., 2007). Data were collected from 3 sites in North America (N=634). Participants were predominantly university students (M=21.3 years, SD=5.4). ASI-3 data were evaluated using an integration of mixture modeling and confirmatory factor analysis-factor mixture modeling (FMM; Muthén, 2008). Results supported a 2-class 3-factor partially invariant model of AS. Specifically, the FMM analyses indicated that AS is a taxonic (two-class) variable, and that each categorical class has a unique multidimensional factor structure. Consistent with the specific point-prediction regarding the hypothesized parameters of the putative latent class variable, FMM indicated that the putatively "high-risk" subgroup of cases or latent form of AS composed approximately 12% of the studied sample whereas the putatively "normative" subgroup of cases or latent form of AS composed 88% of the sample. In addition, the AS Physical and Psychological Concerns subscales, but not the Social Concerns subscale, most strongly discriminated between the two latent classes. Finally, comparison of continuous levels of AS Physical and Psychological Concerns between FMM-derived AS latent classes and independent clinical samples of patients with anxiety disorders provided empirical support for the theorized taxonic-dimensional model of AS and anxiety psychopathology vulnerability. Findings are discussed in regard to the implications of this and related research into the nature of AS and anxiety psychopathology vulnerability.
... In addition, the sample studied here was a non-clinical sample. Although this replicates the samples used in the two previous CASI-R investigations, a key next step in the development of the CASI-R would be to examine its structure and validity in a clinical sample in which at least a subset of youth has been diagnosed with an anxiety disorder; this may be particularly important in the case of AS, given that some recent studies have found evidence to suggest that AS operates differently at high (clinical) versus low (non-clinical) levels (e.g., Bernstein et al. 2007) Specifically, it is suggested that whereas a fourfactor AS structure might be most applicable to non-clinical youth, a unifactorial model might best explain the AS construct in high-risk youth (Bernstein et al. 2007). Continued work in this area would be particularly informative as the present results tentatively suggest that at least two CASI-R subscales (Fear of Publicly Observable Reactions and Fear of Cognitive Dyscontrol) might yield psychometrically stronger measures of these AS facets in youth than their parallel CASI scales in older youth. ...
... In addition, the sample studied here was a non-clinical sample. Although this replicates the samples used in the two previous CASI-R investigations, a key next step in the development of the CASI-R would be to examine its structure and validity in a clinical sample in which at least a subset of youth has been diagnosed with an anxiety disorder; this may be particularly important in the case of AS, given that some recent studies have found evidence to suggest that AS operates differently at high (clinical) versus low (non-clinical) levels (e.g., Bernstein et al. 2007) Specifically, it is suggested that whereas a fourfactor AS structure might be most applicable to non-clinical youth, a unifactorial model might best explain the AS construct in high-risk youth (Bernstein et al. 2007). Continued work in this area would be particularly informative as the present results tentatively suggest that at least two CASI-R subscales (Fear of Publicly Observable Reactions and Fear of Cognitive Dyscontrol) might yield psychometrically stronger measures of these AS facets in youth than their parallel CASI scales in older youth. ...
Article
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The multifactorial nature of anxiety sensitivity (AS) in children has been assessed almost solely with the Childhood Anxiety Sensitivity Index (CASI; Silverman et al. Journal of Clinical Child Psychology, 20(2), 162–168, 1991); however, multiple studies have suggested that the item content of the CASI is too limited to adequately assess multiple AS factors in youth. Here we examined the psychometric properties of the Revised Childhood Anxiety Sensitivity Index (CASI-R; Muris Behaviour Research and Therapy, 40, 299–311, 2002), developed to assess a higher-order global AS factor and four lower-order factors. In a non-clinical sample of youth aged 8–14 we (a) examined the psychometric properties of the CASI-R, comparing findings for children aged 11 and younger with those aged 12 and older, (b) evaluated and compared the internal consistency of the four-factor CASI-R and the three- and four-factor CASI, and (c) examined and compared the convergent validity of the CASI and CASI-R subscales with child-reported anxiety symptoms. Reliability estimates for the CASI-R total, Cardiovascular, and Respiratory scales were high for all youth; the Cognitive Dyscontrol and Publicly Observable Reactions scales yielded low estimates of internal consistency for the younger group. Compared to the parallel CASI scales, these CASI-R scales demonstrated stronger internal consistency in both the older and younger groups. Comparatively larger correlations between the CASI-R physical and cognitive scales with symptoms of panic and between the CASI-R social scale and symptoms of social anxiety were observed. These findings suggest continued use and examination of the CASI-R in child and adolescent non-clinical and clinical samples to comprehensively assess the AS construct in youth.
... Bernstein, Zvolensky, Weems, Stickle, and Leen-Feldner (2005) and Bernstein, Zvolensky, Stewart, and Comeau (2007) conducted two taxometric studies of anxiety sensitivity. Anxiety sensitivity reflects relatively stable individual differences in the fear of anxiety and anxiety-related sensations (Mcnally, 2002). ...
... These rates are similar to those found in adult populations (Bernstein et al., 2006;Schmidt et al., 2005). The second study, Bernstein et al. (2007) conducted using similar data from the CASI and a larger sample (n = 4,462) of North American youth, also supported a taxonic latent class structure, although with a slightly lower base rate of 9%. Subsequent confirmatory factor analysis supported a continuous multidimensional four-factor model of anxiety sensitivity among the nontaxonic 'normative form' of anxiety sensitivity, but not the taxonic 'high risk' form. ...
Article
The question of whether child and adolescent mental disorders are best classified using dimensional or categorical approaches is a contentious one that has equally profound implications for clinical practice and scientific enquiry. Here, we explore this issue in the context of the forth coming publication of the DSM-5 and ICD-11 approaches to classification and diagnosis and in the light of recent empirical studies. First, we provide an overview of current category-based systems and dimensional alternatives. Second, we distinguish the various strands of meaning and levels of analysis implied when we talk about categories and dimensions of mental disorder--distinguishing practical clinical necessity, formal diagnostic systems, meta-theoretical beliefs and empirical reality. Third, we introduce the different statistical techniques developed to identify disorder dimensions and categories in childhood populations and to test between categorical and dimensional models. Fourth, we summarise the empirical evidence from recent taxometric studies in favour of the 'taxonomic hypothesis' that mental disorder categories reflect discrete entities with putative specific causes. Finally, we explore the implications of these findings for clinical practice and science.
... Although initially conceptualized as existing along a continuum (Taylor, 1999; also see Taylor et al., 1999), emerging evidence from taxometric analyses is mixed as to whether this conceptualization is accurate. Specifically, Bernstein and co-workers (Bernstein, Leen-Feldner, et al., 2006; Bernstein, Zvolensky, Norton, et al., 2007; Bernstein, Zvolensky, Stewart, et al., 2007; Bernstein, Zvolensky, Weems, et al., 2005;) have consistently shown that the latent structure of AS may be taxonic (i.e., comprising two qualitatively distinct classes, one not clinically significant and the other pathological). Conversely , recent studies by Broman-Fulks co-workers (2008 have failed to replicate evidence of an AS taxon class. ...
... Taken together, our results provide additional support for the dimensional latent structure of the AS construct, and thus corroborate the findings of Broman-Fulks co-workers (2008, 2010). Evidence of a dimensional latent structure for AS contrasts earlier taxometric findings that suggest a taxonic latent structure (Bernstein, Leen-Feldner, et al., 2006; Bernstein, Zvolensky, Norton, et al., 2007; Bernstein, Zvolensky, Stewart, et al., 2007; Bernstein, Zvolensky, Weems, et al., 2005; ). There are several potential explanations for the divergent findings; for example, some of the precedent studies used mathematically redundant taxometric analyses (i.e., MAXCOV and MAXEIG; e.g., see Ruscio, 2009a) and did not employ objective and quantifiable measures of data interpretation, such as the CCFI (also see Broman-Fulks et al., 2010). ...
Article
Anxiety sensitivity (AS) was initially conceptualized as existing along a continuum; however, emerging evidence from taxometric analyses is mixed as to whether the latent structure of AS is dimensional or taxonic. The purpose of the present study was to further evaluate the latent structure of AS in an effort to clarify the contrasting findings reported in the literature. To do so, we examined the latent structure of AS in two large independent samples unselected with regard to AS level (comprising undergraduate respondents and/or community residents). MAXEIG and MAMBAC analyses were performed with indicator sets drawn from distinct self-report measures of AS within either sample. MAXEIG and MAMBAC, as well as comparison analyses utilizing simulated taxonic and dimensional datasets, yielded converging evidence that AS has a dimensional latent structure. Implications of these finding for the conceptualization and measurement of AS are discussed and future research directions are highlighted.
... Thus, the cumulative findings of Studies 1, 2, and 3 provide convergent evidence that AS is dimensional at the latent level. Taxometric Analyses Without Social Concerns Items Several previous AS taxometric studies have suggested that items designed to assess the social concerns facet of AS do not discriminate well between putative AS taxon and nontaxon classes (e.g., Bernstein, Zvolensky, Stewart, et al., 2007; Bernstein, Zvolensky, Weems, et al., 2005). To ensure that the dimensional findings presented in Studies 1–3 (above) were not attributable to the inclusion of a problematic indicator, additional analyses were conducted on each dataset with social concerns items excluded from the analyses. ...
... b r o m a n -f u l k s e t a l . MAMBAC curves have rarely been distinguishable (e.g., Bernstein, Zvolensky, Stewart, et al., 2006; Bernstein, Zvolensky, Stewart, & Comeau, 2007; Schmidt et al., 2005), suggesting that in those cases MAMBAC may not have been able to effectively discriminate between a low base rate taxon and a dimension. In some instances, researchers have noted the apparent unsuitability of MAMBAC tests and omitted these results from their reports. ...
Article
Anxiety sensitivity, or the fear of anxiety sensations, has been implicated in the etiology of anxiety disorders, particularly panic disorder. Recently, inconsistent findings have been reported regarding the latent structure of anxiety sensitivity. Whereas some taxometric studies of anxiety sensitivity have reported evidence of categorical latent structure, others have found evidence of a latent dimension. The purpose of the present research was to further examine the latent structure of anxiety sensitivity using taxometric procedures and commonly utilized measures of anxiety sensitivity. To this end, three mathematically independent taxometric procedures (MAXEIG, MAMBAC, and L-Mode) were applied to data collected from two large nonclinical samples (n's=1,171 and 2,173) that completed the Anxiety Sensitivity Index and the Anxiety Sensitivity Index-Revised. Results from both studies converged in support of a dimensional conceptualization of anxiety sensitivity. A third study was conducted using indicators derived from the newly revised Anxiety Sensitivity Index-3 in a separate sample of 1,462 nonclinical participants. Results of these analyses provided further support for a dimensional anxiety sensitivity solution. The implications of these results for anxiety sensitivity research are discussed, and several potential directions for future research are considered.
... Finally, research suggests some utility in alternative measurement approaches to AS, such as viewing it as a taxonic (e.g., with a dichotomous latent class structure), rather than dimensional (e.g., single latent continuous structure) construct (e.g., Bernstein, Zvolensky, Stewart, & Comeau, 2007;Schmidt, Kotov, Lerew, Joiner, & Ialongo, 2005). If this were the case, it may be useful to evaluate AS-health associations from the perspective that there is a normative/low-risk form of AS, as well as a high-risk or vulnerability-conferring form. ...
Article
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Anxiety sensitivity (AS; fear of anxiety-related symptoms) is an established transdiagnostic risk factor for psychiatric disorders and is related to a variety of chronic medical conditions. However, AS has not been established as a risk factor for chronic medical conditions. In this study, we review studies on AS and chronic medical conditions (and symptoms/behaviors related to chronic medical conditions) and propose four pathways through which AS may increase risk of chronic medical conditions: (a) increasing fear of medical condition-specific symptoms, (b) perpetuating avoidance of healthy activities, (c) promoting engagement in unhealthy behaviors, and (d) increasing risk of detrimental pathophysiological and pathomechanical alterations. We also discuss the potential utility of using AS reduction interventions as a means of reducing risk of chronic medical conditions.
... AS appears to be a logical reduction of anxiety and, therein, most if not all anxiety disorders (Taylor, 1999). AS accounts for variance in higher-order constructs (Naragon-Gainey, 2010; Olatunji et al., 2010;Smits, Berry, Tart, & Powers, 2008;Taylor, 1999), including neuroticism (Calkins et al., 2009;Olatunji & Wolitzky-Taylor, 2009;Schmidt et al., 2010;Schmidt & Mallott, 2006;Taylor, 1999), and has dimensions that appear continuously distributed in the population (Asmundson, Weeks, Carleton, Thibodeau, & Fetzner, 2011;Bernstein, Zvolensky, Norton et al., 2007;Bernstein, Zvolensky, Stewart, & Comeau, 2007). FNE is the hallmark logical reduction of social anxiety and accounts for variance in the higher-order construct (e.g., Heimberg et al., 2010); furthermore, the latent structure of FNE and social anxiety appears continuous (Weeks, Carleton, Asmundson, McCabe, & Antony, 2010;Weeks, Norton, & Heimberg, 2009). ...
Article
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The current review and synthesis was designed to provocatively develop and evaluate the proposition that “fear of the unknown may be a, or possibly the, fundamental fear” (Carleton, 2016) underlying anxiety and therein neuroticism. Identifying fundamental transdiagnostic elements is a priority for clinical theory and practice. Historical criteria for identifying fundamental components of anxiety are described and revised criteria are offered. The revised criteria are based on logical rhetorical arguments using a constituent reductionist postpositivist approach supported by the available empirical data. The revised criteria are then used to assess several fears posited as fundamental, including fear of the unknown. The review and synthesis concludes with brief recommendations for future theoretical discourse as well as clinical and non-clinical research.
... Other studies have offered support for a 4-factor model with a single higher order factor (Adornetto et al. 2008;Silverman et al. 2003) ( Table 1). These results were confirmed by Bernstein et al. (2007) using a taxometric approach, where it was found that the 4-factor model fits well when examining the normative form of anxiety sensitivity but that a unidimensional structure held better for more extreme forms , 4, 6, 7, 8, 9, 10, 11, 13, 14, 16, 18 3, 4, 6, 7, 8, 9, 10, 13, 14, 18 1, 5, 17 2, 11, 12, 15, 16 Silverman et al. (1999) Nonclinical sample: N=249 Social concerns Mental incapacitation concerns Control CASI 3 , 6, 9, 11, 14, 16, 18 1, 17 2, 12, 13, 15 4, 5, 7, 8, 10 Silverman et al. (2003) 3, 4, 6, 7, 8, 9, 10, 11, 13, 14, 16, 18 1, 5, 17 2, 12, 15 of anxiety sensitivity. Finally, across these existing studies, the identified factors (e.g. ...
Article
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Anxiety sensitivity (AS) refers to a person’s tendency to fear anxiety-related symptoms due to the belief that they have harmful consequences. The Childhood Anxiety Sensitivity Index (CASI) is a well accepted operationalization of the AS construct in children and adolescents. This study evaluated the factor structure, gender stability and psychometric properties of the CASI, modified to a 5-point scale, in a sample of Croatian children and adolescents (N = 1,679). Exploratory and confirmatory analysis and a Schmid-Leiman solution confirmed the multidimensional and hierarchical structure of the CASI, which consisted of three lower-order factors and a single higher-order factor. Further, the modification of the CASI to a 5-point scale resulted in higher reliability, while maintaining acceptable levels of factor stability and validity.
... However, earlier analyses did suggest that OC and AS symptoms were more consistent with categorical models that propose qualitatively distinct, criterion level symptoms. These inconsistent findings have been attributed to differences in the application of statistical tests and in the samples used (Bernstein et al., 2006;Bernstein Zvolensky, Stewart & Comeau, 2007;Kyrios, McKay, & Taylor, 2005;. As this issue has not been resolved, research from both the dimensional and categorical perspectives continue to merit investigation. ...
... In contrast, among the reducednormative AS group, greater continuous levels of AS physical and psychological concerns were predictive of decreased risk for relapse (i.e., increased probability of staying quit); this effect neared, but did not reach, statistical significance. These findings are generally consistent with the dimensional component of the AS taxonic-dimensional hypothesis ( Bernstein et al., 2010;Bernstein, Zvolensky, Stewart, & Comeau, 2007). Although the latter findings were unexpected, they are consistent with the perspective that it may be important to discriminate between the latent forms of AS because greater levels of the normative form of AS may be adaptive, whereas greater continuous individual differences in levels of AS among the high-AS taxon class may confer vulnerability . ...
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This study evaluated the associations between change in anxiety sensitivity (AS; fear of the negative consequences of anxiety and related sensations) and lapse and relapse during a 4-week group NRT-aided cognitive-behavioral Tobacco Intervention Program. Participants were 67 (44 women; M (age) = 46.2 years, SD = 10.4) adult daily smokers. Results indicated that participants who maintained high levels of AS from pretreatment to 1 month posttreatment, compared to those who demonstrated a significant reduction in AS levels during this time period, showed a significantly increased risk for lapse and relapse. Further inspection indicated that higher continuous levels of AS physical and psychological concerns, specifically among those participants who maintained elevated levels of AS from pre- to posttreatment, predicted significantly greater risk for relapse. Findings are discussed with respect to better understanding change in AS, grounded in an emergent taxonic-dimensional factor mixture model of the construct, with respect to lapse and relapse during smoking cessation.
... However, earlier analyses did suggest that OC and AS symptoms were more consistent with categorical models that propose qualitatively distinct, criterion level symptoms. These inconsistent findings have been attributed to differences in the application of statistical tests and in the samples used (Bernstein et al., 2006;Bernstein Zvolensky, Stewart & Comeau, 2007;Kyrios, McKay, & Taylor, 2005;. As this issue has not been resolved, research from both the dimensional and categorical perspectives continue to merit investigation. ...
Article
In the context of the integrative model of anxiety and depression, we examined whether the essential problem of hypochondriasis is one of anxiety. When analyzed, data from a large nonclinical sample corresponded to the integrative model's characterization of anxiety as composed of both broad, shared and specific, unique symptom factors. The unique hypochondriasis, obsessive-compulsive, and panic attack symptom factors all had correlational patterns expected of anxiety with the shared, broad factors of negative emotionality and positive emotionality. A confirmatory factor analysis showed a higher-order, bifactor model was the best fit to our data; the shared and the unique hypochondriasis and anxiety symptom factors both contributed substantial variance. This study provides refinements to an empirically based taxonomy and clarifies what hypochondriasis is and, importantly, what it is not.
... Meehl and his colleagues developed several data-analytic procedures to assist them in identifying the latent structure of constructs, to include mean above minus below a cut (MAMBAC; Meehl & Yonce, 1994), maximum covariance (MAXCOV; Meehl & Yonce, 1996), and latent-mode factor analysis (L-Mode; Waller & Meehl, 1998). The taxometric method has been used to assess the latent structure of unipolar depression (Solomon, Ruscio, Seeley, & Lewisohn, 2006), anxiety sensitivity (Bernstein, Zvolensky, Stewart, & Comeau, 2007), nicotine addiction (Goedeker & Tiffany, 2008), alcohol dependence (Walters, 2008), borderline personality disorder (Edens, Marcus, & Ruiz, 2008), and feigned psychopathology (Walters et al., 2008), among other topics. ...
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The purpose of this study was to determine whether the latent structure of childhood aggression, like the latent structure of adult antisocial behavior, is dimensional. One thousand and five Israeli schoolchildren completed a translation of the Buss-Perry Aggression Questionnaire (AQ; Buss & Perry, 1992) and were rated by their homeroom teachers on the Eyberg Child Behavior Inventory (ECBI; Robinson, Eyberg, & Ross, 1980). The AQ Physical Aggression and Verbal Aggression scales were combined to form the 1st indicator, the AQ Anger and Hostility scales were combined to form the 2nd indicator, the 10-item ECBI Oppositional Defiant Behavior Toward Adults scale composed the 3rd indicator, and the 8-item ECBI Conduct Problem Behavior scale composed the 4th indicator. Subjecting these indicators to taxometric analysis revealed consistent support for dimensional latent structure in the full sample as well as in 5 of the 6 subsamples. Childhood aggression, it would seem, differs quantitatively along a dimension (degree of aggression) rather than bifurcating into qualitatively distinct categories (aggressive vs. nonaggressive).
... Although some taxometric research suggests that the underlying structure of AS may be dimensional (Broman-Fulks et al., in press; BromanFulks et al., 2008), other studies suggest that discrete maladaptative and adaptive latent classes may underlie AS (Bernstein et al., 2006;). If the structure of AS were, in fact, taxonic, then based on previous research, we expect that 80 to 90 percent of our young, non-clinical sample would fall into the complement (e.g., adaptive) class (Bernstein, Zvolensky, Stewart, & Comeau, 2007). Thus, while including participants in both AS taxon and complement classes may have attenuated our current results, we would not have had enough participants in the taxon class to power (or estimate parameters in) analyses examining the relationship between the taxonic form of AS and a hierarchical structure of mood and anxiety symptoms. ...
Article
A large body of research suggests that common and specific psychopathology dimensions underlie the symptoms that occur within mood and anxiety disorders. As of yet, it is unclear precisely how the facets of Anxiety Sensitivity (AS), or fear of the symptoms of fear and anxiety, relate to these latent factors. Using data from 606 adolescents participating in the baseline phase of a longitudinal study on risk factors for emotional disorders, we modeled the facets of AS as measured by the Anxiety Sensitivity Index-Expanded Form (ASI-X) and related these facets to a hierarchical model of latent symptoms of psychological distress. Results suggest that one facet of AS is associated with a broad General Distress factor underlying symptoms of most emotional disorders while others relate to intermediate-level and conceptually-meaningful narrow factors representing aspects of psychological distress specific to particular emotional disorders.
... To help ensure that further theoretical development of AS validly reflects its latent structure and so is maximally clinically meaningful, both latent qualitative variability observed in taxometric research and quantitative variability observed in factor analytical research should be empirically and theoretically considered [32,36]. Two recent efforts have attempted to do so by sequentially applying taxometric and then confirmatory and exploratory factor analyses to the same data among youths [37] and adults [38]. In summary, these studies found that: AS is taxonic; the well-established hierarchical, multidimensional factor structure of AS fits the low-risk form of AS but not the AS taxon or high-risk form; and the AS taxon demonstrates a unique, previously undocumented latent continuous factor structure. ...
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Taxometric procedures have been used extensively to investigate whether individual differences in personality and psychopathology are latently dimensional or categorical (‘taxonic’). We report the first meta-analysis of taxometric research, examining 317 findings drawn from 183 articles that employed an index of the comparative fit of observed data to dimensional and taxonic data simulations. Findings supporting dimensional models outnumbered those supporting taxonic models five to one. There were systematic differences among 17 construct domains in support for the two models, but psychopathology was no more likely to generate taxonic findings than normal variation (i.e. individual differences in personality, response styles, gender, and sexuality). No content domain showed aggregate support for the taxonic model. Six variables – alcohol use disorder, intermittent explosive disorder, problem gambling, autism, suicide risk, and pedophilia – emerged as the most plausible taxon candidates based on a preponderance of independently replicated findings. We also compared the 317 meta-analyzed findings to 185 additional taxometric findings from 96 articles that did not employ the comparative fit index. Studies that used the index were 4.88 times more likely to generate dimensional findings than those that did not after controlling for construct domain, implying that many taxonic findings obtained before the popularization of simulation-based techniques are spurious. The meta-analytic findings support the conclusion that the great majority of psychological differences between people are latently continuous, and that psychopathology is no exception.
Article
Objective The default assumption among most psychologists is that personality varies along a set of underlying dimensions, but belief in the existence of discrete personality types persists in some quarters. Taxometric methods were developed to adjudicate between these alternative dimensional and typological models of the latent structure of individual differences. The aim of the present review was to assess the taxometric evidence for the existence of personality types. Method A comprehensive review yielded 102 articles reporting 194 taxometric findings for a wide assortment of personality attributes. Results Structural conclusions differed strikingly as a function of methodology. Primarily older studies that did not assess the fit of observed data to simulated dimensional and typological comparison data drew typological conclusions in 65.2% (60/92) of findings. Primarily newer studies employing simulated comparison data supported the typological model in only 3.9% (4/102) of findings, and these findings were largely in the domain of sexual orientation rather than personality in the traditional sense. Conclusions In view of strong Monte Carlo evidence for the validity of the simulated comparison data method, it is highly likely that personality types are exceedingly scarce or non‐existent, and that many early taxometric research findings claiming evidence for such types are spurious.
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Anxiety sensitivity (AS; fear of anxiety‐related symptoms) is an established transdiagnostic risk factor for psychiatric disorders and is related to a variety of chronic medical conditions. However, AS has not been established as a risk factor for chronic medical conditions. In this study, we review studies on AS and chronic medical conditions (and symptoms/behaviors related to chronic medical conditions) and propose four pathways through which AS may increase risk of chronic medical conditions: (a) increasing fear of medical condition‐specific symptoms, (b) perpetuating avoidance of healthy activities, (c) promoting engagement in unhealthy behaviors, and (d) increasing risk of detrimental pathophysiological and pathomechanical alterations. We also discuss the potential utility of using AS reduction interventions as a means of reducing risk of chronic medical conditions.
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Anxiety Sensitivity (AS) has been defined as a fear of anxiety arising from beliefs that symptoms of anxiety have harmful somatic, psychological, and social consequences (Reiss & McNally, 1985). Upon noticing symptoms of anxiety or fear, individuals with high levels of AS interpret these symptoms catastrophically. This has been theorized to lead to increased state anxiety and fear in the short run and an increased risk for mood and anxiety disorders in the long run. Indeed, a growing body of research suggests that AS not only predicts the development of panic symptoms but also relates to a broad range of emotional disorders and symptoms (Lewis et al., 2010; Olatunji&Wolitzky-Taylor, 2009). In this chapter, we review research on the latent structure of AS, its relationship to emotional disorders, and its relationship to other aspects of personality. In doing so, we highlight gaps in the research literature and suggest directions for future study.
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Where the Evidence is Strong: “Coping Cat” and its Derivatives Other Psychosocial Treatments for “Emotional Disorders” of Childhood Interventions for Individual Disorders or Conditions Using Empirically Supported Treatments in Community Settings Conclusions Summary of Key Points
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Anxiety sensitivity (AS) is a cognitive individual difference actor involving an enduring fear of anxiety-related arousal sensations (e.g., increased heart rate) that arises from the tendency to catastrophize about these sensations, believing they will have serious psychological, physiological, and/or social consequences. AS may have particular relevance for adolescents as the onset of puberty heralds the arrival of a wide range of new and unexpected bodily sensations, as well as changes in cognitive and social development. Research has implicated AS in the development and maintenance of a number of mental health disorders in adolescents including panic disorder, social phobia, posttraumatic stress disorder, chronic pain, substance misuse, and depression. Furthermore, AS has been shown to be composed of several lower-order factors (e.g., Physical, Social, and Psychological Concerns), which may have unique associations with psychopathology. Understanding AS will help in the identification of youth at risk for mental health problems and might have implications for prevention and intervention.
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Anxiety sensitivity (AS) is a multidimensional construct composed of several lower order factors and has been implicated in the development and maintenance of anxiety and depression symptoms and disorders. Recently, it has been suggested that AS is a dimensional-categorical construct, reflecting classes of individuals with different levels of and relations between AS factors. Factor mixture modeling was applied to examine the latent structure of AS in a sample of 1,151 college students (M age = 18.88, SD = 1.91). Results indicated that the best fitting model comprised three classes consisting of individuals with normative AS (n = 953), moderate AS (n = 124), and high AS (n = 74). Relations among the factors appeared to be different across groups, with the highest relations found in the normative AS class and the lowest relations found in the high AS class. There were significant differences in mean levels of anxiety and depression symptoms across classes, with the exception of social anxiety disorder symptoms. This study was the first to find and provide support for a third AS class. Implications for research and clinical utility are discussed, including the benefit of developing cut scores for AS classes based on this and similar studies. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
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Anxiety sensitivity has been implicated as an important risk factor, generalizable to most anxiety disorders. In adults, factor mixture modeling has been used to demonstrate that anxiety sensitivity is best conceptualized as categorical between individuals. That is, whereas most adults appear to possess normative levels of anxiety sensitivity, a small subset of the population appears to possess abnormally high levels of anxiety sensitivity. Further, those in the high anxiety sensitivity group are at increased risk of having high levels of anxiety and of having an anxiety disorder. This study was designed to determine whether these findings extend to adolescents. Factor mixture modeling was used to examine the best fitting model of anxiety sensitivity in a sample of 277 adolescents (M age = 11.0 years, SD = 0.81). Consistent with research in adults, the best fitting model consisted of 2 classes, 1 containing adolescents with high levels of anxiety sensitivity (n = 25) and another containing adolescents with normative levels of anxiety sensitivity (n = 252). Examination of anxiety sensitivity subscales revealed that the social concerns subscale was not important for classification of individuals. Convergent and discriminant validity of anxiety sensitivity classes were found in that membership in the high anxiety sensitivity class was associated with higher mean levels of anxiety symptoms, controlling for depression and externalizing problems, and was not associated with higher mean levels of depression or externalizing symptoms controlling for anxiety problems. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
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Because of the traditional BP neural network's limitation, including easily falling into local minimum, slow convergence and iteration for a long time, we propose a diagnostic system of mental disorders based on Levenberg-Marquardt algorithm. This article illustrates the basic principles of the neural network algorithm and establishes a mental diagnosis model based on L-M algorithm which uses common mental illness among college students as subjects. The outcome of the simulation illustrates the fact that it is effective to apply the neural network to establish a mental diagnostic system because it has reduced the training iterations and training period and it has high accuracy as well.
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The aim of the present study was to evaluate a factor mixture-based taxonic-dimensional model of anxiety sensitivity (AS) (Bernstein et al. Behavior Therapy 41:515-521, 2010), as measured by the ASI-3 (Taylor et al. Psychological Assessment 19:176-188, 2007), in regard to panic attacks, anxiety symptoms, and behavioral impairment among a university sample (N = 150, n females = 107, M age = 21.3 years, SD = 4.3) and a clinical sample (N = 150, n females = 102, M age = 39.0 years, SD = 12.0) from Mexico City, Mexico. Findings demonstrated cross-national support for the conceptual and operational utility of the AS taxonic-dimensional hypothesis (Bernstein et al. Journal of Anxiety Disorders 20:1-22, 2007b). Specifically, (1) the FMM-based AS taxon class base rate was significantly greater among the clinical relative to the university sample; (2) risk for panic attacks was significantly greater among the AS taxon class relative to the AS normative class; and (3) continuous individual differences in AS physical and psychological concerns, within the AS taxon class, were associated with level of risk for panic attacks, as well as panic attack severity and anxiety symptom levels. Similar AS taxonic-dimensional effects were observed in relation to degree of behavioral impairment across domains of functioning. The study results are discussed with respect to their implications for better understanding the nature of AS-related cognitive vulnerability for panic and related anxiety psychopathology.
Article
BACKGROUND: The purpose of the present study was to shed light on the latent structure and nature of individual differences in anxiety sensitivity (AS) and related risk for psychopathology. METHODS: The present study evaluated the latent structure of AS using factor mixture modeling (FMM; Lubke and Muthén, 2005) and tested the relations between the observed FMM-based model of AS and psychopathology in a large, diverse adult clinical research sample (N=481; 57.6% women; M(SD)(age)=36.6(15.0) years). RESULTS: Findings showed that a two-class three-factor partially invariant model of AS demonstrated significantly better fit than a one-class dimensional model and more complex multi-class models. As predicted, risk conferred by AS taxonicity was specific to anxiety psychopathology, and not to other forms of psychopathology. LIMITATIONS: The sample was not epidemiologic, self-report and psychiatric interview data were used to index AS and psychopathology, and a cross-sectional design limited inference regarding the directionality of observed relations between AS and anxiety psychopathology. CONCLUSIONS: Findings are discussed with respect to the nature of AS and related anxiety psychopathology vulnerability specifically, as well as the implications of factor mixture modeling for advancing taxonomy of vulnerability and psychopathology more broadly.
Article
This article provides an introduction to the articles featured in the current issue of Behavior Therapy. Overall, this series of articles highlights the importance of addressing affect intolerance, emotional sensitivity, and emotion regulation in psychopathology and the public health importance of cultivating systematic work in this domain. As the special issue helps illustrate, such work will likely have the greatest impact when it is conducted with explicit attention to theoretical processes and mechanisms of action and proceeds in a manner that includes both a basic and applied (integrative) conceptual focus. The present series of papers help to indicate that the time is indeed ripe to proceed with work in this domain in a more integrated manner and to translate such knowledge into novel clinical strategies for individuals in need. Together, there is robust evidence that behaviorally oriented researchers are at the forefront of investigations into the nature of tolerance, sensitivity, and regulatory processes and their respective roles in various forms of psychopathology, and moreover, are increasingly well-poised to marshal such work toward more powerful next-generation prevention and treatment protocols. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Chapter
The diagnosis of anxiety disorders in children and adolescents is associated with several problems including high comorbidity and low clinical utility of diagnostic categories. This chapter will begin by outlining the weaknesses of the current categorical diagnostic system and reviewing the history and evidence for taking a dimensional approach to the diagnosis of anxiety disorders in children and adolescents. The problem of the high comorbidity of anxiety and depression in youth will be discussed, followed by a review of several quantitative structural models which have been proposed to differentiate between the shared and specific components of anxiety and depression. Based on the research indicating that anxiety disorders are best classified as highly correlated symptom clusters comprising internalizing syndromes, approaches to assessment and diagnosis will be covered in the last section of this chapter. Tools that have been validated to measure anxiety and depression dimensionally in youth will be presented, as well as measurement of narrow traits that have been found to put children and adolescents at risk for the development of pathological anxiety. Finally, we will discuss the need to move toward a system of classification that corresponds more directly to effective interventions for anxiety disorders in youth.
Article
The aim of this study was to evaluate the associations between a factor mixture-based taxonic-dimensional model of anxiety sensitivity (AS) and posttraumatic stress, panic, generalized anxiety, depression, psychiatric multimorbidity, and quality of life among a young adult sample exposed to traumatic stress (N = 103, n (females) = 66, M (age) = 23.68 years, SD (age) = 9.55). Findings showed support for the conceptual and operational utility of the AS taxonic-dimensional model with respect to concurrent transdiagnostic vulnerability among trauma-exposed adults. Specifically, relative to the low-AS group, the high-AS group demonstrated elevated levels of panic, depressive, and posttraumatic stress symptom severity as well as greater psychiatric multimorbidity and poorer quality of life. Furthermore, past-month MDD, GAD, PTSD, and panic attacks occurred nearly exclusively among the high-AS group. Continuous AS physical and psychological concerns scores were found to be significantly related to levels of panic and posttraumatic stress symptom severity, psychiatric multimorbidity as well as panic attack status only among the high-AS group and not among the low-AS group. Findings are discussed with respect to their implications for the conceptual and operational utility of the FMM-based taxonic-dimensional model of AS, related vulnerability for psychopathology in the context of trauma, and the clinical implications of these findings for assessment and intervention.
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Taxometric research methods were developed by Paul Meehl and colleagues to distinguish between categorical and dimensional models of latent variables. We have conducted a comprehensive review of published taxometric research that included 177 articles, 311 distinct findings and a combined sample of 533 377 participants. Multilevel logistic regression analyses have examined the methodological and substantive variables associated with taxonic (categorical) findings. Although 38.9% of findings were taxonic, these findings were much less frequent in more recent and methodologically stronger studies, and in those reporting comparative fit indices based on simulated comparison data. When these and other possible confounds were statistically controlled, the true prevalence of taxonic findings was estimated at 14%. The domains of normal personality, mood disorders, anxiety disorders, eating disorders, externalizing disorders, and personality disorders (PDs) other than schizotypal yielded little persuasive evidence of taxa. Promising but still not definitive evidence of psychological taxa was confined to the domains of schizotypy, substance use disorders and autism. This review indicates that most latent variables of interest to psychiatrists and personality and clinical psychologists are dimensional, and that many influential taxonic findings of early taxometric research are likely to be spurious.
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Anxiety sensitivity (AS) refers to a person’s tendency to fear anxiety-related symptoms due to the belief that these symptoms may have harmful consequences. The most widely used operationalization of AS in adults is the Anxiety Sensitivity Index (ASI). The factor structure, gender stability, and psychometric properties of the ASI in a sample of Croatian adults (N = 984) were evaluated. Results confirm the multidimensional and hierarchical structure of the ASI, which consisted of three lower-order factors (Physical Concerns, Psychological Concerns, and Social Concerns) and a single higher-order factor, AS. Furthermore, the achievement of normative scores for the ASI in a Croatian adult sample demonstrates the cross-national stability of the ASI. Reliability coefficients for the ASI, Physical Concerns, and Psychological Concerns are high and satisfactory in the total sample and for both genders. Overall, the results confirmed the cross-national stability, gender stability, reliability, and validity of the ASI in a sample of Croatian adults.
Article
The current study assessed the incremental prediction of anxiety sensitivity (AS) in both taxonic (categorical) and dimensional representations at various time points before and after a single vital capacity inhalation of a 35% CO(2), 65% balanced O(2) gas mixture. Participants were 128 young adults screened for a history of panic attacks. By controlling for traitwise factors including state anxiety and testing both categorical and continuous conceptualizations of the AS construct at various timepoints, the present report was able to evaluate the temporal and structural dynamics of AS in relation to fearful responding to the challenge. Relevant variables were evaluated in a hierarchical linear regression framework, and it was found that a continuous conceptualization of AS provided incremental predictive validity above and beyond trait anxiety immediately post-challenge, while a categorical representation of AS was equivalent to a continuous model of AS at post-challenge but outperformed a continuous model at follow-up. These data provide basic but important evidence suggesting that AS is uniquely associated with anxious responding to a 35% CO(2) challenge, and that categorical representations of AS should be considered in biological challenge studies.
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There has been significant interest in the role of anxiety sensitivity (AS) in the anxiety disorders. In this meta-analysis, we empirically evaluate differences in AS between anxiety disorders, mood disorders, and nonclinical controls. A total of 38 published studies (N = 20,146) were included in the analysis. The results yielded a large effect size indicating greater AS among anxiety disorder patients versus nonclinical controls (d = 1.61). However, this effect was maintained only for panic disorder patients compared to mood disorder patients (d = 0.85). Panic disorder was also associated with greater AS compared to other anxiety disorders except for posttraumatic stress disorder (d = 0.04). Otherwise the anxiety disorders generally did not differ from each other in AS. Although these findings suggest that AS is central to the phenomenology of panic disorder and posttraumatic stress disorder, causal inferences regarding the role of AS in these anxiety disorders cannot be made. Moderator analyses showed that a greater proportion of female participants was associated with larger differences in AS between anxiety and nonclinical control groups. However, more female participants were associated with a smaller AS difference between anxiety and mood disorder groups. This finding suggests that AS is less robust in distinguishing anxiety from mood disorders among women. Age also moderated some observed effects such that AS was more strongly associated with anxiety disorders in adults compared to children. Type of AS measure used also moderated some effects. Implications of these findings for the conceptualization of AS in anxiety-related disorders are discussed.
Article
This study examined the factor structure, reliability, and validity of the German translation of the Childhood Anxiety Sensitivity Index (CASI). A total of 1292 adolescents participated in the study. Analyses using the Schmid-Leiman solution showed the CASI to have one higher order factor and three orthogonal lower order factors. CASI scores correlated significantly with anxiety symptoms and with general difficulties. Hierarchical multiple regression showed CASI to make a significant contribution in predicting anxiety even after controlling for variance due to general difficulties, thus giving further support to the incremental validity of the CASI. The CASI is a potentially useful measure to include in longitudinal studies that examine the development of childhood and adolescent anxiety disorders.
Article
The current study evaluated a novel latent structural model of anxiety sensitivity (AS) in relation to panic vulnerability among a sample of young adults (N=216). AS was measured using the 16-item Anxiety Sensitivity Index (ASI; Reiss, Peterson, Gursky, & McNally, 1986), and panic vulnerability was indexed by panic attack responding to a single administration of a 4-minute, 10% CO(2) challenge. As predicted, vulnerability for panic attack responding to biological challenge was associated with dichotomous individual differences between taxonic AS classes and continuous within-taxon class individual differences in AS physical concerns. Findings supported the AS taxonic-dimensional hypothesis of AS latent structure and panic vulnerability. These findings are discussed in terms of their theoretical and clinical implications.
Article
The present study meta-analytically reviewed the efficacy of cognitive-behavioral therapy (CBT) vs. control conditions in the reduction of anxiety sensitivity. A computerized search was conducted to identify CBT outcome studies that included the Anxiety Sensitivity Index as a dependent variable. Of the 989 studies that were identified, 24 randomized-controlled trials with a total of 1851 participants met inclusion criteria and were included in the analysis. Data were extracted separately for treatment-seeking (16 studies) and at-risk (eight studies) samples. Results indicated large effect sizes for treatment-seeking samples, Hedges' g=1.40, SE=0.21, 95% CI: 1.00-1.81, p<0.001, and moderate to large effect sizes for at risk samples Hedges' g=0.74, SE=0.18, 95% CI: 0.39-1.08, p<0.001. Additionally, both the amount of therapist contact and control modality (waitlist vs. psychological control) moderated the effect sizes for treatment-seeking samples. Our review indicates that CBT is efficacious in reducing anxiety sensitivity. However, more research is needed to determine the mechanisms by which CBT exert its effects on anxiety sensitivity.
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Two studies were designed to establish whether high anxiety sensitive (AS) university students selectively process threat cues pertaining to their feared catastrophic consequences of anxiety, and to examine potential gender differences in the selective processing of such threat cues among high versus low AS subjects. Forty students (20 M; 20 F) participated in Study 1. Half were high AS and half low AS, according to scores on the Anxiety Sensitivity Index (ASI). Subjects completed a computerised Stroop colournaming task involving social/psychological threat (e.g. EMBARRASS; CRAZY), physical threat (e.g. CORONARY; SUFFOCATED), and neutral (e.g. MOTEL; TOWEL) target words. High AS subjects demonstrated more threat-related interference in colour-naming than did low AS subjects, overall. High AS menevidencedgreater interference relative to low AS men only for the social/psychological threat stimuli; highAS women evidencedgreater interference relative to low AS women only for the physical threat stimuli. Study 2 was designed to replicate and extend the novel Study 1 finding of a cognitive bias favouring the processing of social/psychological threat cues among high AS men. Participants were 20 male university students (10 high AS; 10 low AS). In addition to social/psychological threat, physical threat, and neutral words, a category of positive emotional words (e.g. HAPPINESS; CELEBRATION) was included as a supplementary control on the Stroop. Consistent with Study 1, high AS males evidenced greater Stroop interference than did low AS males, but only for social/psychological threat words. No AS group differences in Stroop interference were revealed for the physical threat or positive words. Clinical implications, and potential theoretical explanations for the gender differences, are discussed.
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The present article sets forth the argument that psychological assessment should be based on a construct’s latent structure. The authors differentiate dimensional (continuous) and taxonic (categorical) structures at the latent and manifest levels and describe the advantages of matching the assessment approach to the latent structure of a construct. A proper match will decrease measurement error, increase statistical power, clarify statistical relationships, and facilitate the location of an efficient cutting score when applicable. Thus, individuals will be placed along a continuum or assigned to classes more accurately. The authors briefly review the methods by which latent structure can be determined and outline a structure-based approach to assessment that builds on dimensional scaling models, such as item response theory, while incorporating classification methods as appropriate. Finally, the authors empirically demonstrate the utility of their approach and discuss its compatibility with traditional assessment methods and with computerized adaptive testing.
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Four taxometric procedures were applied to the self-report responses of 1,239 Ss who completed the Jenkins Activity Survey (JAS). All 4 procedures provided clear evidence for a latent class variable. A continuous model simulation that mimicked the item characteristics of the JAS correctly rejected the presence of a latent class variable. Using an external validation procedure, I reexamined 5 previously published studies to determine if the simple Type A–B dichotomy was as predictive of outcome measures as the use of continuous JAS scores. The presence of a latent class variable predicts no gain in predictive power in moving from a simple dichotomy to continuous scores. Across 5 studies, there was a slight decrease in the size of the relation between Type A-B and outcome for the continuous JAS scores relative to the simple Type A-B dichotomy. Taken together, these results suggest that the Type A-B distinction is based on a latent typology. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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The empirical literature on prevention programs for anxiety psychopathology is reviewed. Programs targeting the prevention of nonspecific anxiety psychopathology as well as specific anxiety disorders are critically evaluated in the context of the Institute of Medicine's conceptualization of universal, selected, and indicated prevention. General conclusions embedded within contemporary models of prevention are discussed in order to outline future directions for the area in terms of methodological and conceptual issues.
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The present study evaluated 2 interrelated hypotheses concerning the relation between specific anxiety sensitivity dimensions and how one responds to bodily sensations in a population with no known history of psychopathology (N = 214). Specifically, the Physical Concerns subscale of the Anxiety Sensitivity Index (ASI; S. Reiss, R. A. Peterson, M. Gursky, & R. J. McNally, 1986) was found to be uniquely and statistically predictive of bodily vigilance, whereas the Mental Incapacitation ASI subscale was predictive of emotional avoidance. These effects were above and beyond the variance accounted for by demographic variables, treatment history for common interoceptive medical conditions, subclinical panic attack history, and trait anxiety. We discuss these findings in relation to differential predictive validity conceptualizations of anxiety sensitivity, with implications for understanding models of health functioning and panic disorder.
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The present study evaluated the association between the lower-order facets of anxiety sensitivity construct (physical, mental incapacitation, and social concerns) and positive (expectancies about negative affect reduction) and negative (expectancies about negative personal consequences) smoking outcome expectancies. Participants were 90 young adult regular smokers [37 females; M age = 23.4 years (SD = 8.9); mean number of cigarettes/day = 11.7 (SD = 6.1)] with no history of psychopathology or nonclinical panic attacks recruited from the general population. Anxiety sensitivity physical concerns and mental incapacitation concerns, as indexed by the Anxiety Sensitivity Index (ASI; S. Reiss, R. A. Peterson, M. Gursky, & R. J. McNally, 1986), were significantly and incrementally associated with smoking outcome expectancies, as indexed by the Smoking Consequences Questionnaire (SCQ; T. H. Brandon & T. B. Baker, 1991), for negative affect reduction as well as negative personal consequences; the observed effects were over and above the variance accounted for by theoretically relevant smoking history characteristics, gender, and negative affectivity. Results are discussed in relation to better understanding motivational processes for smoking among groups at heightened risk for developing panic psychopathology.
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The present study examined the efficacy of an 8-wk, cognitive-behavioral group treatment for panic disorder. Patients meeting DSM-III-R criteria for panic disorder with or without agoraphobia were randomly assigned to treatment (N = 34) or delayed treatment control (N = 33). The treatment consisted of: (a) education and corrective information; (b) cognitive therapy; (c) training in diaphragmatic breathing; and (d) interoceptive exposure. At posttreatment, 85% of treated Ss were panic free, compared to 30% of controls. Treated Ss also showed clinically significant improvement on indices of anxiety, agoraphobia, depression and fear of fear. Recovery, as estimated conservatively by the attainment of normal levels of functioning on each of the major clinical dimensions of the disorder (i.e. panic, anxiety and avoidance), was achieved in 64% of the treated Ss and 9% of the controls. At the 6 month follow-up, 63% of the treated patients met criteria for recovery. These findings mirror those from recently-completed trials of individually-administered cognitive-behavioral treatment, and suggest that CBT is a viable alternative to pharmacotherapy in the treatment of panic disorder.
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Increasing evidence suggests that anxiety sensitivity (AS) may be a premorbid risk factor for the development of anxiety pathology. The principal aim of this study was to replicate and extend a previous longitudinal study evaluating whether AS acts as a vulnerability factor in the pathogenesis of panic (N. Schmidt, D. Lerew, & R. Jackson, 1997). A large nonclinical sample of young adults (N = 1,296) was prospectively followed over a 5-week, highly stressful period of time (i.e., military basic training). Consistent with the authors' initial study, AS predicted the development of spontaneous panic attacks after controlling for a history of panic attacks and trait anxiety, and AS was found to possess symptom specificity with respect to anxiety versus depression symptoms. AS 1st-order factors differentially predicted panic attacks, with the Mental Concerns factor being the best predictor of panic in this sample.
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Several theories of the development of panic disorder (PD) with or without agoraphobia have emerged in the last 2 decades. Early theories that proposed a role for classical conditioning were criticized on several grounds. However, each criticism can be met and rejected when one considers current perspectives on conditioning and associative learning. The authors propose that PD develops because exposure to panic attacks causes the conditioning of anxiety (and sometimes panic) to exteroceptive and interoceptive cues. This process is reflected in a variety of cognitive and behavioral phenomena but fundamentally involves emotional learning that is best accounted for by conditioning principles. Anxiety, an anticipatory emotional state that functions to prepare the individual for the next panic, is different from panic, an emotional state designed to deal with a traumatic event that is already in progress. However, the presence of conditioned anxiety potentiates the next panic, which begins the individual's spiral into PD. Several biological and psychological factors create vulnerabilities by influencing the individual's susceptibility to conditioning. The relationship between the present view and other views, particularly those that emphasize the role of catastrophic misinterpretation of somatic sensations, is discussed.
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To examine adolescents' peer crowd affiliation and its linkages with health-risk behaviors, their friends' health-risk behaviors, the presence of close friends in the same peer crowd, and adolescents' social acceptance. We interviewed 250 high school students and identified six categories: popular, jocks, brains, burnouts, nonconformists, or average/other. Adolescents also reported on their health-risk behaviors (including use of cigarettes, alcohol, marijuana and other drugs; risky sexual behaviors; and other risk-taking behaviors), the health-risk behaviors of their friends, the peer crowd affiliation of their closest friends, and their perceived social acceptance. Burnouts and nonconformists had the highest levels of health-risk behaviors across the areas assessed, the greatest proportions of close friends who engaged in similar behaviors, and relatively low social acceptance from peers. Brains and their friends engaged in extremely low levels of health-risk behaviors. Jocks and populars also showed evidence of selected areas of health risk; these teens also were more socially accepted than others. In general, adolescents' closest friends were highly nested within the same peer crowds. The findings further our understanding of adolescent behaviors that put them at risk for serious adult onset conditions associated with high rates of morbidity and mortality. We discuss the implications of the findings for developing health promotion efforts for adolescents.
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The purposes of this 9-year, prospective longitudinal study were (a) to investigate hypothesized reciprocal growth in negative emotions between parents and adolescents and (b) to examine the influence of this reciprocal process on the development of social relationships during early adulthood. The results showed that both parents' and adolescents' initial levels of negative emotion toward each other predicted the rate of growth and rate of change in growth of expressed negative affect. In addition, the analyses indicated that an adolescent's enmeshment in reciprocal negativity in the family of origin carried over into early adult social relationships. The findings demonstrate the reciprocal nature of negative affect in interactions between parents and adolescents and suggest that family experience with this interactional style may have an adverse influence on the development of early adult social relationships.
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Examined the reliability, validity, and factor structure of the Childhood Anxiety Sensitivity Index (CASI; Silverman, Fleisig, Rabian, & Peterson, 1991) in a Dutch sample. Five hundred forty-four Dutch schoolchildren between 8 and 16 years of age completed Dutch translations of the CASI; the State-Trait Anxiety Inventory for Children (Spielberger, Edwards, Lushene, Montuori, & Platzek, 1973); and the Fear Survey Schedule for Children-Revised (Ollendick, 1983). The Dutch CASI was found to have adequate internal consistency for use with children as well as adolescents. Results reveal that the CASI predicted fear beyond a measure of trait anxiety in this Dutch sample. Both exploratory and confirmatory factor analyses comparing different models were undertaken. The model with 3 first-order factors found in previous studies showed an acceptable fit in this cross-validation sample. Loadings on the 3 factors (Physical Concerns, Mental Concerns, and Publicly Observable Concerns) did not differ between children and adolescents. Results are compared with previous research on the CASI. Directions for future research are discussed.
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The present study tested the hypothesis that limited ability to tolerate physical and psychological distress is associated with early relapse from smoking cessation. Specifically, the authors exposed 16 current smokers who had failed to sustain any previous quit attempt for more than 24 hr (immediate relapsers) and 16 smokers with at least 1 sustained quit attempt of 3 months or longer (delayed relapsers) to psychological (mental arithmetic) and physical (carbon dioxide inhalation-breath holding) stressors. Relative to delayed relapsers, immediate relapsers were characterized by higher baseline levels of affective vulnerability, by greater levels of dysphoria and urge to smoke after 12 hr of nicotine deprivation, and by less task persistence on the stressors, suggesting that these may be risk factors for early lapse in the context of quitting smoking.
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Results of past factor analytic studies of the Childhood Anxiety Sensitivity Index and Anxiety Sensitivity Index were used to formulate hypotheses about factor models of anxiety sensitivity. Using a nonclinical sample of 767 children and adolescents and confirmatory factor analysis, hypothesized models with 2, 3, and 4 lower order factors (facets) were tested. Goodness-of-fit criteria indicated that a model with 4 facets fits these data well. Support was found for factorial invariance of the 4 facets across age and gender, using nonclinical and clinical samples. Results support a hierarchical factor model in that there was a strong general factor, explaining 71% of the variance. Findings are discussed in the context of anxiety sensitivity theory and research with children and adolescents.
Article
This chapter reviews the conceptual and empirical support for a dimensional classification of personality disorders, focusing in particular on the five-factor model (FFM). The authors discuss the advantages and disadvantages of the categorical and dimensional models of classification. They then discuss the empirical data that are relevant to the respective validity of these two perspectives, focusing on empirical support for the five-factor dimensional model. Although the dimensional FFM may be limited by lack of familiarity, it provides a particularly compelling alternative to the Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) categorical diagnoses. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Several theories of the development of panic disorder (PD) with or without agoraphobia have emerged in the last 2 decades. Early theories that proposed a role for classical conditioning were criticized on several grounds. However, each criticism can be met and rejected when one considers current perspectives on conditioning and associative learning. The authors propose that PD develops because exposure to panic attacks causes the conditioning of anxiety (and sometimes panic) to exteroceptive and interoceptive cues. This process is reflected in a variety of cognitive and behavioral phenomena but fundamentally involves emotional learning that is best accounted for by conditioning principles. Anxiety, an anticipatory emotional state that functions to prepare the individual for the next panic, is different from panic, an emotional state designed to deal with a traumatic event that is already in progress. However, the presence of conditioned anxiety potentiates the next panic, which begins the individual's spiral into PD. Several biological and psychological factors create vulnerabilities by influencing the individual's susceptibility to conditioning. The relationship between the present view and other views is discussed.
Article
Taxometric and biometric analyses were conducted on 2 North American samples to investigate the prevalence and biometric structure of pathological dissociation. Results indicated that approximately 3.3% of the general population belongs to a pathological dissociative taxon. A brief 8-item self-report scale called the DES-T can be used to calculate taxon membership probabilities in clinical and nonclinical samples of adults (a SAS scoring program is provided for this purpose). The genetic and environmental architecture of pathological dissociative symptoms was explored by conducting a biometric analysis on DES-T ratings from 280 identical and 148 fraternal twins. The findings suggest that approximately 45% of the observed variance on the DES-T can be attributed to shared environmental influences. The remaining variance is due to nonshared environmental influences.
Article
Anxiety sensitivity (AS) is the fear of anxiety-related sensations. According to Reiss’s (e.g., Reiss, 1991) expectancy theory, AS amplifies fear and anxiety reactions, and plays an important role in the etiology and maintenance of anxiety disorders, particularly panic disorder. Recent evidence suggests that AS has a hierarchical structure, consisting of multiple lower order factors, loading on a single higher order factor. If each factor corresponds to a discrete mechanism (Cattell, 1978), then the results suggest that AS arises from a hierarchic arrangement of mechanisms. A problem with previous studies is that they were based on the 16-item Anxiety Sensitivity Index, which may not contain enough items to reveal the type and number of lower order factors. Also, some of the original ASI items are too general to assess specific, lower order factors. Accordingly, we developed an expanded measure of AS—the ASI-R—which consists of 36 items with subscales assessing each of the major domains of AS suggested by previous studies. The ASI-R was completed by 155 psychiatric outpatients. Factor analyses indicated a four-factor hierarchical solution, consisting of four lower order factors, loading on a single higher factor. The lower order factors were: (1) fear of respiratory symptoms, (2) fear of publicly observable anxiety reactions, (3) fear of cardiovascular symptoms, and (4) fear of cognitive dyscontrol. Each factor was correlated with measures of anxiety and depression, and fear of cognitive dyscontrol was most highly correlated with depression, which is broadly consistent with previous research. At pretreatment, patients with panic disorder tended to scored highest on each of the factors, compared to patients with other anxiety disorders and those with nonanxiety disorders. These findings offer further evidence that Reiss’s expectancy theory would benefit from revision, to incorporate the notion of a hierarchic structure of AS.
Article
This study tested the utility of assessing anxiety sensitivity (AS) in children by investigating the long term stability and psychometric properties of a Catalan version of the Childhood Anxiety Childhood Anxiety Sensitivity Index (CASI, Silverman et al ., 1991, Journal of Clinical Child Psychology , 20 , 162-168) in a sample of 291 elementary-school children. The Catalan CASI demonstrated acceptable internal consistency and convergent validity estimates, similar to previous research with the English version. The measure also showed incremental validity in relation to other measures of anxiety and test-retest analyses suggested considerable three month and one-year stability in children's level of AS. Finally, a principal component analysis of the Catalan CASI yielded five lower-order factors grouped on a unique higher-order factor. The similarity of the findings to previous research on the CASI and on AS in English speaking children and adults is discussed and some suggestions for future investigations are presented.
Article
The present investigation evaluated the Anxiety Sensitivity (AS) taxon using the 16-item Anxiety Sensitivity Index (Reiss, Peterson, Gursky, & McNally, 1986) and its relation with two theoretically relevant cognitive processes associated with panic vulnerability: bodily vigilance and perceived uncontrollability over anxiety-related events. Taxometric analyses of 589 young adults indicated that the latent structure of AS was taxonic with an estimated base rate ranging between 13% and 14%. As predicted, an 8-item ASI Taxon Scale accounted for significant variance above and beyond that accounted for by the full-scale ASI total score in terms of bodily vigilance and perceived controllability of anxiety-related events. Moreover, after accounting for the variance explained by the full-scale ASI total score, the total score for the 8 ASI items not included in the ASI Taxon Scale was associated with significant variance in these same dependent measures, but it was in the opposite direction from that predicted by contemporary panic disorder theory. Dichotomous taxon membership accounted for significant variance above total ASI scores for bodily vigilance but not perceptions of control for anxiety-related events. These findings are discussed in terms of their theoretical implications for the study of AS and panic vulnerability.
Article
The purpose of this book is to begin the ambitious task of "true diagnostics," standing on the shoulders of taxometric theory, by reviewing taxometric studies, analyzing several large new data sets, and trusting in the future cooperation and enterprise of psychologists and others who read this book. The book begins with a review of the nature of classification procedures by highlighting some of its main problems and controversies. In chapter 2, the evolution of our current diagnostic system--the DSM--is discussed and the central argument is advanced. The authors suggest that for the DSM to continue to advance, we must begin to scientifically determine the underlying nature of these diagnostic entities through the use of procedures such as taxometrics. Chapter 3 offers a detailed analytic primer on the nature of taxometrics. The primer is written in a user-friendly manner so clinicians and others not familiar with the underlying mathematics associated with taxometrics can gain a full understanding of the importance and utility of these procedures. Chapter 4 is specifically focused on outlining a method by which taxometric procedures can be applied to diagnostic entities within the DSM. The final two chapters provide a review of the current taxometrics literature and the degree to which it has been applied to specific psychopathological entities (e.g., schizophrenia spectrum, anxiety, eating disorders). In summary, this book represents a "call to action" to revolutionize the diagnostic system. The point of this book is not that a diagnostic revolution has occurred; it is that it can and should occur and that, to a degree, it is occurring. Through this book, the authors hope to stimulate this enterprise by describing it, summarizing its initial progress, and contributing toward it. The enterprise, although difficult, is clearly feasible (within years not decades), if a core of psychological scientists join the fray. One of the main purposes of the book is to invite them to contribute to this cause. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Given 2 quantitative indicators of a conjectured latent taxon, a statistical function defined as the difference between the observed means for cases of one indicator (designated for the procedure as the "output" indicator) falling above and below a sliding cut on the other indicator (designated as the "input" indicator) indicates whether the latent structure is taxonic or nontaxonic ("factorial," "dimensional"). If it is taxonic, latent parameters (e.g., base rate, hit rates, complement and taxon means) can be estimated. Graphs can be inspectionally sorted with very high accuracy, even by laypersons. Mean Above Minus Below A Cut (MAMBAC) is one of a related family of taxometric procedures in P. E. Meehl's coherent cut kinetics method. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Diathesis-stress models have long been cited in conceptualizations of the etiology of clinical disorders (Meehl, 1962; Rosenthal, 1970). These models suggest that specific types of psychopathology arise from a combination of vulnerability factors (diatheses) and life stress (Fowles, 1992). Despite an accumulating body of evidence demonstrating that specific diatheses, in the context of life stress, predict depressive symptomatology (Metalsky, Joiner, Hardin, and Abramson, 1993; Satterfield, Folkman, and Acree, 2002), few attempts have been made to directly test diathesis-stress models of anxiety disorders. Recent research, however, has indicated anxiety sensitivity (AS), defined as the fear of bodily sensations, interacts with life stress to predict panic-related problems (Zvolensky, Kotov, Antipova, and Schmidt, in press; Zvolensky and Schmidt, 2003). Although promising, extant panic-relevant diathesis-stress research has not addressed recently emerging taxometric research indicating that AS may be characterized by an underlying qualitative discontinuity between normal and pathological groups rather than an evenly graded dimension. Such neglect is unfortunate, as failure to accurately conceptualize the latent structure of the diathetic component of the panic-relevant diathesis-stress model may (1) limit the model's construct valid representation of the panic-relevant diathesis-stress phenomenon; and (2) preclude psychopathologists from further elucidating the specific processes underlying panic vulnerability. To begin to address this gap in the literature, the present study sought to test a panic-relevant diathesis-stress model using a taxometrically-derived categorical index of AS. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
151 college students to whom the Anxiety Sensitivity Index (ASI) was administered in 1984 were retested in 1987 for anxiety sensitivity and tested for panic attacks, state-trait anxiety, and anxiety disorder history. ASI scores in 1984 predicted the frequency and intensity of panic attacks in 1987. Compared to Ss with low 1984 ASI scores, Ss with high 1984 ASI scores were 5 times more likely to have an anxiety disorder during the period 1984 to 1987. Test-retest reliability for the ASI across 3 yrs was .71. Data provide evidence for the stability of anxiety sensitivity over time and that the concept of anxiety sensitivity should be considered a personality variable. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
This book discusses the MAXCOV-HITMAX procedure to reveal the underlying rationale of MAXCOV in simple terms and show how this technique can be used in a variety of disciplines by researchers in their taxonomic work. The misconceptions concerning the psychometric and philosophical status of taxonic constructs are discussed, and several meanings of the term "taxon" and the philosophy of science that has guided the authors' work in this area are reviewed. The authors describe MAXCOV-HITMAX and demonstrate how MAXCOV uses the General Covariance Mixture Theorem to test taxonic hypotheses (using utility programs written in S-Plus to do the taxometric procedures). Two new taxometric procedures are introduced, MAXEIG-HITMAX and L-Mode, for the simultaneous analysis of multiple taxon indicators. These techniques are contrasted with other data clustering and classification methods, such as latent profile analysis and Q-technique factor analysis. Guidelines are provided for corroborating taxonic models and the role of taxometrics in scientific methodology is described. The book is intended for professionals and practitioners in statistics, evaluation, survey research, sociology, psychology, education and communication research, policy studies, management, public health, and nursing. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Evaluated a scale for measuring anxiety sensitivity (i.e., the belief that anxiety symptoms have negative consequences), the Child Anxiety Sensitivity Index (CASI), in 76 7th–9th graders and 33 emotionally disturbed children (aged 8–15 yrs). The CASI had sound psychometric properties for both samples. The view that anxiety sensitivity is a separate concept from that of anxiety frequency and that it is a concept applicable with children was supported. The CASI correlated with measures of fear and anxiety and accounted for variance on the Fear Survey Schedule for Children—Revised and the State-Trait Anxiety Inventory for Children (Trait form) that could not be explained by a measure of anxiety frequency. The possible role of anxiety sensitivity as a predisposing factor in the development of anxiety disorder in children is discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Guttman's classic lower bound for the number of common factors is extended to the completely general case where communalities may lie in the closed interval from zero to one.
Book
Readers who want a less mathematical alternative to the EQS manual will find exactly what they're looking for in this practical text. Written specifically for those with little to no knowledge of structural equation modeling (SEM) or EQS, the author's goal is to provide a non-mathematical introduction to the basic concepts of SEM by applying these principles to EQS, Version 6.1. The book clearly demonstrates a wide variety of SEM/EQS applications that include confirmatory factor analytic and full latent variable models.
Chapter
We know of only two unpublished case reports examining the use of ACT with childhood anxiety disorders. In the first case, ACT was used to treat anxiety-based school refusal behavior in an 11-year-old boy, with gains maintained over a 2-year follow-up period (Wilson & Coyne, 2003). In a second report,ACTwas used with a 10-year-old girl with social phobia and generalized anxiety disorder (Greco, 2002). Core components of ACT were implemented in a 12-week outpatient protocol composed of eight individual and four family sessions. Throughout treatment, the young girl demonstrated improved school attendance. Furthermore, she reported decreases in social anxiety and increases in acceptance and values-consistent behavior at posttreatment and 4-week follow-up. Collectively, clinical and empirical work suggests that ACT can be adapted for children and adolescents experiencing a range of presenting concerns. It is clear, however, that continued treatment development and rigorous empirical evaluation are needed to document the short- and long-term effects of ACT relative to other treatment approaches.
Article
Taxometrics is a statistical tool that can be used to discern psychopathological categories from continua. In this study, taxometric analyses were conducted to determine whether a psychopathological category (or taxon) underlies a cognitive vulnerability to panic (i.e., fear of anxiety symptoms and body vigilance). The construct was operationalized with 3 variables: the Anxiety Sensitivity Index, the Body Sensations Questionnaire, and the Body Vigilance Scale. The test was performed in a large nonclinical sample (N = 1,224). Analyses and consistency tests support the taxonic conjecture for the existence of a latent cognitive vulnerability taxon with a base rate of about 18% in this population. Moreover, tests of the taxon’s utility indicated that taxon membership has incremental validity in predicting future panic attacks.
Article
According to Reiss and McNally's expectancy theory, a high level of anxiety sensitivity (“fear of anxiety”) increases the risk for anxiety disorders, and plays a particularly important role in panic disorder (PD). There has yet to be a comprehensive comparison of anxiety sensitivity across the anxiety disorders. Using a measure of anxiety sensitivity known as the Anxiety Sensitivity Index (ASI), we assessed 313 patients, representing each of the six DSM-III-R anxiety disorders. ASI scores associated with each anxiety disorder were greater than those of normal controls, with the exception of simple phobia. The latter was in the normal range. The ASI scores associated with PD were significantly higher than those of the other anxiety disorders, with the exception of posttraumatic stress disorder (PTSD). There was a trend for the ASI scores associated with PD to be greater than those associated with PTSD. Analysis of the ASI item responses revealed that PD patients scored significantly higher than PTSD patients on items more central to the concept of anxiety sensitivity, as determined by principal components analysis. The pattern of results did not change when trait anxiety was used as a covariate. The implications for the expectancy theory are considered, and directions for further investigation are outlined.
Article
The present study investigated relations of anxiety sensitivity and other theoretically relevant personality factors to Copper's [Psychological Assessment 6 (1994) 117.] four categories of substance use motivations as applied to teens' use of alcohol, cigarettes, and marijuana. A sample of 508 adolescents (238 females, 270 males; mean age=15.1 years) completed the Trait subscale of the State-Trait Anxiety Inventory for Children, the Childhood Anxiety Sensitivity Index (CASI), and the Intensity and Novelty subscales of the Arnett Inventory of Sensation Seeking. Users of each substance also completed the Drinking Motives Questionnaire-Revised (DMQ-R) and/or author-compiled measures for assessing motives for cigarette smoking and marijuana use, respectively. Multiple regression analyses revealed that, in the case of each drug, the block of personality variables predicted “risky” substance use motives (i.e., coping, enhancement, and/or conformity motives) over-and-above demographics. High intensity seeking and low anxiety sensitivity predicted enhancement motives for alcohol use, high anxiety sensitivity predicted conformity motives for alcohol and marijuana use, and high trait anxiety predicted coping motives for alcohol and cigarette use. Moreover, anxiety sensitivity moderated the relation between trait anxiety and coping motives for alcohol and cigarette use: the trait anxiety–coping motives relation was stronger for high, than for low, anxiety sensitive individuals. Implications of the findings for improving substance abuse prevention efforts for youth will be discussed.
Article
The relationship between panic attack symptoms, anxiety sensitivity, and academic performance was evaluated in a sample of 77 high school students. Although it has been suggested that children and adolescents are unlikely to experience panic attacks and panic disorder, the results of recent studies suggest that symptoms frequently occur in this age group. Evaluation of symptoms reported on the Panic Attack Questionnaire revealed that 39% of our sample experienced panic attacks, and that five subjects (6.5%) met diagnostic criteria for panic disorder at some time during their life. Furthermore, a significant correlation between scoring on the PAQ and scores on the Childhood Anxiety Sensitivity Index, a fear of anxiety measure, was found. Results suggest that there is a relationship between anxiety sensitivity and panic symptomatology in adolescents, a finding comparable with the adult literature. The observed relationship between anxiety sensitivity and panic symptomatology in adolescents is congruent with theorizing that anxiety sensitivity is a cognitive risk factor for the development of panic disorder.
Article
Taxometrics is a statistical procedure for determining whether relationships among observables reflect the existence of a latent taxon (type, species, category, disease entity). A formal-numerical definition is needed because intuitive, commonsense notions of “carving nature at its joints” or “identifying natural kinds” cannot resolve disagreements as to taxonic reality for hard cases. Specific etiology (e.g., major gene, germ, traumatic event) is often unknown and is not appropriate in nonmedical domains. Lacking an infallible criterion, the taxonic inference relies on the internal configural relations among the conjectural fallible indicators. An essential feature is multiple consistency tests that will not be satisfied if the latent structure is not taxonic or the parameters are badly estimated. Common misconceptions are that the taxon must be “sharply” distinguished, quantitative indicators must be bimodal, the causal origin must be biological, emergence of a large dimensional factor refutes taxonicity, and adopting a taxon is a mere matter of convention or preference.
Article
Meehl's (1962, 1990) model of schizotypy and the development of schizophrenia implies that the structure of liability for schizophrenia is dichotomous and that a "schizogene" determines membership in a latent class, or taxon (Meehl & Golden, 1982). The authors sought to determine the latent structure and base rate of schizotypy. They applied Meehl's (1973; Meehl & Golden, 1982) MAXCOV-HITMAX taxometric analytic procedures to a subset of items from the Perceptual Aberration Scale (PAS; Chapman, Chapman, & Raulin, 1978), a prominent psychometric index of schizotypy, derived from a randomly ascertained nonclinical university sample (N = 1,093). The results, in accordance with Meehl's conjectures, strongly suggest that schizotypy, as assessed by the PAS, is taxonic at the latent level with a general population taxon base rate of approximately .10.
Article
This investigation examines the predictive significance of peer reputation in elementary school for the quality of adaptation in adolescence. A normative sample (N = 207) of third to sixth graders was administered the Revised Class Play (RCP). Each received 3 scores (Sociability-Leadership, Aggression-Disruption, and Sensitivity-Isolation). 7 years later, 88% of these children and their parents participated in a questionnaire follow-up study utilizing a broad range of adolescent outcome measures (e.g., social and athletic competence, academic performance, behavioral symptoms, well-being). The 3 RCP scores were significantly related to both adolescent competence and psychopathology, supporting the predictive validity of the RCP as well as the continuity of general adaptation. Each dimension of peer reputation had a different pattern of prediction depending on the outcome criteria under consideration, suggesting the importance of a multidimensional approach to peer reputation. Positive peer reputation proved to be an important predictor of later adjustment. Sex differences were examined; results suggested somewhat different patterns of prediction for boys and girls, especially for the sensitive-isolated dimension.
Article
A distinction is proposed between anxiety (frequency of symptom occurrence) and anxiety sensitivity (beliefs that anxiety experiences have negative implications). In Study 1, a newly-constructed Anxiety Sensitivity Index (ASI) was shown to have sound psychometric properties for each of two samples of college students. The important finding was that people who tend to endorse one negative implication for anxiety also tend to endorse other negative implications. In Study 2, the ASI was found to be especially associated with agoraphobia and generally associated with anxiety disorders. In Study 3, the ASI explained variance on the Fear Survey Schedule—II that was not explained by either the Taylor Manifest Anxiety Scale or a reliable Anxiety Frequency Checklist. In predicting the development of fears, and possibly other anxiety disorders, it may be more important to know what the person thinks will happen as a result of becoming anxious than how often the person actually experiences anxiety. Implications are discussed for competing views of the ‘fear of fear’.
Article
Sensitivity theory holds that people differ in both the types of reinforcement they desire and in the amounts of reinforcement they need to satiate. People who crave too much love, too much attention, too much acceptance, too much companionship, or too much of some other fundamental reinforcer are at risk for aberrant behavior because normative behavior does not produce the desired amounts of reinforcement. People who are intolerant of even everyday amounts of anxiety or frustration also are at risk for aberrant behavior. Individual differences in desired amounts of particular reinforcers may predict person-environment interactions, risk factors for psychopathology, and the occurrence of generalized and durable therapy effects versus the occurrence of relapses. Parallel predictions are made for individual differences in tolerance of aversive stimuli. Implications are discussed for applied behavior analysis, the development of psychopathology, and treatment strategies.
Article
Taxometric and biometric analyses were conducted on 2 North American samples to investigate the prevalence and biometric structure of pathological dissociation. Results indicated that approximately 3.3% of the general population belongs to a pathological dissociative taxon. A brief 8-item self-report scale called the DES-T can be used to calculate taxon membership probabilities in clinical and nonclinical samples of adults (a SAS scoring program is provided for this purpose). The genetic and environmental architecture of pathological dissociative symptoms was explored by conducting a biometric analysis on DES-T ratings from 280 identical and 148 fraternal twins. The findings suggest that approximately 45% of the observed variance on the DES-T can be attributed to shared environmental influences. The remaining variance is due to nonshared environmental influences.
Article
Anxiety sensitivity (AS) is the fear of anxiety-related sensations. According to Reiss's (e.g., Reiss, 1991) expectancy theory, AS amplifies fear and anxiety reactions, and plays an important role in the etiology and maintenance of anxiety disorders, particularly panic disorder. Recent evidence suggests that AS has a hierarchical structure, consisting of multiple lower order factors, loading on a single higher order factor. If each factor corresponds to a discrete mechanism (Cattell, 1978), then the results suggest that AS arises from a hierarchic arrangement of mechanisms. A problem with previous studies is that they were based on the 16-item Anxiety Sensitivity Index, which may not contain enough items to reveal the type and number of lower order factors. Also, some of the original ASI items are too general to assess specific, lower order factors. Accordingly, we developed an expanded measure of AS--the ASI-R--which consists of 36 items with subscales assessing each of the major domains of AS suggested by previous studies. The ASI-R was completed by 155 psychiatric outpatients. Factor analyses indicated a four-factor hierarchical solution, consisting of four lower order factors, loading on a single higher factor. The lower order factors were: (1) fear of respiratory symptoms, (2) fear of publicly observable anxiety reactions, (3) fear of cardiovascular symptoms, and (4) fear of cognitive dyscontrol. Each factor was correlated with measures of anxiety and depression, and fear of cognitive dyscontrol was most highly correlated with depression, which is broadly consistent with previous research. At pretreatment, patients with panic disorder tended to scored highest on each of the factors, compared to patients with other anxiety disorders and those with nonanxiety disorders. These findings offer further evidence that Reiss's expectancy theory would benefit from revision, to incorporate the notion of a hierarchic structure of AS.
Article
To identify risk factors for onset of panic attacks in adolescents, a prospective cohort design was used to evaluate the following risk factors: negative affectivity, female sex, anxiety sensitivity, and childhood separation anxiety disorder. These risk factors were also evaluated for predicting onset of major depression to test their specificity. The sample consisted of 2,365 high school students assessed over a 4-year period. Assessments included self-report questionnaires and structured clinical interviews. Cox proportional hazards models were used to evaluate risk. Consistent with previous studies, prior major depression predicted onset of panic attacks and a history of panic attacks predicted onset of major depression. After adjusting for the effects of prior major depression, negative affectivity and anxiety sensitivity, but not female sex or childhood separation anxiety disorder, predicted onset of 4-symptom panic attacks. However, female sex and negative affectivity but not anxiety sensitivity or childhood separation anxiety disorder predicted onset of major depression after adjustment for the effects of prior panic attacks. Negative affectivity appears to be a nonspecific risk factor for panic attacks and major depression, whereas anxiety sensitivity appears to be a specific factor that increases the risk for 4-symptom panic attacks in adolescents.
Article
A large body of research has suggested that anxiety sensitivity (AS) acts as a specific vulnerability factor in the development of anxiety pathology. More recently, attention has turned to the etiology of AS per se. The present study represents a specific test of a Scar model of AS. A Scar model posits that the experience of distress will affect the vulnerability factor. We were specifically interested in evaluating the effects of a specific stressor (spontaneous panic) as well as general distress on changes in AS over time. A large nonclinical sample of young adults (N = 1296) was prospectively followed over a five week highly stressful period of time (i.e. military basic training). Findings were consistent with the Scar model and suggested that the specific stressor of experiencing a panic attack as well as general stressors creating significant anxiety symptoms uniquely contributed to increased levels of AS (regardless of prior history of panic). Moreover, the experience of spontaneous panic in the context of generally low levels of distress (both anxiety and depression) appeared to be particularly pernicious in terms of resulting in greater increases in AS. In sum, anxiety-related stressors appear to have the potential to 'scar' individuals in regard to this cognitive vulnerability factor.
Article
We used structural equation modeling (SEM) to test the hypothesis that childhood instrumental and vicarious learning experiences influence frequency of panic attacks in young adulthood both directly, and indirectly through their effects on anxiety sensitivity (AS). A total of 478 university students participated in a retrospective assessment of their childhood learning experiences for arousal-reactive sensations (e.g., nausea, racing heart, shortness of breath, dizziness) and arousal-non-reactive sensations (i.e., colds, aches and pains, and rashes). SEM revealed that learning history for arousal-reactive somatic symptoms directly influenced both AS levels and panic frequency; AS directly influenced panic frequency; and learning history for arousal-non-reactive symptoms directly influenced AS but did not directly influence panic frequency. These results are consistent with the findings of previous retrospective studies on the learning history origins of AS and panic attacks, and provide the first empirical evidence of a partial mediation effect of AS in explaining the relation between childhood learning experiences and panic attacks in young adulthood. Implications for understanding the etiology of panic disorder are discussed.
Article
The present article sets forth the argument that psychological assessment should be based on a construct's latent structure. The authors differentiate dimensional (continuous) and taxonic (categorical) structures at the latentand manifest levels and describe the advantages of matching the assessment approach to the latent structure of a construct. A proper match will decrease measurement error, increase statistical power, clarify statistical relationships, and facilitate the location of an efficient cutting score when applicable. Thus, individuals will be placed along a continuum or assigned to classes more accurately. The authors briefly review the methods by which latent structure can be determined and outline a structure-based approach to assessment that builds on dimensional scaling models, such as item response theory, while incorporating classification methods as appropriate. Finally, the authors empirically demonstrate the utility of their approach and discuss its compatibility with traditional assessment methods and with computerized adaptive testing.
Article
This study assessed some ways in which schools, neighborhoods, nuclear families, and friendship groups jointly contribute to positive change during early adolescence. For each context, existing theory was used to develop a multiattribute index that should promote successful development. Descriptive analyses showed that the four resulting context indices were only modestly intercorrelated at the individual student level (N = 12,398), but clustered more tightly at the school and neighborhood levels (N = 23 and 151 respectively). Only for aggregated units did knowing the developmental capacity of any one context strongly predict the corresponding capacity of the other contexts. Analyses also revealed that each context facilitated individual change in a success index that tapped into student academic performance, mental health, and social behavior. However, individual context effects were only modest in size over the 19 months studied and did not vary much by context. The joint influence of all four contexts was cumulatively large, however, and because it was generally additive in form, no constellation of contexts was identified whose total effect reliably surpassed the sum of its individual context main effects. These results suggest that achieving significant population changes in multidimensional student growth during early adolescence most likely requires both theory and interventions that are explicitly pan-contextual.
Article
This study examined the concurrent and prospective relation between anxiety sensitivity (AS) and panic attack symptomatology among a community sample of African-American adolescents (N = 107; mean age 15.6 years) from predominantly low-income, single-parent households. On two occasions, 6 months apart, youth completed self-report measures of AS, measured by the Childhood Anxiety Sensitivity Index (CAS I), and panic symptomatology, measured by the Panic Attack Questionnaire (PAQ) and/or the Panic subscale of the Screen for Child Anxiety-Related Emotional Disorders (SCARED-P). Results indicated that adolescents with high levels of AS reported higher concurrent levels of panic symptomatology, compared to their less anxious peers. Earlier levels of AS were correlated with panic symptoms 6 months later but did not predict later panic symptoms once initial levels of panic were controlled. Panickers, compared to non-panickers, also reported significantly higher levels of AS at Time 2. Overall, these findings are consistent with research on AS and panic in adult and Caucasian populations and support the hypothesis that elevated levels of AS may be one of several risk factors implicated in the development of panic attack symptomatology.
Article
Anxiety sensitivity refers to fears of anxiety-related sensations. Most often measured by the Anxiety Sensitivity Index (ASI), anxiety sensitivity is a dispositional variable especially elevated in people with panic disorder. Regardless of diagnosis, ASI scores often predict panic symptoms in response to biological challenges (e.g., carbon dioxide inhalation) that provoke feared bodily sensations. Prospective longitudinal studies indicate that scores on the ASI predict subsequent spontaneous attacks, indicating that elevated anxiety sensitivity is a risk factor for panic and perhaps panic disorder. Cognitive behavioral treatment reduces anxiety sensitivity in panic patients, perhaps protecting against relapse. Imipramine likewise decreases anxiety sensitivity.