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Taxonicity of anxiety sensitivity: A multi-national analysis

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Abstract

Taxometric coherent cut kinetic analyses were used to test the latent structure of anxiety sensitivity in samples from North America (Canada and United States of America), France, Mexico, Spain, and The Netherlands (total n = 2741). Anxiety sensitivity was indexed by the 36-item Anxiety Sensitivity Index--Revised (ASI-R; [J. Anxiety Disord. 12(5) (1998) 463]). Four manifest indicators of anxiety sensitivity were constructed using the ASI-R: fear of cardiovascular symptoms, fear of respiratory symptoms, fear of publicly observable anxiety reactions, and fear of mental incapacitation. Results from MAXCOV-HITMAX, internal consistency tests, analyses of simulated Monte Carlo data, and a MAMBAC external consistency test indicated that the latent structure of anxiety sensitivity was taxonic in each of the samples. The estimated base rate of the anxiety sensitivity taxon differed slightly between nations, ranging from 11.5 to 21.5%. In general, the four ASI-R based manifest indicators showed high levels of validity. Results are discussed in relation to the conceptual understanding of anxiety sensitivity, with specific emphasis on theoretical refinement of the construct.

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... stein, Zvolensky, Kotov, et al., 2006;Bernstein, Zvolensky, Stewart, Nancy Comeau, & Leen-Feldner, 2006;Broman-Fulks et al., 2008). Finally, a recent line of work using factor mixture modeling (FMM) provided support for the dimensional-taxonic nature of AS (e.g., Allan, Korte, Capron, Raines, & Schmidt, 2014;Bernstein, Stickle, & Schmidt, 2013). ...
... These methods allow one to answer the question of whether people differ among each other only in the degree of AS (quantitatively), or whether those high in AS belong to a class qualitatively different from people with lower AS scores. In several studies, evidence for a categorical structure of AS was reported, suggesting the existence of a "normative/ adaptive" AS class, composed of about 80% of the sample, and a "vulnerable/high risk" AS class (Bernstein, Zvolensky, Kotov, et al., 2006;Bernstein et al., 2007;Bernstein, Zvolensky, Stewart, et al., 2006;Bernstein, Zvolensky, Weems, Stickle, & Leen-Feldner, 2005). A drawback of these studies was their reliance on the same taxometric procedure, precluding consistency testing. ...
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Anxiety sensitivity (AS) is an established transdiagnostic risk factor for emotional disorders. It is defined as the fear of anxiety sensations that arises from beliefs that those sensations can have harmful consequences on cognitive, physical, and social functioning. Thus, AS is usually considered a multidimensional construct comprised of the following dimensions: Cognitive, Physical, and Social concerns. Some studies have questioned its continuous latent structure providing taxometric evidence for its categorical nature. However, more advanced factor mixture modeling (FMM) has offered support for a hybrid, dimensional-categorial latent structure of AS. In other words, 3 qualitatively different classes were identified, with a 3-factor model within each class. In the current study, FMM was used in 2 independent Serbian samples: an adult convenient community (Facebook) sample (N = 359) and a young treatment-seeking sample (N = 342). The obtained results are fairly in line with the most recent work targeting the nature of the AS construct, using the Anxiety Sensitivity Index-3 (ASI-3). By model fit, especially comparing the 2- and 3-class solution in Sample 1, and testing external validity in Sample 2, the empirical evidence supports the 3-class solution, with classes labeled as Normative AS, Moderate AS, and High AS. Important theoretical and practical questions were raised and discussed in the article. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
... As noted above, principal components analysis has indicated that the ASI-R assesses four lower order factors: (a) fear of respiratory symptoms, (b) fear of publicly observable anxiety reactions, (c) fear of cardiovascular symptoms, (d) fear of cognitive dyscontrol (Taylor & Cox, 1998b). At least one previous taxometric analysis of anxiety sensitivity that indicated a taxonic solution (Bernstein, Zvolensky, Kotov, et al., 2006) created indicators by summing the items that loaded on each of these lower order factors. Thus, consistent with the study, ASI-R items loading on each of the lower order factors were summed to create four composite indicators (Ruscio, Borkovec, & Ruscio, 2001). ...
... For example, the psychometric properties or overall structure of the ASP or ASP indicators may have prevented our ability to uncover a taxon that was in fact present. In an effort to evaluate this hypothesis, Study 2 attempted to replicate the findings of previous taxonic reports using the same measure (the ASI-R) and the same indicators as those used by Bernstein, Zvolensky, Kotov, et al. (2006). Despite the similarities in study methods, Study 2 did not reveal any evidence of a latent taxon, thus ruling out measurement differences as a source of divergence. ...
... Whilst the first taxometric study of anxiety sensitivity in adults failed to find a taxonic structure (Taylor, Rabian, & Fedoroff, 1999), this study has been criticised as having several significant limitations. Two further studies in adults (Bernstein et al., 2006;Schmidt, Kotov, Lerew, Joiner, & Ialongo, 2005) suggested a taxonic structure. In the first of their investigations into the structure of anxiety sensitivity in youth, Bernstein et al. (2005) used two sets of indicators from the Childhood Anxiety Sensitivity Questionnaire (CASI); three composite indicators indexing disease concerns, unsteady concerns and mental health concerns and nine single item indicators representing each of these three facets of anxiety sensitivity. ...
... The taxometric analyses indicated that the latent structure of anxiety sensitivity in this group of young people (n = 371) was taxonic, with a base rate of between 13.6% and 16.5% for the anxiety sensitivity taxon. 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%. ...
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.
... Wie zuvor bereits erwähnt, wird die Vergleichbarkeit von Interventionen durch die Verwendung uneinheitlicher Cut-Off-Werte für die Einteilung von hoher und niedriger AS erschwert und beeinflusst möglicherweise auch die gefundenen Effekte. Um AS als intermediären Risikofaktor für klinische und präventive Fragestellungen optimal nutzen zu können, ist daher ein besseres Verständnis der zugrundeliegenden latenten Struktur des Konstrukt AS und die Ableitung reliabler klinischer Cut-Off-Werte für die Identifikation von Risikogruppen wichtig(Allan, Korte, et al., 2014).Während einige Studien Belege für eine taxonomische Struktur im Sinne einer kleinen hoch angstsensitiven und einer zweiten großen Klasse mit normativen AS-Werten(Bernstein et al., 2010;Bernstein et al., 2006;Bernstein et al., 2007) oder gar einer dreiteiligen Struktur mit einer zusätzlichen moderat hohen Klasse(Allan, Korte, et al., 2014; darlegen, weisen andere darauf hin, dass intraindividuelle Unterschiede lediglich dimensionaler, also quantitativer Natur sind (Asmundson, Weeks, Carleton, Thibodeau & Fetzner, 2011; Broman-Fulks et al., 2010). Hier ist noch weitere Forschung notwendig, um die divergenten Befunde erklären zu können und fundierte Richtlinien für die Übertragung in die klinische Praxis zu formulieren. ...
Thesis
Angsterkrankungen stellen mit einer 12-Monats-Prävalenz von 14% die häufigsten psychischen Erkrankungen in der westlichen Gesellschaft dar. Angesichts der hohen querschnittlichen wie sequentiellen Komorbidität von Angsterkrankungen, der ausgeprägten individuellen Einschränkungen sowie der hohen ökonomischen Belastung für das Gesundheitssystem ist neben therapeutischen Behandlungsansätzen die Entwicklung von kurzzeitigen, kostengünstigen und leicht zugänglichen Präventionsmaßnahmen von großer Bedeutung und steht zunehmend im Fokus des gesundheitspolitischen Interesses, um die Inzidenz von Angsterkrankungen zu reduzieren. Voraussetzung für die Entwicklung von gezielten und damit den effektivsten Präventionsmaßnahmen sind valide Risikofaktoren, die die Entstehung von Angsterkrankungen begünstigen. Ein Konstrukt, das in der Literatur als subklinisches Symptom in Form einer kognitiven Vulnerabilität für Angsterkrankungen und damit als Risikofaktor angesehen wird, ist die sogenannte Angstsensitivität (AS). AS umfasst die individuelle Tendenz, angstbezogene körperliche Symptome generell als bedrohlich einzustufen und mit aversiven Konsequenzen zu assoziieren. Das Ziel der vorliegenden Arbeit war daher die Etablierung und Validierung eines Präventionsprogramms zur Reduktion der AS an einer nicht-klinischen Stichprobe von 100 Probanden (18-30 Jahre) mit einer erhöhten AS (Anxiety Sensitivity Index [ASI-3] ≥17) sowie die Rekrutierung von 100 alters- und geschlechtsangeglichenen Probanden mit niedriger Angstsensitivität (ASI-3 <17). In einem randomisiert-kontrollierten Studiendesign durchliefen die Probanden mit hoher AS entweder das über fünf Wochen angelegte „Kognitive Angstsensitivitätstraining“ (KAST) als erste deutschsprachige Übersetzung des Computer-basierten „Cognitive Anxiety Sensitivity Treatment“ (CAST) von Schmidt et al. (2014) oder wurden der Wartelisten-Kontrollgruppe zugeteilt. Das KAST Training bestand aus einer einmaligen Vermittlung kognitiv-behavioraler Psychoedukation zum Thema Stress und Anspannung sowie deren Auswirkungen auf den Körper und der Anleitung von zwei interozeptiven Expositionsübungen (‚Strohhalm-Atmung‘ und ‚Hyperventilation‘), die über den anschließenden Zeitraum von fünf Wochen in Form von Hausaufgaben wiederholt wurden. Es konnte gezeigt werden, dass die Teilnehmer des KAST-Programms nach Beendigung des Trainings (T1) eine signifikant niedrigere AS-Ausprägung im Vergleich zur Wartelisten-Kontrollgruppe aufwiesen und diese Reduktion auch über den Katamnese-Zeitraum von sechs Monaten (T2) stabil blieb. Ergänzend wurde auch die Targetierbarkeit weiterer intermediärer Risikomarker wie der Trennungsangst (TA), des Index der kardialen Sensitivität sowie der Herzratenvariabilität (HRV) untersucht, die jedoch nicht durch das KAST-Training direkt verändert werden konnten. Im Vergleich der Subgruppen von Probanden mit hoher AS und gleichzeitig hoher TA (Adult Separation Anxiety Questionnaire [ASA-27] ≥22) und Probanden mit hoher AS, aber niedriger TA (ASA-27 <22) zeigte sich, dass die AS-TA-Hochrisikogruppe ebenfalls gut von der KAST-Intervention profitieren und eine signifikante Reduktion der AS erzielen konnte, indem sie sich bei T1 dem Niveau der Gruppe mit niedriger TA anglich. Zudem korrelierte die prozentuale Veränderung der Einstiegswerte der inneren Anspannung während der Strohhalm-Atmungsübung positiv mit der prozentualen Veränderung der dimensionalen TA bei T1. Zusammenfassend weisen die Ergebnisse der vorliegenden Arbeit erstmalig auf die Wirksamkeit der deutschsprachigen Übersetzung des CAST-Programms (Schmidt et al., 2014), eines Computer-basierten, und damit leicht zu implementierenden sowie kostengünstigen Programms, in Bezug auf die Reduktion der AS sowie indirekt der TA hin und können damit zur indizierten und demnach besonders effektiven Prävention von Angsterkrankungen in Hochrisikogruppen beitragen.
... Future research may also benefit from identifying classes of cognitive AS concerns at highest risk for suicide. Prior studies utilizing taxometric data analytic techniques have found distinct classes of AS (e.g., high AS, normative AS; Bernstein et al., 2006Bernstein et al., , 2007Kotov, Schmidt, Lerew, Joiner, & Ialongo, 2005). Incidentally, cognitive AS concerns appear to comprise a plurality of items in the "high AS" class (e.g., Zvolensky, Forsyth, Bernstein, & Leen-Feldner, 2007). ...
Article
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Objective: Suicide is a global public health concern. To inform the prevention and treatment of suicidality, it is crucial to identify transdiagnostic vulnerability factors for suicide and suicide-related conditions. One candidate factor is anxiety sensitivity (AS)-the fear of anxiety-related sensations-which has been implicated in the pathogenesis of a host of mental health outcomes, including suicidal thoughts and behaviors. Importantly, AS is distinct from trait anxiety and negative affectivity, highlighting its potential incremental utility in the understanding of psychopathology. Despite a burgeoning body of literature demonstrating that AS is linked to suicidal thoughts and behaviors, this research has yet to be synthesized. Method: This meta-analysis includes 33 articles representing 34 nonredundant samples (N = 14,002) that examined at least one relationship between AS global or subfactor (i.e., cognitive, physical, social) scores and suicidal ideation and/or suicide risk. Results: Findings revealed small-to-moderate and moderate associations between global AS and suicidal ideation (r = .24, 95% confidence interval (CI): [.21, .26], p < .001) and suicide risk (r = .35, 95% CI [.31, .38], p < .001), respectively. All AS subfactors evinced significant associations with suicidal ideation (rs = .13-.24) and suicide risk (rs = .22-.32). Conclusions: AS is related to suicidal ideation and global suicide risk. Research is needed to disentangle AS from other indices of distress in the prediction of suicidal thoughts and behaviors. Theoretical and clinical implications of these findings are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
... Anxiety Sensitivity Index -3 (ASI -3; Taylor et al., 2007) It is an 18-item scale measuring fear of anxious arousal. Past work has documented that fear of cognitive or psychological dyscontrol due to anxious arousal (e.g., "It scares me when I am unable to keep my mind on a task") specifically is most predictive of anxiety-related psychopathology (Olthuis et al., 2014); and taxometric and factor mixture modeling research documented that anxiety sensitivity has a latent taxonic structuresuch that lower vs. higher values on measures of anxiety sensitivity reflect qualitatively distinct forms or kinds of anxiety sensitivity (adaptive versus maladaptive) rather than a dimensional latent construct (Bernstein et al., 2006(Bernstein et al., , 2010(Bernstein et al., , 2013Bernstein and Zvolensky, 2007;Leen-Feldner et al., 2005). In the present study we used ASI-3 sub-scale measuring the cognitive fear of dyscontrol due to anxious arousal (α = .85 in the present study). ...
Article
Re-examining decades of the social construal of Oxytocin, the General Approach-Avoidance Hypothesis of Oxytocin (GAAO) predicts that Oxytocin will modulate responding to emotionally-evocative and personally-relevant social and non-social stimuli due to its action on the neural substrate of approach and avoidance motivation. We report the first critical experimental test of GAAO predictions by means of a double-blind intra-nasal administration of Oxytocin vs. placebo in 90 healthy adults (N = 90, 50% women). As predicted, we found that among men and women for whom negative emotion (anxious arousal) is motivationally-relevant, intra-nasal administration of Oxytocin reduced behavioral avoidance of emotionally-evocative negatively-valenced social and non-social stimuli, but not closely matched emotionally-neutral stimuli. Findings cannot be explained by extant social theories of Oxytocin. We discuss the implications of the present findings for basic and translational clinical Oxytocin research.
... occurring along a latent continuum ranging from low to high), whereas evidence to date suggests that AS is taxonic (i.e. having qualitatively distinct normative and pathological forms; Bernstein et al. 2006a ;Bernstein et al. 2006b ). Based on the available research to date, pain-related anxiety and AS appear to be related, but distinct (Carleton et al. in press). ...
... Indeed, even though the influence of genetic factors in the etiology of AS has been confirmed (Stein et al., 1999;Taylor et al., 2008), both empirical (Taylor et al., 2008) and retrospective Scher and Stein, 2003) studies have bolstered the role of environmental factors in AS development. For example, although a few studies found that AS is associated in the same way with anxiety and related disorders across socio-cultural contexts (Zvolensky et al., 2001(Zvolensky et al., , 2003Bernstein et al., 2006;Taylor et al., 2007), symptom perception and expression may be affected by cultural variability (Kirmayer et al., 1995). Furthermore, employing a crossculturally validated instrument allows to compare international research results and to perform international research projects (Van Widenfelt et al., 2005). ...
Article
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Anxiety Sensitivity (AS) is defined as the fear of anxiety and of arousal-related bodily sensations, arising from erroneous beliefs that these sensations will have adverse consequences. AS plays a key role both in the onset and in the maintenance of several disorders, particularly anxiety disorders. To date, only two studies on American samples have examined the bifactor structure of the Anxiety Sensitivity Index-3 (ASI-3); therefore, findings on different cultures are needed. The main purpose of the present study was to assess the factor structure and psychometric properties of the ASI-3 in an Italian community sample. Participants were recruited from the general population (N = 1507). The results of a series of confirmatory factor analyses indicated that the bifactor structure fitted the data better than the most commonly accepted structure for the measure and that it was invariant across gender. Moreover, the current study provided evidence regarding the ASI-3’s reliability and its convergent and divergent validity. Lastly, results pertaining incremental validity of the ASI-3 Physical and Cognitive Concerns subscales above and beyond the total showed that the former was not associated with a measure of physiological anxiety, whereas the latter was weakly associated with a measure of worry. Findings suggest that the ASI-3 is comprised of a dominant general factor and three specific independent factors; given the dominance of the general factor, the use of the ASI-3 total score as a measure of the general fear of anxiety is recommended in both clinical and research settings.
... This result can also be considered in the light of recent studies on AS. These suggest that the construct is taxonic rather than dimensional and that it may be more accurate to conceptualize two discrete forms of AS-a taxon (pathological) form and a non-taxon (normative) form (Bernstein et al., 2006;Bernstein, Zvolensky, Weems, Stickle & Leen-Feldner, 2005). Thus, future research should replicate the present study in the light of the taxometric approach. ...
... Generalmente, la sensibilidad a la ansiedad se ha empleado como una medida unidimensional, tal y como defiende la teoría de la expectativa (Reiss, 1991;Taylor, Koch, & Crockett, 1991). No obstante, y según afirman Bernstein et al. (2006) en su reciente estudio, basado en la versión revisada del ASI (ASI-R, Taylor & Cox, 1998), los análisis factoriales indican una solución jerárquica de 4 factores de segundo orden que se agrupan en un único factor de primer orden: 1) miedo a los síntomas respiratorios, 2) miedo a los síntomas cardiovasculares, 3) miedo a las reacciones de ansiedad públicamente observables, y 4) miedo a la incapacidad mental. En la misma línea que éstos, Sandín, Chorot, Valiente, Santed y Lostao (2004) corroboran la estructura factorial jerárquica del ASI español, pero esta vez con sólo tres factores de segundo orden, conceptualmente similares a las tres subescalas del ASI original que apoyan otros estudios (Stewart, Taylor, & Baker, 1997;. ...
... Análise: foi realizado o cálculo do kappa para a mensuração da concordância entre os pesquisadores e uma análise descritiva da frequência de estudos por base de dados, sua caracterização segundo o tipo de estudo, tipo de transtorno psiquiátrico e país de origem, e de dados cienciométricos, como número de publicações por ano, por base, fator de impacto e periódicos publicados. Dos 15 estudos sobre síndromes transculturais ("culture bound syndrome"), dois eram sobre "nervios ou ataque de nervios" 11,12 , dois sobre "susto" 13,14 , quatro sobre a relação entre crenças religiosas, espiritismo, "feitiçaria", transe e apresentação dos transtornos mentais [15][16][17][18] , um sobre a proposta de uma nova categoria diagnóstica intitulada "fetal and early trauma syndrome" 19 , três artigos teóricos 3,20,21 e três sobre a psicopatoplastia dos transtornos mentais [22][23][24] . Todos estes estudos descreviam síndromes transculturais baseando-se em poucos casos clínicos ou descreviam fatores culturais que pudessem estar relacionados com o aparecimento dos transtornos mentais. ...
Article
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OBJETIVO: Esta revisão visa identificar as evidências dos estudos de países da América Latina e do Caribe para a inclusão das síndromes transculturais na versão da Classificação Internacional de Doenças para sua 11ª Edição. MÉTODO: Os estudos foram identificados nas bases do Medline, LILACS e EMBASE, no período de 1992 a 2008, e classificados segundo o tipo de estudo, tipo de transtorno, país e número de publicações por ano. RESULTADOS: Foram selecionadas e classificadas 163 publicações: 33 no Medline, 90 no EMBASE e 40 no LILACS. A percentagem das síndromes transculturais ("culture bound-syndrome") correspondeu a 9% no Medline, 12% no EMBASE e 2,5% no LILACS. Dos 15 estudos sobre síndromes transculturais, dois eram sobre "nervios e ataque de nervios", dois sobre "susto", quatro sobre a relação entre crenças religiosas, "feitiçaria", transe e apresentação dos transtornos mentais, um sobre proposta de uma nova categoria diagnóstica, três artigos teóricos e três sobre psicopatoplastia dos transtornos mentais. CONCLUSÃO: A escassez de estudos sobre síndromes transculturais pode ter ocorrido pela dificuldade em rastrear os estudos por problema de indexação das publicações, falta de interesse em publicar tais estudos em periódicos indexados e a dificuldade de acesso às publicações. Dentre os estudos identificados, não há uma evidência clara que aponte quais modificações são necessárias nas classificações diagnósticas atuais.
... Taxometric methods (e.g., Meehl, 1999) were some of the first methods to examine the presence or absence of classes of individuals based on their AS levels (e.g., Asmundson, Weeks, Carelton, Thibodeau, & Fetzner, 2011;Bernstein, Zvolensky, Stewart, Comeau, & Leen-Feldner, 2006;Schmidt, Kotov, Lerew, Joiner, & Ialongo, 2005). Several of these studies found support for the presence of a small high-AS class comprising approximately 10-20% of individuals and a larger normative-AS class comprising 80-90% of individuals (Bernstein, Zvolensky, Kotov et al., 2006;Bernstein et al., 2007;Bernstein, Zvolensky, Weems, Stickle, & Leen-Feldner, 2005;Schmidt et al., 2005). However, other studies have not found support for the presence of multiple classes of individuals based on their AS levels (Asmundson et al., 2011;Broman-Fulks et al., 2010). ...
Article
Anxiety sensitivity (AS), a multidimensional construct, has been implicated in the development and maintenance of anxiety and related disorders. Recent evidence suggests that AS is a dimensional-categorical construct within individuals. Factor mixture modeling was conducted in a sample of 579 adult smokers (M age = 36.87 years, SD = 13.47) to examine the underlying structure. Participants completed the Anxiety Sensitivity Index-3 and were also given a Structured Clinical Interview for DSM-IV-TR. Three classes of individuals emerged, a high AS (5.2% of the sample), a moderate AS (19.0%), and a normative AS class (75.8%). A cut-score of 23 to identify high AS individuals, and a cut-score of 17 to identify moderate-to-high AS individuals were supported in this study. In addition, the odds of having a concurrent anxiety disorder (controlling for other Axis I disorders) were the highest in the high AS class and the lowest in the normative AS class.
... Hence, the predictive role of AS in men and women needs to be considered from the perspective of both continuous and categorical measurement, particularly given that there is debate on the latent structure of AS. Although a number of studies have found AS to be taxonic (Bernstein et al. 2006;Broman-Fulks et al. 2008;Schmidt et al. 2005;Zvolensky et al. 2007), other recent studies provide evidence for dimensionality (Broman-Fulks et al. 2008. ...
Article
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Anxiety sensitivity, one measure of distress intolerance, has been increasingly shown to play a role in a variety of health behaviors. A number of reports now suggest that individuals with higher levels of anxiety sensitivity (AS) are less likely to engage in exercise. However, this finding has been inconsistent across sex and limited by measurement strategy. This study examined the relationship between AS and self-reported exercise in a mixed-sex sample of 233 individuals. Consistent with prediction, AS was negatively associated with engagement in vigorous-intensity exercise; however, the strength of this association when covarying for sex was dependent on the measurement strategy used (continuous vs. categorical ASI scores). Sex did not moderate the AS-vigorous exercise association. AS was not associated with moderate-intensity exercise or walking. Results suggest a role of distress intolerance in exercise behavior and confirm the importance of continued research on this topic.
... Researchers also have applied coherent cut kinetic (CCK) taxometric methods (Waller and Meehl 1998) to the study of the latent structure of AS. Several CCK taxometric studies of AS have found that AS is taxonic (dichotomous latent class variable), with a relatively low base rate taxon or putatively "high risk" group (approximately 9% -18%) and a more prevalent, normative or putatively "low risk" group (approximately 82%-91%; e.g., Bernstein et al. 2006;Bernstein et al. 2006b;Schmidt et al. 2005;Zvolensky et al. 2007). Exploratory and confirmatory factor analytic studies of taxometrically-derived AS classes have documented dimensional variability between cases within the AS taxon class (or "high risk" class) and between cases within the putative "normative" AS class (Bernstein et al. 2007;Bernstein 2007;Bernstein et al. 2006). ...
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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.
... However, the BAI has been widely used in the extant AS research as a covariate to control for anxiety. Third, some recent work has found that AS may maintain continuous, categorical, and hierarchical properties but the present examination only focused on AS as a continuous construct (Bernstein et al., 2006(Bernstein et al., , 2010Zinbarg et al., 1997). Although future work on AS as a categorical and hierarchical construct is needed, the focus in the current paper on AS as a continuous construct is most consistent with Reiss' (1991) original prediction. ...
Article
Despite the high impact of anxiety sensitivity (AS; a fear of anxiety related sensations) research, almost no research attention has been paid to its parent theory, Reiss' expectancy theory (ET). ET has gone largely unexamined to this point, including the prediction that AS is a better predictor of number of fears than current anxiety. To test Reiss' prediction, we used a large (N=317) clinical sample of anxiety outpatients. Specifically, we examined whether elevated AS predicted number of comorbid anxiety and non-anxiety disorder diagnoses in this sample. Consistent with ET, findings indicated that AS predicted number of comorbid anxiety disorder diagnoses above and beyond current anxiety symptoms. Also, AS did not predict the number of comorbid non-anxiety diagnoses when current anxiety symptoms were accounted for. These findings represent an important examination of a prediction of Reiss' ET and are consistent with the idea that AS may be a useful transdiagnostic treatment target.
... The preponderance of dimensional findings for anxiety disorders and subtypes might cast doubt on the earlier categorical finding for anxiety sensitivity, but this finding has been replicated four times since 2002 [36][37][38][39]. Although they were all carried out by an overlapping set of researchers, the replications have been quite thorough, separately investigating adults and adolescents, men and women, and people from six countries. ...
Article
Taxometric analysis is a statistical methodology for testing between categorical and dimensional models of latent variables. This article reviews taxometric research on the structure of mental disorders conducted since previous reviews in 2003, a period in which the quantity of this work has more than doubled. Taxometric studies have addressed a wide variety of mental disorders whose status as discrete categories or dimensional continua has been controversial, including unipolar depression, schizophrenia subtypes, post-traumatic stress disorder, and attention deficit-hyperactivity disorder. They continue to yield categorical and dimensional findings with approximately equal frequency, and with adequate levels of replication. These findings are summarized, practical implications are discussed, and several concerns about current taxometric practice are raised.
... Future research could benefit from the use of a health information control group which might provide a more robust test of similar hypotheses, as well as a multi-method approach (e.g., biological challenges, implicit cognitive processing) to the assessment of treatment outcome. Selecting participants based on high and low AS cut-off scores may not accurately 692 M. Watt et al. represent the latent structure of the AS construct, and use of taxometric methods to determine those individuals in the high-risk latent class of AS might be a more fruitful approach (Bernstein et al., 2006). Alcohol use disorder is one of the most prevalent disorders in young people and carries with it significant risk for serious, long-term adverse consequences (O'Neil, Parra, & Sher, 2001). ...
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Background: High anxiety sensitivity (AS; fear of anxiety sensations) is associated with frequent and problem drinking (Stewart, Samoluk, & MacDonald, 1999). Aims: It was hypothesized that a program designed to reduce AS levels in young adult women would also result in a decrease in their dysfunctional drinking behavior. Method: The brief cognitive behavioral therapy (CBT) intervention was conducted in small group format. Participants were selected to form high and low AS groups, according to their scores on the Anxiety Sensitivity Index (ASI; Peterson & Reiss, 1992), and randomly assigned to participate in 3 one-hour sessions of either brief CBT (i.e., psycho-education, cognitive restructuring, and physical exercise interoceptive exposure) or a control group seminar (discussion about psychology ethics). Drinking measures were assessed at pre-treatment and 10 weeks post-intervention. Results: Following the intervention, high AS participants in the CBT condition revealed significant reduction in conformity motivated drinking and emotional relief expectancies, as well as a 50% reduction in proportion meeting criteria for hazardous alcohol use as compared to other three groups. Conclusion: Findings suggest that alcohol abuse might be effectively prevented among high risk individuals with a brief CBT approach targeting high AS, and that AS may operate as one underlying determinant of dysfunctional drinking behavior. Declaration of interests: None.
... Latent structural work suggests that AS may be conceptualized as having two naturally occurring, distinct groups (with continuous dimensional variability within each of the classes) or "taxons" Zvolensky, Forsyth, Bernstein, & Leen-Feldner, 2007; although, see Asmundson, Weeks, Carleton, Thibodeau, & Fetzner, 2011). The taxon (high risk) form occurs significantly less often than the nontaxon (normative) form, with studies suggesting that the population base rate of the high-risk AS taxon is between 11% and 21% Bernstein et al., 2006;Schmidt, Kotov, Lerew, Joiner, & Ialongo, 2005;Zvolensky et al., 2007). Consideration of AS taxonicity provides significant utility for both clinicians and researchers, as research indicates the high-risk AS taxon demonstrates incremental validity above continuous measures of AS in the prediction of both anxiety disorder symptoms and psychopathology Bernstein, Zvolensky, Feldner, Lewis, Fauber et al., 2005). ...
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There is a well-established and clinically meaningful relation between the cognitive-affective-based construct of anxiety sensitivity (AS) and risk for the development and maintenance of anxiety psychopathology (B. J. Cox, Fuentes, Borger, & Taylor, 2001). Research findings within this area have revealed mixed results; however, there is evidence to suggest that some individuals with anxiety disorder diagnoses may demonstrate enhanced subcortical arousal (e.g., exaggerated startle response to unexpected, aversive stimuli [A. M. Waters et al., 2008], and deficient prepulse inhibition [PPI; S. Ludewig, Ludewig, Geyer, Hell, & Vollenweider, 2002]), it is presently unclear whether these differences are found within the general population. To address this gap in the extant literature, the current investigation examined the impact of AS on acoustic startle response magnitude and PPI. Results indicated that individuals high and low in AS differ with regard to subcortical measures of arousal, with individuals expressing high levels of AS demonstrating enhanced startle response and deficient PPI. Results are discussed in terms of the role of the cognitive-affective-based factor of AS in the context of physiologic markers for vulnerability for anxiety psychopathology. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
... In addition, the diagnostic specificity of the appraisal biases observed in individuals high on IU will need to be examined in a clinical sample to ascertain the extent to which these biases are present in individuals with GAD versus other anxiety disorders (e.g., obsessive-compulsive disorder). Finally, although the use of a categorical approach was useful in this investigation, it is acknowledged that there are methods of categorization that are more empirically robust than the one used in this study (e.g., see Bernstein et al., 2006). The application of cut scores should, ideally, be informed by data supporting the taxonic latent structure of IU. ...
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Several studies have been conducted to examine whether the construct of intolerance of uncertainty (IU) (Dugas, Gagnon, Ladouceur, & Freeston, Behaviour Research and Therapy, 36, 215–226, 1998b) meets formal criteria as a cognitive vulnerability for excessive and uncontrollable worry. Cognitive models of anxiety suggest that vulnerability is manifest in the manner in which individuals process information. As such, cognitive bias is expected to be observed in individuals characterized by high levels of a putative cognitive vulnerability. In this study, individuals low (n=110) and high (n=89) on IU were compared on their appraisals of ambiguous, negative, and positive situations. Individuals high on IU appraised all situation types as more disconcerting relative to the comparison group. However, when controlling for demographics, generalized anxiety disorder (GAD) symptoms, and mood variables, the groups differed only in their appraisals of ambiguous situations. Further, in the high-vulnerability group, degree of IU was a stronger predictor of appraisals of ambiguous situations than were GAD symptoms and mood variables. Tests of mediation showed that appraisals of ambiguous situations partly mediated the relationship of IU to worry, the main symptom of GAD; however, worry also emerged as a partial mediator of the relation of IU to appraisals of ambiguous situations. An exploratory analysis revealed that in individuals high on IU, appraisals were not specific to the content of current worries, whereas they were to some extent in individuals low on IU. The results are discussed within the context of findings emerging from cognitive models of GAD, in particular the model proposed by Dugas etal. (1998b).
... 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. ...
... Furthermore, although the majority of studies investigating AS to date have examined the construct as a continuous variable, recent evidence suggests the latent structure of AS may be taxonic (see Bernstein et al., 2006), and therefore, the examination of AS as continuously distributed may not provide the best representation of this variable. As this line of research progresses, future studies may benefit from exploring the relationship between AS and other variables using a taxonic conceptualization of AS. ...
Article
Models of panic disorder are primarily cognitive in nature, and the role of emotion regulation has not been extensively examined. This study investigates the extent to which emotion dysregulation predicts uncued panic attack frequency and symptom severity above and beyond anxiety sensitivity (AS). Participants were 77 undergraduate students reporting a recent history of uncued panic attacks. Emotion dysregulation was not found to significantly predict past year panic attack frequency above and beyond AS dimensions (fear of respiratory symptoms, publicly observable anxiety reactions, cardiovascular symptoms, and cognitive dyscontrol). Fear of respiratory symptoms emerged as the only significant predictor of panic attack frequency. However, emotion dysregulation did significantly predict panic symptom severity above and beyond AS dimensions. Results offer preliminary evidence of the differential influence of emotion dysregulation and AS on panic-related variables and suggest the need to examine emotion dysregulation as it pertains to the development and maintenance of panic-related psychopathology.
... Third, although the majority of studies investigating AS to date have examined the construct as a continuous variable, recent evidence suggests the latent structure of AS may be taxonic (see Bernstein et al., 2006), and therefore, the examination of AS as continuously distributed may not provide the best representation of this variable (and could potentially explain why AS did not emerge as a significant predictor in our final proxy risk factor model). It will be important for future studies to explore the relationship between AS and other variables using a taxonic conceptualization of AS. ...
Article
Both non-clinical panic attacks and panic disorder (PD) have been found to be associated with generalized anxiety disorder (GAD). This study examined a proxy risk factor model of the relationship between non-clinical panic attacks, PD, and GAD. Specifically, it was proposed that non-clinical panic attacks and PD predict GAD only due to their shared association with anxiety sensitivity (AS) and difficulties in emotion regulation. Results demonstrated that emotion regulation difficulties reliably predicted GAD above and beyond the experience of non-clinical panic attacks and PD. However, although PD lost strength as a predictor, it remained significantly associated with GAD in the full model, providing only partial support for the proposed proxy risk factor model. Findings speak to the underlying role of emotion regulation difficulties in GAD, and suggest that it may be the shared relationship of these difficulties with both PD and GAD that partially explain the association of these disorders.
... It also warrants mention that, although this study examined AS as a continuous variable, some researchers have found evidence that the latent structure of AS may be taxonic (suggesting that the examination of AS as continuously distributed may not provide the best representation of this variable; see Bernstein, Zvolensky, Feldner, Lewis, & Leen-Feldner, 2005;Bernstein et al., 2006Bernstein et al., , 2007. However, it is important to note that a recent large-scale study that utilized four mathematically-independent taxometric procedures to examine the latent structure of AS did not find support for a taxonic structure; on the contrary, these procedures provided consistent evidence for a dimensional conceptualization of AS (Broman-Fulks et al., 2008). ...
Article
Current research suggests the importance of anxiety sensitivity (AS) in the risk for posttraumatic stress disorder (PTSD), and a growing body of research has demonstrated that difficulties in emotion regulation may also play a role. This study examined the unique relationships between AS dimensions, difficulties in emotion regulation, and a probable PTSD diagnosis among a sample of inner-city crack/cocaine dependent patients in residential substance abuse treatment. Probable PTSD participants exhibited higher levels of the AS dimension of social concerns and emotion regulation difficulties. Emotion regulation difficulties reliably distinguished probable PTSD participants from non-PTSD participants above and beyond both anxiety symptom severity and the AS dimension of social concerns. Further, social concerns did not account for unique variance when difficulties in emotion regulation was entered into the model. Results provide support for the central role of difficulties in emotion regulation relative to AS dimensions in the prediction of PTSD within a crack/cocaine dependent population.
... Análise: foi realizado o cálculo do kappa para a mensuração da concordância entre os pesquisadores e uma análise descritiva da frequência de estudos por base de dados, sua caracterização segundo o tipo de estudo, tipo de transtorno psiquiátrico e país de origem, e de dados cienciométricos, como número de publicações por ano, por base, fator de impacto e periódicos publicados. Dos 15 estudos sobre síndromes transculturais ("culture bound syndrome"), dois eram sobre "nervios ou ataque de nervios" 11,12 , dois sobre "susto" 13,14 , quatro sobre a relação entre crenças religiosas, espiritismo, "feitiçaria", transe e apresentação dos transtornos mentais [15][16][17][18] , um sobre a proposta de uma nova categoria diagnóstica intitulada "fetal and early trauma syndrome" 19 , três artigos teóricos 3,20,21 e três sobre a psicopatoplastia dos transtornos mentais [22][23][24] . Todos estes estudos descreviam síndromes transculturais baseando-se em poucos casos clínicos ou descreviam fatores culturais que pudessem estar relacionados com o aparecimento dos transtornos mentais. ...
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This review aims to verify the scientific evidences for the inclusion of culture bound syndromes in the International Classification of Diseases towards its 11th edition based on studies from Latin American and Caribbean countries. Studies were identified in Medline, LILACS and EMBASE databases for the period between 1992 and 2008, and then classified according to the type of study, to the mental disorder, country and number of publications per year. 163 studies were selected and classified: 33 in MedlLne, 90 in EMBASE e 40 in LILACS. The percentage of culture bound-syndrome corresponded to 9% in Medline, 12% in EMBASE e 2.5% in LILACS. Among fifteen studies on cultural bound syndromes, two were about "nervios and ataque de nervios", two about "susto", four about the relationship between religion beliefs, witchery, trance and mental disorders, one with a proposal for new diagnostic category, three about theoretic issues and three about the pathoplasty of mental disorders. The scarcity of studies on culture bound syndromes might be due to the indexation problems hindering the screening of studies; lack of interest on publishing such studies in indexed journals (publication bias) and due to difficulty to access them. There is no robust evidence identified among cross-cultural studies to recommend changes for International Classification of Diseases-11th edition.
... AS has been measured using the Anxiety Sensitivity Index (ASI; Reiss, Peterson, Gursky, & McNally, 1986), the Anxiety Sensitivity Index-Revised (ASI-R; Taylor & Cox, 1998), and the Anxiety Sensitivity Index-3 (ASI-3; Taylor et al., 2007). Later versions of the ASI have identified three separate dimensions of anxiety-related symptoms, including physical, cognitive, and social concerns ( Taylor et al., 2007), and it has recently been suggested that AS may be taxonic in nature (i.e., categorical vs. dimensional), depicting two forms of AS, pathological and normative ( Bernstein et al., 2006Bernstein et al., , 2007. ...
Article
The 2:1 female-to-male sex difference in the prevalence of panic disorder (PD) suggests that there is a sex-specific vulnerability involved in the etiology and/or maintenance of this disorder. The purpose of this paper is to present a new conceptual model, which emphasizes the interaction between a cognitive vulnerability for PD, anxiety sensitivity, and the effects of progesterone and its metabolite, allopregnanolone, on behavioral and physiological responses to stress during the premenstrual phase. This interaction is proposed to be a potential sex-specific pathway that may initiate and/or maintain panic and anxiety symptoms in women. This review paper presents preliminary evidence from both the human and animal literatures to support this new model. Specific topics reviewed include: psychopathology related to the menstrual cycle, anxiety sensitivity and its relationship to the menstrual cycle, PMS, and PMDD, anxiety-modulating effects of progesterone and its neuroactive metabolite, allopregnanolone, and how results from the neuroendocrine literature relate to psychopathology or symptoms associated with the menstrual cycle.
... 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.
... It should be noted that for purposes of testing the proposed model we have conceptualized both cardiac sensitivity and anxiety sensitivity as continuous rather than categorical constructs. However, there is some evidence (e.g., Bernstein et al., 2006Bernstein et al., , 2007Schmidt, Kotov, Lerew, Joiner, & Ialongo, 2005) suggesting that anxiety sensitivity may be taxonic. To date, tests of the taxonic hypothesis for AS have been mixed (see Broman-Fulks et al., 2008). ...
Article
The present study tested several predictions of a context-sensitivity panic vulnerability model emphasizing the interaction between threat context and threat sensitivities. Participants without a history of panic (N=47) completed both global and domain-specific panic relevant sensitivity measures and were then randomized to undergo a 35% CO2 inhalation challenge in the presence or absence of a cardiac defibrillator (threat context). As predicted by the model, cardiac sensitivity (but not trait anxiety or anxiety sensitivity) potentiated the effects of the presence of the defibrillator on CO2 fear responding. Moreover, as predicted by the model, the observed potentiation effects of cardiac sensitivity on CO2 fear responding were mediated by participants' threat appraisals connected to the presence of the defibrillator. Theoretical and clinical implications are discussed.
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Panic disorder is costly, and while evidence-based interventions for panic disorder are effective, obtaining a diagnosis often precludes access to such treatments. This is problematic because the categorical diagnosis of panic disorder (i.e. "you have it, or you don't") supported by modern diagnostic manuals contradicts empirically supported dimensional models of panic disorder. Taxometric analyses, which test the dimensional or categorical latent structure of constructs, have consistently revealed dimensional latent structures when applied to other anxiety disorders and panic-related processes, but taxometric analyses have never been applied to panic disorder. To address this gap in the literature, three nonredundant taxometric procedures were applied to seven theoretically-relevant indicators of panic disorder derived from Panic Disorder Severity Scale data collected from 663 participants recruited via Amazon Mechanical Turk. Simulated comparison plots and objective fit indices were also evaluated. The collective results provided consistent empirical support for a dimensional model of panic disorder, with an overall mean CCFI score of .39. The implications of the present findings for the measurement, assessment, diagnosis, and treatment of panic disorder are discussed.
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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.
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The fear avoidance model (FAM) represents a cognitive-behavioral explanatory approach for pain chronification. The core assumption is that fear of pain (FOP) following an acute pain experience facilitates the development of pain chronification, disability, and receding functionality. Thus, the model predicts a positive association between FOP and pain intensity in pain patients, which was frequently investigated; however, results were inconsistent. To highlight inconsistencies, we performed integrative statistical analysis aimed at evaluating the strength of the cross-sectional relation between FOP and pain intensity in clinical research and reviewing its moderation through demographic, pain-specific and psychosocial characteristics. To this end, we searched the databases PsycINFO, PubMed, and Web of Science and included 253 independent effect size estimates (N = 42 463). The overall mean effect size was computed based on a random-effects model. By utilizing the artifact distribution method, we supplemented it with an analysis correcting for artifacts. The magnitude of the positive association equated to the threshold between a small to medium effect size, which was expected as the FAM predicts an indirect relation only. The association turned out to be stable across different FOP measures, but was significantly moderated by age, pain localization, first-time pain episode, pain onset, treatment status, and anxiety sensitivity. A potentially necessary differentiation of patient subgroups and suggestions for an adjusted methodological approach of future research are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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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) 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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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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Concurrent use of cannabis and tobacco is associated with poor tobacco cessation outcomes. As little research has examined why treatment-seeking tobacco users engage in cannabis use, the objective of this study was to discover if emotional vulnerability and cannabis use motives are associated with concurrent users' cannabis use. One hundred thirty-eight (n = 138) daily cigarette smokers seeking smoking cessation treatment completed measures of anxiety sensitivity, cannabis use motives, and cannabis use. Stronger coping, enhancement, social, and expansion motives were associated with using greater amounts of cannabis per use occasion. In a model accounting for all these motives, anxiety sensitivity moderated the relationship between enhancement motives and cannabis use. Clinical interventions for concurrent tobacco-cannabis users may be advanced by targeting low anxiety sensitive individuals' use of cannabis to increase excitement and fun. Such an approach may consist of having clients identify and engage in healthier pleasurable activities and by teaching clients to accept the trade-off between perceived less pleasurable, but healthier activities and cannabis use. (Am J Addict 2014;23:7-14).
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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.
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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.
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This study examined the relationship between social fears and the three subscales of the Anxiety Sensitivity Index (ASI) in a non-clinical, student sample. In particular, the unique variance that the three ASI factors accounted for in social scrutiny fears, social interaction fears, and fear during a social challenge was investigated. Anxiety Sensitivity-Social Concern (AS-Social Concern) was hypothesised to account for a significant proportion of the variance in social fears compared to the other two subscales. Seventy one university students completed a series of psychological-based questionnaires and participated in a social challenge (videotaped speech task). Contrary to prediction, AS-Social Concern did not account for a unique proportion of the variance in social fears, but AS-Physical Concern and AS-Mental Concern did account for unique variance in social fears. Results are interpreted in light of recent findings on the structure of ASI.
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Recent developments in near-infrared spectroscopy (NIRS) have enabled non-invasive clarification of brain functions in psychiatric disorders. Functional neuroimaging studies of patients with obsessive-compulsive disorder (OCD) have suggested that the frontal cortex and subcortical structures may play a role in the pathophysiology of the disorder. Twelve treatment-naïve children with OCD and 12 age- and sex-matched healthy control subjects participated in the present study after giving consent. The relative concentrations of oxyhemoglobin (oxy-Hb) were measured with prefrontal probes every 0.1 s during the Stroop color-word task, using 24-channel NIRS machines. During the Stroop color-word task, the oxy-Hb changes in the OCD group were significantly smaller than those in the control group in the prefrontal cortex, especially in the frontopolar cortex. The present study suggests that children with OCD have reduced prefrontal hemodynamic response as measured by NIRS.
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Anxiety sensitivity (AS) is a trait-like characteristic capturing fears of the experience of anxiety and the potential psychological, somatic, or social consequences associated with anxiety. Recently, research has provided evidence for the latent structure of AS suggesting two discrete types, i.e. a taxonic class and a complement class. Investigations have identified combinations from the 16-items of the Anxiety Sensitivity Index (ASI) that are able to predict the taxon class of AS, referred to as the ASI taxon scales. The current study investigated the ability of a new ASI taxon scale, comprised of the seven overlapping items of the previously identified ASI taxon scales, to predict CO(2) challenge responses. This was examined in a sample of 387 nonclinical participants presenting for an AS treatment program. Participants completed a battery of questionnaires and a 20% CO(2) challenge as part of the program. Analyses indicated that the ASI taxon scale uniquely predicted CO(2) challenge response, whereas the complement scale did not have a significant association. The present study provides the first evidence of the AS taxon having the ability to predict an exaggerated fear response to a novel stressor known to be associated with anxiety psychopathology. Implications of these findings are discussed.
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Cognitive models of alcohol abuse posit that the context typically associated with alcohol use, such as negative affect, implicitly activates alcohol use cognitions, which in turn leads to alcohol consumption. We selected 40 undergraduate women based upon their alcohol use and reported anxiety sensitivity, and proposed that drinking for the purpose of negative reinforcement would predict increased semantic priming between anxiety and alcohol concepts. A lexical decision task compared the response latencies of alcohol targets preceded by anxiety words to those same targets preceded by neutral words (anxiety–alcohol priming). Level of anxiety sensitivity did not relate to anxiety–alcohol priming, but drinking following social conflict was associated with increased anxiety–alcohol priming. This study specifically suggests that the contextual antecedents to drinking behavior relate to the organization of semantic information about alcohol, and more generally supports cognitive models of substance abuse.
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Purpose: Despite evidence that smoking elevates peripheral autonomic nervous system activity, cigarette smokers commonly report smoking to reduce negative affect, or "calm down." Studies suggest that anxiety sensitivity is positively associated with the use of anxiolytic substances, but anxiety sensitivity is also characterized by aversive responding to elevations in physiological arousal. As such, anxiety sensitivity may be an important factor in the study of smoking, affect, and arousal. Method: Smokers smoked cigarettes in two experimental sessions: a Stressful Speech Condition and a No Stress Condition. Psychophysiological and self-report served as within-subjects, repeated measures. Results: Findings revealed that smoking reduced anxiety in high anxiety sensitive smokers who smoked during a stressful situation, but not a no stress situation. Low anxiety sensitive smokers endorsed anxiolysis in both conditions. Conclusions: Results suggest that high anxiety sensitive smokers may be sensitive to the physiologically arousing effects of smoking in low stress, low arousal, situations.
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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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.
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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.
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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.
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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.
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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.
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Although control over aversive events maintains a central role in contemporary models of anxiety pathology, particularly panic disorder, there is little understanding about the emotional consequences of specific types of control processes. In the present study, offset control over 8 20% carbon dioxide-enriched air administrations was experimentally manipulated in a large nonclinical population (n = 96) varying in anxiety sensitivity (high or low) and gender. Dependent measures included self-reported anxiety, affective reports of valence, arousal, emotional control, and physiological indices of heart rate and skin conductance. High anxiety-sensitive participants who lacked offset control reported significantly greater elevations in self-reported anxiety, emotional displeasure, arousal, and dyscontrol relative to their yoked counterparts with offset control. In contrast, low anxiety-sensitive individuals responded with similar levels of cognitive and affective distress regardless of the offset control manipulation. Although the provocation procedure reliably produced bodily arousal relative to baseline, at a physiological level of analysis, no significant differences emerged across conditions. These findings are discussed in relation to offset control during recurrent interoceptive arousal, with implications for better understanding anxiety about abrupt bodily sensations.
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Researchers have described 2 types of worriers, normal and pathological, who differ in the frequency, intensity, and controllability of their worry experiences. Although normal and pathological worry are generally treated as separate though related phenomena, no study has tested for separateness against the alternative hypothesis that all worry exists along a single dimension. In the present study, worry ratings of 1,588 college students were submitted to taxometric procedures designed to evaluate latent structure. Results provided evidence for the dimensionality of worry. These findings suggest that generalized anxiety disorder (GAD), whose central feature is worry, may also be quantitatively rather than qualitatively different from normal functioning. The authors argue that a focus on normal and pathological extremes has constrained the study of worry phenomena and that dimensional conceptualization of worry may significantly enhance understanding of both worry and GAD.
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Describes the development of the Agoraphobic Cognitions Questionnaire and the Body Sensations Questionnaire, companion measures for assessing aspects of fear of fear (panic attacks) in agoraphobics. The instruments were administered to 175 agoraphobics (mean age 37.64 yrs) and 43 controls (mean age 36.13 yrs) who were similar in sex and marital status to experimental Ss. Results show that the instruments were reliable and fared well on tests of discriminant and construct validity. It is concluded that these questionnaires are useful, inexpensive, and easily scored measures for clinical and research applications and fill a need for valid assessment of this dimension of agoraphobia. (22 ref)
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Maximum covariance (MAXCOV) is a method for determining whether a group of 3 or more indicators marks 1 continuous or 2 discrete latent distributions of individuals. Although the circumstances under which MAXCOV is effective in detecting latent taxa have been specified, its efficiency in classifying cases into groups has not been assessed, and few studies have compared its performance with that of cluster analysis. In the present Monte Carlo study, the classification efficiencies of MAXCOV and the k-means algorithm were compared across ranges of sample size, effect size, indicator number, taxon base rate, and within-groups covariance. When the impact of these parameters was minimized, k-means classified more data points correctly than MAXCOV. However, when the effects of all parameters were increased concurrently, MAXCOV outperformed k-means.
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Anxiety sensitivity (AS) has been defined as the fear of anxiety and anxiety-related sensations, and evidence suggests that AS plays an important role in the psychopathology of panic. It is entirely unclear whether the relation between AS and panic should be attributed to one (or more) of the AS group factors, the general AS factor, or to factors at both levels of the AS hierarchy. The authors reanalyzed data presented earlier by R. M. Rapee, T. A. Brown, M. A. Antony, and D. H. Barlow (1992) to tease apart the contributions of the different levels of the AS hierarchy to fear responses to hyperventilation and 5.5% carbon dioxide challenges. ne results demonstrated that AS-Physical Concerns is the only one of the three AS group factors that contributes to relations with fear responses to these two challenges. However, AS-Mental Incapacitation Concerns had a stronger positive linear association with depressed mood than did AS-Physical Concerns.
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Mental health professionals have debated whether posttraumatic stress disorder (PTSD) can be qualitatively distinguished from normal reactions to traumatic events. This debate has been fueled by indications that many trauma-exposed individuals evidence partial presentations of PTSD that are associated with significant impairment and help-seeking behavior. The authors examined the latent structure of PTSD in a large sample of male combat veterans, Three taxometric procedures-MAMBAC, MAXEIG, and L-Mode-were performed with 3 indicator sets drawn from a clinical interview and a self-report measure of PTSD. Results across procedures, consistency tests, and analysis of simulated comparison data all converged on a dimensional solution, suggesting that PTSD reflects the upper end of a stress-response continuum rather than a discrete clinical syndrome.
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Expectancy theory posits that anxiety sensitivity may serve as a premorbid risk factor for the development of anxiety pathology (S. Reiss, 1991). The principal aim of the present study was to determine whether anxiety sensitivity acts as a specific vulnerability factor in the pathogenesis of anxiety pathology. A large, nonclinical sample of young adults (N = 1,401) was prospectively followed over a 5-week highly stressful period of time (i.e., military basic training). Anxiety sensitivity was found to predict the development of spontaneous panic attacks after controlling for a history of panic attacks and trait anxiety. Approximately 20% of those scoring in the upper decile on the Anxiety Sensitivity Index (R. A. Peterson & S. Reiss, 1987) experienced a panic attack during the 5-week follow-up period compared with only 6% for the remainder of the sample. Anxiety sensitivity also predicted anxiety symptomatology, functional impairment created by anxiety, and disability. These data provide strong evidence for anxiety sensitivity as a risk factor in the development of panic attacks and other anxiety symptoms.
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Units of personality may be of 2 varieties: dimensional variables (traits), which involve continuously distributed differences in degree, and class variables, which involve discretely distributed differences in kind. There exists, however, a prevailing assumption that the units of personality are continuous dimensions and an accompanying prejudice against class variables. Thus, differences between people are presumed to be differences in degree, not kind. The authors examine this prejudice, the arguments that generated it, and those that uphold it. It is concluded that these arguments are applicable to class variables as they often have been explicated, in phenetic terms; by contrast, genetically explicated class variables are not vulnerable to these arguments. Criteria are proposed and methods are presented for corroborating the existence of class variables in personality. A test is described of a class model of a construct, the conceptual status of which makes it reasonable to evaluate whether or not the differences between individuals represented by this construct constitute discrete classes. Self-monitoring is demonstrated to be a discretely distributed class variable that influences social behavior. Implications for conceptualizing and investigating the nature and origins of personality are examined. (3½ p ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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The possibility that hypnotic ability is typological rather than dimensional was evaluated in a series of 4 studies. Study 1 used two samples of mass-testing measures of hypnotic ability, which were analyzed using the MAXCOV-HITMAX method (R.E. Meehl, 1973). Results of these analyses were in keeping with the existence of a latent typology in hypnotic ability scores. Study 2 investigated the possibility that these results could be a false-positive artifact of factor structure. Results of the simulation analyses indicated that the possibility of a false-positive was unacceptably high. Studies 3 and 4 used larger samples, combined with data-simulation control analyses. Results of Studies 3 and 4 were in keeping with the existence of a latent typology in hypnotic ability scores, whereas datasimulation control analyses demonstrated that the risk of false-positive results was acceptably low. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Past research evaluating the continuity and discontinuity models of bulimia has produced inconclusive results. In the current study, we performed a taxometric analysis of bulimia nervosa using means above minus below a sliding cut and maximum covariance analysis with a sample of women diagnosed with bulimia nervosa ( n = 201) or women college students ( n =  412). Indicators were derived from the Bulimia Test—Revised and the Eating Attitudes Test—26, and both a mixed sample and the nonclinical sample were analyzed. With both taxometric methods and both mixed and nonclinical samples, results were consistently suggestive of a latent taxon for bulimia. These results challenge a dimensional model of bulimia nervosa. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Describes the Maximum Covariance (MAXCOV) taxometric procedure within the coherent cut kinetics method. Using MAXCOV, when given 3 quantitative indicators of a conjectured latent taxon, a statistical function defined as the covariance of 2 indicators (designated for the procedure as the "output" indicators) computed within successive intervals along the third (designated as "input") indicator reveals whether the latent structure of the data is taxonic or not. If it is taxonic, latent parameters (base rate, hit rates, complement and taxon means) can be estimated, the latent distributions drawn, and subjects assigned to the taxon or the complement group. Several consistency tests are presented, using Monte Carlo configurations. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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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)
Article
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The Anxiety Sensitivity Index (ASI) is one of the most widely used measures of the construct of anxiety sensitivity. Until the recent introduction of a hierarchical model of the ASI by S. O. Lilienfeld, S. M. Turner, and R. G. Jacob (1993), the factor structure of the ASI was the subject of debate, with some researchers advocating a unidimensional structure and others proposing multidimensional structures. In the present study, involving 432 outpatients seeking treatment at an anxiety disorders clinic and 32 participants with no mental disorder, the authors tested a hierarchical factor model. The results supported a hierarchical factor structure consisting of 3 lower order factors and 1 higher order factor. It is estimated that the higher order, general factor accounts for 60% of the variance in ASI total scores. The implications of these findings for the conceptualization and assessment of anxiety sensitivity are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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This study examined the factor structure of the Anxiety Sensitivity Index (ASI) among African American college students. Confirmatory factor analysis indicated the 3-factor solution commonly found among other populations did not fit the data for African Americans. Although an exploratory factor analysis indicated the presence of a Mental Incapacitation factor, the Physical Concerns factor was divided into unsteady and cardiovascular concerns. Items typically comprising the Social factor were reflective of emotional controllability among African Americans. The ASI was also moderately correlated with measures of anxiety and depression providing only weak evidence of convergent and discriminate validity of the ASI for African Americans. Although support for the multidimensional nature of AS was found, the factor composition differs for African Americans.
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Anxiety sensitivity (AS; the fear of anxiety-related sensations) has been proposed as a risk factor for the development of panic disorder. The present study involved a conceptual replication of Ehlers' (1993, Behaviour Research and Therapy, 31, 269–278) study on childhood learning experiences and panic attacks, but also extended her work by investigating the relationship between early learning experiences and the development of AS, in a non-clinical sample. A sample of 551 university students participated in a retrospective assessment of their childhood and adolescent instrumental and vicarious learning experiences with respect to somatic symptoms (i.e. anxiety and cold symptoms, respectively) using an expanded version of Ehler's (1993) Learning History Questionnaire. AS levels were assessed using the Anxiety Sensitivity Index, and panic history was obtained using the Panic Attack Questionnaire, Revised. Contrary to hypotheses, the learning experiences of high AS individuals were not found to be specific to anxiety symptoms, but involved parental reinforcement of sick-role behavior related to somatic symptoms in general. High AS subjects reported both more anxiety and cold symptoms prior to age 18 than individuals with lower levels of AS. In addition, both cold and anxiety symptoms elicited more special attention and/or instructions from parents for high AS individuals to take special care of themselves. These findings are contrasted with the results for self-reported panickers who reported more learning experiences (modeling and parental reinforcement) specific to anxiety-related symptoms, than the non-panickers. The results suggest that higher-than-normal levels of AS may arise from learning to catastrophize about the occurrence of bodily symptoms in general, rather than anxiety-related symptoms in particular.
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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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Panic disorder has been the subject of considerable research and controversy. Though biological conceptualizations have been predominant, psychological theorists have recently advanced conditioning, personality, and cognitive hypotheses to explain the etiology of panic disorder. The purpose of this article is to provide an empirical and conceptual analysis of these psychological hypotheses. This review covers variants of the "fear-of-fear" construal of panic disorder (i.e., Pavlovian interoceptive conditioning, catastrophic misinterpretation of bodily sensations, anxiety sensitivity), research on predictability (i.e., expectancies) and controllability, and research on information-processing biases believed to underlie the phenomenology of panic. Suggestions for future research are made.
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One of the many controversies concerning the borderline personality disorder (BPD) diagnosis is whether the construct refers to a categorical or dimensional variable. The current study used Meehl's (1973) maximum covariance analysis to investigate this issue. The charts of 409 psychiatric inpatients were systematically reviewed for the presence of BPD and dysthymic symptoms. Charts of 244 inpatients were also reviewed to assess the presence of indicators of male sex, a categorical variable. The results for BPD and dysthymia were consistent with a dimensional model, whereas those for male sex were consistent with a categorical model. A dimensional model of classification of BPD is recommended, and suggestions for future research are provided.
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Taxometric analyses were applied to the construct of psychopathy (as measured by the Psychopathy Checklist) and to several variables reflecting antisocial childhood, adult criminality, and criminal recidivism. Subjects were 653 serious offenders assessed or treated in a maximum-security institution. Results supported the existence of a taxon underlying psychopathy. Childhood problem behaviors provided convergent evidence for the existence of the taxon. Adult criminal history variables were continuously distributed and were insufficient in themselves to detect the taxon.
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Body vigilance, consciously attending to internal cues, is a normal adaptive process. The present report investigated whether body vigilance is exaggerated among those with panic disorder, a condition characterized by intense fear and worry regarding bodily sensations. The Body Vigilance Scale is validated in nonclinical and anxiety disorder samples. Study 1 suggests that body vigilance is normally distributed in a nonclinical sample (n = 472) but vigilance is related to a history of spontaneous panic attacks, anxiety symptomatology, and anxiety sensitivity. Study 2 suggests that body vigilance is elevated in panic disorder patients (n = 48) relative to social phobia patients (n = 18) and nonclinical controls (n = 71). During cognitive-behavioral treatment, panic disorder patients show substantial reductions in body vigilance associated with reductions in anxiety symptomatology. Anxiety sensitivity was found to be related to body vigilance and to predict changes in body vigilance during treatment.
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Expectancy theory posits that anxiety sensitivity may serve as a premorbid risk factor for the development of anxiety pathology (S. Reiss, 1991). The principal aim of the present study was to determine whether anxiety sensitivity acts as a specific vulnerability factor in the pathogenesis of anxiety pathology. A large, nonclinical sample of young adults (N = 1,401) was prospectively followed over a 5-week highly stressful period of time (i.e., military basic training). Anxiety sensitivity was found to predict the development of spontaneous panic attacks after controlling for a history of panic attacks and trait anxiety. Approximately 20% of those scoring in the upper decile on the Anxiety Sensitivity Index (R. A. Peterson & S. Reiss, 1987) experienced a panic attack during the 5-week follow-up period compared with only 6% for the remainder of the sample. Anxiety sensitivity also predicted anxiety symptomatology, functional impairment created by anxiety, and disability. These data provide strong evidence for anxiety sensitivity as a risk factor in the development of panic attacks and other anxiety symptoms.
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The relation of anxiety sensitivity (AS) to personality dimensions has received little attention. In this study, 4 AS indexes were administered along with measures of personality, fears, and panic attacks to 220 undergraduates. At the higher order level, AS was positively correlated with negative emotionality (NE) but was largely unrelated to either positive emotionality or constraint. At the lower order level, AS was positively correlated with absorption and NE indexes. Most of these correlations were significant even among participants with no panic attack history. AS exhibited incremental validity above and beyond a number of personality variables, including absorption and trait anxiety, in the prediction of fears and panic attack history. These findings are consistent with the hypothesis that a propensity toward immersion in sensory experiences is a diathesis for panic attacks.
Article
The Anxiety Sensitivity Index (ASI) is one of the most widely used measures of the construct of anxiety sensitivity. Until the recent introduction of a hierarchical model of the ASI by S. O. Lilienfeld, S. M. Turner, and R. G. Jacob (1993), the factor structure of the ASI was the subject of debate, with some researchers advocating a unidimensional structure and others proposing multidimensional structures. In the present study, involving 432 outpatients seeking treatment at an anxiety disorders clinic and 32 participants with no mental disorder, the authors tested a hierarchical factor model. The results supported a hierarchical factor structure consisting of 3 lower order factors and 1 higher order factor. It is estimated that the higher order, general factor accounts for 60% of the variance in ASI total scores. The implications of these findings for the conceptualization and assessment of anxiety sensitivity are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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
A disease entity is initially defined implicitly or contextually by the researcher clinician's presenting a cluster of symptoms, complaints, and signs which covary over the population of patients (and usually over time in the individual patient). This observational finding suggests the conjecture that the cluster, usually called the 'syndrome', exhibits its statistical togetherness because of a causal source shared in common by the several indicators. An arbitrariness as to deciding for the presence or absence of the syndrome in individual patients arises from the fact that the pair wise relations of the syndrome elements are typically imperfect correlations, which in turn arises because each of them is only a fallible (nonpathognomonic) indicator of the latent pathologic situation. A disease entity is expected to become defined jointly by pathology and etiology when these become known, and it is recognized that it cannot be defined explicitly until that advanced state of knowledge has been achieved. A series of progressively weaker meanings of the expression 'specific etiology' is set out without a claim to completeness or present exemplification of all of them in genetics, psychopathology, or medicine. Some related dependencies of a similar kind (strong etiology) but too weak for labeling specific etiology are developed as well.
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
Two aspects of translation were investigated: (1) factors that affect translation quality, and (2) how equivalence between source and target versions can be evaluated. The variables of language, content, and difficulty were studied through an analysis of variance design. Ninety-four bilinguals from the University of Guam, representing ten languages, translated or back-translated six essays incorporating three content areas and two levels of difficulty. The five criteria for equivalence were based on comparisons of meaning or predictions of similar responses to original or translated versions. The factors of content, difficulty, language and content-language interaction were significant, and the five equivalence criteria proved workable. Conclusions are that translation quality can be predicted, and that a functionally equivalent translation can be demonstrated when responses to the original and target versions are studied.
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
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
ABSTRACT A taxon is a nonarbitrary class whose existence is conjectured as an empirical question, not a mere semantic convenience. Numerous taxa are known to exist in nature and society (chemical elements, biological species, organic diseases, geological strata, kinds of stars, elementary particles, races, cultures, Mendelizing mental deficiencies, major psychoses, vocations, ideologies, religions). What personality types, if any, occur in the nonpathological population remains to be researched by sophisticated methods, and cannot be settled by fiat or “dimensional” preference. The intuitive concept of taxonicity is to be explicated by a combination of formal-numerical and causal criteria. Taxometric methods should include consistency tests that provide Popperian risk of strong discorroboration. In social science, latent class methods are probably more useful than cluster algorithms.
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
Research has shown that 'fear of anxiety' plays a significant role in the occurrence of panic and is predictive of both the development and severity of panic disorder. The most frequently used measures of fear of anxiety are the Anxiety Sensitivity Index (ASI), the Agoraphobic Cognitions Questionnaire (ACQ), and the Body Sensations Questionnaire (BSQ). In an attempt to further our understanding of fear of anxiety the present study sought to evaluate the extent to which these common measures assess unique aspects of the construct. Results of data collected from 48 panickers and 48 control Ss with no panic history indicate that: (a) the measures of fear of anxiety are modestly correlated with each other and, in panickers, with trait anxiety; (b) panickers score higher than control Ss on the ASI and the total score of the ACQ, but not on the Physical or Social/Behavioral Concerns Scales of the ACQ or on the BSQ; and (c) the measures provide unique contributions to discriminant function classification of panickers and nonpanickers. These results suggest that, while the measures are associated with panic experiences, each may be measuring unique aspects of fear of anxiety. Theoretical and practical implications are discussed.
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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.
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The purposes of this article are to summarize the author's expectancy model of fear, review the recent studies evaluating this model, and suggest directions for future research. Reiss' expectancy model holds that there are three fundamental fears (called sensitivities): the fear of injury, the fear of anxiety, and the fear of negative evaluation. Thus far, research on this model has focused on the fear of anxiety (anxiety sensitivity). The major research findings are as follows: simple phobias sometimes are motivated by expectations of panic attacks; the Anxiety Sensitivity Index (ASI) is a valid and unique measure of individual differences in the fear of anxiety sensations; the ASI is superior to measures of trait anxiety in the assessment of panic disorder; anxiety sensitivity is associated with agoraphobia, simple phobia, panic disorder, and substance abuse; and anxiety sensitivity is strongly associated with fearfulness. There is some preliminary support for the hypothesis that anxiety sensitivity is a risk factor for panic disorder. It is suggested that future researchers evaluate the hypotheses that anxiety and fear are distinct phenomena; that panic attacks are intense states of fear (not intense states of anxiety); and that anxiety sensitivity is a risk factor for both fearfulness and panic disorder.
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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.