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Gender differences in Childhood Anxiety Sensitivity Index (CASI) dimensions

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Abstract

We examined the hierarchical structure of the Childhood Anxiety Sensitivity Index (CASI) as a function of gender and examined the occurrence of gender differences in anxiety sensitivity (AS) dimensions in a large nonclinical sample of children and adolescents (N = 1698). Separate principal components analyses (PCAs) on the 18 CASI items for the total sample, boys, and girls revealed similar lower-order three-factor structures for all groups. The three factors reflected Physical, Social/Control, and Psychological Concerns. PCAs on the lower-order factor scores revealed similar unidimensional higher-order solutions for all groups. Girls scored higher than boys on the Physical and, to a lesser extent, Social/Control Concerns factors; girls scored higher on the Physical Concerns factor relative to their scores on the Social/Control and Psychological Concerns factors; and boys scored higher on the Social/Control and Psychological Concerns factors relative to their scores on the Physical Concerns factor. Girls also scored higher than boys on the higher-order factor representing the Global AS construct. The present study provides additional support for the theoretical hierarchical structure of AS and suggests that there is a difference in the manifestation of AS between girls and boys.

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... The total mean score reported here is for the adjusted total c Silverman et al. used an Australian sample for derivation and cross-validation purposes and an American sample for cross-validation purposes. Only those results pertaining to the Australian samples are noted here Although subsequent support for a hierarchical multidimensional factor structure for the CASI comprising three lower-order factors was demonstrated by van Widenfelt et al. (2002), Walsh et al. (2004), McLaughlin et al. (2007, and Essau et al. (2010), these authors also noted that the limited item content comprising each scale contributed to low estimates of internal consistency, which in turn could adversely affect validity across studies. ...
... Using CFAs, Wright et al. (2010) compared three factor models previously identified in the literature: (1) a two-factor model proposed by , (2) a three-factor model reported by Walsh et al. (2004), and (3) a four-factor model suggested by Silverman et al. (2003) while also assessing factor invariance across sex. Wright et al. (2010) observed acceptable model fit for all three of the tested structures for boys, although the three-factor structure provided the best fit for the data. ...
... Citing the previous lack of agreement over the AS factor structure in youth and suggesting that genetic methods might help to identify the optimal number of AS factors, Brown et al. (2012) used data from a large-scale longitudinal study of adolescent twin and sibling pairs to conduct a confirmatory analysis of the CASI. Specifically, previously identified two- , three- (Walsh et al. 2004;Wright et al. 2010), and four-factor (Silverman et al. 1999(Silverman et al. , 2003 models were used to compare their data, with subsequent analyses employed to examine genetic and environmental contributions to AS. Although three-and four-factor solutions provided comparable fits to the data, a three-factor solution was favored due to considerations of "greater interpretability and parsimony" (Brown et al. 2012). ...
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Background Child anxiety sensitivity (AS) is measured almost exclusively using the Childhood Anxiety Sensitivity Index (CASI). Yet, in the context of significant discrepancies regarding the CASI factors and how they are scored and reported, it remains unclear whether the CASI reliably and validly assesses the purported multifactorial AS construct. Objective This paper will: (1) provide a comprehensive summary of previous CASI factor analyses by which these factor structures were identified, (2) evaluate evidence regarding the multifactorial nature of AS in youth, and (3) discuss potential directions for continued research in this area. Method In a PsycInfo search, peer-reviewed studies published between 1991 and 2018 were identified for inclusion if they examined the factor structure of the CASI or reported data on the CASI subscales as administered to child participants. Results Findings from the 50 studies reviewed suggested that (1) the 18-item CASI does not consistently yield internally reliable assessments of specific AS facets, (2) significant discrepancies exist regarding the CASI subscales identified, the items comprising these scales, and their predictive validity in terms of anxiety, and (3) alternatives to assess the multifactorial construct of AS in youth do exist, but they have not been systematically examined in the literature. Conclusions Directions for future study include further examining expanded scales for AS in youth, continued study of shorter scales assessing more consistently reliable AS content, and evaluating the utility of an expanded response scale for the CASI.
... Anxiety sensitivity is defined as fear of the consequences of anxiety and arousal sensations ( Reiss & McNally, 1985 ). AS and anxious arousal in response to bodily sensations are conceptually distinct concepts; the former refers to an outcome expectancy regarding the consequences of anxiety, while the latter reflects "real-time" emotional responsiveness to interoceptive sensations ( Taylor, 1999 ). Factor analyses suggest the global AS factor is comprised of three lower-order factors reflecting domain-specific concerns about the consequences of anxiety-related sensations (i.e., physical, mental, and social concerns; Brown et al., 2012 ;Walsh, Stewart, McLaughlin, & Comeau, 2004 ;Wright et al., 2010 ). ...
... Notably, there may be sex differences in how adolescents experience AS (e.g., Walsh et al., 2004 ). Indeed, recent work suggests female adolescents may experience more physical concerns and fear in the presence of unusual bodily sensations as compared to males ( Wright et al., 2010 ). ...
... The CASI has a hierarchical structure, with one global factor and three lower order factors ( Silverman et al., 1991 ;Wright et al., 2010 ). The 12-item physical concerns factor (e.g., "it scares me when my heart beats fast"), the 3-item social concerns factor (e.g., "I don't like to let my feelings show"), and the 3-item mental concerns factor (e.g., "when I cannot keep my mind on schoolwork, I worry that I might be going crazy") were examined ( Brown et al., 2012 ;Walsh, Stewart, McLaughlin, & Comeau, 2004 ). Internal consistency estimates for the physical, social, and mental concerns factors were similar to previously published work (alphas = 0.84, 0.57, and 0.68, respectively; Knapp, Blumenthal, Mischel, Badour, & Leen-Feldner, 2015 ;Walsh et al., 2004 ). ...
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Evidence suggests that smoking to cope among adolescents is associated with a number of problematic outcomes (e.g., greater smoking frequency, higher rates of dependence). It is thus imperative to better understand factors that may increase the likelihood of smoking to cope among adolescents. Research suggests anxiety sensitivity (AS) is associated with smoking to cope among adults, although the link between AS and coping motives for cigarette use among youth is less clear. Gender differences have also been noted in AS. The current study investigates this association using a biological challenge paradigm. Specifically, the indirect effects of anxious reactivity to bodily arousal on the relation between the physical and mental AS factors and coping motives for cigarette smoking were examined within a sample of 108 adolescent cigarette smokers. Gender was examined as a moderator. Results suggested significant indirect effects of self-reported anxiety in response to bodily arousal on the relation between physical AS and coping motives for cigarette smoking. This indirect effect was moderated by gender, such that it was significant for females but not males. Models examining AS mental concerns and psychophysiological responding to the challenge were not significant. These results suggest that, relative to their low AS counterparts, female adolescents high in physical concerns respond with elevated anxiety in response to interoceptive arousal and, in turn, endorse elevated coping-related smoking motives. Findings are discussed in terms of implications for understanding the nature and origins of coping-related smoking motives and how such information can be used to inform intervention efforts. (PsycINFO Database Record
... Third, the effect of gender was investigated. We hypothesised that girls would score higher than boys for AS (Muris, 2002;van Widenfelt et al., 2002;Walsh, Stewart, McLaughlin, & Comeau, 2004). ...
... Like other studies, our results show that girls report significantly more fear of anxious feelings than boys (e.g., Muris, 2002;Walsh et al., 2004). The effect of gender was also observed for the various factors, except for factor 1 "fear of cognitive dyscontrol". ...
... The effect of gender was also observed for the various factors, except for factor 1 "fear of cognitive dyscontrol". Thus, and consistently with previous findings, girls reported greater fear of anxiety-related social concerns (factors 2 and 4; e.g., Walsh et al., 2004) and fear of physical symptoms (factors 3 and 4); boys and girls feared cognitive dyscontrol equally (e.g., Deacon, Valentiner, Gutierrez, & Blacker, 2002;Muris, 2002). Muris, Meesters, and Knoops (2005) explain this gender effect as resulting from different parenting practices for boys and girls and a greater willingness among girls to speak of their fears. ...
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This study (n = 237 Belgian children; mean age = 12.3 years; SD = 0.41) exam- ined the factor structure, reliability, and validity of the French translation of the Revised Childhood Anxiety Sensitivity Index (CASI-R). We obtained a hier- archical factor structure with four lower-order factors – “fear of cognitive dys- control,” “fear of publicly observable anxiety reactions,” “fear of respiratory symptoms,” and “fear of cardiovascular symptoms” – loading on a single higher-order factor (“anxiety sensitivity”). The French translation revealed acceptable internal consistency and a good interitem structure. Anxiety sensi- tivity was connected with the anxiety and depression scales but the correlation between the CASI-R and the depression score was more modest than that between the CASI-R and the trait anxiety score, indicating that the CASI-R is an anxiety scale. Girls reported more fear of anxious feelings than boys. This revised version allows for a more fine-grained assessment of the anxiety sensi- tivity concept.
... In addition to a global dimension, factor analytic work with both youth and adults suggest anxiety sensitivity is comprised of three lowerorder factors reflecting fear of the specific consequences of anxiety, such as cognitive dyscontrol (i.e., cognitive concerns), social rejection or embarrassment (i.e., social concerns), and serious physical illness (i.e., physical concerns; Brown et al. 2012;Reiss and McNally 1985;Walsh, Stewart, McLaughlin, and Comeau 2004;Wright et al. 2010). In a recent meta-analysis, Naragon-Gainey (2010) suggested all three of the lower-order factors may be expected to relate to generalized anxiety disorder among adults. ...
... Anxiety Sensitivity The Child Anxiety Sensitivity Index (CASI; Silverman et al. 1991;Wright et al. 2010) is an 18-item measure utilizing a 3-point Likert-type scale (1 None to 3 A Lot) to index anxiety sensitivity. The CASI was used to measure the single, higher-order factor of anxiety sensitivity (AS) as well as the three lower-order factors of physical concerns (12 items; example: BIt scares me when I feel like I am going to faint^), social concerns (3 items; example: BI don't like to let my feelings show^), and mental concerns (3 items; example: BWhen I cannot keep my mind on my schoolwork, I worry that I might be going crazy^; Brown et al. 2012;Silverman et al. 1991;Walsh et al. 2004;Wright et al. 2010). This scale has adequate psychometric properties (Wright et al. 2010); internal consistency estimates for the current sample are very similar to published work (Walsh et al. 2004): global score (α=0.84), ...
... The CASI was used to measure the single, higher-order factor of anxiety sensitivity (AS) as well as the three lower-order factors of physical concerns (12 items; example: BIt scares me when I feel like I am going to faint^), social concerns (3 items; example: BI don't like to let my feelings show^), and mental concerns (3 items; example: BWhen I cannot keep my mind on my schoolwork, I worry that I might be going crazy^; Brown et al. 2012;Silverman et al. 1991;Walsh et al. 2004;Wright et al. 2010). This scale has adequate psychometric properties (Wright et al. 2010); internal consistency estimates for the current sample are very similar to published work (Walsh et al. 2004): global score (α=0.84), physical concerns subscale (α=0.85); ...
Article
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Anxiety psychopathology, one of the most prevalent classes of disorder among youth, is linked to detrimental outcomes. Accordingly, identifying factors that influence vulnerability to anxiety disorders is important. One promising factor, given emerging evidence for its transdiagnostic nature, is anxiety sensitivity (AS); however, relatively little is known about the linkage between AS and indicators of generalized anxiety disorder (GAD), particularly among youth. The aim of the current investigation was to address this gap in the literature using a community-based sample of adolescents aged 10–17 years (n = 165; M age = 14.49 years, SD = 2.26). Results indicated global AS and the AS-physical concerns dimension were significantly associated with worry, generalized anxiety symptoms, and GAD diagnosis assessed via a structured clinical interview, above and beyond key theoretically-relevant covariates. These findings add to a growing body of work underscoring the relevance of AS for multiple types of anxiety-related disorders among youth.
... Although some studies found that private school students report higher levels of test anxiety (Dhull, 2013;Tehrani et al., 2014), others found the opposite (Aydin, 2013), whereas others found no significant differences between school types (von der Embse and Hasson, 2012). Furthermore, studies consistently showed that girls report greater levels of anxiety sensitivity (Walsh et al., 2004) and test anxiety (Putwain, 2007;Tehrani et al., 2014;von der Embse et al., 2018) compared to boys. Therefore, in studying boys and girls of both elementary and secondary school, as well as from public and private schools, this study will provide a clearer Frontiers in Psychology 04 frontiersin.org ...
... First, boys were more likely to be in the No-susceptibility profile, whereas girls were more likely to be in the profiles including a susceptibility to anxiety sensitivity (the unique and double profiles). This aligns with the literature reporting that girls are more sensitive to anxiety than boys (Walsh et al., 2004). Though contrary to other studies (Putwain, 2007;Tehrani et al., 2014;von der Embse et al., 2018), boys and girls in our sample were equally likely to be in the Uniquesusceptibility to test anxiety profile. ...
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Background Studies report a growing tendency for students to experience state anxiety in schools. However, the combination of individual susceptibilities likely to trigger students’ anxious states remains unclear. Aims This study examined whether distinct profiles of students emerge regarding their susceptibility to anxiety sensitivity and/or test anxiety and evaluated whether students’ profile predicted anxious states. We also verified whether susceptibility profiles varied across gender, school level, and school type. Sample and methods In total, 1,404 Canadian students in Grades 5 and 10 (589 boys; Mage = 15.2, SD = 2.1) from 13 public and private schools completed self-reported measures of state/trait anxiety, anxiety sensitivity, and test anxiety. Results Latent profile analyses identified four susceptibility profiles: (1) Double-susceptibility: highest anxiety sensitivity and test anxiety scores; (2) Unique-susceptibility to test anxiety: high test anxiety score and low anxiety sensitivity score; (3) Unique-susceptibility to anxiety sensitivity: high anxiety sensitivity score and low test anxiety score; and (4) No-susceptibility: lowest anxiety sensitivity and test anxiety scores. The profiles comprised 12, 9, 6, and 73% of the sample, respectively, and their membership varied across gender and school type, but not across school levels. A linear mixed-effect model showed that state anxiety varied significantly between profiles, where the Double-susceptibility profile predicted the highest state anxiety scores, followed by the two Unique-susceptibility profiles (indifferently), and the No-susceptibility profile. Conclusion Beyond their theoretical contribution to the state–trait anxiety literature, these findings suggest that selective interventions designed more specifically for students with the Double-susceptibility profile may be worthwhile. Results also highlight the high proportion of students with the No-susceptibility profile and shed light on the reassuring portrait regarding students’ anxiety.
... Although some studies found that private school students report higher levels of test anxiety (Dhull, 2013;Tehrani et al., 2014), others found the opposite (Aydin, 2013), whereas others found no significant differences between school types (von der Embse and Hasson, 2012). Furthermore, studies consistently showed that girls report greater levels of anxiety sensitivity (Walsh et al., 2004) and test anxiety (Putwain, 2007;Tehrani et al., 2014;von der Embse et al., 2018) compared to boys. Therefore, in studying boys and girls of both elementary and secondary school, as well as from public and private schools, this study will provide a clearer Frontiers in Psychology 04 frontiersin.org ...
... First, boys were more likely to be in the No-susceptibility profile, whereas girls were more likely to be in the profiles including a susceptibility to anxiety sensitivity (the unique and double profiles). This aligns with the literature reporting that girls are more sensitive to anxiety than boys (Walsh et al., 2004). Though contrary to other studies (Putwain, 2007;Tehrani et al., 2014;von der Embse et al., 2018), boys and girls in our sample were equally likely to be in the Uniquesusceptibility to test anxiety profile. ...
Preprint
Background and Objective: State anxiety, trait anxiety, anxiety sensitivity and test anxiety are four related but distinct normative anxiety forms that may co-occur amongst youth. The main objective of this study was to assess whether these anxiety forms vary as a function of age and/or presence of stressful school periods. Design and Methods: In total, 1404 Canadian students in Grades 5,6 and 10,11 (58% girls) from 13 private and public schools were assessed on these four anxiety forms using validated questionnaires at two time points: during a stressful examination period and a normal school curriculum period. Results: High school students scored higher on state, trait and test anxiety compared to elementary school students, while the two age groups did not differ on anxiety sensitivity scores. Anxiety scores did not vary as a function of examination periods. Conclusions: Regardless of their age, students appear prone to experience anxiety in a wide range of situations that go beyond examination periods. Students experience anxiety sensitivity early on and levels remain similar during childhood and adolescence, whereas other anxiety forms become more pronounced during high school. These results contribute to a better understanding of normative anxiety in youth. Recommendations for preventive interventions are discussed.
... The existence of such fears has also been reported by other authors (e.g. [12,33]). In sum, the PAS provides information about the type and frequency of anxiety symptoms and evaluates whether a child is at risk for developing anxiety disorders. ...
... This model would prevail over the other models if parents perceived anxiety in their children as one phenomenon rather than as distinct clusters of symptoms. Although this model was not holding up well in former PAS studies, there are indications that a higher-order factor model may provide a good explanation for the high correlations between the five factors [28,31,35] and for other anxiety factors identified in studies using other instruments than the PAS [33,46]. ...
Article
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The experience of fear is universal and is among the earliest of all forms of psychopathology, if excessively present. To prevent negative developmental outcomes due to early-onset excessive fears in children, it is important to systematically assess these experiences as early as possible. Using the preschool anxiety scale (PAS), we aimed to assess the frequency and structure of anxiety symptoms of 489 preschool-aged children raised in their biological family and 88 raised in foster care (as a high-risk sample) in Germany. While these young children displayed the same types of anxiety most commonly as young children in other countries, the overall occurrence seems to be reported less often by parents in Germany compared to parents from other countries. Anxiety symptoms clustered into five correlated factors (generalized anxiety, social anxiety, obsessive–compulsive disorder (OCD), physical injury fear and separation anxiety). Young children in foster care exhibited more OCD and significantly less social anxiety symptoms indicating early repetitive and social disturbances in children in foster care.
... The results of this study showed that anxiety sensitivity was higher among female students than male students. This result was consistent with many studies (24)(25)(26). In a study by Silverman et al. in 2003 on 767 children and adolescents, the results indicated that young women had higher anxiety level than men (25). ...
... In a study by Silverman et al. in 2003 on 767 children and adolescents, the results indicated that young women had higher anxiety level than men (25). In another study by Walsh et al. on 1698 children and adolescents, similar results were obtained (24). These studies show that women have higher scores compared to men in general with anxiety sensitivity components such as fear of physical symptoms, fear of cognitive symptoms and fear of publicly observed symptoms, while a recent study showed that there are gender differences in this component (27). ...
... In terms of gender, a number of studies that have compared CASI factor models across gender have shown that AS appears similar in structure for males and females. For example, Walsh et al. (2004) reported similar structures across gender for their three-factor lower-order models in a large school-attending sample of children and adolescents. Similarly, Wright et al. (2010) found that the fit for a three-factor model was similar across gender in a comparable sample and Silverman et al. (2003) found support for factorial invariance across gender for their four-factor lower-order models in both clinical and non-clinical samples of children and adolescents. ...
... The remaining 11 items reveal concerns predominantly relating to physical concerns (or disease concerns) and also contain some items that reflect psychological concerns (or mental incapacitation concerns) [e.g., items 12 and 15]. Given that the one-factor model appeared to best fit our data, our findings indicate a lack of equivalence with models found in Western samples (Silverman et al., 1999(Silverman et al., , 2003Muris et al., 2001;Lambert et al., 2004;Walsh et al., 2004). ...
Article
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Anxiety sensitivity (AS) is a risk factor for the development of anxiety disorders in youth. To date, the applicability of the Childhood Anxiety Sensitivity Index (CASI) in youth from a low or middle income country (LMIC) setting on the African continent has not been assessed. A representative sample of 1149 secondary school learners from 29 schools in Cape Town, South Africa, participated in the study. Participants completed the CASI on a single occasion. One-, two-, and four-factor models of the CASI were assessed. A one-factor solution that comprised items predominantly represented by physical concerns appeared to provide the best fit to our data, however, relatively low variance (26%) was explained. Subsequent item deletion resulted in a 9-item ‘physical concerns’ factor that showed good construct reliability (0.83) but also explained a low amount of variance (35%). In terms of gender, a one-factor model provided the best fit, however, low variance was explained (i.e., 25%). Configural, metric and scalar invariance of the CASI by gender was determined. Our results suggest that the 18-item CASI is not applicable to our target population and may require adaptation in this population; however, replication of this study in other multicultural adolescent samples in South Africa is first needed to further assess the validity of the AS construct as measured by the CASI.
... The differences between boys' and girls' anxiety scores have led to investigate the underlying reasons for these dissimilarities. The role of gender role orientation has been suggested (Stassart, Hansez, Delvaux, Depauw, & Etienne, 2013;Walsh, Stewart, McLaughlin, & Comeau, 2004). In early childhood, children learn, by the differentiated socialization boys and girls receive, to develop socially prescribed attitudes consistent with their sex, resulting in ''masculine'' and ''feminine'' sex-typed behaviors and characteristics. ...
... In addition, gender role orientation mediated the relation between biological sex and AS. According to several studies (Deacon et al., 2002;Stassart et al., 2013;Walsh et al., 2004), girls display higher levels of AS symptoms than boys. Moreover, the sex effect disappeared when gender role orientation was included in the regression model, which suggests that Masculinity and Femininity levels fully explain the different levels of AS observed in boys and girls. ...
Article
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The present study evaluates gender role theory as an explanation for the observed gender differences in anxiety sensitivity (AS) symptoms among children, and emotional intelligence (EI) as a protective factor in the relation between gender role orientation and AS. Specifically, these two hypotheses are investigated in a moderated mediation analysis. The sample comprises 200 children, aged 9–13 years (95 boys, 105 girls). Results reveal that Masculinity (M) and EI are negatively associated with AS while Femininity (F) is positively associated with AS. Gender role orientation mediates the relation between biological gender and AS scores and EI moderates the relation between M (but not F) and overall AS symptoms. Findings support gender role orientation as an explanation for the observed gender disparity in AS; in the case of masculine orientation, the protective effect also depends on high emotional intelligence. This study provides valuable insights for understanding the emotional socialization of children, as well as preventing or treating AS symptoms.
... Ranney et al. (2021) found maternal and paternal anxiety to be associated with adolescent anxiety more strongly for female offspring. There are also gender differences related to AS, such that adolescent girls experience more physical and social concerns than adolescent boys (Walsh et al., 2004;Wright et al., 2010). Additionally, youth gender may moderate the association between parent and child AS, as Graham and Weems (2015) found a positive association between female offspring and parent AS and a negative association between male offspring and parent AS. ...
Article
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Anxiety disorders often onset in adolescence and continue into adulthood. Multiple factors contribute to anxiety disorder development, such as parent emotional availability (EA) and adolescent anxiety sensitivity (AS). Previous research determined attachment is a similar construct to EA, and attachment is related to anxiety disorders. Moreover, EA is a more specific construct than attachment that can be targeted in therapy. It has been determined that adolescent attachment to parental figures contributes to anxiety, with AS mediating this relationship. The present research sought to determine if AS is one mechanism underlying the relationship between parent EA and adolescent anxiety, while exploring the moderating roles of parent and adolescent gender. In a Midwestern sample (13–19 years old), this study examined adolescent AS as a mediator of the relationship between perceived parent EA and adolescent anxiety, and gender as a potential moderator. Self-report data were collected from adolescents via Qualtrics. The findings supported the mechanism of adolescent AS as a mediator between perceived parent EA and adolescent anxiety. As AS emerges during adolescence, it is a pertinent treatment target for youth anxiety. Furthermore, this study underscores the significance of parent and adolescent gender and parental EA as treatment targets for adolescent anxiety. While targeting adolescent AS and enhancing parental EA can be beneficial for both male and female adolescents, focusing on parental EA may offer greater benefits for male adolescents. In sum, these findings can increase the efficacy of current parenting programs and further increase treatment outcomes for youth and families.
... A related question pertains to whether differing cutoffs should be used for men and women (or boys and girls) when selecting individuals for AS-targeted intervention. Women and girls score higher on average than men and boys in overall AS levels both in childhood/adolescence and adulthood (e.g., Stewart et al., 1997;Walsh et al., 2004) and a higher proportion of girls than boys belong to the high AS taxon (Bernstein et al., 2006). If we use genderspecific norms in selecting individuals for AS-targeted intervention, the average woman participant has more severe AS than the average man participant which could create artificial gender differences in who benefits most from intervention. ...
Article
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Le présent article résume notre programme de recherche sur la sensibilité à l’anxiété (SA) – un facteur dispositionnel cognitif et affectif impliquant des craintes de sensations liées à l’anxiété en raison de croyances selon lesquelles ces sensations entraînent des conséquences catastrophiques. La SA et ses dimensions d’ordre inférieur sont considérées comme des facteurs transdiagnostiques de risque ou de maintien des troubles émotionnels et des troubles addictifs. La compréhension des mécanismes par lesquels la SA exerce ses effets peut révéler des cibles d’intervention clés pour les programmes de prévention et de traitement axés sur la SA. Dans le présent article, je passe en revue les recherches fondamentales que nous avons menées pour comprendre les mécanismes qui relient la SA à ces troubles et à leurs symptômes. Je décris également les interventions transdiagnostiques ciblées sur la SA et j’illustre la manière dont la recherche fondamentale a permis d’orienter le contenu de ces interventions. Enfin, je passe en revue les projets en cours dans mon laboratoire et je souligne les orientations futures importantes dans ce domaine. Bien que des progrès considérables aient été réalisés au cours des trois dernières décennies et que la recherche ait considérablement fait avancer notre compréhension de la SA en tant que facteur transdiagnostique, de nombreuses questions restent en suspens. Les réponses devraient nous aider à affiner les interventions afin d’en faire bénéficier au maximum les personnes qui ont une grande peur d’avoir peur.
... For boys, anxiety sensitivity played a role in the development of BP, whereas, for girls, no influence on the development of HA or BP was found. 36 In line with existing research, 28 we found that girls achieved higher scores for Anxiety Sensitivity Index than boys. However, these scores do not appear to have a predictive role for BP; such a role we found only for boys. ...
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Background Previous research has shown positive relationships between dysfunctional cognitive styles and different aspects of pain (eg, pain frequency). One goal of our longitudinal study was to investigate potential risk factors for the incidence of headache (HA) and back pain (BP). Methods In the first wave (2003), questionnaires were sent to 6,400 children between the ages of 9 and 14 years. Those who answered in wave 1 were contacted again every year (four survey waves in total: 2003–2006). The data presented are based on the children’s self-reports in the second wave (2004) and third wave (2005). Potential risk factors (dysfunctional stress coping, pain catastrophizing, anxiety sensitivity, and somatosensory amplification) were collected in wave 2. Binary logistic regression analyses – for boys and girls – were performed to assess the predictive value of the risk factors for HA and BP in wave 3. Results In the comprehensive model, none of the examined variables predicted the incidence of HA. Anxiety sensitivity increased the risk that boys would report BP after 1 year by 50% and dysfunctional stress coping increased the risk by 40%. For girls, somatosensory amplification increased the risk of the incidence of BP 1 year later by 80%, whereas pain catastrophizing reduced the risk by 50%. Conclusion In this incidence sample, the amount of variance explained by the psychological variables investigated was very small. Integrating this result with existing findings from cross-sectional studies suggests that dysfunctional cognitive processing styles may develop more as a consequence or a concomitant feature of BP or HA, but play a less important role in its initial development.
... Anxiety sensitivity is related to but distinct from trait anxiety (or the tendency to experience anxiety across many situations and experiences) [34]. A cognitive construct, AS is the belief that the physical sensations that accompany anxiety will lead to 'catastrophic outcomes' such as dangerous physical symptoms or social embarrassment [35,36]. It is the feeling of dread associated with anxiety-related bodily sensations (e.g., racing heart, butterflies in the stomach, quivering hands, and feelings of loss of control over bodily sensations [37][38][39]. ...
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Background Anxiety and eating disorders (EDs) are rising at alarming rates. These mental health disorders are often comorbid, yet the factors associated with their comorbidity are not well understood. The present study examined a theoretical model of the pathways and relative associations of anxiety sensitivity (AS) with different dimensions of ED risk, controlling for generalized anxiety. Methods Participants (N = 795) were undergraduate students with an average age of 21 (SD = 4.02), predominantly female (71%), and Hispanic (71.8%). Participants completed an online survey with established measures of AS (i.e., Anxiety Sensitivity Index-3; ASI-3), general anxiety (i.e., Beck Anxiety Inventory; BAI), and eating behaviors (i.e., Eating Attitudes Test-26; EAT-26). Results The results of our structural equation models indicated that AS subscales were significantly associated with dimensions of the EAT-26, even when controlling for generalized anxiety. Specifically, the ASI-3 factors reflecting cognitive and social concerns provided the most consistent significant associations with EDs. Whereas reporting higher cognitive concerns was associated with higher ED symptoms (e.g., reporting the urge to vomit after a meal), reporting higher social concerns was associated with fewer ED symptoms. These differential results may suggest risk and resilience pathways and potential protective or buffering effects of social concerns on ED risk. Discussion Findings advance understanding of the role of AS in the comorbidity of anxiety and EDs, demonstrating the strong association of AS with ED pathology. These findings provide cognitive indicators for transdiagnostic therapeutic intervention in order to reduce the risk of EDs.
... This would be especially important, given that some ER strategies (e.g., suppression but not necessarily reappraisal) appear to be used more frequently by girls than boys (Gullone & Taffe, 2012;Sanchis-Sanchis et al., 2020). Studies have found that girls also report higher AS (Walsh et al., 2004), and DT appears to be more strongly related to internalizing symptoms in girls than in boys (Daughters et al., 2009). Additionally, some measures (e.g., DTS) were validated in samples with slightly older children than those in this study. ...
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Objective: Transdiagnostic models of youth psychopathology posit shared, underlying core features of emotional disorders that confer risk for and/or maintain symptoms. Youth may differ in the presence and severity of these underlying core features, and matching intervention strategies to such features may help personalize transdiagnostic interventions. We used latent profile analysis (LPA) to identify profiles of youth based on core underlying transdiagnostic dysfunctions and examined associations of profiles with treatment outcome. Method: LPA was conducted with 298 youth ages 7-18.8 (Mage = 12, SD = 3.2; 48.7% female; primarily White and Hispanic/Latinx) with a primary emotional disorder. Indicators for LPA included self-report measures of affect, anxiety sensitivity (AS), distress tolerance (DT), and emotion regulation (ER). Longitudinal associations between profile membership and treatment outcome were examined in a subset of 177 youth (Mage = 11.8, SD = 3.2; 52% female; primarily White and Hispanic/Latinx). Results: LPA identified three profiles characterized by differing levels of DT, affect, and ER. A Moderately Distressed and Dysregulated profile had the largest membership (65.1%) and poorer youth-reported anxiety and depression outcomes compared to a Distress Tolerant, Regulated Expressive profile (24.9%). A Distressed, High Affect Avoidant profile (10%) had the greatest baseline severity and the poorest depression outcomes, although most youth improved. Conclusions: Youth characterized by certain profiles of transdiagnostic core processes appear to have the poorest functioning and treatment prognosis, although most youth improved. Targeting these processes more directly and/or earlier in treatment may help to improve outcomes for youth. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
... Geschlecht. Geschlechtsunterschiede, nach denen Mädchen in allen Untertests sowie im Gesamtscore höhere Angstwerte als Jungen erzielten, werden in diversen Studien berichtet (Fullana, Servera, Weems, Tortella-Feliu, & Caseras, 2003;Muris et al., 2001;Walsh, Stewart, McLaughlin, & Comeau, 2004). In den meisten Studien wiesen Mädchen 2 bis 4mal höhere Raten von Angststörungen auf als Jungen (Essau, 2003). ...
Thesis
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Mehrere Autoren weisen darauf hin, dass Patienten mit unterschiedlichsten Störungsbildern, insbesondere mit Angststörungen und Depressionen, bereits in der Kindheit beeinträchtigt waren. So berichten Patienten retrospektiv, dass sie bereits im Grundschulalter eine erhöhte Ängstlichkeit erlebten. Dieser Umstand liefert den Ansatz einer frühzeitigen Prä- bzw. Intervention psychischer Störungen im Grundschulalter. Über ihre Ängstlichkeit können bereits Kinder im Grundschulalter Auskunft geben (Selbsturteile). Selbst beurteilte Ängstlichkeit muss sich nicht im Verhalten äußern. Somit ist das Selbsturteil für bestimmte, nicht an der Verhaltensebene festzumachende, Ängste wichtige Informationsquelle. Um eine erhöhte Ängstlichkeit bei Grundschulkindern feststellen zu können, fehlen jedoch bisher geeignete deutschsprachige Instrumente. Im Rahmen dieser Arbeit sollte die Testgüte des Ängstlichkeitsscreenings für Kinder (ÄSK) überprüft werden. Zur Bestimmung von Referenzwerten und Testgütekriterien des ÄSK wurden 818 Grundschulkinder aus Norddeutschland teilweise wiederholt getestet. Ein Retest erfolgte nach vier Wochen mit 76 Kindern, ein weiterer mit 97 Kindern nach drei Monaten. Zur Überprüfung der Validität kamen verschiedene quantitative Verfahren (i-iv und vi) sowie qualitative Verfahren (iv und v) zum Einsatz: (i) Kinder der Normstichprobe füllten zusätzlich zum ÄSK einschlägige Fragebögen aus, die Angst (n=115), Angstsensitivität (n=115), Empathie (n=337) oder Neurotizismus (n=154) erfassen. (ii) 66 Kinder einer klinischen Stichprobe mit internalisierenden Symptomen und anderen psychischen Auffälligkeiten beantworteten das ÄSK. (iii) Ein Vergleich hinsichtlich der selbsteingeschätzten gesundheitsbezogenen Lebensqualität erfolgte an zwei Gruppen von Grundschulkindern, die durch den ÄSK entweder als hoch- (n=84) oder als niedrigängstlich (n=64) klassifiziert wurden. (iv) Insgesamt 54 praktisch und/oder wissenschaftlich arbeitende Berufsexperten beurteilten die Inhalte der Items des ÄSK sowie weitere übergeordnete Aspekte des ÄSKs mittels Fragebögen. (v) Acht Grundschulkinder charakterisierten die Inhalte, Akzeptanz und Praktikabilität des ÄSK in strukturierten Interviews. (vi) Zur Bestimmung der Veränderungssensitivität wurde das ÄSK im Rahmen des Präventionsprogramms Löwenherz bei internalisierenden Störungen mit 50 Grundschulkindern (und einer Kontrollgruppe von 20 Kindern) eingesetzt. Insgesamt bescheinigen die Ergebnisse dem ÄSK eine hohe Güte. Hervorzuheben sind die gegebene Durchführungs- und Auswertungsobjektivität sowie zufriedenstellende bis gute Reliabilitäten und eine ausreichende bis gute Retest-Reliabilität. Die niedrigen bis mittleren positiven Korrelationen des ÄSK mit der selbsteingeschätzten emotionalen Instabilität (Neurotizismus) und Empathie (diskriminante Validität) kontrastieren mit den hohen und positiven Zusammenhängen mit ähnlichen Konstrukten (konvergente Validität). Die Ergebnisse zum Vergleich der klinisch auffälligen Kinder mit der Grundschulstichprobe sowie hoch- und niedrigängstlicher Grundschulkinder hinsichtlich ihrer Lebensqualität belegen die differentielle Validität des ÄSK. Die Veränderungssensitivität wurde durch den Nachweis großer kurz- und langfristiger Effekte im Rahmen der Evaluation des Präventionsprogramms Löwenherz an Grundschulkindern bestätigt. Im Rahmen dieser Arbeit ist es gelungen, Methoden der klassischen mit dem Ansatz der probabilistischen Testtheorie sowie qualitativen Forschungsmethoden zu kombinieren und damit die Güte des neuen Verfahrens zu belegen. Die Ergebnisse kennzeichnen das ÄSK als objektiven, reliablen und validen Test zur Erfassung der Ängstlichkeit im Selbsturteil von Grundschulkindern. Insbesondere die Befunde hinsichtlich geringer Konkordanz des kindlichen mit dem elterlichen bzw. Lehrerurteil legen nahe, dass Kinder zuverlässigere Informationsquellen für internalisierende Problematiken sind als ihre erwachsenen Bezugspersonen. Für den ÄSK bieten sich vielfältige Anwendungsperspektiven nicht nur in der Forschung sondern auch im schulischen Bereich, in Erziehungsberatungsstellen und in kinderpsychologischen Praxen. Several authors allude to the fact that patients afflicted with the most diverse psychological disorders, especially anxiety disorder and depression, have already been affected by it in their childhood. These aforementioned patients report retrospectively having experienced heightened anxiety at primary school age. This fact provides a basis for an approach for early mental disorder prevention and intervention in primary school children. Children at this age are already able to provide information about their level of anxiety. Self-reported anxiety is not bound to be expressed in perceivable behavior. Therefore the self-report is an important source of information for anxieties which are not recognizable on behavioral level. However, there is a lack of instruments available in the German language in order to be able to assess heightened primary school aged children’s anxiety levels so far. This study aims to examine the test quality of the “Ängstlichkeitsscreening für Kinder (ÄSK)” (anxiety screening for kids). In order to define reference values and psychometric properties for the ÄSK 818 primary school children from northern Germany were tested, some of them repeatedly. One retest was conducted four weeks later with 76 children, another one three months later with 97 children. Different quantitative methods (i-iv and vi) as well as qualitative methods (iv and v) were applied to examine the validity of the test. (i) Children from the norm sample completed relevant questionnaires in addition to the ÄSK either measuring anxiety (n=115), anxiety sensitivity (n=115), empathy (n=337) or neuroticism (n=154). (ii) 66 children from a clinical sample with internalized symptoms and other mental health issues completed the ÄSK. (iii) A comparison considering the self-reported health-related quality of life was conducted between two groups of primary school children who were classified either as highly anxious (n=84) or lowly anxious (n=64) by the ÄSK. (iv) Overall, 54 experts working in the either applied research or academical field of this discipline judged the contents of the items as well as superordinate aspects of the ÄSK by utilizing questionnaires. (v) In structured interviews, eight primary school children were asked to describe the contents, the acceptance and the practicability of the ÄSK. (vi) In order to define its sensitivity to change the ÄSK was used within the prevention program Löwenherz against internalizing disorders with 50 primary school children (and a control group of 20 children). Overall, the results verify the high test quality of the ÄSK. The given objectivity as well as satisfying up to good reliabilities and a satisfactory up to good retest reliability are to be highlighted. The low up to moderate positive correlations of the ÄSK with the self-reported emotional instability (neuroticism) and empathy (discriminant validity) contrast with the high and positive relationships with similar constructs (convergent validity). The results of a comparison between clinically referred children and the primary school sample as well as of a comparison between highly anxious and lowly anxious primary school children concerning their life quality verify the differential validity of the ÄSK. The sensitivity to change has been confirmed by the demonstration of great short- and long-term effects within the Löwenherz prevention program for primary school children. Within this work, methods of the classical test theory could be successfully combined with approaches of the probabilistic test theory as well as qualitative research methods and thereby confirm the test quality of this new instrument. The results characterize the ÄSK as an objective, reliable and valid test for measuring self-reported anxiety of primary school children. Notably the findings with respect to the low concordance between the child’s judgment and the parents’ and teachers’ judgment suggest that children are more reliable sources of information for internalizing problems than their adult attachment figures. For the ÄSK there are diverse application possibilities not only in the area of research but also in schools, child guidance centers and (private) practices for child psychology.
... This crucial subject from early childhood is discussed within the research literature in the sense of increasingly possible integration of emotional well-being and therapy of patients with HCV. Health study shows that women are more vulnerable than men to fear (Walsh et al., 2004;Michael et al., 2007;Panayiotou et al., 2017). ...
... Finally, while the use of our brief personality measure [SURPS; (31)] allowed for brevity in the context of a large-scale survey, it did not allow for nuanced assessment of the components of each of our traits. For example, the longer Childhood Anxiety Sensitivity Index (115) would have allowed for examination of the relative contributions of the AS Physical, Social/Control, and Psychological concerns dimensions (116) to the anxiety symptom mediated pathway to sedative/tranquilizer misuse observed in the present study. Similarly, the longer Barratt Impulsiveness Scale (117) would have allowed for examination of the relative contributions of the Attentional, Motor, and Non-planning Impulsiveness components (118) to the CD and ADHD symptom mediated pathways to PD misuse observed in the present study. ...
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Background: Fifteen to 25-year-olds are the age group most likely to misuse prescription drugs. Few studies have tested theory-driven models of adolescent risk for prescription drug misuse. Moreover, rarely are distinct pathways to different forms of prescription drug misuse considered. Methods: We tested mediational paths from personality to mental health symptoms to prescription drug misuse, informed by etiological models of addiction. We specified pathways from particular personality traits to unique forms of prescription drug misuse via specific mental health symptoms. We used semi-longitudinal data collected across two waves of the Co-Venture Trial. Our sample included students from 31 Canadian high schools tested in Grade 9 (n = 3,024) and again in Grade 10 (n = 2,869; 95% retention). Personality (hopelessness, anxiety sensitivity, impulsivity, sensation seeking) was assessed in Grade 9. Mental health symptoms (depression, anxiety, ADHD, conduct disorder) and prescription drug misuse (opioids, sedatives/tranquilizers, stimulants) were assessed at both time points. Results: Consistent with the negative affect regulation model, hopelessness was specifically associated with opioid misuse via depressive symptoms, and anxiety sensitivity was specifically associated with sedative/tranquilizer misuse via anxiety symptoms. Consistent with positive affect regulation, sensation seeking was directly associated with stimulant misuse. Consistent with the psychological dysregulation model, impulsivity was associated with stimulant misuse via ADHD symptoms. And consistent with the deviance proneness model, impulsivity was also associated with unconstrained (i.e., all three forms of) prescription drug misuse via conduct disorder symptoms. Conclusions: Screening for adolescents high in hopelessness, anxiety sensitivity, sensation seeking, or impulsivity and providing them with personality-matched cognitive-behavioral interventions may be helpful in preventing or mitigating prescription drug misuse. Our results point to the specific mental health symptoms that are important to target in each of these personality-matched interventions.
... People who are high in this dimension believe that various physiological symptoms that they experience such as increased heart rate, dizziness, sweating etc, are terrific and will harm them a lot as these will go on developing dreadful results. [8] On the other hand "test anxiety is a combination of physiological over-arousal, tension and somatic symptoms, along with worry, dread, fear of failure, and catastrophizing, that occur before or during test situations". [9] The aim of the present study is to see the role or impact of parenting style on anxiety sensitivity and test anxiety among eighth grade school students. ...
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The central aim of the study is to examine the role of parenting style in anxiety sensitivity and test anxiety among the 8 th grade adolescents" school students. In this study, the researcher contacted with 8 th grade school students with the age 13 to 14 years of Bengali families in Kolkata with monthly family income of Rs. 10,000-50,000/-per month. The total number of participants were initially about 300 students, but finally 120 (60 males and 60 females) could be retained. Candidates, whose highest obtained score in Parental Authority Questionnaire was same in at least two prototypes (permissiveness, authoritarianism and authoritativeness) in respect of either father or mother or both, were not considered for the present study. Besides, candidates whose selected prototype (the dominant one; selected on the basis of highest obtained score in a particular prototype among different prototypes such as permissiveness, authoritarianism and authoritativeness) differed in scales for father and mother were also not considered. An assurance was made that the selected participants did not suffer from chronic physical and mental disturbances. Results showed that the mean values for both anxiety sensitivity and test anxiety were maximum in case of authoritarian parenting style and the difference between male and female was not significant both for perception of stress and test anxiety. Results further showed that the 8 th grade students differed significantly in anxiety sensitivity and test anxiety with the variation in parenting styles. Overall, this study indicated that the parenting style which regards autonomy and consider a rational approach is most preferred one.
... The reliability of these scales has been good for items comprising the Bphysical^or Bautonomic^items of the CASI, but has been questionable or unacceptable for items comprising the remaining scales, including those assessing cognitive and social aspects of child AS (see Francis et al. 2019). Amongst those researchers who have assessed or employed a multifactorial CASI with children and adolescents, several have concluded that more items are needed to comprehensively and reliably assess AS as a multifactorial construct in youth (e.g., Essau et al. 2010;Muris et al. 2001;Walsh et al. 2004;van Widenfelt et al. 2002). Indeed, in response to similar concerns raised with the adult Anxiety Sensitivity Index (ASI; Reiss et al. 1986), the item content assessing the multifactorial construct of AS amongst adults was revised and expanded upon multiple times, resulting in the ASI-Revised (ASI-R; Taylor and Cox 1998a), the Anxiety Sensitivity Profile (ASP; Taylor and Cox 1998b), and the ASI-3 ) (see Olatunji and Wolitzky-Taylor 2009 for a review of these measures). ...
Article
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The multifactorial nature of anxiety sensitivity (AS) in children has been assessed almost solely with the Childhood Anxiety Sensitivity Index (CASI; Silverman et al. Journal of Clinical Child Psychology, 20(2), 162–168, 1991); however, multiple studies have suggested that the item content of the CASI is too limited to adequately assess multiple AS factors in youth. Here we examined the psychometric properties of the Revised Childhood Anxiety Sensitivity Index (CASI-R; Muris Behaviour Research and Therapy, 40, 299–311, 2002), developed to assess a higher-order global AS factor and four lower-order factors. In a non-clinical sample of youth aged 8–14 we (a) examined the psychometric properties of the CASI-R, comparing findings for children aged 11 and younger with those aged 12 and older, (b) evaluated and compared the internal consistency of the four-factor CASI-R and the three- and four-factor CASI, and (c) examined and compared the convergent validity of the CASI and CASI-R subscales with child-reported anxiety symptoms. Reliability estimates for the CASI-R total, Cardiovascular, and Respiratory scales were high for all youth; the Cognitive Dyscontrol and Publicly Observable Reactions scales yielded low estimates of internal consistency for the younger group. Compared to the parallel CASI scales, these CASI-R scales demonstrated stronger internal consistency in both the older and younger groups. Comparatively larger correlations between the CASI-R physical and cognitive scales with symptoms of panic and between the CASI-R social scale and symptoms of social anxiety were observed. These findings suggest continued use and examination of the CASI-R in child and adolescent non-clinical and clinical samples to comprehensively assess the AS construct in youth.
... In contrast to previous studies (Výrost et al. 1995;Lazarus and Folkman 1984), gender proved to be a significant predictor of effective or ineffective coping in patients. Epidemiological evidence indicates that women are more vulnerable to anxiety disorders than men (Michael et al. 2007;Walsh et al. 2004), showing higher distress and illness burden (Panayiotou et al. 2017). Women are more vulnerable to stressful events than men (Gray 2003). ...
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Coping has emerged as a vital indicator among patients in the chronic conditions. The current study examined the role of demographic characteristics (such as age, education, gender, marital status, residential background, family type and number of children) in adoption of coping (emotion-focused, problem-solving, religious–spiritual) strategies for nursing among hepatitis patients. A sample of 500 patients (of hepatitis C) was drawn from five most populous districts (Lahore, Faisalabad, Rawalpindi, Gujranwala and Multan) of Punjab, Pakistan, by using Epi Info software with an alpha level of 0.03. The data were collected using a well-structured multi-sectional interview schedule through multistage proportionate sampling technique. Descriptive analysis, regression analysis and reliability analysis were computed using SPSS (version 21.0). In the overall adoption of coping strategies, lower monthly household income, lower education, rural residences, nuclear family setting and married status were contributing to the adoption of higher coping strategies among Muslim chronic patients with hepatitis C. The results of socio-demographics are also discussed with other coping strategies (such as religious–spiritual coping strategies, problem-solving coping strategies, emotion-focused coping strategies and constructive coping strategies). It was the first quantitative study of adoption of coping strategies among Muslim hepatitis patients in Pakistan. The study highlighted the importance of socio-demographic resources to cope with chronic illness. The empirical findings would start a new discussion from hepatic, counseling and nursing perspective. For terminal patients, these socio-demographic characteristics can serve as a guideline to provide community sources of social support. Medical social workers and healthcare experts need to facilitate the efforts of patients to cope with chronic illness through revision of nursing policy according to the socio-demographic and spiritual–religious needs of the patients.
... Muris, Mayer, & Schubert, 2010 209 (106) 11.07 (10−13) A feminine gender role is positively associated with fear and anxiety in children, indicating that gender role orientation apart from physiological sex influences affective patterns in children. Walsh, Stewart, McLaughlin, & Comeau, 2004 1698 (821) 14.3 a Girls score higher on global measures of anxiety sensitivity. Factors contributing to anxiety differ between girls and boys, with girls demonstrating more physically-related concerns relative to psychological or social concerns. ...
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Mindfulness training has been used to improve emotional wellbeing in early adolescents. However, little is known about treatment outcome moderators, or individual differences that may differentially impact responses to treatment. The current study focused on gender as a potential moderator for affective outcomes in response to school-based mindfulness training. Sixth grade students (N = 100) were randomly assigned to either the six weeks of mindfulness meditation or the active control group as part of a history class curriculum. Participants in the mindfulness meditation group completed short mindfulness meditation sessions four to five times per week, in addition to didactic instruction (Asian history). The control group received matched experiential activity in addition to didactic instruction (African history) from the same teacher with no meditation component. Self-reported measures of emotional wellbeing/affect, mindfulness, and self-compassion were obtained at pre and post intervention. Meditators reported greater improvement in emotional wellbeing compared to those in the control group. Importantly, gender differences were detected, such that female meditators reported greater increases in positive affect compared to females in the control group, whereas male meditators and control males displayed equivalent gains. Uniquely among females but not males, increases in self-reported self-compassion were associated with improvements in affect. These findings support the efficacy of school-based mindfulness interventions, and interventions tailored to accommodate distinct developmental needs of female and male adolescents.
... Combining the findings of 2016 and 2017, girls tended to score significantly higher than boys on the physical-concerns dimension of AS and anxiety and depression symptoms (see Table 1). Consistent with the literature (Walsh, Stewart, McLaughlin, & Comeau, 2004), girls reported greater fears toward anxiety-related somatic sensations as signs of physical illness. The results also indicated that, concordant with previous epidemiological research, girls and boys were equivalent in degree of mental (or psychological) concerns related to anxiety. ...
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Background/Objective: To examine the roles of anxiety sensitivity and attentional bias in the development of anxiety and depression symptoms among adolescents. Method: 214 grade 7 to grade 10 Hong Kong Chinese students completed a package of psychometric inventories to measure levels of anxiety sensitivity, selective attentional processing, and anxiety and depressive symptoms in 2016 and then again in 2017. Results: Girls, when compared with boys, exhibited more anxiety symptoms and anxiety sensitivity in 2016. They also reported a significant increase in mean depression level from 2016 to 2017. Regression analyses revealed that the physical-concerns dimension of anxiety sensitivity, positive attentional bias, and to a lesser extent negative attentional bias were related to the development of both anxiety and depression symptoms one year later. Fear of mental incapacity could predict depression one year later but not anxiety symptoms. Conclusions: Intervention through anxiety sensitivity training to reduce somatic concerns and attentional bias modification to increase habitual attention to positive stimuli and to disengage from negative stimuli can reduce anxiety and depression symptoms among high school students.
... Responses at age 16 to the items showed good internal consistency (Cronbach's α = .86), matching that reported by the test authors (.87), and means and variances were similar to those previously reported in a large community sample of children and adolescents (Walsh, Stewart, McLaughlin, & Comeau, 2004). ...
Thesis
Autism spectrum disorders (ASD) are characterised by social-communication difficulties and non-social symptoms such as restricted and repetitive behaviours and interests. ASD characteristics can be investigated at the subclinical trait level within the general population, and these quantitative autistic traits have been shown to have a smooth distribution. Adolescence is an important developmental stage, particularly for the emergence of internalising problems. However, few studies to date have investigated the causes of co-occurring autistic traits and internalising traits during adolescence. The aim of this thesis is to explore the aetiological causes of this trait association between the ages of 12 to 16 years using a quantitative genetic approach. This thesis employs a classic twin design and the sample came from the Twins Early Development Study (TEDS). The causes of the association between autistic and internalising traits in early adolescence are the first focus of this thesis. The analyses in Chapter 4 explore this aetiological association at ages 12-14 years, revealing a moderate phenotypic trait association and at the aetiological level moderate genetic overlap, substantial shared environmental and modest nonshared environmental overlap. Teasing apart these associations further, Chapter 5 identifies specific autistic-like behaviours by means of factor analysis. Relating these factor-derived autistic trait subdomains to the internalising trait measure demonstrated distinguishable patterns of phenotypic and aetiological associations. A factor named autistic-like ‘Social Unease’ showed the most phenotypic and genetic overlap with internalising traits. Secondly, this thesis investigates in Chapter 6 the role of childhood nonshared environment on internalising and autistic traits in early adolescence using the monozygotic twin differences design. Analyses showed that birth weight, childhood hyperactivity and peer problems played a role, via the nonshared environment, in influencing individual differences in internalising and autistic traits in early adolescence. Finally, Chapter 7 presents findings on later adolescence, at age 16 years, exploring the association of autistic traits with anxiety traits and depression traits separately and drawing on both parent and self ratings. The implications of these findings, their limitations and their contribution to the current literature are considered in the Discussion (Chapter 8).
... Demographics-We included gender (0 = female, 1 = male) as a planned covariate as there is evidence of gender differences in emotional dysfunction in children and adolescents (Salk, Petersen, Abramson, & Hyde, 2016;Walsh, Stewart, McLaughlin, & Comeau, 2004). Given that BMI can affect pharmacological metabolism (Maudens, et al., 2014), we included BMI as a planned covariate. ...
Article
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Maladaptive emotional traits (anxiety sensitivity [AS], fear of anxiety-related sensations and consequences) and symptoms (major depressive disorder [MDD] and generalized anxiety disorder [GAD] symptoms) could play a role in altering sensitivity to the subjective effects of drugs of abuse in adolescents. Data were drawn from a longitudinal study of high school students in Los Angeles, CA, USA who completed surveys and reported past six-month use of alcohol (n = 1054), cigarettes (n = 297), or cannabis (n = 706). At each of the four semi-annual waves during mid-adolescence (14–16 years old), students reported positive and negative subjective drug effects experienced in the prior six-months. Controlling for covariates and the simultaneous covariance across the three domains of emotional dysfunction, AS was associated with more positive and negative cannabis effects (βs = 0.09–0.16, ps < 0.05), and MDD symptoms were associated with fewer negative cigarette effects (β = − 0.13, p = 0.04) and more negative cannabis effects (β = 0.10, p = 0.004). The acceleration of positive alcohol and cannabis effects over time was slower among adolescents with higher baseline MDD (MDD × time: β = − 0.04, p = 0.044) and GAD (GAD × time: β = − 0.05, p = 0.03) symptoms, respectively. These findings suggest that emotional dysfunction factors show differential and overlapping effects on subjective drug effects, which may vary across time. Future research should investigate emotional dysfunctions and subjective drug effects in relation to substance use across adolescence and emerging adulthood.
... Epidemiological evidence indicates that women are more vulnerable to anxiety disorders than men (Michael, Zetsche & Margrafe, 2007) showing higher prevalence, more symptoms (Lewinhson, Gotlib, Lewinhson, Seeley, & Allen, 1998), greater distress, service seeking, impairment and illness burden (Yonkers & Gurguis, 1995). Women are also characterized by higher anxiety sensitivity (Stewart, Taylor, & Baker, 1997;Walsh, Stewart, McLaughlin & Comeau, 2004), a diathesis factor for anxiety pathology (Schmidt, Zvolensky, & Maner, 2006;Taylor, Jang, Stewart, & Stein, 2008), which refers to having concerns about the consequences of anxiety symptoms themselves, (Reiss, 1991). Yet few theoretical explanations of gender differences in anxiety have been proposed (Pigott, 1999) and to-date none seem to fully explain these statistics. ...
Article
To-date no models adequately address the higher vulnerability of women to anxiety pathology, in contrast to other disorders, such as depression where ruminative thinking has been identified as accounting for women's greater risk. This investigation examines the hypothesis that gender differences in coping, with women relying more on specific types of avoidance, may in part explain women's anxiety risk. Coping, experiential avoidance, anxiety symptoms, anxiety sensitivity and perceived stress due to life stressors were assessed in a community sample (N=456). Women were more likely to meet clinical screening cut-offs for anxiety disorders, report more symptoms and experience greater anxiety sensitivity than men. They also reported greater reliance on avoidant coping and experiential avoidance, which were associated with increased anxiety. Gender moderated coping effects so that the coping style that mostly differentiated women from men in predicting anxiety was behavioral disengagement. To the contrary, self-reported stress due to life events did not significantly explain anxiety gender effects as no significant moderation by gender was observed. Results suggest that greater reliance on avoidance, especially behavioral avoidance, may be associated with increased vulnerability to anxiety specifically among women.
... The vulnerability associated with female sex reported in the present study is also in line with the pediatric PTSD literature (Trickey et al., 2012), suggesting that the finding also applies in a pediatric TBI population. Female sex has been associated with a higher anxiety sensitivity (Walsh, Stewart, McLaughlin, & Comeau, 2004) and avoidant and ruminative coping style (Wilson, Pritchard, & Revalee, 2005) in previous non-TBI PTSD studies, which may result in difficulties coping post trauma (i.e., TBI). Results supported the hypothesis that postinjury neurocognitive deficits would predict symptom outcomes at 6 months following a severe TBI. ...
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Objective: Various neurocognitive mechanisms have been proposed to explain the development of Posttraumatic Stress Disorder (PTSD) symptoms. However, the neurocognitive mechanisms underlying comorbid PTSD following Traumatic Brain Injury (TBI) have not been fully investigated, especially among children. This study prospectively examined the influence of theorized neurocognitive deficits at 3 months post pediatric TBI on the development of PTSD symptoms 6 months postinjury. Method: One hundred sixty-six children aged between 6 and 14 years were recruited after sustaining a TBI. Their demographic information and injury severity were assessed at 2 months postinjury, their neurocognitive outcomes in selective attention, sustained attention, verbal learning, working memory, and processing speed were assessed at 3 months postinjury, and PTSD symptoms were measured at 6 months postinjury. Results: Consistent with the Neurobiological Theory of PTSD, sustained attention deficits 3 months postinjury emerged as the key predictor for greater future PTSD severity at 6 months, especially following a mild TBI. However, contrary to the expectations of the Emotional Processing Theory and Dual Representation Theory, verbal learning and working memory deficits at 3 months postinjury protected children from the development of PTSD symptoms 6 months postinjury. Conclusions: PTSD involves a complex interplay between attention and memory functions post pediatric TBI. When trauma memory is relatively intact, difficulties disengaging from distractors contribute to the development of PTSD symptoms.
... "It scares me when I feel nervous") on a 3-point Likert scale ranging from 0 (none) to 2 (a lot). The CASI showed acceptable two-week test-retest reliability and good criterion-related validity in clinical and nonclinical samples of children and teens [30,31]. The internal consistency in the present sample was high (α = 0.87). ...
Article
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Problematic substance use and mental health problems often co-occur in adolescents. Effective school-based interventions that are brief and target multiple problems are promising in the field of health promotion. Preventure is a brief, school-based, selective preventive intervention, tailored to four personality profiles. Preventure has already proved effective on alcohol outcomes. Previous trials also reveal effects on several mental health outcomes, yet the evidence for these outcomes is limited. This study presents the results of the Dutch Preventure Trial, on a range of mental health outcomes. In a cluster RCT, including 699 high risk students (mean age 14 years), the intervention effects on mental health problems at 2, 6, and 12 months post intervention were tested in the total high risk population and in four specific personality groups. No significant intervention effects were found on 22 from the 24 tests. A positive intervention effect on anxiety was found in the anxiety sensitivity personality group at 12-month follow-up, and a negative intervention effect on depression was found at 12-month follow-up in the negative thinking group. In post hoc growth curve analyses these effects were not found. This study found no convincing evidence for the effectiveness of Preventure in The Netherlands on mental health problems. This finding is not in line with the results of an earlier effectiveness study in the UK. This highlights the need for more research into the knowledge transfer model of interventions, to ensure that interventions are effective in a variety of circumstances.
... medium effect). Similar to the etiology of gender differences in anxiety disorders, the gender disparity AS has been shown to begin in childhood and adolescence (Walsh et al., 2004;Wright et al., 2010) and continue through adulthood (Armstrong and Khawaja, 2002). ...
... These contradictory results may be explained by psychological characteristics of these individuals. Previous studies have suggested that females experienced more symptoms of anxiety than males [31][32][33] . Accordingly, the present study also found statistically significant associations between symptoms of anxiety and the presence of DOH (in univariate and multivariate analysis), corroborating with Tanaka et al 12 . ...
Article
This study aimed to evaluate the associations between psychological factors and the presence of deleterious oral habits in children and adolescents. 147 students aged 8 to 14-years-old were divided in two groups concerning the presence and absence of DOH Habit group (HG) and Habit free group (HFG). Participants were asked about the presence of DOH using the domain III (Oral Habits) of the Nordic Orofacial Test-Screening (NOT-S). Symptoms of anxiety and depression were evaluated using the Brazilian Portuguese versions of the Revised Children's Manifest Anxiety Scale (RCMAS) and the Children's Depression Inventory (CDI), respectively. Saliva was collected 30 min after waking and at night to determine the diurnal decline in salivary cortisol (DDSC). Data were analyzed using the Chi-squared, Mann-Whitney, Spearman's correlation and logistic regression. The prevalence of DOH was higher in females than males (65.1 vs 34.9; p < 0.05). The most frequent DOH was nail biting (58.7%). HG presented more depressive symptoms than HFG (p < 0.05). There was positive correlation between salivary cortisol levels and age (p < 0.01). Logistic regression analysis found association between symptoms of anxiety and the presence of DOH (OR = 2.35; p < 0.05). In conclusion, children and adolescents with DOH presented more symptoms of depression than their counterparts. Moreover, they were more likely to report symptoms of anxiety.
... Estimates were somewhat lower for social and mental concerns dimensions because there were fewer items within those subscales. However, estimates were comparable to other samples (Walsh et al. 2004;Joiner et al. 2002). ...
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Background: The classification of anxiety and depressive disorders has long been debated and has important clinical implications. The present study combined a genetically sensitive design and multiple time points to investigate cognitive content specificity in anxiety and depressive disorder symptoms across anxiety sensitivity dimensions, a cognitive distortion implicated in both disorders. Method: Phenotypic and genetic correlations between anxiety sensitivity dimensions, anxiety and depressive disorder symptoms were examined at five waves of data collection within childhood, adolescence and early adulthood in two representative twin studies (n pairs = 300 and 1372). Results: The physical concerns dimension of anxiety sensitivity (fear of bodily symptoms) was significantly associated with anxiety but not depression at all waves. Genetic influences on physical concerns overlapped substantially more with anxiety than depression. Conversely, mental concerns (worry regarding cognitive control) were phenotypically more strongly associated with depression than anxiety. Social concerns (fear of publicly observable symptoms of anxiety) were associated with both anxiety and depression in adolescence. Genetic influences on mental and social concerns were shared to a similar extent with both anxiety and depression. Conclusions: Phenotypic patterns of cognitive specificity and broader genetic associations between anxiety sensitivity dimensions, anxiety and depressive disorder symptoms were similar at all waves. Both disorder-specific and shared cognitive concerns were identified, suggesting it is appropriate to classify anxiety and depression as distinct but related disorders and confirming the clinical perspective that cognitive therapy is most likely to benefit by targeting cognitive concerns relating specifically to the individual's presenting symptoms across development.
... For boys, anxiety sensitivity played a role in the development of BP, whereas, for girls, no influence on the development of HA or BP was found. 36 In line with existing research, 28 we found that girls achieved higher scores for Anxiety Sensitivity Index than boys. However, these scores do not appear to have a predictive role for BP; such a role we found only for boys. ...
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Background Previous research has shown positive relationships between dysfunctional cognitive styles and different aspects of pain (eg, pain frequency). One goal of our longitudinal study was to investigate potential risk factors for the incidence of headache (HA) and back pain (BP). Methods In the first wave (2003), questionnaires were sent to 6,400 children between the ages of 9 and 14 years. Those who answered in wave 1 were contacted again every year (four survey waves in total: 2003–2006). The data presented are based on the children’s self-reports in the second wave (2004) and third wave (2005). Potential risk factors (dysfunctional stress coping, pain catastrophizing, anxiety sensitivity, and somatosensory amplification) were collected in wave 2. Binary logistic regression analyses – for boys and girls – were performed to assess the predictive value of the risk factors for HA and BP in wave 3. Results In the comprehensive model, none of the examined variables predicted the incidence of HA. Anxiety sensitivity increased the risk that boys would report BP after 1 year by 50% and dysfunctional stress coping increased the risk by 40%. For girls, somatosensory amplification increased the risk of the incidence of BP 1 year later by 80%, whereas pain catastrophizing reduced the risk by 50%. Conclusion In this incidence sample, the amount of variance explained by the psychological variables investigated was very small. Integrating this result with existing findings from cross-sectional studies suggests that dysfunctional cognitive processing styles may develop more as a consequence or a concomitant feature of BP or HA, but play a less important role in its initial development.
... Gender issues are important part of the discussion on time-related and developmental trends especially on the component level due to the differences in different types of anxiety symptoms reported by females and males. For instance, research (Walsh, Stewart, McLaughlin, & Comeau, 2004) showed that girls report significantly more psychological and social symptoms of anxiety than boys but no gender differences were found for psychological symptoms of anxiety. ...
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Research on developmental and time-related trends (cohort effects) of anxiety is important for the assessment of anxiety levels that are not in line with expected developmental trends, and are in need of intervention. We present the results of a large cross-sectional, two-wave cohort study for anxiety for emotional and cognitive components of anxiety, respectively. We measured anxiety using the Lestvica Anksioznosti za Otroke in Mladostnike [LAOM (Anxiety Scale for Children and Adolescents)] anxiety scale (general trait anxiety, and two cognitive components and one emotional component) in two age groups: 10-year-olds (N ¼ 4351; 2621 males and 2663 females), and 14-year-olds (N ¼ 4043; 2545 males and 2569 females) over a 4-year period (2007–2011). The results of threeway analysis of variance showed significant gender, age and cohort effects with significant age £ gender interaction effects (h 2 ¼ 0.002) and age £ cohort effects (h 2 ¼ 0.000). The effect sizes are small. As expected, females showed higher levels of anxiety and, in line with developmental trends, 14-year-olds showed higher levels of anxiety compared with 10-year-olds. The time-related trends (cohort effects) show a significant increase in anxiety and its components from 2007 to 2011. The effect sizes are small, with cohort effect being the largest one (.07 , d , .34) and larger effect sizes generally in 14-year-olds than in 10-yearolds. The implications of the findings are discussed, and in line with the results early intervention is supported. Keywords: Anxiety; Cohort; Age; Gender.
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Though anxiety sensitivity (AS)—fear of anxiety-related experiences—is primarily tied to anxiety vulnerability, AS has also been prospectively associated with general negative affect and depression. Furthermore, depression has been longitudinally associated with different forms of substance use, and some AS subfactors (e.g., cognitive concerns) have been associated more consistently with depression and substance use than others. However, no previous study has investigated if longitudinal associations of AS with substance use may be mediated by depression or whether aspects of AS may be prospectively associated with substance use among adolescents. Hence, the present study tested depressive affect (the negative affective aspect of depression) as a prospective mediator of AS associations with substance use and examined longitudinal AS subfactor associations with substance use and problems. High school 9th graders (N = 2,877; Mage = 14.1 years; 55.3% female) completed self-report measures at baseline and at 6 months and 1 year later. Depressive affect mediated AS associations with subsequent alcohol, cigarette, electronic cigarette, cannabis, benzodiazepine, and opioid use. Also, AS cognitive and social concerns (vs. physical concerns) were more consistently associated with later depressive affect and substance use and problems. Current findings suggest that adolescents high in anxiety sensitivity tend to prospectively experience greater depressive affect, which in turn is related to a higher likelihood of engaging in several different forms of substance use. Thus, it is possible that interventions which target AS (particularly AS cognitive concerns) may help to treat or prevent depression and substance use among adolescents.
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Background: Children diagnosed with anxiety disorders show altered cortisol and state anxiety reactivity to stressful situations. To date, it remains unclear whether these dysregulations emerge after the pathology or whether they are also detectable in healthy children. If the latter is true, this may provide insight into children's vulnerability to develop clinical anxiety. Various personality factors (anxiety sensitivity, intolerance of uncertainty, perseverative cognitions) increase youth's vulnerability to develop anxiety disorders. This study aimed to examine whether vulnerability to anxiety was associated with cortisol reactivity and state anxiety in healthy youth. Methods: 114 children (8-12 y/o) were exposed to the Trier Social Stress Test for Children (TSST-C), where saliva samples were collected for cortisol quantification. State anxiety was assessed 20 min before and 10 min after the TSST-C using the state form of the State-Trait Anxiety Inventory for Children. Vulnerability to anxiety was assessed using a composite score of the Childhood Anxiety Sensitivity Index, Intolerance of Uncertainty Scale for Children, and Perseverative Thinking Questionnaire. Results: Higher vulnerability to anxiety was associated with enhanced cortisol reactivity in boys. Irrespective of vulnerability level, girls reported greater changes in state anxiety in response to the TSST. Limitations: Given the correlational nature of this study, the directionality of the results remains to be elucidated. Conclusions: These results indicate that endocrine patterns characterizing anxiety disorders are detectable in healthy boys who exhibit a high level of self-reported vulnerability to anxiety. These results could aid in the early identification of children at risk of developing anxiety disorders.
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Anxiety sensitivity is a transdiagnostic construct that has been associated with the etiology of emotional disorders, especially panic and other anxiety disorders. Although it is well known that, for the adult population, the factor structure of anxiety sensitivity includes three separate facets (physical, cognitive, and social concerns), the facets of anxiety sensitivity for adolescents have not yet been established. The main goal of the present study was to examine the factor structure of the Spanish version of the Childhood Anxiety Sensitivity Index (CASI). A large sample of nonclinical adolescents completed the Spanish version of the CASI in school settings (N = 1655; aged 11–17 years; 800 boys and 855 girls). Exploratory and confirmatory factor analyses of the full scale (CASI-18) indicate that a three first-order factor solution represents appropriately the three anxiety sensitivity facets previously defined for the adult population. The 3-factor structure had a better fit and was more parsimonious than a 4-factor solution. Results also indicate that the 3-factor structure remains invariant across genders. Girls scored significantly higher than boys on the total scale and on all three dimensions of anxiety sensitivity. In addition, the present study provides information concerning normative data for the scale. The CASI holds promise as a useful tool for assessing general and specific facets of anxiety sensitivity. It could be helpful for the assessment of this construct in clinical and preventive settings. The limitations of the study and suggestions for further research are outlined.
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Male= 160, Female= 160) who were selected randomly form various educational institution of Gujranwala city. The age range of the participants was 12 to 19 years with (M=16.7, SD=1.81). The significant findings of the reliability analyses indicated a Cronbach's alpha value of .86 for the internal consistency. Whereas the split half reliability coefficient of .81 indicated that the adapted version of ASI-R is reliable measure to assess anxiety sensitivity among adolescents in indigenous settings.
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The co-occurrence between anxiety and depression symptoms among children with anxiety disorders is well-known, yet there is considerable heterogeneity in terms of explanatory factors. Although cognitive–affective processes have been hypothesized to play a prominent role, surprisingly, no research to date has examined the role of anxiety sensitivity in this co-occurrence. The present investigation examined the role of anxiety sensitivity in the co-occurrence of anxiety and depression symptoms among clinically anxious children. We expected that anxiety sensitivity would moderate the co-occurrence between anxiety and depression symptoms, such that higher anxiety would be related to higher depression among boys and girls with high (but not low) anxiety sensitivity. Participants (N = 44, age range = 8–12 years; 52% female; 52% African American) were interviewed with the Anxiety Disorders Interview Schedule-IV: Children and Parent Versions and completed self-report measures of anxiety sensitivity, anxiety, and depression symptom severity. Controlling for child age, moderation analyses revealed that higher anxiety was related to higher depression only among girls with high anxiety sensitivity. Among girls with low anxiety sensitivity, the relation between anxiety and depression symptoms was not significant. Anxiety and depression symptoms were strongly correlated among clinically anxious boys irrespective of their levels of anxiety sensitivity. Anxiety sensitivity is an important factor related to anxiety–depression symptom co-occurrence among clinically anxious females in particular. Targeted interventions focused on anxiety sensitivity reduction may prove useful for reducing anxiety–depression symptom co-occurrence among clinically anxious girls. Future research should explore additional moderators that may explain the high correlation between anxiety and depressive symptoms observed among clinically anxious boys.
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Traumatic brain injury (TBI) is both prevalent and potentially disabling. Extant literature has demonstrated women to report greater post-concussive symptoms (PCS) compared to men, highlighting the necessity of investigations into malleable, gender-linked risk factors for PCS that hold promise for reducing this gender disparity. Anxiety Sensitivity (AS) and Distress Tolerance (DT) are gender-linked risk factors that may be related to PCS. Despite a breadth of research supporting elevated AS and reduced DT in women, no study to date has investigated whether AS and DT mediate gender differences in PCS. The current sample was composed of 59 participants selected from a larger study based on their report of a past TBI. Findings indicated that AS, but not DT, significantly mediated gender differences in PCS. The present results suggest that AS is a cognitive risk factor that can partially account for the gender disparity in the expression of PCS. AS may influence an individual's interpretation of PCS as dangerous, thereby amplifying the perception of PCS severity. This suggests that efforts to reduce the burden of TBI may benefit from targeting AS in prevention and treatment paradigms, especially among women.
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Cigarette smoking during adolescence is linked to a number of sleep disturbances and has been consistently linked to sleep onset latency among adults. However, little research has examined factors that may influence the relation between cigarette smoking level and sleep onset latency among adolescents. One factor that may be particularly important in this regard is anxiety sensitivity (AS). The current study examined whether cigarette smoking level interacted with AS in its association with sleep onset latency among 94 adolescent (Mage = 15.72) cigarette smokers. As hypothesized, AS interacted with smoking level to relate to sleep onset latency, even after controlling for age and gender. This relation was specific to sleep onset latency as opposed to other types of sleep disturbances, and that adolescents who smoked at higher levels tended to go to sleep later and wake up later than adolescents who smoked at relatively lower levels.
Chapter
In addition to the assessment methods described in Chap. 7, there are specific methods, procedures, and instruments to assess anxiety symptoms and disorders. The assessment of anxiety should also be considered from the contextual approach of developmental psychopathology discussed in Chaps. 1 and 2. In this chapter, discussion of methods specific to anxiety and anxiety disorders will be presented and integrated with developmental psychopathology concepts. A case example will be provided that describes the referral questions, the assessment procedures used, diagnostic conclusions, and potential recommendations.
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The sex difference in physical and verbal aggression is one of the most robust, universal, and durable. In the United States, men constitute eighty six percent of all violent offenders. The proportionate involvement of men rises with the seriousness of the offence. Meta-analyses of psychological studies using experimental, observational, and self- or other-report methods also find that men are more verbally and physically aggressive than women and that this difference is greater for physical aggression. The ubiquity of this effect, its early developmental onset, and its consistency with other primate species suggest the utility of an explanation on evolution. This article suggests that the psychological instantiation of the reluctance to directly expose oneself to physical danger is fear. Fear also forms the developmental infrastructure for behavioural inhibition so that females are better able to control the behavioural expression of anger when provoked than are men.
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Anxiety sensitivity (AS) is a cognitive individual difference actor involving an enduring fear of anxiety-related arousal sensations (e.g., increased heart rate) that arises from the tendency to catastrophize about these sensations, believing they will have serious psychological, physiological, and/or social consequences. AS may have particular relevance for adolescents as the onset of puberty heralds the arrival of a wide range of new and unexpected bodily sensations, as well as changes in cognitive and social development. Research has implicated AS in the development and maintenance of a number of mental health disorders in adolescents including panic disorder, social phobia, posttraumatic stress disorder, chronic pain, substance misuse, and depression. Furthermore, AS has been shown to be composed of several lower-order factors (e.g., Physical, Social, and Psychological Concerns), which may have unique associations with psychopathology. Understanding AS will help in the identification of youth at risk for mental health problems and might have implications for prevention and intervention.
Chapter
Pharmacogenomics and the search for personalized medicine focus on the attainment of individualized pharmacotherapies that cover genetic variation and target groups of patients that present neurodevelopmental aspects of symptom profiles and biomarkers underlying the pathophysiology of mood disorders. The identification of genetic biomarkers facilitates choice of treatment, prediction of response, and prognosis of outcome over a wide spectrum of symptoms associated with affective states thereby optimizing clinical practice procedures. Several strategies, under development and refinement, show the propensity for derivation of essential elements in the etiopathogenesis of disorder affecting drug efficacy, drug metabolism, and drug adverse effects, e.g., with regard to SSRIs; these include the following: transporter gene expression and genes encoding receptor systems, hypothalamic-pituitary-adrenal axis factors, neurotrophic factors, and inflammatory factors affecting neuroimmune function. Nevertheless, procedural considerations of pharmacogenetics presume the parallel investment of policies and regulations to withstand eventual attempts at misuse thereby ensuring patient integrity.
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The present study discusses retention criteria for principal components analysis (PCA) applied to Likert scale items typical in psychological questionnaires. The main aim is to recommend applied researchers to restrain from relying only on the eigenvalue-than-one criterion; alternative procedures are suggested for adjusting for sampling error. An additional objective is to add evidence on the consequences of applying this rule when PCA is used with discrete variables. The experimental conditions were studied by means of Monte Carlo sampling including several sample sizes, different number of variables and answer alternatives, and four non-normal distributions. The results suggest that even when all the items and thus the underlying dimensions are independent, eigenvalues greater than one are frequent and they can explain up to 80% of the variance in data, meeting the empirical criterion. The consequences of using Kaiser's rule are illustrated with a clinical psychology example. The size of the eigenvalues resulted to be a function of the sample size and the number of variables, which is also the case for parallel analysis as previous research shows. To enhance the application of alternative criteria, an R package was developed for deciding the number of principal components to retain by means of confidence intervals constructed about the eigenvalues corresponding to lack of relationship between discrete variables.
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Introduction: Anxiety sensitivity (AS) refers to the fear of anxiety-related sensa- tions due to beliefs that these sensations will lead to catastrophic outcomes. AS plays a central role in the etiology and maintenance of anxiety disorders. From a clinical perspective, it therefore seems important to possess a valid scale to assess AS in children. Objective, Method: This study examines the factor structure, reli- ability, and validity of the French translation of the Childhood Anxiety Sensitivity Index (CASI) in 353 Belgian children (9 to 13 years). Result: Results show that AS can be adequately measured using the French version of the CASI and conceptual- ized as a hierarchical factor structure with four lower-order factors – Physical Concerns, Mental Incapacity Concerns, Social Concerns, and Losing Control Con- cerns – loading on a single higher-order factor, Anxiety Sensitivity. The reliability was acceptable for the total scale. Hierarchical multiple regressions show that the CASI makes a significant contribution in predicting anxiety. Conclusion: The data support the relevance of the French CASI in the assessment of AS in nonclinical children.
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Anxiety disorders constitute the most common mental health disturbance experienced by youth. Sleep-related problems (SRPs) are highly prevalent among anxious youth and encompass a variety of problems including nighttime fears, insomnia, and refusal to sleep alone. Given that chronic sleep disturbance is associated with a range of behavioral and physical problems in youth and predicts future psychopathology, it is important to elucidate the nature of SRPs in anxious youth. The present study investigated the relationship between sleep problems and anxiety sensitivity in a sample of 101 anxious youth, ages 6-17. Heightened anxiety sensitivity significantly predicted prolonged sleep onset latency across the sample, even after accounting for severity of anxiety, depression, and age. Results support previous research indicating that SRPs are common among anxious youth and suggest that anxiety sensitivity may play a particularly important role in sleep onset latency. Copyright © 2015. Published by Elsevier Ltd.
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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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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 performance of five methods for determining the number of components to retain (Horn's parallel analysis, Velicer's minimum average partial [MAP], Cattell's scree test, Bartlett's chi-square test, and Kaiser's eigenvalue greater than 1.0 rule) was investigated across seven systematically varied conditions (sample size, number of variables, number of components, component saturation, equal or unequal numbers of variables per component, and the presence or absence of unique and complex variables). We generated five sample correlation matrices at each of two sample sizes from the 48 known population correlation matrices representing six levels of component pattern complexity. The performance of the parallel analysis and MAP methods was generally the best across all situations. The scree test was generally accurate but variable. Bartlett's chi-square test was less accurate and more variable than the scree test. Kaiser's method tended to severely overestimate the number of components. We discuss recommendations concerning the conditions under which each of the methods are accurate, along with the most effective and useful methods combinations.
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The literature on the assessment of anxiety sensitivity (AS) in children and adolescents is reviewed. Following a discussion of theoretical and developmental issues relevant to AS and anxiety disorders, the construct validity of measures of childhood AS is reviewed using J. Loevinger's (1957) threefold framework. The collective evidence suggests mixed support at present for the validity of the clinical assessment of AS in youths, owing to (a) a limited number of adequate measures, (b) insufficient data on construct validity, and (c) a deficiency of knowledge regarding the potential influence of developmental factors on AS and anxiety disorders. Limitations of the literature are summarized, and suggestions for future research are provided. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Investigated the performance of 5 methods for determining the number of components to retain—J. L. Horn's (see record 1965-13273-001 ) parallel analysis, W. F. Velicer's (see record 1977-00166-001 ) minimum average partial (MAP), R. B. Cattell's (see PA, Vol 41:969) scree test, M. S. Bartlett's (1950) chi-square test, and H. F. Kaiser's (see record 1960-06772-001 ) eigenvalue greater than 1 rule—across 7 systematically varied conditions (sample size, number of variables, number of components, component saturation, equal or unequal numbers of variables for each component, and the presence or absence of unique and complex variables). Five sample correlation matrices were generated at each of 2 sample sizes from the 48 known population correlation matrices representing 6 levels of component pattern complexity. Results indicate that the performance of the parallel analysis and MAP methods was generally the best across all situations; the scree test was generally accurate but variable; and Bartlett's chi-square test was less accurate and more variable than the scree test. Kaiser's method tended to severely overestimate the number of components. (65 ref)
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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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Examined the reliability, validity, and factor structure of the Childhood Anxiety Sensitivity Index (CASI; Silverman, Fleisig, Rabian, & Peterson, 1991) in a Dutch sample. Five hundred forty-four Dutch schoolchildren between 8 and 16 years of age completed Dutch translations of the CASI; the State-Trait Anxiety Inventory for Children (Spielberger, Edwards, Lushene, Montuori, & Platzek, 1973); and the Fear Survey Schedule for Children-Revised (Ollendick, 1983). The Dutch CASI was found to have adequate internal consistency for use with children as well as adolescents. Results reveal that the CASI predicted fear beyond a measure of trait anxiety in this Dutch sample. Both exploratory and confirmatory factor analyses comparing different models were undertaken. The model with 3 first-order factors found in previous studies showed an acceptable fit in this cross-validation sample. Loadings on the 3 factors (Physical Concerns, Mental Concerns, and Publicly Observable Concerns) did not differ between children and adolescents. Results are compared with previous research on the CASI. Directions for future research are discussed.
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"What does a manager do?" This question interested a few researchers on both sides of the Atlantic in the 1950s and 1960s, starting with Sune Carlson (1951) in Sweden in the early 1950s. They, like some other social scientists at the time, thought it important to explore what actually happened, whether in organizations, or in managerial activities, rather than to rely on the current theories about the principles of good organization or the nature of managerial functions. Joan Woodward (1965) and Tom Burns and George Stalker (1961) were the pioneers in exploring how organizations actually worked. Leonard Sayles was one of the early researchers to adopt a similar approach to managerial behavior.
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Monte Carlo research increasingly seems to favor the use of parallel analysis as a method for determining the "correct" number of factors in factor analysis or components in principal components analysis. We present a regression equation for predicting parallel analysis values used to decide the number of principal components to retain. This equation is appropriate for predicting criterion mean eigenvalues and was derived from random data sets containing between 5 and 50 variables and between 50 and 500 subjects. This relatively simple equation is more accurate for predicting mean eigenvalues from random data matrices with unities in the diagonals than a previously published equation. Moreover, given that the parallel analysis decision rule may be too dependent on chance, our equation is also used to predict the 95th percentile point in distributions of eigenvalues generated from random data matrices. Multiple correlations for all analyses were at least .95. Regression weights for predicting the first 33 mean and 95th percentile eigenvalues are given in easy-to-use tables.
Article
The purpose of the paper is to describe a more generally applicable method of factor analysis which has no restrictions as regards group factors and which does not restrict the number of general factors that are operative in producing the intercorrelation. Applications of the method to different types of correlation problems are suggested. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Evaluated a scale for measuring anxiety sensitivity (i.e., the belief that anxiety symptoms have negative consequences), the Child Anxiety Sensitivity Index (CASI), in 76 7th–9th graders and 33 emotionally disturbed children (aged 8–15 yrs). The CASI had sound psychometric properties for both samples. The view that anxiety sensitivity is a separate concept from that of anxiety frequency and that it is a concept applicable with children was supported. The CASI correlated with measures of fear and anxiety and accounted for variance on the Fear Survey Schedule for Children—Revised and the State-Trait Anxiety Inventory for Children (Trait form) that could not be explained by a measure of anxiety frequency. The possible role of anxiety sensitivity as a predisposing factor in the development of anxiety disorder in children is discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
This study examined the item properties, factor structure, and convergent, discriminant, and incremental validity of items on the Childhood Anxiety Sensitivity Index (CASI). A large sample of children and adolescents with anxiety disorders (N = 228) was administered semistructured clinical interviews and self-report measures of anxiety sensitivity, anxiety, and depression. Overall, the CASI was found to exhibit good convergent and discriminant properties in relation to clinician-rated panic and generalized anxiety severity, respectively. Results identified a subset of items (autonomic items) that demonstrated psychometric properties superior to the full scale, in both child (7 to 11 years) and adolescent (12 to 17 years) subsamples. The findings point to strategies for continued investigation regarding the clinical assessment of AS in children and adolescents.
Article
Anxiety sensitivity (AS) is the fear of anxiety-related sensations arising from beliefs that these sensations have harmful physical, psychological, or social consequences. AS is measured using the Anxiety Sensitivity Index (ASI), a 16-item self-report questionnaire. Little is known about the origins of AS, although social learning experiences (including sex-role socialization experiences) may be important. The present study examined whether there were gender differences in: (a) the lower- or higher-order factor structure of the ASI; and/or (b) pattern of ASI factor scores. The ASI was completed by 818 university students (290 males; 528 females). Separate principal components analyses on the ASI items of the total sample, males, and females revealed nearly identical lower-order three-factor structures for all groups, with factors pertaining to fears about the anticipated (a) physical, (b) psychological, and (c) social consequences of anxiety. Separate principal components analyses on the lower-order factor scores of the three samples revealed similar unidimensional higher-order solutions for all groups. Gender × AS dimension analyses on ASI lower-order factor scores showed that: females scored higher than males only on the physical concerns factor; females scored higher on the physical concerns factor relative to their scores on the social and psychological concerns factors; and males scored higher on the social and psychological concerns factors relative to their scores on the physical concerns factor. Finally, females scored higher than males on the higher-order factor representing the global AS construct. The present study provides further support for the empirical distinction of the three lower-order dimensions of AS, and additional evidence for the theoretical hierarchical structure of the ASI. Results also suggest that males and females differ on these various AS dimensions in ways consistent with sex role socialization practices.
Article
The present study investigated relations of anxiety sensitivity and other theoretically relevant personality factors to Copper's [Psychological Assessment 6 (1994) 117.] four categories of substance use motivations as applied to teens' use of alcohol, cigarettes, and marijuana. A sample of 508 adolescents (238 females, 270 males; mean age=15.1 years) completed the Trait subscale of the State-Trait Anxiety Inventory for Children, the Childhood Anxiety Sensitivity Index (CASI), and the Intensity and Novelty subscales of the Arnett Inventory of Sensation Seeking. Users of each substance also completed the Drinking Motives Questionnaire-Revised (DMQ-R) and/or author-compiled measures for assessing motives for cigarette smoking and marijuana use, respectively. Multiple regression analyses revealed that, in the case of each drug, the block of personality variables predicted “risky” substance use motives (i.e., coping, enhancement, and/or conformity motives) over-and-above demographics. High intensity seeking and low anxiety sensitivity predicted enhancement motives for alcohol use, high anxiety sensitivity predicted conformity motives for alcohol and marijuana use, and high trait anxiety predicted coping motives for alcohol and cigarette use. Moreover, anxiety sensitivity moderated the relation between trait anxiety and coping motives for alcohol and cigarette use: the trait anxiety–coping motives relation was stronger for high, than for low, anxiety sensitive individuals. Implications of the findings for improving substance abuse prevention efforts for youth will be discussed.
Article
Examined the construct validity of the Childhood Anxiety Sensitivity Index (CASI) in young children through the use of a behavioral challenge task. Elementary-school children completed the CASI as well as self-report measures of state and trait anxiety and subjective fear prior to and immediately following a stair-stepping task designed to increase physiological arousal. Results indicate that the CASI was a significant predictor of the degree of state anxiety and subjective fear reported in response to the challenge task, even after controlling for pretask levels of state anxiety and fear, respectively. Additionally, the CASI predicted changes in fear experienced in response to the challenge task. The findings lend support to the validity of the CASI in preadolescent children and suggest that the CASI possesses unique clinical utility relative to measures of trait anxiety. However, results of this study must be interpreted cautiously, because a large portion of the variance in response to arousal was left unaccounted for by the CASI and the overall model.
Article
We developed various factor models of the Childhood Anxiety Sensitivity Index [Silverman, W. K., Fleisig, W., Rabian, B. & Peterson, R. A. (1991). Childhood anxiety sensitivity index. Journal of Clinical Child Psychology, 20, 162-168] and tested the goodness of fit of the models in an independent sample. Of primary interest was to examine the question that characterized the factor analytic studies conducted on the adult version of the anxiety sensitivity index, i.e. the ASI [Reiss, S., Peterson, R. A., Gursky, D. M. & McNally, R. J. (1986). Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behaviour Research and Therapy, 24, 1-8]: is anxiety sensitivity in children a unidimensional construct, an orthogonal multidimensional construct, or a hierarchical construct? Two independent samples (a clinic sample and a nonclinical sample) were used for development and replication of the factor models. The clinic sample consisted of 258 children (105 girls and 153 boys) who presented to a child anxiety disorders specialty clinic. The unselected, nonclinic sample consisted of 249 children (122 girls and 127 boys) enrolled in an elementary school. The results provided strong empirical support for a hierarchical multidimensional model with either three or four first-order factors. The two factors that emerged that appeared to be robust were Physical Concerns and Mental Incapacitation Concerns. What remains unresolved is whether Control of anxiety symptoms and Social Concerns are to be differentiated (as in the hierarchical model with four first-order factors) or not (as in the hierarchical model with three first-order factors). In addition to discussing this issue, the convergence of the present study's findings with past findings obtained with the ASI is discussed.
Article
Research on gender differences in children's fears has generally shown that girls are more fearful than boys. A common hypothesis offered for this finding is that gender role orientations or expectations may be operating. However, this hypothesis has not been directly investigated in child samples. The present study examined the relation between a self-report measure of gender role orientation (i.e., masculinity/femininity) and the intensity of self-reported fears in a clinic sample of children (N = 66; ages 6-11; 41 boys and 25 girls) with anxiety disorders. Results revealed that masculinity was negatively related to overall levels of fearfulness as well as specific fears of failure and criticism, medical fears, and fears of the unknown. In contrast, no relation was found between femininity and fearfulness. These findings suggest that gender role orientation, especially masculinity, may play a role in the development and/or maintenance of fearfulness in children.
Article
The current study examined the anxiety sensitivity construct in a large sample of normal Dutch adolescents aged 13-16 years (n=819). Children completed the Childhood Anxiety Sensitivity Index (CASI; Silverman, W. K., Fleisig, W., Rabian, B. & Peterson, R. A. (1991). Journal of Clinical Child Psychology, 20, 162-168) and measures of trait anxiety, anxiety disorder symptoms and depression. Results showed that (1) anxiety sensitivity as indexed by the CASI seems to be a hierarchically organized construct with one higher-order factor (i.e., anxiety sensitivity) and three or four lower-order factors, (2) anxiety sensitivity and trait anxiety were strongly correlated, (3) anxiety sensitivity was substantially connected to symptoms of anxiety disorders (in particular of panic disorder and agoraphobia) and depression, and (4) anxiety sensitivity and trait anxiety both accounted for unique proportions of the variance in anxiety disorder symptoms. Altogether these findings are in agreement with those of previous research in adult and child populations, and further support the notion that anxiety sensitivity should be viewed as an unique factor of anxiety vulnerability.
Article
This study examines the factor structure underlying the Anxiety Sensitivity Index for Children (ASIC. J Anxiety Disord, 12 (1998) 307) in an adolescent sample. Three-hundred-and-eight adolescents, aged 12 to 18, completed the ASIC and measures of anxiety and depression. Factor analysis of the ASIC items resulted in a two-factor structure that is similar to that reported by Laurent et al. These two factors included a physical concerns dimension and a mental concerns dimension similar to those found in studies of adult anxiety sensitivity. Subscales measuring these two factors demonstrated concurrent validity, showing particularly close associations with measures of panic symptoms. In addition, both of these subscales showed incremental validity in predicting panic symptoms after controlling for the other anxiety sensitivity subscale and a measure of depression. These results provide evidence that the anxiety sensitivity construct is applicable during adolescence and support the use of the ASIC.
Childhood anxiety sensitivity index factors predict unique variance in DSM-IV anxiety disorder symptomsAnxiety sensitivity in childhood and adolescents: origins, gender differences, and associations with anxiety-related disorders
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Stewart, S. H., Comeau, N., Loba, P., Theakson, J. (2002). Social anxiety and conformity-motivated drinking in adolescents: moderating effects of fear of loss of control. Presented at the Annual Meeting of the Association for Advancement of Behavior Therapy, Reno, NV, November. Stewart, S. H., Taylor, S., & Baker, J. M. (1997). Gender differences in dimensions of anxiety sensitivity. Journal of Anxiety Disorders, 11, 179–200.
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Social anxiety and conformity-motivated drinking in adolescents: moderating effects of fear of loss of control
  • S H Stewart
  • N Comeau
  • P Loba
  • J Theakson
Stewart, S. H., Comeau, N., Loba, P., Theakson, J. (2002). Social anxiety and conformity-motivated drinking in adolescents: moderating effects of fear of loss of control. Presented at the Annual Meeting of the Association for Advancement of Behavior Therapy, Reno, NV, November.
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Anxiety sensitivity in childhood and adolescents: origins, gender differences, and associations with anxiety-related disorders
  • E Mclaughlin
  • S H Stewart
  • S Taylor