Skip to main content
Log in

Fear of fear and the anxiety disorders

  • Published:
Cognitive Therapy and Research Aims and scope Submit manuscript

Abstract

The responses of 271 outpatients with diagnoses of agoraphobia with panic attacks, panic disorder, generalized anxiety disorder, social phobia, obsessive-compulsive disorder, or depression (major depressive disorder or dysthymic disorder) to the Agoraphobic Cognitions Questionnaire (ACQ) and the Body Sensations Questionnaire (BSQ) were examined. Agoraphobics scored significantly higher than all other groups on fear of body sensations associated with anxiety. In addition, agoraphobics, together with clients with panic disorder, had significantly higher scores on thoughts that physical illness would be caused by their anxiety. All clinical groups scored significantly higher than normal controls on thoughts that their anxiety would lead to social embarrassment or loss of control; there were no significant differences among clinical subjects on this measure, although agoraphobics' scores were higher than those of all other groups. In addition, analyses of data from 364 agoraphobics showed that the ACQ and BSQ predicted an important feature of agoraphobia—namely, self-reported avoidance behavior, even once the common variance of fear of fear with trait anxiety was partialed out. In summary, it appears that fear of fear is an important distinguishing characteristic among clients with anxiety disorders, and one that cannot be reduced to global psychological distress or trait anxiety.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • American Psychiatric Association. (1980).Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association. (1987).Diagnostic and statistical manual of mental disorders (3rd ed.-rev.). Washington, DC: Author.

    Google Scholar 

  • Beck, A. T. (1976).Cognitive therapy and the emotional disorders. New York: International Universities Press.

    Google Scholar 

  • Beck, A. T., & Emery, G. (1985).Anxiety disorders and phobias. New York: Basic Books.

    Google Scholar 

  • Belfer, P., & Glass, C. (in press). Agoraphobic anxiety and fear of fear: Test of a cognitive-attentional model.Journal of Anxiety Disorders.

  • Chambless, D. L. (1985a). Agoraphobia. In M. Hersen & A. S. Bellack (Eds.),Handbook of clinical behavior therapy with adults (pp. 49–87). New York: Plenum Press.

    Google Scholar 

  • Chambless, D. L. (1985b). The relationship of severity of agoraphobia to associated psychopathology.Behaviour Research and Therapy, 23 305–310.

    Google Scholar 

  • Chambless, D. L., Caputo, G. C., Bright, P., & Gallagher, R. (1984). Assessment of fear of fear in agoraphobics: The Body Sensations Questionnaire and the Agoraphobic Cognitions Questionnaire.Journal of Consulting and Clinical Psychology, 52 1090–1097.

    Google Scholar 

  • Chambless, D. L., Caputo, G. C., Jasin, S. E., Gracely, E. J., & Williams, C. (1985). The Mobility Inventory for Agoraphobia.Behaviour Research and Therapy, 23 35–44.

    Google Scholar 

  • Chambless, D. L., & Gracely, E. J. (1988). Prediction of outcome following in vivo exposure treatment of agoraphobia. In I. Hand & H.-U. Wittchen (Eds.),Panic and phobias. II. Berlin: Springer-Verlag.

    Google Scholar 

  • Chambless, D. L., & Mason, J. (1986). Sex, sex-role stereotyping and agoraphobia.Behaviour Research and Therapy, 24 231–235.

    Google Scholar 

  • Clark, D. M. (1986). A cognitive approach to panic.Behaviour Research and Therapy, 24 461–470.

    Google Scholar 

  • Craske, M. G., Rachman, S. J., & Tallman, K. (1986). Mobility, cognitions, and panic.Journal of Psychopathology and Behavioral Assessment, 8 199–210.

    Google Scholar 

  • Goldstein, A. J., & Chambless, D. L. (1978). A reanalysis of agoraphobia.Behavior Therapy, 9 47–59.

    Google Scholar 

  • Jackard, J., Becker, M. A., & Wood, G. (1984). Pairwise multiple comparison procedures: A review.Psychological Bulletin, 96 589–596.

    Google Scholar 

  • Marks, I. M. (1970). The classification of phobic disorders.British Journal of Psychiatry, 116 377–386.

    Google Scholar 

  • McNally, R. J., & Lorenz, M. (1987). Anxiety sensitivity in agoraphobics.Journal of Behavior Therapy and Experimental Psychiatry, 18 3–11.

    Google Scholar 

  • Reiss, S. (1987). Theoretical perspectives on fear of anxiety.Clinical Psychology Review, 7 585–596.

    Google Scholar 

  • 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.

    Google Scholar 

  • Spielberger, C., Gorsuch, A., & Lushene, R. (1970).The State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.

    Google Scholar 

  • Spitzer, R., & Williams, J. B. W. (1983).Instructional manual for the Structured Clinical Interview for DSM-III-R. New York: Biometrics Research Department, New York State Psychiatric Institute.

    Google Scholar 

  • Weekes, C. (1976).Simple, effective treatment for agoraphobia. New York: Hawthorn.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

The authors wish to thank Aaron T. Beck, Gary Brown, and Gail Steketee, whose cooperation in data collection made this study possible; Nazareth Pantaloni, for his assistance in data analysis; and Carol Glass, for her helpful comments on an earlier draft of this paper.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chambless, D.L., Gracely, E.J. Fear of fear and the anxiety disorders. Cogn Ther Res 13, 9–20 (1989). https://doi.org/10.1007/BF01178486

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01178486

Key words

Navigation