Anxiety sensitivity in agoraphobics

doi:10.1016/0005-7916(87)90065-6

Journal of Behavior Therapy and Experimental Psychiatry

Volume 18, Issue 1, March 1987, Pages 3-11

https://doi.org/10.1016/0005-7916(87)90065-6 Get rights and content

Abstract

This study further validated the “Reiss-Epstein-Gursky Anxiety Sensitivity Index” (ASI) as a measure of the fear of anxiety. Agoraphobics scored high on the ASI before, but not after, behavioral treatment. Residual anxiety sensitivity, however, did not predict resurgence of agoraphobic avoidance at six months follow-up. Indeed, anxiety sensitivity continued to decline during the follow-up period. Multiple regression analyses indicated that the ASI predicted the number of fears in agoraphobics beyond that predicted by the level of general anxiety. This findings supports the hypothesis that high anxiety sensitivity enhances fear acquisition; it also suggest that the ASI measures a construct different from that measured by general anxiety scales. Empirical similarities and differences were found between the ASI and two other “fear of fear” measures: the Agoraphobic Cognitions Questionnaire and the Body Sensations Questionnaire.

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Gender moderates the effect of exercise on anxiety sensitivity
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Citation Excerpt :
Normative studies indicate that scores above 25 indicate possible clinical problems (Peterson & Plehn, 1999). The ASI has sound psychometric properties in both clinical and non-clinical samples, including adequate construct validity (McNally & Lorenz, 1987; Reiss, Peterson, Gursky, & McNally, 1986; Taylor, Koch, & McNally, 1992; Telch, Shermis, & Lucas, 1989). The ASI was administered to all participants at four separate time points: pretreatment, mid-treatment (1 week after exercise initiation), posttreatment (end of 2-week exercise program), and 3-week follow-up (i.e., three weeks following completion of exercise intervention).
A moderate to vigorous intensity exercise program is emerging as a promising strategy for reducing anxiety sensitivity (AS). Initial evidence suggests that the effects of exercise on mental health outcomes may vary as a function of gender, with men benefitting more than women. Building upon this evidence, the present study tested the hypothesis that the effect of exercise on AS would vary as a function of gender, such that the effect would be stronger for men than for women. We tested this hypothesis using the data from a published study (Smits, Berry, Rosenfield, et al., 2008). In this study, participants (N = 60) with elevated levels of AS were randomly assigned to a two-week exercise intervention [EX] or a waitlist control condition [WL]. Results revealed that males showed significantly greater initial AS reductions relative to females (following 1 week of exercise). However, these gender differences were no longer evident at the end of the intervention. Possible mechanisms for the observed findings and directions for future research are discussed.
The role of painful events and pain perception in blood-injection-injury fears
2012, Journal of Behavior Therapy and Experimental Psychiatry
Research suggests that blood, injection, and injury (BII) fears are related to painful experiences; however the role of frequency, intensity, and perceived ability to handle such events remains unknown. The aim of this study was to examine the relationship between BII fears and the frequency and intensity of prior painful experiences with blood, injuries, and injections. The relation of BII fears with self-reported tolerance and avoidance of physical discomfort and pain was also examined.
In the context of an undergraduate student survey, 392 participants completed questions about whether they were fearful of blood, injection, and injuries. They also completed questions about experiences with blood and injuries, as well as injections, including pain intensity, frequency of painful experiences, perceived ability to tolerate physical discomfort and pain (pain perception), and avoidance of physical discomfort.
Findings indicated that only pain intensity, but not frequency of painful experiences with blood, injuries, and injections, was related to BII fears. Furthermore, there was a significant association between BII fears and pain perception, such that higher levels of discomfort intolerance were related to greater odds of endorsing BII fears.
These findings provide preliminary evidence that BII fears are associated with experiences with injections of high pain intensity. Individuals with a lower perceived ability to handle physical pain and discomfort are more likely to endorse BII fears. Clinical considerations and future directions are discussed.
Physical activity as a moderator of the association between anxiety sensitivity and binge eating
2012, Eating Behaviors
Individuals with elevated anxiety sensitivity (AS; i.e., fear of somatic arousal) may binge eat to reduce emotional distress. Because physical activity reduces stress reactivity, we predicted that: (1) the relation between AS and binge eating would be moderated by physical activity and (2) coping motives for eating would mediate the association between AS and binge eating such that the relation would be stronger for those low in physical activity. Participants (N = 167) completed online self-report measures. Regression analyses revealed that moderate-intensity physical activity (MPA) moderated the relation between AS and binge eating such that AS was not related to binge eating among those who frequently engaged in MPA but was related to binge eating among those who did not report engaging in MPA. Vigorous-intensity physical activity (VPA) moderated in the opposite direction such that the relation between AS and binge eating was significant among persons reporting high levels of VPA but less strong among persons reporting low levels of VPA. The mediation model was also significant, but was not moderated by MPA or VPA. Theoretical and clinical implications are discussed.
Coping Skills and Exposure Therapy in Panic Disorder and Agoraphobia: Latest Advances and Future Directions
2012, Behavior Therapy
Although cognitive-behavioral treatments for panic disorder have demonstrated efficacy, a considerable number of patients terminate treatment prematurely or remain symtpomatic. Cognitive and biobehavioral coping skills are taught to improve exposure therapy outcomes but evidence for an additive effect is largely lacking. Current methodologies used to study the augmenting effects of coping skills test the degree to which the delivery of coping skills enhances outcomes. However, they do not assess the degree to which acquisition of coping skills and their application during exposure therapy augment outcomes. We examine the extant evidence on the role of traditional coping skills in augmenting exposure for panic disorder, discuss the limitations of existing research, and offer recommendations for methodological advances.
Anxiety sensitivity, the menstrual cycle, and panic disorder: A putative neuroendocrine and psychological interaction
2011, Clinical Psychology Review
Citation Excerpt :
Lastly, chronic psychosocial stressors may interact with ovarian hormone changes to predict as well as exacerbate clinical levels of premenstrual symptoms. Anxiety sensitivity (AS) is the tendency to respond fearfully to the occurrence of anxiety symptoms due to beliefs that certain bodily sensations may indicate harm or illness (McNally, 2002), and is an established cognitive risk factor for the development of PD (Donnell & McNally, 1989; Maller & Reiss, 1992; McNally & Lorenz, 1987). High AS individuals hold the belief that experiencing anxiety or fear will cause severe negative consequences (i.e., heart attack); are hypervigilant to stimuli that signal anxiety (i.e., increased heart rate); worry about becoming anxious; and avoid stimuli that provoke anxiety (McNally, 2002; Reiss, Peterson, Gursky, & McNally, 1986).
The 2:1 female-to-male sex difference in the prevalence of panic disorder (PD) suggests that there is a sex-specific vulnerability involved in the etiology and/or maintenance of this disorder. The purpose of this paper is to present a new conceptual model, which emphasizes the interaction between a cognitive vulnerability for PD, anxiety sensitivity, and the effects of progesterone and its metabolite, allopregnanolone, on behavioral and physiological responses to stress during the premenstrual phase. This interaction is proposed to be a potential sex-specific pathway that may initiate and/or maintain panic and anxiety symptoms in women. This review paper presents preliminary evidence from both the human and animal literatures to support this new model. Specific topics reviewed include: psychopathology related to the menstrual cycle, anxiety sensitivity and its relationship to the menstrual cycle, PMS, and PMDD, anxiety-modulating effects of progesterone and its neuroactive metabolite, allopregnanolone, and how results from the neuroendocrine literature relate to psychopathology or symptoms associated with the menstrual cycle.
Unexpected arousal, anxiety sensitivity, and their interaction on CO<inf>2</inf>-induced panic: Further evidence for the context-sensitivity vulnerability model
2011, Journal of Anxiety Disorders
The present experiment tested several predictions derived from the context-sensitivity vulnerability model of panic. Participants (N = 79) scoring either high or low in anxiety sensitivity (AS) and with no history of unexpected panic were randomly assigned to one of two instructional sets: expected arousal (EA) or expected relaxation (ER). All participants were administered inhalation of room air and 35% CO₂ in a counterbalanced order. Consistent with theoretical predictions, High-AS participants who received ER instructions showed greater emotional responding compared to High-AS participants who received EA instructions, while instructional set did not affect responding among Low-AS participants. Panic attacks were observed in 52% of the High-AS-ER group compared to 17%, 5%, and 5% in the High-AS-EA, Low-AS-ER, and Low-AS-EA groups respectively. These findings are consistent with the theory's assertion that dispositional tendencies, such as anxiety sensitivity potentiate the panicogenic effects of threat-relevant context variables.

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^☆: A shorter version of this paper was presented at the meeting of the Association for Advancement of Behavior Therapy in Chicago, November 1986.

View full text

Anxiety sensitivity in agoraphobics☆

Abstract

Behav. Res. Ther.

Behav. Res. Ther.

Clin. Psychol. Rev.

Behav. Res. Ther.

Behav. Ther.

Behav. Res. Ther.

Behav. Res. Ther.

Behav. Res. Ther.

Behav. Res. Ther.

Behav. Res. Ther.

J. Behav. Ther. Exp. Psychiat.

Diagnostic and Statistical Manual of Mental Disorders

Depression: Causes and Treatment

Agoraphobic anxiety and fear of fear: A cognitive attentional model

Assessment of fear of fear in agoraphobics: The Body Sensations Questionnaire and the Agoraphobic Cognitions Questionnaire

J. Consult. Clin. Psychol.