Dimensions of Anxiety Sensitivity and Their Relationship to Nonclinical Panic

The goal of the present study was to examine the factor structure of the Anxiety Sensitivity Index (ASI; S. Reiss, R. A. Peterson, D M. Gursky, & R. J. McNally, 1986) and the replicability, reliability, and validity of its dimensions in a nonclinical sample. One-thousand-and-seventy-one undergraduate volunteers completed the ASI and a modified version of the Panic Attack Questionnaire (PAQ; G. R. Norton, J. Dorward, & B. J. Cox, 1986). A principal components analysis, using oblique rotation and parallel analysis, yielded three ASI dimensions that were highly consistent with those reported in previously published studies. Individuals classified as nonclinical panickers scored higher than nonpanickers on the Physical Concerns and Cognitive Concerns subscales of the ASI. Although spontaneous panic attacks were not significantly related to scores on any ASI scale, the occurrence of panic attacks in the past month was related to higher scores on the Cognitive Concerns subscale. The results are discussed in terms of cognitive theories of panic, and limitations of the present study and directions for future research are addressed.     

Child Anxiety Sensitivity and Family Environment as Mediators of the Relationship between Parent Psychopathology, Parent Anxiety Sensitivity, and Child Anxiety

This study examined child anxiety sensitivity and family environment as mediators of the relationship between (1) parent psychopathology and anxiety sensitivity and (2) child anxiety in a community sample of 157 youths aged 7–18 years. Parents completed measures of anxiety sensitivity, psychopathology, and family environment. Youths completed measures of anxiety sensitivity and anxiety. One structural equation model was tested with child anxiety sensitivity as a mediator of (1) parent psychopathology and parent anxiety sensitivity and (2) child anxiety. Mediation was found with respect to parent psychopathology but not anxiety sensitivity. A second structural equation model was tested with family environment (conflict and control) as a mediator of (1) parent psychopathology and parent anxiety sensitivity and (2) child anxiety. Mediation was found with respect to parent psychopathology and anxiety sensitivity. Possible explanations for these pathways are discussed, including information transmission from parents to children, modeling anxiety-based reactions, temperament, and isolation of children from anxiety-provoking situations.     

Assessing the Relationship Between Cold Pressor Pain Responses and Dimensions of the Anxiety Sensitivity Profile in Healthy Men and Women

Anxiety sensitivity (AS) has been shown previously to be an important factor in the perception and experience of experimentally induced pain within healthy adults. The aim of the current study was to extend this research by: (i) using the Anxiety Sensitivity Profile (ASP) as an alternative measure of AS; (ii) examining whether different coping instructions affect pain reports; and (iii) investigating potential differences between men and women. Participants were 50 healthy adults (23 males, 27 females) who were required to complete 2 versions of the cold pressor pain task; one version required the use of control instructions, whereas the other made use of acceptance‐based instructions. Although the coping instructions were found to affect pain thresholds (acceptance resulted in lower thresholds), a similar pattern of correlations were found between the pain indexes and AS under both conditions. Of the ASP subscales, the gastrointestinal and cognitive concerns components were found to be the most strongly related to pain experiences. When the analysis was conducted separately for each sex, the ASP scales were related to the self‐report measures of pain in women, whereas they were related to the behavioural measures of pain in men. These results not only confirm that AS is associated with experimental pain, but that there may be sex differences in this relationship.     

An Examination of the Relationship Between Parent Language and Child Anxiety

Research suggests that parents of anxious children behave differently when interacting with their children than do parents of nonanxious children. However, the relationship between parent language use in this context and child anxiety remains unclear. The present study investigates how parent language use relates to child anxiety during parent–child interactions using a community sample recruited to participate in a study of familial anxiety. Results indicate that parent language use varies in relation to child anxiety. Further, this idiosyncratic pattern of parent linguistic activity uniquely predicts child anxiety diagnostic status. Implications of this study and future directions for research are discussed.     

Sensitivity for Treatment Effects of the Screen for Child Anxiety Related Emotional Disorders

The Screen for Child Anxiety Related Emotional Disorders (SCARED) is a relatively new self-report questionnaire that measures DSM-defined anxiety disorders symptoms in children. The present study examined the treatment sensitivity of the SCARED. Eleven anxiety-disordered children aged 10 to 13 years received cognitive-behavioral treatment, an intervention that is generally known to be effective. Children completed the SCARED on three occasions: (1) 3 months before treatment (i.e., baseline), (2) at pretreatment, and (3) at posttreatment. Before and after treatment, scores on traditional childhood anxiety measures (i.e., State-Trait Anxiety Inventory for Children, Revised Children's Manifest Anxiety Scale, and Fear Survey Schedule for Children) were also obtained. Results showed that children's SCARED scores remained relatively stable from baseline to pretreatment. However, from pre- to post-treatment, significant decreases were evident for the SCARED and for all traditional measures. These results suggest that the SCARED reliably taps treatment effects and, thus, provide further support for its utility as a self-report index of childhood anxiety in clinical and research settings.     

Experiential Avoidance as a Moderator of the Relationship Between Anxiety Sensitivity and Perceived Stress

Given the significant deleterious effects of stress on psychological and physical well-being, the present two-part study sought to clarify relations among putative vulnerability factors (i.e., anxiety sensitivity, experiential avoidance) for perceived stress. Relations among anxiety sensitivity, experiential avoidance, and perceived stress were examined using a large college student sample (N = 400) in Study 1 and were replicated using a large community sample (N = 838) in Study 2. As predicted, experiential avoidance moderated the relationship between anxiety sensitivity and perceived stress. Contrary to expectations, simple effects in both studies revealed that anxiety sensitivity shared a significant positive association with perceived stress at low, but not high, levels of experiential avoidance. The moderating role of experiential avoidance was found to be robust to the effects of general distress. Moreover, anxiety sensitivity and experiential avoidance evidenced a differential pattern of relations with perceived stress than was evidenced with related negative affective states (i.e., anxiety and depression). The present results suggest that experiential avoidance appears to be a vulnerability factor of particular importance for understanding the phenomenology of perceived stress. Conceptual and clinical implications are discussed.     

The Interaction of Extraversion and Anxiety Sensitivity on Social Anxiety: Evidence of Specificity Relative to Depression

Neuroticism and extraversion have been linked to the etiologies and course of anxiety and mood disorders, such that neuroticism is broadly associated with numerous disorders and extraversion is most strongly associated with social anxiety and depression. While previous research has established the broad associations between temperament and emotional disorders, less is known about the specific, proximal factors that are associated with them, and very few studies have situated these risk factors into a larger etiological model that specifies how they may relate to one another. The current study examined the interaction of extraversion and anxiety sensitivity (AS) in predicting social anxiety symptoms in a large, diagnostically diverse clinical sample (N = 826). Symptoms were assessed with self-report and dimensional interview measures, and regression analyses were performed examining the main effects and interaction of extraversion and AS (examining both total and lower-order components) on social anxiety. Results showed that at higher levels of AS, the inverse relationship between extraversion and social anxiety was stronger, and the social concerns component of AS is responsible for this effect. This interaction was also observed with regard to depression symptoms, but the interaction was not present after accounting for shared variance (i.e., comorbidity) between depression and social anxiety symptoms. Clinical and theoretical implications of the results are discussed.     

The Nature of the Association between Anxiety Sensitivity and Pain-Related Anxiety: Evidence from Correlational and Intervention Studies

High anxiety sensitivity (AS) has been associated with elevated pain-related anxiety in anxiety and pain samples. The present study investigated (a) the associations among the lower order dimensions of AS and pain-related anxiety, using a robust measure of AS, and (b) the pain-related anxiety outcomes of a telephone-delivered cognitive behavioural treatment (CBT) designed to reduce high AS. Participants were 80 anxiety treatment-seeking participants with high AS (M age = 36 years; 79% women). After providing baseline data on AS and pain-related anxiety, participants were randomly assigned to an eight-week telephone CBT or a waiting list control. At baseline, bivariate correlations showed AS physical and cognitive, but not social, concerns were significantly associated with pain-related fear and arousal but not escape/avoidance behaviours. Multiple regression revealed that after accounting for emotional distress symptoms, AS physical, but not cognitive or social, concerns uniquely predicted pain-related anxiety. Multilevel modelling showed that the AS-targeted CBT reduced pain-related anxiety and treatment-related changes in global AS and AS physical concerns mediated changes in pain-related anxiety. Results suggest that an AS-targeted intervention may have implications for reducing pain-related anxiety. Further research is needed in a chronic pain sample.     

Learning Experiences and Anxiety Sensitivity in Normal Adolescents

The present study examined the relationships between learning experiences with respect to somatic symptoms and levels of anxiety sensitivity in youths. Fifty-two normal adolescents aged 12 to 14 years were interviewed about their learning experiences with anxiety-related and nonanxiety-related somatic symptoms and completed the Childhood Anxiety Sensitivity Index. Results showed that informational learning to some extent contributed to adolescents' anxiety sensitivity levels. That is, parents' transmission of the idea that somatic symptoms might be dangerous was significantly associated with levels of anxiety sensitivity. Other learning experiences such as parental reinforcement or observational learning were not found to be related to anxiety sensitivity. It can be concluded that learning experiences seem to play a small but significant role in the development of high levels of anxiety sensitivity.     

Dimensions of Perfectionism and Anxiety Sensitivity

The current study investigated the extent to which dimensions of perfectionism are associated with components of the anxiety sensitivity construct. A sample of 177 undergraduate students completed the Multidimensional Perfectionism Scale, the Perfectionism Cognitions Inventory, the Perfectionistic Self-Presentation Scale, and the Expanded Anxiety Sensitivity Index developed by Taylor and Cox (1998). The results confirmed that automatic thoughts involving perfectionism and the interpersonal aspects of the perfectionism construct are associated with anxiety sensitivity. Examination of the Anxiety Sensitivity Index factors showed that perfectionism cognitions were associated primarily with anxiety sensitivity involving fears of cognitive dyscontrol, while socially prescribed perfectionism and perfectionistic self-presentation were associated primarily with fears of publicly observable anxiety reactions in a manner suggesting that the interpersonal perfectionism dimensions are linked closely with an anxious sensitivity to negative social evaluation and subsequent panic attacks. The theoretical and treatment implications of the link between perfectionism and anxiety sensitivity are discussed.     

Parent sex education beliefs in a rural South African setting

This study explored beliefs held by African community parents which are important in their children’s sexual health education. The informant parents (n = 30) were predominantly rural dwelling (female = 70%; black = 95%; rural = 80%; age range = 30 to 65 years old) from the Free State, South Africa. They reported on their child sex education beliefs; addressing appropriateness, resources, and content issues. Thematic analysis revealed that parents were more comfortable engaging in sex education with their older or young adult children rather than the younger children. Moreover, the parents considered sex education topics on sexual intercourse and instruments taboo subjects. Resourcing parents regarding sex education would require working around cultural barriers about the age appropriateness of sex education, as well as permissible content.     

Maternal Sensitivity and Anxiety: Impacts on Child Outcome

ABSTRACT

Children of anxious parents have been shown to be at an increased risk of developing an anxiety disorder. Thus, it is critically important to identify factors that increase or decrease that risk. The depression literature has shown that maternal sensitivity decreases negative child outcome associated with maternal depression. The current study was designed to determine whether maternal sensitivity may buffer children of anxious mothers in a similar way. Three hypotheses were tested. First, that anxious mothers would display less sensitivity than nonanxious mothers in interactions with their children; that there would be an interaction between sensitivity and anxiety on child outcome; and that sensitivity would account for variance in child outcome beyond that attributed to anxiety. One hundred and twenty-five mothers (75 anxious) and their children (ages 3–12) completed the study. Mothers were administered the Anxiety Disorders Interview Schedule-IV and Parent, and a subset also completed the Beck Anxiety Inventory. Children completed the Anxiety Disorders Interview Schedule-Child. Dyads also engaged in two interaction tasks (one cognitive, one social) which were coded for maternal sensitivity and three child outcome behaviors. Results showed that anxious mothers displayed less sensitivity in the social task but not in the cognitive task. An interaction between anxiety and sensitivity was found only when predicting child negativity in the social task. Finally, maternal sensitivity was found to account for variance in child outcome beyond that of anxiety. Implications and directions for future research are discussed.     

The Relation Between Anxiety Sensitivity and Attachment Style in Adolescence and Early Adulthood

Given the accumulating evidence for a role of anxiety sensitivity in the etiology of panic, it is important to understand the developmental origins of anxiety sensitivity. To this end, this study examined the relation between attachment beliefs and anxiety sensitivity in a sample of high school students (n = 203; mean age 15.7 years) and university students (n = 324; mean age 21.7 years). The Experiences in Close Relationships (ECR; K. Brennan, C. Clark, &; P. Shaver, 1998) was used to assess attachment beliefs and to classify participants into attachment groups. The Anxiety Sensitivity Index (ASI; R. A. Peterson &; S. Reiss, 1987) was used to assess participants' levels of anxiety sensitivity. Results supported the hypothesis that individuals with insecure attachment, specifically those classified as preoccupied and fearful (i.e., those with a negative model of self), had significantly higher anxiety sensitivity scores than securely attached individuals in both the high school and college samples.     

The Role of Anxiety Sensitivity Components in Mediating the Relationship Between Childhood Exposure to Parental Dyscontrol and Adult Anxiety Symptoms

This retrospective study investigated the relationship between childhood exposure to parental dyscontrol (i.e., loss of control behaviors) and levels of anxiety sensitivity (AS) components in early adulthood. Four-hundred-and-sixty-five undergraduate students completed self-report measures including the Dyscontrol Experiences Questionnaire. Specificity emerged between AS components and particular dyscontrol experiences. Although exposure to parental dyscontrol related to negative emotional states was significantly positively correlated with all AS dimensions, exposure to parental dyscontrol related to drinking was significantly positively correlated with psychological concerns only. Mediator regression analyses showed AS psychological concerns to play a significant mediating role between parental dyscontrol related to anger and drinking and both general and panic-related anxiety symptoms in the adult offspring. Results suggest that specific parental behaviors may be etiologic in the development of AS, and acquired AS may help explain relations between childhood learning experiences and the development of psychopathological symptoms in young adulthood.     

Predictors of Self-Reported Anxiety and Panic Symptoms: An Evaluation of Anxiety Sensitivity, Suffocation Fear, Heart-Focused Anxiety, and Breath-Holding Duration

The purpose of this study was to examine the extent to which anxiety-related individual difference variables predict anxious responding when individuals experience aversive bodily sensations. Thus, we explore several psychological and behavioral predictors of response to a single 25-sec inhalation of 20% carbon dioxide-enriched air in 70 nonclinical participants. Predictor variables included anxiety sensitivity, suffocation fear, heart-focused anxiety, and breath-holding duration. Multiple regression analyses indicated that only anxiety sensitivity significantly predicted postchallenge panic symptoms, whereas both anxiety sensitivity and suffocation fear predicted postchallenge anxiety. These data are in accord with current models of panic disorder that emphasize the role of fear of fear in producing heightened anxiety and panic symptoms and help clarify specific predictors of anxiety-related responding to biological challenge.     

Health Perceptions and Anxiety Sensitivity in Patients with Panic Disorder

Separate lines of research indicate that patients with panic disorder display negative perceptions of physical health and elevated fear of autonomic arousal. Because health perceptions and anxiety sensitivity may be related, the present study evaluated the degree to which these constructs can be distinguished in patients meeting DSM-IV criteria for panic disorder (N = 44). Perceived health, anxiety sensitivity, and the clinical features of panic disorder were assessed at pretreatment and following 12 sessions of cognitive–behavioral treatment. Findings consistently indicated that perceived health and anxiety sensitivity can be meaningfully differentiated. Perceived physical health was only moderately associated with anxiety sensitivity, and each was uniquely associated with pretreatment symptomatology and posttreatment end-state functioning. Perceived physical health appears to be a clinically useful index in the overall evaluation of panic disorder and is readily distinguishable from anxiety sensitivity.     

Hearing Impairment, Coping Strategies, and Anxiety Sensitivity

The aim was to study coping strategies among hearing-impaired individuals by using a validated coping instrument—The Ways of Coping Questionnaire (WOCQ; S. Folkman & R. Lazarus, 1988)—and to relate the use of coping with anxiety sensitivity and experience of hearing impairment. A questionnaire booklet was sent out to the members of the local branch of the Swedish Hard of Hearing Association. Ninety-four members responded to the questionnaire, yielding a 53% response rate. Primary outcome measures were the WOCQ, the Anxiety Sensitivity Index, and visual analogue scale rating of discomfort from hearing impairment. Repeated measures analysis of WOCQ subscales showed that the participants used planful problem solving and self-controlling coping strategies whereas escape/avoidance responses were less frequently used than the other coping strategies. Anxiety sensitivity was associated with escape/avoidance coping (r = .63, p < .0001). In conclusion, hearing-impaired individuals do not use escape/avoidance coping more than other coping strategies. However, escape/avoidance coping is associated with anxiety sensitivity, suggesting that sensitivity to anxiety sensations is an important associated factor. Coping strategies were not associated with discomfort from hearing impairment in any meaningful way.     

Evaluating the Etiology of Anxiety Sensitivity: Relation to Cardiovascular Perception and Reactivity

A large body of research has suggested that anxiety sensitivity (AS) acts as a specific vulnerability factor in the development of anxiety pathology. More recently, attention has turned to the etiology of AS per se. The present study tested several related etiological hypotheses derived from Expectancy theory. S. Reiss and R. J. McNally (1985) originally proposed that greater physiological reactivity would increase risk for developing heightened AS. Reactive individuals are believed to have greater opportunity to perceive unpleasant bodily perturbations, thereby increasing the likelihood that concerns and fears could be attached to the sensations. Nonclinical participants (N = 86) completed physical (e.g., orthostatic) and biological (e.g., 35% CO₂) challenges and a heart beat perception task. AS was not related to heart beat perception but was related to greater tonic heart rate and greater diastolic blood pressure (DBP) reactivity to both the challenges. Higher DBP and higher heart beat accuracy interacted to predict higher AS.     

Examining the State-Trait Anxiety Relationship: A Behavioural Genetic Approach

State and trait anxiety define different aspects of anxiety, and may represent environmentally and genetically mediated components of this phenotype. Furthermore their relationship, where trait anxiety is expressed through levels of state anxiety under threatening circumstances, may represent a process of interplay between a genetic vulnerability factor and an environmental stressor. To test these hypotheses, we explored genetic and environmental influences on measures of state and trait anxiety in a sample of 1058 twins (521 males and 537 females) aged 8–16. The results were consistent with these hypotheses. State anxiety is largely influenced by environmental factors in males and females whereas trait anxiety shows moderate genetic effects and substantial non-shared environment effects. Their association was accounted for by non-shared environmental effects, with modest genetic and shared environmental inputs. The implications of these results for vulnerability mechanisms involving stress reactivity on anxiety are discussed.