The Anxiety Sensitivity Index - Revised: psychometric properties and factor structure in two nonclinical samples

Anxiety sensitivity (AS) is the fear of anxiety-related sensations based on beliefs about their harmful consequences. Despite its status as the most popular measure of AS, the anxiety sensitivity index is too abbreviated to adequately measure the somatic, cognitive, and social facets of the construct. The Anxiety Sensitivity Index - Revised (ASI-R) is a revised and expanded version of the ASI that was developed to improve the assessment of AS and its dimensions. The present study was conducted to examine the psychometric properties and factor structure of the ASI-R. Two large undergraduate samples completed a psychometric assessment package that included the ASI-R and measures of anxiety, depression, and related constructs. Exploratory factor analysis revealed four lower-order ASI-R factors: (1) beliefs about the harmful consequences of somatic sensations; (2) fear of publicly observable anxiety reactions; (3) fear of cognitive dyscontrol; and (4) fear of somatic sensations without explicit consequences. These factors loaded on a single, higher-order factor. Correlations between the ASI-R factors and related variables were consistent with AS theory. Results across both samples in the present study were highly similar. The strengths and limitations of the ASI-R are discussed, and the implications of our findings for the nature and measurement of AS are considered.     

Fear and Disgust Responding to Heterogeneous Blood-Injection-Injury Stimuli: Distinctions from Anxiety Symptoms

Discrepancies exist in the literature regarding the unique role of disgust in Blood-Injection-Injury (BII) phobia. The present study attempts to clarify the discrepancy using a sample of analogue BII phobics (n = 40) and nonphobics (n = 40) who completed a series of questionnaires and were exposed to blood, mutilation, and injection pictures. The findings revealed that BII phobics reported greater disgust and contamination fears than nonphobics after controlling for anxious symptoms. When rating phobia-relevant pictures, BII phobics responded with greater fear and disgust than nonphobics after controlling for baseline anxiety scores. Furthermore, disgust was the dominant emotional response for BII phobics for the blood and mutilation stimuli. However, no differences were found between fear and disgust within the BII group when rating injection stimuli. The implications of these findings for better understanding the potential unique role of disgust in the etiology, maintenance, and treatment of BII phobia are discussed.

Disgust Sensitivity and Psychopathological Symptoms: Distinctions from Harm Avoidance

The present study examined the relationship between disgust sensitivity and symptoms of somatization, obsessive-compulsive disorder (OCD), interpersonal sensitivity, depression, anxiety, anger/hostility, phobic anxiety, paranoid ideation, and psychoticism in a community sample. Participants (n = 121) completed the Disgust Scale-2, the Symptom Checklist-90, and the harm avoidance subscale of the Temperament and Character Inventory. Disgust sensitivity was found to be correlated with a broad range of psychopathological symptoms. However, results also indicated that these correlations were partially mediated by harm avoidance. That is, when controlling for levels of harm avoidance, the association between disgust sensitivity and psychopathological symptoms was either substantially reduced or became nonsignificant. These findings suggest that the tendency towards behavioral inhibition to avoid punishment and non-reward may partially account for the association between disgust sensitivity and a broad range of psychopathological symptoms.

Assessment of Disgust Sensitivity in Children With an Age-Downward Version of the Disgust Emotion Scale

The present study examined the psychometric properties of the Disgust Emotion Scale for Children (DES-C). Principal components analysis of the DES-C data revealed five factors reflecting disgust toward (a) rotting foods, (b) injection and blood, (c) odors, (d) mutilation and death, and (e) animals, which were largely in keeping with the intended subscales. The DES-C showed good reliability, excellent convergent validity (as established by correlations with an alternative self-report index of disgust), fairly good predictive validity (as assessed by correlations with measures of fear/anxiety and a behavioral index of disgust), and acceptable parent–child agreement (in particular with the mothers). Importantly, the DES-C proved to perform better on some psychometric indicators than an age-downward version of the Disgust Scale. These findings indicate that the DES-C should be regarded as the preferred scale for measuring disgust sensitivity and its role in the etiology and maintenance of anxiety problems in children.     

The Anxiety Sensitivity Index for Children: factor structure and relation to panic symptoms in an adolescent sample

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.     

Psychometric Properties of the Gaze Anxiety Rating Scale: Convergent,Discriminant, and Factorial Validity

Fear and avoidance of gaze are two features thought to be associated with problematic social anxiety. Avoidance of eye contact has been linked with such undesirable traits as deceptiveness, insincerity, and lower self-esteem. The Gaze Anxiety Rating Scale (GARS) is a self-report measure designed to assess gaze anxiety and avoidance, but its psychometric properties have only been assessed in one preliminary study. We further investigated psychometric properties of the GARS by assessing convergent and factorial validity. We obtained a two-factor solution: gaze anxiety and avoidance across situations (1) in general (GARS-General) and (2) related to dominance communication (GARS-Dominance). The GARS-General factor related more strongly to social anxiety than the GARS-Dominance, and convergent validity of the factors was supported by expected relationships with personality and social anxiety variables. Our results indicate that the GARS subscales are psychometrically valid measures of gaze aversion, supporting their use in future study of the relationship between social anxiety and eye contact behavior.     

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.     

Psychometric Properties of the Childhood Anxiety Sensitivity Index in A sample of Catalan School Children

This study tested the utility of assessing anxiety sensitivity (AS) in children by investigating the long term stability and psychometric properties of a Catalan version of the Childhood Anxiety Childhood Anxiety Sensitivity Index (CASI, Silverman et al ., 1991, Journal of Clinical Child Psychology , 20 , 162-168) in a sample of 291 elementary-school children. The Catalan CASI demonstrated acceptable internal consistency and convergent validity estimates, similar to previous research with the English version. The measure also showed incremental validity in relation to other measures of anxiety and test-retest analyses suggested considerable three month and one-year stability in children's level of AS. Finally, a principal component analysis of the Catalan CASI yielded five lower-order factors grouped on a unique higher-order factor. The similarity of the findings to previous research on the CASI and on AS in English speaking children and adults is discussed and some suggestions for future investigations are presented.     

Disgust sensitivity and the HEXACO model of personality

In the current investigation, we test for relationships between three domains of disgust sensitivity (pathogen, sexual, and moral disgust) and the six dimensions of the HEXACO personality model in a large, demographically diverse Dutch sample. Our results extend upon previous investigations into the relationship between disgust sensitivity and personality in two important ways. First, in contrast with most previous investigations into disgust sensitivity, we measure sensitivities to sexual and moral disgust, two domains that elicit self-reports of disgust and facial expressions of disgust. Second, in contrast with the few investigations that have tested for relationships between sensitivities to sexual and moral disgust and Five Factor Model personality dimensions, we use the HEXACO personality model. We find that honesty–humility, a personality dimension assessed in the HEXACO model but not the Five Factor Model, accounts for unique variance in sensitivities to sexual and moral disgust, but not sensitivity to pathogen disgust. Other relationships between disgust sensitivity and personality are discussed, as are implications for understanding the fitness-relevant tradeoffs potentially underlying disgust sensitivity and personality.     

Factor structure and stability of the Anxiety Sensitivity Index in a longitudinal study of anxiety disorder patients

The past decade witnessed considerable debate over the factor structure of the Anxiety Sensitivity Index (ASI), with an eventual consensus emerging that supported a hierarchically organized factor structure. The present study attempted to replicate and examine the overall stability and utility of the hierarchical ASI factor pattern using a large sample of outpatients participating in an ongoing longitudinal study of anxiety disorders. Results supported a hierarchical factor structure for the ASI consisting of three lower-order factors measuring physical concerns, mental incapacitation concerns, and social concerns, all of which loaded significantly on a single second-order factor. Correlational analyses show good test-retest reliability and consistent patterns of intercorrelation for these factor-derived subscales across a 10-month time frame. Additional analyses provide support for the discriminant validity of the ASI subscales with regard to individuals with specific anxiety disorders. The theoretical implications of these findings for future evaluations of anxiety sensitivity are discussed.     

Treatment Sensitivity of a Brief Rating Scale for Attention-Deficit Hyperactivity Disorder (ADHD) Symptoms

This study examined the treatment sensitivity of the ADHD Questionnaire (ADHD-Q), which is a brief rating scale for measuring symptoms of inattention, hyperactivity, and impulsivity in children. Parent, teacher, and child self-report data of the ADHD-Q were obtained for 17 clinically referred children with ADHD on the three occasions: (1) during the regular intake assessment, (2) just before the start of the stimulant medication (i.e., methylphenidate) intervention, and (3) four weeks after the start of the medication intervention. Results showed that ADHD-Q scores remained fairly stable in the period prior to the intervention, but then showed a substantial decline after the stimulant medication had been administered. Clearly, this finding supports the treatment sensitivity of the ADHD-Q.     

Effectiveness of the Hamilton Anxiety Rating Scale with Older Generalized Anxiety Disorder Patients

To expand the collection of instruments available for assessment of anxiety in the elderly, this report examined the original and revised Hamilton anxiety scales in a sample of 50 older adults diagnosed with Generalized Anxiety Disorder (GAD) and 93 normal community participants (ages 55–82). Although the revised anxiety scale had better discriminant validity (lower correlation with the revised Hamilton depression scale) than the original anxiety and depression scales, a considerable amount of shared variance still existed (41% shared variance, GAD sample alone; 17% control sample alone; 74% shared variance, both samples combined). Near-perfect group classification was possible using 7 items from the original anxiety scale and 10 items from the revised anxiety scale. Results are discussed in light of their implications for use of the Hamilton anxiety rating scale with older anxiety-disordered patients.     

Anxiety Sensitivity Moderates Relations Among Tobacco Smoking,Panic Attack Symptoms,and Bodily Complaints in Adolescents

The present study evaluated associations among smoking and anxiety sensitivity (fear of anxiety and anxiety related sensations) in predicting panic attack symptomatology, somatic complaints, and depressive symptomatology in a community sample of adolescents (ages 12 to 17 years; N=206). As predicted, the combination of high levels of anxiety sensitivity and being a current smoker predicted panic symptomatology and somatic complaints, but not depressive symptomatology. These findings suggest anxiety sensitivity may moderate the relation between smoking and prototypical panic psychopathology variables (panic attacks and somatic complaints) even after controlling for gender and negative affectivity, and that these associations are specific to panic-relevant processes. The primary implication of the study findings is that there may be segments of the adolescent population who are at relatively greater risk for panic-related problems by virtue of individual differences in AS and smoking status.

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 Beck Anxiety Inventory: Psychometric Properties with Older Adults

The assessment of anxiety disorders in late life is often hindered by the lack of measures specifically validated with older adults. Because anxiety manifestations may vary across age groups, it is important to design new instruments or validate existing measures with older adults. This study examined the psychometric properties of the Beck Anxiety Inventory (BAI) in a sample of 281 older adults who were community-dwelling (82.6%) or living in residential care facilities (17.4%). The mean total BAI score was 6.5 (SD = 7.2), indicating minimal anxiety symptomatology in this older sample. There was a trend for older subjects to score higher. Females scored higher than males, and subjects living in a residential facility scored higher than did community dwellers. Item-total correlations were in the moderate range and the internal consistency of the BAI was adequate (alpha = 0.89). A factor analysis yielded a six-factor structure accounting for 64.6% of the variance, with a somatic factor accounting for the largest portion of the variance (32.2%). Because somatic symptoms are more prevalent with aging, such symptoms should not be weighed as heavily in the total BAI score as cognitive or behavioral symptoms. The findings indicate that the BAI is a useful self-report scale for assessing anxiety symptomatology among older adults.     

Psychometric properties of the Revised Child Anxiety and Depression Scale in a clinical sample

This study examined the psychometric properties of the Revised Child Anxiety and Depression Scale (RCADS) in a clinical sample of 513 youth referred for mental health assessment at a university clinic. Internal consistency and factor analysis provided support for the factorial validity of the RCADS. Convergent and discriminant validity tests against both clinical interview and self-report criteria also suggested favorable properties of the RCADS. In comparative tests with traditional measures of anxiety and depression, the RCADS generally showed greater correspondence to specific diagnostic syndromes. Clinical cutoffs are reported for the purposes of future clinical and research applications.     

A Swedish translation and validation of the Disgust Scale: a measure of disgust sensitivity

The psychometric properties of a Swedish version of Haidt, McCauley and Rozin's (1994) Disgust Scale were studied. Confirmatory factor analysis of the original model with eight factors (food, animals, body products, sex, body envelope violations, death, hygiene, and magic) provided satisfactory fit to the data (N= 280), significantly better than to the alternative one-factor and five-factor models. As in the US version women scored significantly higher than men. Positive correlations with measures of food neophobia (r= 0.30, p < 0.0001) and nausea frequency (rs= 0.28, p < 0.001) indicate convergent validity. In a separate study (N= 30) a behavioral measure of the willingness to touch, hold, and taste disgusting food objects correlated negatively with the Disgust Scale (r=-0.46, p < 0.01), indicating criterion-related validity.