Assessment of anxiety sensitivity in young American Indians and Alaska Natives

In the present study, the Anxiety Sensitivity Index [ASI; Behav. Res. Ther. 24 (1986) 1] was administered to 282 American Indian and Alaska Native college students in a preliminary effort to: (a) evaluate the factor structure and internal consistency of the ASI in a sample of Native Americans; (b) examine whether this group would report greater levels of anxiety sensitivity and gender and age-matched college students from the majority (Caucasian) culture lesser such levels; and (c) explore whether gender differences in anxiety sensitivity dimensions varied by cultural group (Native American vs. Caucasian). Consistent with existing research, results of this investigation indicated that, among Native peoples, the ASI and its subscales had high levels of internal consistency, and a factor structure consisting of three lower-order factors (i.e. Physical, Psychological, and Social Concerns) that all loaded on a single higher-order (global Anxiety Sensitivity) factor. We also found that these Native American college students reported significantly greater overall ASI scores as well as greater levels of Psychological and Social Concerns relative to counterparts from the majority (Caucasian) culture. There were no significant differences detected for ASI physical threat concerns. In regard to gender, we found significant differences between males and females in terms of total and Physical Threat ASI scores, with females reporting greater levels, and males lesser levels, of overall anxiety sensitivity and greater fear of physical sensations; no significant differences emerged between genders for the ASI Psychological and Social Concerns dimensions. These gender differences did not vary by cultural group, indicating they were evident among Caucasian and Native Americans alike. We discuss the results of this investigation in relation to the assessment of anxiety sensitivity in American Indians and Alaska Natives, and offer directions for future research with the ASI in Native peoples.     

Does the social concerns component of the anxiety sensitivity index belong to the domain of anxiety sensitivity or the domain of negative evaluation sensitivity?

The present study utilized an exploratory factor-analytic approach (i.e. principal-components analysis; PCA) to investigate whether the Social Concerns component of the Anxiety Sensitivity Index (ASI [Peterson, R. A., & Reiss, S. (1992). Anxiety Sensitivity Index manual (2nd ed.). Worthington, OH: International Diagnostic Systems.]) is best conceptualized as belonging to the domain of anxiety sensitivity (AS) and/or the domain of negative evaluation sensitivity (NES). A sample of university students (N = 216) was administered measures of both NES (i.e. Brief Fear of Negative Evaluation scale; Leary, 1983) and AS (i.e. ASI). Participants' responses to the items comprising these measures were subjected to a PCA with oblique rotation. Factors representing the NES construct and the three lower-order AS constructs (i.e. AS Physical, Psychological and Social Concerns) were obtained. Subscales derived from these four factors were positively and significantly correlated with one another and loaded on a single higher-order factor labeled Threat Sensitivity. Thus, the present findings suggest that the AS Social Concerns factor is distinct from NES and the other lower-order components of AS. However, correlational analyses and higher-order PCA indicated that the AS Social Concerns factor taps a blend of AS and NES as well as something unique and distinct from both global AS and NES.     

Childhood anxiety sensitivity index factors predict unique variance in DSM-IV anxiety disorder symptoms

Anxiety sensitivity (AS) is an established cognitive risk factor for anxiety disorders. In children and adolescents, AS is usually measured with the Childhood Anxiety Sensitivity Index (CASI). Factor analytic studies suggest that the CASI is comprised of 3 lower-order factors pertaining to Physical, Psychological and Social Concerns. There has been little research on the validity of these lower-order factors. We examined the concurrent and incremental validity of the CASI and its lower-order factors in a non-clinical sample of 349 children and adolescents. CASI scores predicted symptoms of DSM-IV anxiety disorder subtypes as measured by the Spence Children's Anxiety Scale (SCAS) after accounting for variance due to State-Trait Anxiety Inventory scores. CASI Physical Concerns scores incrementally predicted scores on each of the SCAS scales, whereas scores on the Social and Psychological Concerns subscales incrementally predicted scores on conceptually related symptom scales (e.g. CASI Social Concerns scores predicted Social Phobia symptoms). Overall, this study demonstrates that there is added value in measuring AS factors in children and adolescents.     

Childhood Anxiety Sensitivity Index Factors Predict Unique Variance in DSM‐IV Anxiety Disorder Symptoms

Anxiety sensitivity (AS) is an established cognitive risk factor for anxiety disorders. In children and adolescents, AS is usually measured with the Childhood Anxiety Sensitivity Index (CASI). Factor analytic studies suggest that the CASI is comprised of 3 lower‐order factors pertaining to Physical, Psychological and Social Concerns. There has been little research on the validity of these lower‐order factors. We examined the concurrent and incremental validity of the CASI and its lower‐order factors in a non‐clinical sample of 349 children and adolescents. CASI scores predicted symptoms of DSM‐IV anxiety disorder subtypes as measured by the Spence Children's Anxiety Scale (SCAS) after accounting for variance due to State‐Trait Anxiety Inventory scores. CASI Physical Concerns scores incrementally predicted scores on each of the SCAS scales, whereas scores on the Social and Psychological Concerns subscales incrementally predicted scores on conceptually related symptom scales (e.g. CASI Social Concerns scores predicted Social Phobia symptoms). Overall, this study demonstrates that there is added value in measuring AS factors in children and adolescents.     

Factor Structure and Psychometric Properties of the Modified Childhood Anxiety Sensitivity Index in a Sample of Croatian Children and Adolescents

Anxiety sensitivity (AS) refers to a person’s tendency to fear anxiety-related symptoms due to the belief that they have harmful consequences. The Childhood Anxiety Sensitivity Index (CASI) is a well accepted operationalization of the AS construct in children and adolescents. This study evaluated the factor structure, gender stability and psychometric properties of the CASI, modified to a 5-point scale, in a sample of Croatian children and adolescents (N = 1,679). Exploratory and confirmatory analysis and a Schmid-Leiman solution confirmed the multidimensional and hierarchical structure of the CASI, which consisted of three lower-order factors and a single higher-order factor. Further, the modification of the CASI to a 5-point scale resulted in higher reliability, while maintaining acceptable levels of factor stability and validity.     

ANXIETY SENSITIVITY AND TRAIT-SYMPTOM MEASURES OF ANXIETY AND DEPRESSION

The Icelandic version of the Anxiety Sensitivity Index was investigated in two studies of college students. A principal components analysis of ASI scores from both studies (N=718) yielded three components similar to what has been found previously: Psychological Concerns, Physical Concerns and Social Concerns. In the first study the relationship between the ASI and trait anxiety was investigated. It was analysed at the level of the total scales but also at the level of subscales of both instruments. Two subscales of the STAI, measuring respectively Anxiety-trait and Depression-trait, were used as well as the Psychological Concerns and Physical Concerns subscales of the ASI. In a second study the relationships between ASI and its subscales and two symptom measures of anxiety and depression were addressed. ASI was in both studies more strongly related to the anxiety than the depression scales. Also, in both studies the Physical Concerns subscale of the ASI was more strongly related to anxiety than to depression, whereas the Psychological Concerns subscale was equally related to anxiety and depression. Taken together the studies support the notion of different relationships between different aspects of anxiety sensitivity, and anxiety and depression as traits, cognitive symptoms and mood related symptoms.     

The structure and correlates of anxiety sensitivity in older adults

Anxiety sensitivity (AS) has been defined as the fear of symptoms of anxiety and panic, and is most frequently assessed with the Anxiety Sensitivity Index (Peterson & Reiss, 1987). To investigate the nature and structure of AS in an older sample, data were collected from a sample of 322 adults aged 65 to 97, with mean age 75. Confirmatory factor analysis indicated a hierarchical structure with three group factors (physical concerns, mental incapacitation concerns, and social concerns), as well as a general factor, consistent with previous investigations. Results suggest that the nature and structure of the AS trait in older adults are highly similar to those of younger adults.     

Dimensional, categorical, or dimensional-categories: testing the latent structure of anxiety sensitivity among adults using factor-mixture modeling

The present study tested multiple, competing latent structural models of anxiety sensitivity (AS), as measured by the Anxiety Sensitivity Index-3 (ASI-3; Taylor et al., 2007). Data were collected from 3 sites in North America (N = 634). Participants were predominantly university students (M = 21.3 years, SD = 5.4). ASI-3 data were evaluated using an integration of mixture modeling and confirmatory factor analysis—factor mixture modeling (FMM; Muthén, 2008). Results supported a 2-class 3-factor partially invariant model of AS. Specifically, the FMM analyses indicated that AS is a taxonic (two-class) variable, and that each categorical class has a unique multidimensional factor structure. Consistent with the specific point-prediction regarding the hypothesized parameters of the putative latent class variable, FMM indicated that the putatively “high-risk” subgroup of cases or latent form of AS composed approximately 12% of the studied sample whereas the putatively “normative” subgroup of cases or latent form of AS composed 88% of the sample. In addition, the AS Physical and Psychological Concerns subscales, but not the Social Concerns subscale, most strongly discriminated between the two latent classes. Finally, comparison of continuous levels of AS Physical and Psychological Concerns between FMM-derived AS latent classes and independent clinical samples of patients with anxiety disorders provided empirical support for the theorized taxonic-dimensional model of AS and anxiety psychopathology vulnerability. Findings are discussed in regard to the implications of this and related research into the nature of AS and anxiety psychopathology vulnerability.     

Taxometric and factor analytic models of anxiety sensitivity: integrating approaches to latent structural research

This study represents an effort to better understand the latent structure of anxiety sensitivity (AS), as indexed by the 16-item Anxiety Sensitivity Index (ASI; S. Reiss, R. A. Peterson, M. Gursky, & R. J. McNally, 1986), by using taxometric and factor-analytic approaches in an integrative manner. Taxometric analyses indicated that AS has a taxonic latent class structure (i.e., a dichotomous latent class structure) in a large sample of North American adults (N=2,515). As predicted, confirmatory factor analyses indicated that a multidimensional 3-factor model of AS provided a good fit for the AS complement class (normative or low-risk form) but not the AS taxon class (high-risk form). Exploratory factor analytic results suggested that the AS taxon may demonstrate a unique, unidimensional factor solution, though there are alternative indications that it may be characterized by a 2-factor solution. Findings suggest that the latent structural nature of AS can be conceptualized as a taxonic latent class structure composed of 2 types or forms of AS, each of these forms characterized by its own unique latent continuity and dimensional structure.     

Anxiety sensitivity in traumatized Cambodian refugees: a discriminant function and factor analytic investigation

We examined the psychometric properties and factor structure of a Cambodian translation of the Anxiety Sensitivity Index (ASI) and an Augmented ASI (the ASI supplemented with a 9-item addendum that assesses additional Cambodian concerns about anxiety-related sensations). Both the ASI and the Augmented ASI distinguished among three diagnostic groups: highest score, PTSD with panic disorder (PP group); next, panic disorder without PTSD (P group); and then, other disorders than PTSD or panic disorder (O group). In the discriminant function analysis using the Augmented ASI, the best classificatory predictor (PP vs. P vs. O) was an Addendum item (“It scares me when I stand up and feel dizzy”). The principal component analysis (oblimin rotation) of the ASI yielded a 3-factor solution (I, Weak Heart Concerns; II, Control Concerns; III, Social Concerns) and of the Augmented ASI, a 4-factor solution (I, Weak Heart Concerns; II, Control Concerns; III, Wind Attack Concerns; IV, Social Concerns). The item clustering within the factor solution of both the ASI and Augmented ASI illustrates the role of cultural syndromes in generating fear of mental and bodily events.     

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.     

Factor structure of the childhood anxiety sensitivity index.

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.     

Relationship between Anxiety Sensitivity subscales and social fears

This study examined the relationship between social fears and the three subscales of the Anxiety Sensitivity Index (ASI) in a non‐clinical, student sample. In particular, the unique variance that the three ASI factors accounted for in social scrutiny fears, social interaction fears, and fear during a social challenge was investigated. Anxiety Sensitivity–Social Concern (AS‐Social Concern) was hypothesised to account for a significant proportion of the variance in social fears compared to the other two subscales. Seventy one university students completed a series of psychological‐based questionnaires and participated in a social challenge (videotaped speech task). Contrary to prediction, AS‐Social Concern did not account for a unique proportion of the variance in social fears, but AS‐Physical Concern and AS‐Mental Concern did account for unique variance in social fears. Results are interpreted in light of recent findings on the structure of ASI.     

Laboratory Test of a Novel Structural Model of Anxiety Sensitivity and Panic Vulnerability

The current study evaluated a novel latent structural model of anxiety sensitivity (AS) in relation to panic vulnerability among a sample of young adults (N = 216). AS was measured using the 16-item Anxiety Sensitivity Index (ASI; Reiss, Peterson, Gursky, & McNally, 1986), and panic vulnerability was indexed by panic attack responding to a single administration of a 4-minute, 10% CO₂ challenge. As predicted, vulnerability for panic attack responding to biological challenge was associated with dichotomous individual differences between taxonic AS classes and continuous within-taxon class individual differences in AS physical concerns. Findings supported the AS taxonic-dimensional hypothesis of AS latent structure and panic vulnerability. These findings are discussed in terms of their theoretical and clinical implications.     

Does anxiety sensitivity predict symptoms of panic, depression, and social anxiety?

This study examined whether the lower-order factors of the Anxiety Sensitivity Index (ASI) exhibited specificity in predicting symptoms of panic, depression, and social anxiety prospectively. This question was addressed using a sample of undergraduates stratified to represent low, medium, and high levels of anxiety sensitivity (AS). It was hypothesized that the physical concerns, mental concerns, and social concerns subscales of the ASI would predict increases in panic, depression, and social anxiety symptoms, respectively, one year later. Results found that the physical concerns subscale predicted increases in both panic and depressive symptoms. Neither the mental concerns nor the social concerns subscales predicted significant variance in any of the Time 2 symptoms. Theoretical implications of these data for AS are discussed.     

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.     

Unique contributions of anxiety sensitivity to avoidance: a prospective study in adolescents

Examination of the prospective relation between anxiety sensitivity (AS) and behavioral avoidance is largely absent from the literature. In a longitudinal study of a community sample of 2246 adolescents, participants completed the Anxiety Sensitivity Index (ASI; Reiss, Peterson, Gursky, & McNally (1986). Behaviour Research & Therapy, 24, 1-8), State-Trait Anxiety Inventory (STAI; Spielberger (1983). STAI: Manual for the Stait-Trait Anxiety Inventory. Palo Alto: Consulting Psychologists Press), and the Fear Questionnaire (Marks & Matthews (1979). Behaviour Research & Therapy, 17, 263-267) on an annual basis. To stringently test AS's ability to prospectively predict behavioral avoidance, linear regression was used to test whether AS factors predicted variance in follow-up behavioral avoidance scores after controlling for gender, trait anxiety, panic attacks, and baseline avoidance. Results indicted that the mental and physical subscales of the ASI predicted change in behavioral avoidance. The findings of the study are consistent with the view that AS may serve as a precursor to avoidant behavior and that, regardless of whether or not acute panic has been experienced, those who fear autonomic arousal may be more likely to avoid situations in which those sensations may be present.     

Prospective evaluation of anxiety sensitivity in the pathogenesis of panic: replication and extension.

Increasing evidence suggests that anxiety sensitivity (AS) may be a premorbid risk factor for the development of anxiety pathology. The principal aim of this study was to replicate and extend a previous longitudinal study evaluating whether AS acts as a vulnerability factor in the pathogenesis of panic (N. Schmidt, D. Lerew, & R. Jackson, 1997). A large nonclinical sample of young adults (N = 1,296) was prospectively followed over a 5-week, highly stressful period of time (i.e., military basic training). Consistent with the authors' initial study, AS predicted the development of spontaneous panic attacks after controlling for a history of panic attacks and trait anxiety, and AS was found to possess symptom specificity with respect to anxiety versus depression symptoms. AS 1st-order factors differentially predicted panic attacks, with the Mental Concerns factor being the best predictor of panic in this sample.     

Anxiety sensitivity as a predictor of panic disorder symptoms: a prospective 3-year study

Background and Objectives: Anxiety sensitivity (AS) is the fear of anxiety symptoms, a feature proven to be an important vulnerability factor for anxiety pathogenesis. The aim of this study was to examine whether AS (as well as its factors) predicts the onset of panic disorder symptoms when controlling for the contribution of trait anxiety.

Design: We conducted a prospective 3 year follow up study.

Methods: The participants, students at the Humanities and Social Sciences in Zagreb (N?=?1087), completed an Anxiety Sensitivity Index and State-Trait Anxiety Inventory (Trait form) and, after a period of three years, were asked to self-assess criteria for panic disorder (according to the DSM-5).

Results: The predictive validity of AS for the onset of panic disorder symptoms, regardless of trait anxiety, was confirmed. Furthermore, the physical concerns dimension of AS was the only significant predictor of panic disorder symptoms. The optimal cutoff score of 25 on the ASI provides poor to moderate accuracy indices in detecting participants who will manifest panic disorder symptoms in the next three years.

Conclusion: This study contributes to our current understanding of AS as a prospective risk factor for panic disorder symptoms.     

Anxiety sensitivity cognitive concerns drive the relation between anxiety sensitivity and symptoms of depression

Depression is typically treated as a homogeneous construct despite evidence for distinct cognitive, affective, and somatic symptom dimensions. Anxiety sensitivity (AS; the fear of consequences of anxiety symptoms) is a cognitive risk factor implicated in the development of depressive symptoms. However, it is unclear how lower order AS dimensions (i.e. physical, cognitive, and social concerns) relate to depressive symptom factors. Confirmatory factor analysis, followed by structural equation modeling, were conducted to examine the factor structure of depression and to then examine the relations between these factors and the lower order factors of AS. This study was conducted in a sample of 374 adults (M age = 35.5, 54.3% female) with elevated levels of psychopathology (89.2% meeting criteria for at least one DSM-5 diagnosis, 25.6% primary depressive disorder). In this study a two-factor model of depression, composed of Cognitive and Affective/Somatic factors, was superior to one- and three-factor solutions. AS cognitive concerns were related to both cognitive and affective/somatic symptoms of depression. Neither of the other AS dimensions was related to depression symptom dimensions. These findings provide a better understanding of the relations between AS and depression symptoms.