Anxiety sensitivity index: normative data and its differentiation from trait anxiety

In the present study we report: (1) normative data on the Spanish version of the Anxiety Sensitivity Index (ASI); and (2) empirical evidence related to differentiation between the constructs of anxiety sensitivity and trait anxiety. A sample of 390 university students (ranging in age from 18 to 34 years) completed the ASI and Spielberger's Trait Anxiety Scale (STAI-T). The means and standard deviations for the Spanish version of the ASI are similar to the ones reported by Peterson and Reiss (Anxiety Sensitivity Index Manual, 2nd edition. Worthington, OH: International Diagnostic Systems, 1992) for the English version. Factor analysis of the joint ASI and STAI-T items yielded two different factors; the STAI-T items load onto one factor (i.e., the trait anxiety factor) and the ASI items load onto the other factor (i.e., the anxiety sensitivity factor). Findings provide empirical support for validation of the Spanish ASI and are consistent with a construct distinction between anxiety sensitivity and trait anxiety.     

Comment on Holloway and McNally's (1987) "Effects of Anxiety Sensitivity on the Response to Hyperventilation"

Holloway and McNally (1987) found that normals with high scores on the Anxiety Sensitivity Index (ASI), an instrument developed to assess beliefs regarding the adverse consequences of anxiety, reported more anxiety and more frequent and intense somatic sensations following hyperventilation than did normals with low scores on the ASI. They concluded that this result provides support for the construct validity of the ASI and thus for the construct of anxiety sensitivity. Nevertheless, we argue that (a) the developers of the ASI have conflated beliefs regarding the adverse consequences of anxiety with fear of these consequences, (b) the accumulated evidence for the construct validity of the ASI is weak, and (c) Holloway and McNally's design and analyses do not permit them to exclude the more parsimonious explanation that trait anxiety accounts for their findings. Implications for research on anxiety sensitivity are discussed.     

Investigating invariance in the factorial structure of the anxiety sensitivity index across adult men and women

The Anxiety Sensitivity Index (ASI; Peterson & Reiss, 1992) is one of the most widely used measures of the fear of anxiety-related sensations. Important gender differences also seem to exist in that women report higher levels of anxiety sensitivity than men. The primary objective of this study was to determine whether an equivalent factorial structure exists for the ASI among nonclinical adult men and women. In Study 1 (568 women; 251 men), the 2-factor (Fear of Cardiopulmonary Sensations and Fear of Mental Catastrophe), 10-item version of the ASI reported by Schmidt and Joiner (2002) provided the best fit to the data for both men and women. Using this model, Study 2 (503 women, 255 men) examined whether the factorial structure of the 10-item ASI was invariant for men and women. Noninvariance was found for one item on the Fear of Mental Catastrophe subscale (Item 15="When I am nervous, I worry that I might be mentally ill"). The implications of this are that this item should be dropped if an equivalent factor structure is to be assumed between men and women.     

Anxiety sensitivity taxonicity: a concurrent test of cognitive vulnerability for post-traumatic stress symptomatology among young adults

This study evaluated the anxiety sensitivity taxon using the 16-item Anxiety Sensitivity Index in relation to 2 criteria relevant to post-traumatic stress disorder; post-traumatic stress disorder symptom severity as indexed by the Post-Traumatic Diagnostic Scale, and post-traumatic cognitions as indexed by the Post-Traumatic Cognitions Inventory. Taxometric analyses of data collected from 331 young adults indicated that the latent structure of anxiety sensitivity was taxonic with an estimated base-rate range of 11-12%. As predicted, an 8-item Anxiety Sensitivity Index Taxon Scale accounted for significant variance above and beyond that accounted for by negative affectivity and the full-scale Anxiety Sensitivity Index total score in terms of both criteria. Moreover, after accounting for variance explained by the full-scale Anxiety Sensitivity Index total score and negative affectivity, the sum score for the 8 Anxiety Sensitivity Index items not included in the Anxiety Sensitivity Index Taxon Scale was associated with significant variance in these same dependent measures, but the relation was in the opposite direction to that predicted by theory. These findings are discussed in terms of theoretical and clinical implications for the study of anxiety sensitivity and post-traumatic stress disorder vulnerability.     

Sixteen-item Anxiety Sensitivity Index: confirmatory factor analytic evidence, internal consistency, and construct validity in a young adult sample from the Netherlands

The present investigation examined the factor structure, internal consistency, and construct validity of the 16-item Anxiety Sensitivity Index (ASI; Reiss Peterson, Gursky, & McNally 1986) in a young adult sample (n = 420) from the Netherlands. Confirmatory factor analysis was used to comparatively evaluate two-factor, three-factor, and four-factor models of the anxiety sensitivity construct. Support was found for a hierarchical structure of anxiety sensitivity, with one global higher-order factor and four lower-order factors. Internal consistency for the global and lower-order factors of the 16-item ASI was adequate. Convergent and discriminant associations between the 16-item ASI and general mood and panic-specific variables were consistent with anxiety sensitivity theory. In addition, incremental validity of the anxiety sensitivity construct was established, relative to negative affectivity, for unexpected panic attacks and agoraphobic avoidance.     

Robust dimensions of anxiety sensitivity: development and initial validation of the Anxiety Sensitivity Index-3

Accumulating evidence suggests that anxiety sensitivity (fear of arousal-related sensations) plays an important role in many clinical conditions, particularly anxiety disorders. Research has increasingly focused on how the basic dimensions of anxiety sensitivity are related to various forms of psychopathology. Such work has been hampered because the original measure--the Anxiety Sensitivity Index (ASI)--was not designed to be multidimensional. Subsequently developed multidimensional measures have unstable factor structures or measure only a subset of the most widely replicated factors. Therefore, the authors developed, via factor analysis of responses from U.S. and Canadian nonclinical participants (n=2,361), an 18-item measure, the ASI-3, which assesses the 3 factors best replicated in previous research: Physical, Cognitive, and Social Concerns. Factorial validity of the ASI-3 was supported by confirmatory factor analyses of 6 replication samples, including nonclinical samples from the United States and Canada, France, Mexico, the Netherlands, and Spain (n=4,494) and a clinical sample from the United States and Canada (n=390). The ASI-3 displayed generally good performance on other indices of reliability and validity, along with evidence of improved psychometric properties over the original ASI.     

A brief cognitive-behavioral approach to reducing anxiety sensitivity decreases pain-related anxiety

Anxiety sensitivity (AS; fear of anxiety-related sensations) is a known risk factor for anxiety disorders and recently has been linked to pain disorders. The present study was guided by the hypothesis that a program designed to reduce AS levels might also result in a decrease in anxiety related to pain sensations. Female undergraduates, selected as either high or low in AS according to screening scores on the Anxiety Sensitivity Index (ASI), were randomly assigned to participate in 3 1-hour, small group sessions of either cognitive behavioral therapy (CBT; psycho-education, cognitive restructuring, and interoceptive exposure) or a non-specific treatment (NST). Immediately prior to and following the intervention, participants completed the 20-item Pain Anxiety Symptoms Scale (PASS-20). Consistent with hypothesis, results revealed a 3-way interaction between AS group, intervention condition, and time on PASS-20 total scores. Only participants with high pre-morbid levels of AS assigned to the CBT condition showed a significant reduction in scores on the PASS-20 from pre- to post-treatment. Implications for improving CBT approaches for pain disorders are discussed.     

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.     

Categorical or Dimensional: A Reanalysis of the Anxiety Sensitivity Construct

Anxiety sensitivity, or the fear of anxiety sensations, has been implicated in the etiology of anxiety disorders, particularly panic disorder. Recently, inconsistent findings have been reported regarding the latent structure of anxiety sensitivity. Whereas some taxometric studies of anxiety sensitivity have reported evidence of categorical latent structure, others have found evidence of a latent dimension. The purpose of the present research was to further examine the latent structure of anxiety sensitivity using taxometric procedures and commonly utilized measures of anxiety sensitivity. To this end, three mathematically independent taxometric procedures (MAXEIG, MAMBAC, and L-Mode) were applied to data collected from two large nonclinical samples (n's = 1,171 and 2,173) that completed the Anxiety Sensitivity Index and the Anxiety Sensitivity Index-Revised. Results from both studies converged in support of a dimensional conceptualization of anxiety sensitivity. A third study was conducted using indicators derived from the newly revised Anxiety Sensitivity Index-3 in a separate sample of 1,462 nonclinical participants. Results of these analyses provided further support for a dimensional anxiety sensitivity solution. The implications of these results for anxiety sensitivity research are discussed, and several potential directions for future research are considered.     

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.     

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.     

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.     

The Social Anxiety Questionnaire for Children: Cross-Cultural Assessment with a New Self-Report Measure

This study describes a series of exploratory and confirmatory factor analyses that were conducted with the 44-item Social Anxiety Questionnaire for Children- 4th version (SAQ-CIV) to identify a reduced set of items that might be used to construct a new abbreviated instrument for measuring social anxiety in children and adolescents. The fourth version of the Social Anxiety Questionnaire for Children (SAQ-CIV) was administered to 12,801 non-clinical participants (ages 9 to 15 years) from 12 Latin American countries and Spain. Exploratory and confirmatory factor analysis supported a 6-factor structure of social anxiety in children, replicating a similar structure to that of adults (Caballo et al. in Behavioral Psychology/Psicología Conductual, 18(1), 5–34, 2010; Caballo et al. in Behavior Therapy, 43(2), 313–328, 2012): 1) Interactions with the opposite sex, 2) Criticism and embarrassment, 3) Speaking in public/Talking to teachers, 4) Assertive expression of annoyance and disgust, 5) Performing in public, and 6) Interactions with strangers. Each of the factors contains 4 items, yielding an abbreviated 24-item instrument, the Social Anxiety Questionnaire for Children (SAQ-C). The present results suggest this is a reliable, valid, and culturally sensitive instrument to assess social anxiety in youth.     

Facets of the Childhood Anxiety Sensitivity Index Among Serbian Youth

Data from factor analytic studies using the Child Anxiety Sensitivity Index (CASI) suggest that global anxiety sensitivity (AS) is best represented by three or four underlying factors or facets. The aim of this study was to identify facets best representing the CASI structure in its Serbian version. Confirmatory factor analysis was used on data collected from 456 non-referred children in Serbia. A 13-item version of the CASI provided a better fit to the data than the original 18-item version. The four-factor model of the CASI-13 with disease, unsteady, mental incapacitation, and social concerns facets provided the best fits for the data and it was found to be fully invariant (configural, metric, and scalar invariance) across gender and age. Among Serbian children, hierarchical structure was found for a 13-item CASI version with a single higher-order factor of global AS represented by four underlying facets. Future research will consider these AS facets and their role in the development, maintenance, and exacerbation of anxiety symptoms in children.     

Anxiety sensitivity and panic attacks in a nonclinical population

In the present study, we administered the Anxiety Sensitivity Index (ASI) and a modified version of the Panic Attack Questionnaire (PAQ) to 425 college students to determine whether high anxiety sensitivity ('fear of fear') occurs in the absence of a history of unpredictable ('spontaneous') panic attacks, or whether such attacks are a necessary precursor to high anxiety sensitivity. Based on their ASI scores, subjects were assigned to either the high, medium, or low anxiety sensitivity groups. High anxiety sensitivity subjects more frequently reported both a personal and family history of panic than did subjects in the other groups. Nevertheless, two-thirds of the high anxiety sensitivity subjects had never experienced an unpredictable panic attack. This suggests that the fear of anxiety can be acquired in ways other than through personal experience with panic.     

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.     

Anxiety sensitivity and panic symptomatology: the mediator role of hypochondriacal concerns

The present study tests the mediating role of hypochondriasis to explain the relation between anxiety sensitivity and panic symptomatology. Fifty-seven outpatients with clinically significant levels of panic symptomatology were selected to participate in the study. Measures of anxiety sensitivity, hypochondriasis, and panic symptomatology were obtained from standardized, self-administered questionnaires: the Anxiety Sensitivity Index (ASI; Reiss, Peterson, Gursky, & McNally, 1986), the Whiteley Index of Hypochondriasis (WI; Pilowsky, 1967), and the Panic-Agoraphobic Spectrum Self-Report (PAS-SR; Cassano et al., 1997; Shear et al., 2001). Regression analyses were performed to test for the mediation models. The results show that the effect of anxiety sensitivity on panic symptomatology is not significant when controlling the hypochondriacal concerns, whereas the latter predicted panic symptoms. This result holds for the overall ASI as well as for the Physical Concerns and the Mental Incapacitation Concerns dimensions of the ASI scale. No evidence of a direct relation between the Social Concerns dimension and panic symptoms was found. The findings suggest that hypochondriacal concerns might represent the mechanism through which anxiety sensitivity is able to influence panic symptoms.     

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.     

The Mathematics Anxiety Rating Scale,a brief version: psychometric data

As a measure of mathematics anxiety, the Mathematics Anxiety Rating Scale (MARS) has been a major scale used for research and clinical studies since 1972. Despite the usefulness of the original scale, researchers have sought a shorter version of the scale partly to reduce the administration time of the original 98-item scale. This study created a shorter version of the MARS and provides reliability and validity information for the new version. The Cronbach alpha of .96 indicated high internal consistency, while the test-retest reliability for the MARS 30-item was .90 (p<.001). The validity data confirm that the MARS 30-item test is comparable to the original MARS 98-item scale.