New Waves in Philosophical Logic,edited by Greg Restall and Gillian Russell

Noël Blas Saenz has recently argued for a counterfactual condition on grounding called Sensitivity, with which he tries to show that there are no mereological sums and that universalism about composition is false. This reply argues, first, that, while Sensitivity may show that there are no mereological sums in Saenz’s idiosyncratic sense, this does not establish the failure of universalism and, second, that Sensitivity is false and ill-motivated in any case.     

Distress Tolerance and Anxiety Sensitivity Cognitive Concerns: Testing the Incremental Contributions of Affect Dysregulation Constructs on Suicidal Ideation and Suicide Attempt

Empirical work has suggested relationships among suicide-related outcomes and several constructs related to affect dysregulation, notably anxiety sensitivity (AS) and distress tolerance (DT). However, important questions remain, including the relative contributions of these affect regulation variables as well as the direct contribution of DT on suicidal ideation and prior attempts. The current study sought to better elucidate the nature of these relationships by examining AS, DT, and suicidal ideation and attempt in a clinical sample (N = 192). Consistent with prior work and prediction, findings revealed a significant relationship between the AS cognitive concerns subfactor and suicidal ideation and suicide attempt history after accounting for the effects of DT, gender, and depressive symptoms. In addition, depressive symptoms significantly moderated the relationship between the AS cognitive concerns subfactor and suicidal ideation. After accounting for the influence of AS, analyses revealed that DT approached significance in predicting suicidal ideation, but did not significantly predict suicide attempt history. These results suggest that elevated AS cognitive concerns are particularly relevant to suicide in the context of depressive symptoms. Clinicians may benefit from implementing AS reduction strategies with individuals who endorse elevated suicide risk as well as elevated AS cognitive concerns.     

Young Children's Phonological Sensitivity After Exposure to a Rhyming or Nonrhyming Story

This study examined the ability of preschool children to make phonological discriminations after hearing rhyming or nonrhyming versions of the same story. Participants first listened to either a rhyming or nonrhyming version of a story, Rainy Day Kate (Blegvad, 1987), then attempted a phonological deletion and a rhyme/alliteration detection task. In accordance with prior theoretical notions that listening to rhyme sensitizes young children to phonological properties of words, children who heard the rhyming version of the story showed significantly higher performance on the rhyme/alliteration task than did participants who heard the nonrhyming narrative. Children in the rhyme condition also offered more rhyming and clang (nonword but phonologically similar) associates in completing the phonological deletion task.     

The Fears of Youth in the 1990s: Contemporary Normative Data

This article reports the findings of a normative fear investigation involving a sample of 918 Australian children and adolescents, ranging in age from 718 years. The Fear Survey Schedule for Children and Adolescents-II (FSSC-II) was administered to determine self-reported prevalence, intensity, and content of fear. Consistent with past research, girls generally reported significantly higher levels of fearfulness than boys. Age differences also were found; younger children reported a higher intensity and a greater number of fears than older children and adolescents. Qualitative differences in normative fear were found, with younger children reporting more animal fears and older children reporting more fears relating to social evaluation or psychic stress. Significantly, although the specific content of children's and adolescents' normative fears in the 1990s (as compared with the 1960s) has changed (now including fear of AIDS and of nuclear war), the fears found to be most prevalent continue to relate to death and danger. These findings are discussed within the context of the prepotency and preparedness concepts of fear.     

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.     

Interoceptive Exposure Therapy Combined with Trauma‐related Exposure Therapy for Post‐traumatic Stress Disorder: a Case Report

Trauma‐related exposure therapy is a useful but not universally effective treatment for post‐traumatic stress disorder. Anxiety sensitivity may play an important role in this disorder, as it does in panic disorder. Studies have shown that interoceptive exposure therapy reduces anxiety sensitivity in panic disorder. The present case study was a preliminary investigation of the merits of including interoceptive exposure therapy in the treatment of post‐traumatic stress disorder, in order to improve treatment outcome for a patient who had no history of panic disorder or panic attacks. Interoceptive exposure therapy (4 sessions) was one component of treatment, combined with trauma‐related exposure therapy (4 sessions of imaginal exposure followed by 4 sessions of in vivo exposure). Treatment outcome was assessed with the Clinician‐Administered Post‐traumatic Stress Disorder Scale, a self‐report measure of post‐traumatic stress disorder symptoms, and measures of symptoms and cognitions commonly associated with post‐traumatic stress disorder. Scores on all outcome measures decreased over the course of treatment, with gains maintained at 1‐ and 3‐month follow‐up. Symptoms of anxiety sensitivity and post‐traumatic stress disorder decreased during interoceptive exposure therapy. The results indicate that interoceptive exposure therapy is a promising adjunctive intervention for post‐traumatic stress disorder. Further research is needed into the merits of combining interoceptive exposure therapy and trauma‐related exposure therapy as a means of boosting treatment efficacy.     

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.     

Book Review

Cognitive Behaviour Therapy - a Guide for the Practising Clinician. Gregoris Simos (Ed.). East Sussex: Brunner-Routledge, 2002. 330 pages. ISBN 1-58391-104-9.     

How Do Elements of a Reduced Capacity to Withstand Uncertainty Relate to the Severity of Health Anxiety?

Intolerance of uncertainty (IU)—a multidimensional cognitive vulnerability factor—is associated with a variety of anxiety disorders and health anxiety (HA). To date, few studies have assessed whether IU dimensions (prospective and inhibitory IU) are differentially associated with HA and whether their contributions are independent of anxiety sensitivity (AS). This study addressed these issues using independent community (n = 155; 81% women) and undergraduate (n = 560; 86% women) samples. Results indicated that prospective IU, but not inhibitory IU, had significant positive associations with HA in community dwellers and undergraduate students. AS somatic and cognitive concerns were also significant predictors among both samples. In addition, severity of IU dimensions among individuals reporting elevated HA were compared against individuals diagnosed with generalized anxiety disorder, social anxiety disorder, panic disorder, and obsessive–compulsive disorder. Results indicated minimal differences between those with elevated HA and each of the anxiety disorder diagnoses. Findings lend support to the unique transdiagnostic nature of IU and support commonalities between HA and anxiety disorders.     

The Role of Fear-Avoidance Cognitions and Behaviors in Patients with Chronic Tinnitus

The current study investigated the role of fear-avoidance—a concept from chronic pain research—in chronic tinnitus. A self-report measure the “Tinnitus Fear-Avoidance Cognitions and Behaviors Scale (T-FAS)” was developed and validated. Furthermore, the role of fear-avoidance behavior as mediator of the relationship between anxiety sensitivity and tinnitus handicap was investigated. From a clinical setting, N = 373 patients with chronic tinnitus completed questionnaires assessing tinnitus handicap (Tinnitus Handicap Inventory), anxiety, depression (Hospital Anxiety and Depression Scale), anxiety sensitivity (Anxiety Sensitivity Index-3), personality factors (Big Five Inventory-10), and fear-avoidance. To analyze the psychometric properties, principal component analysis with parallel component extraction and correlational analyses were used. To examine a possible mediating effect, hierarchical regression analysis was applied. The principal component analysis resulted in a three-factor solution: Fear-avoidance Cognitions, Tinnitus-related Fear-Avoidance Behavior, and Ear-related Fear-Avoidance Behavior. Internal consistency was satisfactory for the total scale and all subscales. High correlations between tinnitus-related handicap scales, depressive and anxiety symptoms, and the T-FAS were found, whereas associations with personality factors were low. Moreover, results indicate a significant partial mediation of fear-avoidance behaviors in the relationship between anxiety sensitivity and the cognitive dimension of tinnitus handicap. Results show that fear-avoidance behavior plays an important role in tinnitus handicap. More attention should be paid to this concept in research and clinical practice of psychotherapy for chronic tinnitus.