Anxiety sensitivity

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Anxiety sensitivity (AS) refers to the fear of behaviours or sensations associated with the experience of anxiety, and a misinterpretation of such sensations as dangerous. Bodily sensations related to anxiety, such as nausea and palpitations, are mistaken as harmful experiences, causing anxiety or fear to intensify. [1] For example, a person with high anxiety sensitivity may fear the shakes as impending neurological disorder, or may suspect lightheadedness is the result of a brain tumour; conversely, a person with low anxiety sensitivity is likely to identify these as harmless and attach no significance to them. [2] The Anxiety Sensitivity Index attempts to assess anxiety sensitivity. [3]

Contents

Anxiety sensitivity (fear of anxiety-related sensations) is distinct from, although related to and associated with, health anxiety (a key feature of which is heightened awareness of physical sensations, known as body vigilance). [3] [4]

Similarly, it is distinguished from general "trait anxiety" by a focus on physical (somatic) symptoms and sensations, as opposed to general stress. [1] [5]

History

In the 1970s and 1980s the fear of fear was considered as an important consequence of panic attacks. It was assumed that after a first panic attack, people learn to fear recurrence, and thus developed agoraphobia.

In 1985 Reiss and McNally re-interpreted the "fear of fear" as anxiety sensitivity. Instead of viewing it as the anticipation of recurrent panic attacks, Reiss and McNally suggested that it arises from beliefs that the experience of anxiety is itself harmful. A person who believes that a pounding heart is a sign of impending cardiac trouble, for example, might show a fear of fear rooted in cognitive beliefs rather than in associative learning.

The concept of anxiety sensitivity expressed two ideas. First, it implied that the fear of fear is at least sometimes rooted in cognition or beliefs, not Pavlovian associations with prior panic experiences. Second, it implied that the fear of fear could precede panic experiences and even presage panic attacks, post-traumatic stress, phobias, and other anxiety conditions.

Anxiety Sensitivity Index

In 1984, Steven Reiss wrote the 16 items on the brief questionnaire he called and copyrighted as the "Anxiety Sensitivity Index" (ASI). In 1986 Reiss, Peterson, Gursky, & McNally published the ASI questionnaire along with initial validity evidence. As of July, 2013, the ASI has been used in more than 1,600 research studies. As was predicted by Reiss and McNally (1985), a high score on the ASI is a powerful and unique predictor of who will have panic attacks, post-traumatic stress, and ordinary fears or phobias.

By helping researchers identify people with a high risk of panic disorder and other anxiety condition, the construct of anxiety sensitivity has created new research opportunities to study the prevention of disorders affecting more than five million Americans.

Harvard's Richard McNally, Florida State's Norman Schmidt, and University of Houston psychologist Michael Zvolensky published research that established the validity of anxiety sensitivity. George Washington University psychologist Rolf Peterson, and Yale's Wendy Silverman, extended the anxiety sensitivity concept to children.

When the ASI was first published, it was widely criticized as superfluous. It was thought that, since everybody avoids anxiety, there is no need to study individual differences. We now know, however, that while everybody avoids anxiety, some people go to much greater lengths than others to do so. These individuals are at risk for panic attacks, post-traumatic stress disorder, and phobias. These individuals also agree with the statement that the sensations and behaviours of anxiety are harmful or dangerous.[ citation needed ]

Steven Taylor and his colleagues published several variants of the original ASI, seeking to rectify limitations of the original ASI. Given the mounting evidence that anxiety sensitivity was not a unidimensional construct, as originally conceptualized by Reiss, Taylor and colleagues developed the ASI-3 in order to assess the basic dimensions of anxiety sensitivity: (1) fear of physical symptoms, (2) fear of cognitive symptoms, and (3) fear of publicly observable symptoms (Taylor et al., 2007). Each dimension predicts different types of psychopathology (e.g., fear of physical symptoms is most closely associated with panic disorder). The analysis of the dimensions of anxiety sensitivity provides are more nuanced way of examining the relationship between specific types of anxiety sensitivity and specific types of psychopathology.

Reiss (2013) has expanded the concept of a "motivational sensitivity" into a comprehensive theory of human motivation, known as the theory of 16 basic desires, or Reiss Motivation Profile. By definition, a "motivational sensitivity" is an individual difference in valuation of a goal common to everyone and deeply rooted in human nature. Everybody wants to be safe and avoid anxiety, for example, but people with high anxiety sensitivity place a significantly higher value on their safety than does the average person. Reiss's model is based on research on the largest cross-cultural database of human motives ever collected. It identifies 16 motivational sensitivities, one of which is called need for tranquility, which is the same as anxiety sensitivity.

Related Research Articles

<span class="mw-page-title-main">Anxiety</span> Unpleasant state of inner turmoil over anticipated events

Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different from fear in that fear is defined as the emotional response to a real threat, whereas anxiety is the anticipation of a future threat. It is often accompanied by nervous behavior such as pacing back and forth, somatic complaints, and rumination.

<span class="mw-page-title-main">Phobia</span> Anxiety disorder classified by a persistent and excessive fear of an object or situation

A phobia is an anxiety disorder, defined by a persistent and excessive fear of an object or situation. Phobias typically result in a rapid onset of fear and are usually present for more than six months. Those affected go to great lengths to avoid the situation or object, to a degree greater than the actual danger posed. If the object or situation cannot be avoided, they experience significant distress. Other symptoms can include fainting, which may occur in blood or injury phobia, and panic attacks, often found in agoraphobia and emetophobia. Around 75% of those with phobias have multiple phobias.

<span class="mw-page-title-main">Anxiety disorder</span> Cognitive disorder with an excessive, irrational dread of everyday situations

Anxiety disorders are a cluster of mental disorders characterized by significant and uncontrollable feelings of anxiety and fear such that a person's social, occupational, and personal functions are significantly impaired. Anxiety may cause physical and cognitive symptoms, such as restlessness, irritability, easy fatigue, difficulty concentrating, increased heart rate, chest pain, abdominal pain, and a variety of other symptoms that may vary based on the individual.

<span class="mw-page-title-main">Agoraphobia</span> Anxiety disorder

Agoraphobia is a mental and behavioral disorder, specifically an anxiety disorder characterized by symptoms of anxiety in situations where the person perceives their environment to be unsafe with no easy way to escape. These situations can include public transit, shopping centers, crowds and queues, or simply being outside their home on their own. Being in these situations may result in a panic attack. Those affected will go to great lengths to avoid these situations. In severe cases, people may become completely unable to leave their homes.

<span class="mw-page-title-main">Panic attack</span> Period of intense fear

Panic attacks are sudden periods of intense fear and discomfort that may include palpitations, sweating, chest pain or chest discomfort, shortness of breath, trembling, dizziness, numbness, confusion, or a feeling of impending doom or of losing control. Typically, symptoms reach a peak within ten minutes of onset, and last for roughly 30 minutes, but the duration can vary from seconds to hours. Although they can be extremely frightening and distressing, panic attacks themselves are not physically dangerous.

<span class="mw-page-title-main">Claustrophobia</span> Fear of small spaces

Claustrophobia is a fear of confined spaces. It is triggered by many situations or stimuli, including elevators, especially when crowded to capacity, windowless rooms, and hotel rooms with closed doors and sealed windows. Even bedrooms with a lock on the outside, small cars, and tight-necked clothing can induce a response in those with claustrophobia. It is typically classified as an anxiety disorder, which often results in panic attacks. The onset of claustrophobia has been attributed to many factors, including a reduction in the size of the amygdala, classical conditioning, or a genetic predisposition to fear small spaces.

<span class="mw-page-title-main">Acrophobia</span> Extreme fear of heights

Acrophobia is an extreme or irrational fear or phobia of heights, especially when one is not particularly high up. It belongs to a category of specific phobias, called space and motion discomfort, that share similar causes and options for treatment.

Phobophobia is a phobia defined as the fear of phobias, or the fear of fear, including intense anxiety and unrealistic and persistent fear of the somatic sensations and the feared phobia ensuing. Phobophobia can also be defined as the fear of phobias or fear of developing a phobia. Phobophobia is related to anxiety disorders and panic attacks directly linked to other types of phobias, such as agoraphobia. When a patient has developed phobophobia, their condition must be diagnosed and treated as part of anxiety disorders.

Cynophobia is the fear of dogs and canines in general. Cynophobia is classified as a specific phobia, under the subtype "animal phobias". According to Timothy O. Rentz of the Laboratory for the Study of Anxiety Disorders at the University of Texas, animal phobias are among the most common of the specific phobias and 36% of patients who seek treatment report being afraid of dogs or afraid of cats. Although ophidiophobia or arachnophobia are more common animal phobias, cynophobia is especially debilitating because of the high prevalence of dogs and the general ignorance of dog owners to the phobia. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) reports that only 12% to 30% of those with a specific phobia will seek treatment.

Exposure therapy is a technique in behavior therapy to treat anxiety disorders.

Social anxiety is the anxiety and fear specifically linked to being in social settings. Some categories of disorders associated with social anxiety include anxiety disorders, mood disorders, autism spectrum disorders, eating disorders, and substance use disorders. Individuals with higher levels of social anxiety often avert their gazes, show fewer facial expressions, and show difficulty with initiating and maintaining a conversation. Social anxiety commonly manifests itself in the teenage years and can be persistent throughout life; however, people who experience problems in their daily functioning for an extended period of time can develop social anxiety disorder. Trait social anxiety, the stable tendency to experience this anxiety, can be distinguished from state anxiety, the momentary response to a particular social stimulus. Half of the individuals with any social fears meet the criteria for social anxiety disorder. Age, culture, and gender impact the severity of this disorder. The function of social anxiety is to increase arousal and attention to social interactions, inhibit unwanted social behavior, and motivate preparation for future social situations.

Interoceptive exposure is a cognitive behavioral therapy technique used in the treatment of panic disorder. It refers to carrying out exercises that bring about the physical sensations of a panic attack, such as hyperventilation and high muscle tension, and in the process removing the patient's conditioned response that the physical sensations will cause an attack to happen.

<span class="mw-page-title-main">Social anxiety disorder</span> Anxiety disorder associated with social situations

Social anxiety disorder (SAD), also known as social phobia, is an anxiety disorder characterized by sentiments of fear and anxiety in social situations, causing considerable distress and impairing ability to function in at least some aspects of daily life. These fears can be triggered by perceived or actual scrutiny from others. Individuals with social anxiety disorder fear negative evaluations from other people.

<span class="mw-page-title-main">Panic disorder</span> Anxiety disorder characterized by reoccurring unexpected panic attacks

Panic disorder is a mental and behavioral disorder, specifically an anxiety disorder characterized by reoccurring unexpected panic attacks. Panic attacks are sudden periods of intense fear that may include palpitations, sweating, shaking, shortness of breath, numbness, or a feeling that something terrible is going to happen. The maximum degree of symptoms occurs within minutes. There may be ongoing worries about having further attacks and avoidance of places where attacks have occurred in the past.

<span class="mw-page-title-main">Richard McNally</span> Professor of psychology

Richard McNally is an American psychologist and director of clinical training at Harvard University's department of psychology. As a clinical psychologist and experimental psycho-pathologist, McNally studies anxiety disorders and related syndromes, such as post-traumatic stress disorder, obsessive–compulsive disorder, and complicated grief.

Driving phobia, driving anxiety, vehophobia, amaxophobia or driving-related fear (DRF) is a pathological fear of driving. It is an intense, persistent fear of participating in car traffic that affects a person's lifestyle, including aspects such as an inability to participate in certain jobs due to the pathological avoidance of driving. The fear of driving may be triggered by specific driving situations, such as expressway driving or dense traffic. Driving anxiety can range from a mild cautious concern to a phobia.

<span class="mw-page-title-main">Steven Reiss</span>

Steven Reiss (1947–2016) was an American psychologist who contributed original ideas, new assessment methods, and influential research studies to four topics in psychology: anxiety disorders, developmental disabilities, intrinsic motivation, and the psychology of religion.

Safety behaviors are coping behaviors used to reduce anxiety and fear when the user feels threatened. An example of a safety behavior in social anxiety is to think of excuses to escape a potentially uncomfortable situation. These safety behaviors, although useful for reducing anxiety in the short term, might become maladaptive over the long term by prolonging anxiety and fear of nonthreatening situations. This problem is commonly experienced in anxiety disorders. Treatments such as exposure and response prevention focus on eliminating safety behaviors due to the detrimental role safety behaviors have in mental disorders. There is a disputed claim that safety behaviors can be beneficial to use during the early stages of treatment.

The Social Interaction Anxiety Scale (SIAS) is a self-report scale that measures distress when meeting and talking with others that is widely used in clinical settings and among social anxiety researchers. The measure assesses social anxiety disorder, which is fear or anxiety about one or more social situations where the individual is subject to possible scrutiny.

Future tripping, also referred to as anticipatory anxiety, describes a type of fear that occurs when an anticipated event in the future causes distress. These events can include both major occasions, such as a presentation, but depending on the individual could also happen before some minor event, like going out. It is not seen as a distinct type of anxiety but rather plays a part in many variations and can be found in numerous disorders and is strongly connected to panic attacks, often following them.

References

  1. 1 2 Borrego, Joaquín; Ortiz-González, Elizabeth; Gissandaner, Tre D. (2019). "Ethnic and Cultural Considerations". Pediatric Anxiety Disorders. Elsevier. pp. 461–497. doi:10.1016/b978-0-12-813004-9.00021-9. ISBN   978-0-12-813004-9.
  2. ↑ Taylor, Steven (2019). "Treating anxiety sensitivity in adults with anxiety and related disorders". The Clinician's Guide to Anxiety Sensitivity Treatment and Assessment. Elsevier. pp. 55–75. doi:10.1016/b978-0-12-813495-5.00004-8. ISBN   978-0-12-813495-5.
  3. 1 2 Rodriguez, Benjamin F.; Bruce, Steven E.; Pagano, Maria E.; Spencer, Michael A.; Keller, Martin B. (2004). "Factor structure and stability of the Anxiety Sensitivity Index in a longitudinal study of anxiety disorder patients". Behaviour Research and Therapy. 42 (1): 79–91. doi:10.1016/s0005-7967(03)00074-3. PMC   3272759 . PMID   14744525.
  4. ↑ Wright, Kristi D.; Lebell, Megan A.N. Adams; Carleton, R. Nicholas (2016). "Intolerance of uncertainty, anxiety sensitivity, health anxiety, and anxiety disorder symptoms in youth". Journal of Anxiety Disorders. Elsevier BV. 41: 35–42. doi:10.1016/j.janxdis.2016.04.011. ISSN   0887-6185. PMID   27302203.
  5. ↑ Dolan, Eric W. (2019-07-27). "Study suggests anxiety sensitivity influences the interpretation of physiological responses to stress". PsyPost. Retrieved 2023-10-13.
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