Anxiety Sensitivity or Interoceptive Sensitivity
An Analysis of Feared Bodily Sensations
Abstract
Abstract. The construct of anxiety sensitivity (AS) – the fear of anxiety-related symptoms – has been highly influential in current conceptualizations of anxiety disorders in general, and panic disorder specifically. However, given documented associations between AS and both non-anxiety psychological disorders as well as medical/health conditions, the extent to which measures of AS are assessing a specific fear or anxiety symptoms versus a broader fear of interoceptive or bodily sensations is unclear. Confirmatory factor analysis of data from 373 participants failed to suggest whether fears of anxiety-related symptoms were factorially distinct from fears of non-anxiety-related bodily sensations, although analyses indicated that while fears of anxiety-related symptoms were more closely associated with panic disorder severity than were fears of non-anxiety-related symptoms, both were similarly and strongly associated with hypochondriacal fears. Implications for the construct of AS, and the broader construct of somatic fears, are discussed.
References
2003). The Somatic Symptoms Inventory (SSI): Development, parameters, and correlates. Current Psychiatry, 10, 114–129.
(2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.
. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
. (2000). Tinnitus and anxiety sensitivity. Scandinavian Journal of Behaviour Therapy, 29, 57–64.
(1999). Beyond pain: The role of fear and avoidance in chronicity. Clinical Psychology Review, 19, 97–119.
(1999). Anxiety sensitivity and fear of pain in patients with recurring headaches. Behaviour Research and Therapy, 37, 703–713.
(1996). Role of anxiety sensitivity in pain-related fear and avoidance. Journal of Behavioral Medicine, 19, 573–582.
(2000). Anxiety sensitivity and disabling chronic health conditions: State of the art and future directions. Scandinavian Journal of Behavioral Therapy, 29, 100–117.
. (2007). Taxometric and factor analytic models of anxiety sensitivity: Integrating approaches to latent structural research. Psychological Assessment, 19, 74–87.
(1993).
(Alternative ways of assessing model fit . In K. A. BollenJ. S. LongEds., Testing Structural Equation Models (pp. 136–162). Beverly Hills, CA: Sage.1995). Predictors of panic-fear in asthma. Health Psychology, 14, 421–426.
(1994). Anxiety sensitivity and panic attacks in an asthmatic population. Behaviour Research and Therapy, 32, 411–418.
(1999).
(Anxiety sensitivity and emotional disorders: Psychometric studies and their theoretical implications . In S. TaylorEd., Anxiety sensitivity (pp. 115–148). Mahwah, NJ: Erlbaum.2001). Psychopathological correlates of anxiety sensitivity: Evidence from clinical interviews and self-report measures. Anxiety Disorders, 15, 317–332.
(1974). The Hopkins symptom checklist (HSCL): A self-report inventory. Behavioral Science, 19, 1–15.
(2014). Health-related dysfunctional beliefs and health anxiety: Further evidence of cognitive specificity. Journal of Clinical Psychology, 70, 248–259.
(2005). Differentiating hypochondriasis from panic disorder. Journal of Anxiety Disorders, 19, 29–49.
(1983). Understanding robust and exploratory data. New York, NY: Wiley.
(2002). Reliability of the self-report version of the Panic Disorder Severity Scale. Depression and Anxiety, 15, 183–185.
(1987). Fears, beliefs, and attitudes in DSM-III hypochondriasis. The Journal of Nervous and Mental Disease, 176, 20–25.
(1986). Hypochondriacal fears and beliefs in medical and law students. Archives of General Psychiatry, 43, 487–489.
(2001). Investigating the effects of anxiety sensitivity and coping strategy on the perception of cold pressor pain in healthy women. European Journal of Pain, 5, 11–25.
(2010). The relationship between anxiety sensitivity and latent symptoms of emotional problems: A structural equation modeling approach. Behaviour Research and Therapy, 48, 761–769.
(1992). Anxiety sensitivity in 1984 and panic attacks in 1987. Journal of Anxiety Disorders, 6, 241–247.
(1996). Assessing goodness of fit: Is parsimony always desirable? The Journal of Experimental Education, 64, 364–390.
(2013). Mplus user’s guide (Version 7.1). Los Angeles, CA: Muthén & Muthén.
(1999). Neurotic butterflies in my stomach: The role of anxiety, anxiety sensitivity, and depression in functional gastrointestinal disorders. Journal of Psychosomatic Research, 47, 233–240.
(2005). Hierarchical model of vulnerabilities for anxiety: Replication and extension with a clinical sample. Cognitive Behaviour Therapy, 34, 49–63.
(2009). Anxiety sensitivity and the anxiety disorders: A meta-analytic review and synthesis. Psychological Bulletin, 135, 974–999.
(1998). Additional findings on the association between anxiety sensitivity and hypochondriacal concerns: Examination of patients with major depression. Journal of Anxiety Disorders, 12, 225–232.
(1995). Elevated Anxiety Sensitivity Index scores in patients with major depression: Correlates and changes with antidepressant treatment. Journal of Anxiety Disorders, 9, 117–123.
(1992). Hypochondriacal concerns, anxiety sensitivity, and panic disorder. Journal of Anxiety Disorders, 6, 93–104.
(1987). Theoretical perspectives on the fear of anxiety. Clinical Psychology Review, 7, 585–596.
(1991). The expectancy model of fear, anxiety and panic. Clinical Psychology Review, 11, 141–153.
(1999).
(The sensitivity theory of aberrant motivation . In S. TaylorEd., Anxiety Sensitivity (pp. 35–58). Mahwah, NJ: Erlbaum.1985).
(Expectancy model of fear . In S. ReissR. R. BootzinEds., Theoretical issues in behavior therapy (pp. 107–121). San Diego, CA: Academic Press.1988). Anxiety sensitivity, injury sensitivity, and individual differences in fearfulness. Behaviour Research and Therapy, 26, 341–345.
(1986). Anxiety sensitivity, anxiety frequency, and the prediction of fearfulness. Behaviour Research and Therapy, 24, 1–8.
(1997). The role of anxiety sensitivity in the pathogenesis of panic: Prospective evaluation of spontaneous panic attacks during acute stress. Journal of Abnormal Psychology, 106, 355–364.
(1999). Prospective evaluation of anxiety sensitivity in the pathogenesis of panic: Replication and extension. Journal of Abnormal Psychology, 108, 532–537.
(2006). Anxiety sensitivity: Prospective prediction of panic attacks and Axis I pathology. Journal of Psychiatric Research, 40, 691–699.
(2003). Hierarchical model of generalized and specific vulnerabilities in anxiety. Cognitive Behaviour Therapy, 32, 82–94.
(1997). Multicenter collaborative panic disorder severity scale. American Journal of Psychiatry, 154, 1571–1575.
(2001). Reliability and validity of the panic disorder severity scale: Replication and extension. Journal of Psychiatric Research, 35, 293–296.
(2008). The Illness Attitude Scales. Psychotherapy and Psychosomatics, 77, 337–350.
(1996). A validation study of the Whitely Index, the Illness Attitude Scales, and the Somatosensory Amplification Scale in general medical and general practice patients. Journal of Psychosomatic Research, 40, 95–104.
(2001). Using multivariate statistics. New York, NY: Harper Collins.
(1994). Comment on Otto et al. (1992): Hypochondriacal concerns, anxiety sensitivity, and panic disorder. Journal of Anxiety Disorders, 8, 97–99.
(1996). Nature and measurement of anxiety sensitivity: Reply to Lilienfeld, Turner, and Jacob (1996). Journal of Anxiety Disorders, 10, 425–451.
(1998). An expanded Anxiety Sensitivity Index: Evidence for a hierarchic structure in a clinical sample. Journal of Anxiety Disorders, 12, 463–483.
(1999).
(The expectancy theory of fear, anxiety, and panic: A conceptual and empirical analysis . In S. TaylorEd., Anxiety sensitivity: Theory, research, and treatment of the fear of anxiety (pp. 17–33). Mahwah, NJ: Erlbaum.1992). How does anxiety sensitivity vary across the anxiety disorders? Journal of Anxiety Disorders, 6, 249–259.
(2007). Robust dimensions of anxiety sensitivity: Development and initial validation of the anxiety sensitivity index-3. Psychological Assessment, 19, 176–188.
(2008). Overcoming the fear of fear: How to reduce anxiety sensitivity. Oakland, CA: New Harbinger.
(1998). A retrospective study of the learning history origins of anxiety sensitivity. Behaviour Research and Therapy, 36, 505–525.
(2001). Anxiety sensitivity, panic, and depressed mood: A reanalysis teasing apart the contributions of the two levels in the hierarchical structure of the anxiety sensitivity index. Journal of Abnormal Psychology, 3, 372–377.
(