The Indirect Effect of Anxiety Sensitivity in the Relationship Between Panic Symptoms and Panic Severity

2015 ◽  
Vol 29 (2) ◽  
pp. 123-133 ◽  
Author(s):  
Alexander M. Talkovsky ◽  
Peter J. Norton
Keyword(s):  
Panic Disorder ◽  
Anxiety Sensitivity ◽  
Indirect Effect ◽  
Cognitive Model ◽  
Primary Diagnosis ◽  
Panic Attacks ◽  
Symptom Intensity ◽  
Bodily Sensations ◽  
Panic Symptoms ◽  
The Relationship

The cognitive model of panic (Clark, 1988) suggests that panic attacks result from the catastrophic misinterpretation of bodily sensations rather than the sensations themselves. Anxiety sensitivity (AS) is fear of anxious bodily sensations (Reiss, 1991) and has implications in panic development, maintenance, and severity. Although previous work has demonstrated that AS amplifies symptoms in response to provocations, few have analyzed the role of AS in the relationship between panic symptoms and panic disorder severity. The purpose of this investigation was to determine if AS, a cognitive risk for panic, has an indirect effect on the association between self-reported panic symptoms and panic severity, both self-reported and clinician-assessed, among 67 treatment-seeking individuals with a primary diagnosis of panic disorder with or without agoraphobia. Data were analyzed using the bootstrapped conditional process indirect effects model. Results indicated that the overall total mediational effect on Panic Disorder Severity Scale (PDSS) was significant with evidence of partial mediation. The direct effect of Beck Anxiety Inventory (BAI) on PDSS remained significant although there was also a significant indirect effect of BAI via AS. Results showed a similar relationship when Clinician Severity Rating was the outcome. Moderation analyses were not significant. Therefore, AS was a significant partial mediator of the relationship between symptom intensity and panic severity, whether clinician-rated or self-reported. This investigation provides support for the importance of AS in panic, highlighting its importance but suggesting that it is not sufficient to explain panic disorder.

The Relationship Between Catastrophic Cognitions and the Components of Panic Disorder

1991 ◽  
Vol 5 (3) ◽  
pp. 175-186 ◽  
Author(s):  
Susan Robinson ◽  
Max Birchwood
Keyword(s):  
Depressive Symptoms ◽  
Panic Disorder ◽  
Avoidance Behavior ◽  
Cognitive Model ◽  
Somatic Symptoms ◽  
Panic Attacks ◽  
Self Report ◽  
Degree Of Belief ◽  
Critical Components ◽  
The Relationship

Cognitive models of panic postulate that panic attacks arise from the catastrophic misinterpretation of somatic symptoms. Hitherto, research has concentrated on the link between cognitions and the somatic sensations experienced during panic attacks; little attention has been directed towards the relationship between cognitions and other critical components of Panic Disorder (e.g., avoidance behavior). Fifty-eight patients presenting with Panic Disorder with Agoraphobia (DSM-III-R) rated their degree of belief in nine “core” catastrophic cognitions and completed self-report measures of the critical symptoms of Panic Disorder. Results demonstrated a link between cognitions of physical catastrophe and somatic symptoms. Additionally, strong links were detected between the cognitions of losing control and “experiential” symptoms, between the cognition of insanity and depressive symptoms, and between the cognition of social embarrassment and avoidance behavior. Implications for the cognitive model and treatment of Panic Disorder are discussed.

The Relative Contributions of Negative Cognitions and Self-efficacy to Severity of Panic Attacks in Panic Disorder

2002 ◽  
Vol 19 (2) ◽  
pp. 102-111 ◽  
Author(s):  
Jeffrey C. Richards ◽  
Vanessa Richardson ◽  
Ciaran Pier
Keyword(s):  
Panic Disorder ◽  
Anxiety Sensitivity ◽  
Self Efficacy ◽  
Panic Attack ◽  
Panic Attacks ◽  
Cognitive Variables ◽  
Behaviour Therapy ◽  
Negative Cognitions ◽  
Cognitive Behaviour ◽  
Panic Symptoms

AbstractThe aim of this study was to determine the degree to which fearful and catastrophic cognitions, and self-efficacy for managing panic predicted various panic attack characteristics in panic disorder. The cognitive variables consisted of anxiety sensitivity, the frequency of fearful agoraphobic cognitions and measures of catastrophic misinterpretation of symptoms. The panic parameters were number and severity of panic symptoms, distress associated with panic attacks, worry about future panics, duration of panic disorder, and life interference due to panic disorder. These variables were measured in 40 people with panic disorder, 31 of whom also had significant agoraphobia. The frequency of fearful agoraphobic cognitions was the strongest predictor of panic attack symptomatology, predicting number of symptoms, symptom severity and degree of anticipatory fear of panic. Catastrophic misinterpretation of symptoms and anxiety sensitivity did not independently predict any panic parameters. Only self-efficacy for managing the rapid build-up of panic symptoms was specifically related to panic severity. The results therefore suggest that cognitive behaviour therapy for panic symptoms in panic disorder should reduce fearful cognitions rather than focus on panic coping strategies. The results offer little support for the contribution of the expectancy or catastrophic misinterpretation theories to the maintenance of panic disorder.

scholarly journals The Relationship Between Attachment Style, Anxiety Sensitivity and Interpretive Bias Among Adolescent Nonclinical Panickers

2006 ◽  
Vol 23 (1) ◽  
pp. 31-41 ◽  
Author(s):  
David W. Austin ◽  
Rachel S. Jamieson ◽  
Jeffrey C. Richards ◽  
John Winkelman
Keyword(s):  
Young Adults ◽  
Panic Disorder ◽  
Attachment Style ◽  
Anxiety Sensitivity ◽  
Insecure Attachment ◽  
Adolescents And Young Adults ◽  
Sensitivity Index ◽  
Interpretive Bias ◽  
Bodily Sensations ◽  
The Relationship

AbstractElevated anxiety sensitivity and the tendency to catastrophically misinterpret ambiguous bodily sensations has been demonstrated in people who experience nonclinical levels of panic (Richards, Austin, & Alvarenga, 2001), and anxiety sensitivity has been shown to be associated with insecure attachment in adolescents and young adults (Weems, Berman, Silverman, & Saavedra, 2001). This study investigated the relationship between attachment style, anxiety sensitivity and catastrophic misinterpretation among 11 nonclinical panickers and 58 nonanxious controls aged 18 to 19 years. Participants completed the Brief Bodily Sensations Interpretation Questionnaire (BBSIQ), Anxiety Sensitivity Index (ASI) and an attachment questionnaire. The hypothesis that insecurely attached individuals would demonstrate greater catastrophic misinterpretation and higher anxiety sensitivity than securely attached individuals was not supported; however, nonclinical panickers gave more anxiety-related interpretations of ambiguous internal stimuli than nonanxious controls. Results do not support the notion that attachment style is related to anxiety sensitivity or catastrophic misinterpretation (regardless of panic experience). Results do, however, support the notion that anxiety-related misinterpretation of ambiguous somatic sensations precedes the onset of panic disorder.

Fear of Autonomic Arousal and Use of Coping Strategies as Predictors of Agoraphobic Avoidance in Panic Disorder

1998 ◽  
Vol 15 (4) ◽  
pp. 228-236 ◽  
Author(s):  
Patricia Rayment ◽  
Jeff Richards
Keyword(s):  
Panic Disorder ◽  
Coping Strategies ◽  
Significant Proportion ◽  
Panic Attacks ◽  
Autonomic Arousal ◽  
Negative Cognitions ◽  
Considerable Controversy ◽  
Dsm Iv ◽  
Panic Symptoms ◽  
Behavioural Strategies

Despite the very significant proportion of people with panic disorder who have accompanying agoraphobia, there is considerable controversy about the variables that influence the development of this avoidance behaviour. This study investigated whether degree of avoidance is a function of extent of fear and prevalence of negative cognitions about autonomic arousal symptoms and whether the use of, and confidence in, behavioural strategies to cope with panic sensations also influences agoraphobic avoidance. Thirty-nine people who met DSM-IV criteria for panic disorder completed questionnaires measuring fear and negative cognitions about autonomic arousal and panic sensations, and a questionnaire measuring their use of largely behavioural strategies to cope with panic attacks. Fear of autonomic arousal and negative cognitions in response to the occurrence of these arousal symptoms were jointly related to situational avoidance. There was little relationship between the use of, and confidence in, panic coping strategies and less agoraphobic avoidance, although simply allowing panic symptoms to develop and pass predicted less avoidance. The results were interpreted as providing an empirical basis for treatment that reduces fear of panic sensations and allows their experience to be tolerated while preventing escape and avoidance of situations in which panic occurs. There was little evidence that additional teaching of behavioural coping strategies would be useful in reducing agoraphobic avoidance.

SELF-FOCUSED ATTENTION: COMMONALITIES ACROSS PSYCHOPATHOLOGIES AND PREDICTORS

2001 ◽  
Vol 29 (2) ◽  
pp. 169-178 ◽  
Author(s):  
Janet Woodruff-Borden ◽  
Andrew J. Brothers ◽  
Sally C. Lister
Keyword(s):  
Problem Solving ◽  
Panic Disorder ◽  
Negative Relationship ◽  
Primary Diagnosis ◽  
Focused Attention ◽  
Affective States ◽  
Significant Relationships ◽  
Causal Direction ◽  
Clinical Syndromes ◽  
The Relationship

Self-focused attention, also thought of a self-absorption, has been linked to a variety of affective states and clinical syndromes, including depression, panic disorder, social anxiety, schizophrenia, and alcoholism. Ingram (1990b) has suggested that self-focus may be a “nonspecific process” that is common across psychopathologies. Studies with nonclinical samples have supported this contention, and the current study assessed whether self-focus was common across various clinically diagnosed groups. A second issue, given this commonality, was to examine the factors across diagnostic conditions to which self-focus was related. One hundred and thirty-eight outpatients were included, and were divided into three groups based on primary diagnosis: “depression”, “panic”, and “other anxiety”. They were assessed with the ADIS-R/IV and completed measures assessing self-focus, affective states, global psychopathology, and problem-solving. Self-focus was common across groups, with minor valence variations. Severity of primary diagnosis predicted total self-focus, with level of depression and trait anxiety predicting negative self-focus. Correlational analyses suggested that self-focused attention is related to general measures of psychopathology and severity, and negatively related to problem-solving. The pattern with negative self-focus was even more pronounced, with significant relationships to all measures of psychopathology, clinician-rated severity, and a negative relationship with problem-solving. Results are discussed in terms of differences between “normal” and problematic self-focus, the causal direction in the relationship between self-focus and negative affect, and the link between self-focus and problem-solving.

The relationship between agoraphobia symptoms and panic disorder in a non-clinical sample of adolescents

2003 ◽  
Vol 33 (4) ◽  
pp. 733-738 ◽  
Author(s):  
C. HAYWARD ◽  
J. D. KILLEN ◽  
C. B. TAYLOR
Keyword(s):  
Anxiety Disorder ◽  
Panic Disorder ◽  
Anxiety Sensitivity ◽  
Separation Anxiety ◽  
Clinical Sample ◽  
Negative Affectivity ◽  
Separation Anxiety Disorder ◽  
Panic Attacks ◽  
Clinical Samples ◽  
Clinical Correlates

Background. The purpose of this study was to evaluate the clinical correlates of agoraphobic fear and avoidance and panic disorder in a non-clinical sample of adolescents.Method. In a sample of 2365 high school students, combined data from a questionnaire and a structured clinical interview were used to classify subjects with agoraphobic fear and avoidance. Panic symptoms, major depression, childhood separation anxiety disorder, anxiety sensitivity and negative affectivity were also assessed.Results. Fifteen subjects met study criteria for agoraphobic fear and avoidance in the past year. Only three (20%) of those with agoraphobia symptoms reported histories of panic attacks and there was no overlap between those with agoraphobic fear and avoidance and the 12 subjects who met DSM-III-R criteria for panic disorder. However, subjects with agoraphobia symptoms and those with panic disorder reported similar levels of anxiety sensitivity and negative affectivity. Childhood separation anxiety disorder was more common among those with agoraphobic fear and avoidance compared to those without.Conclusion. Agoraphobic avoidance is rare in non-clinical samples of adolescents and usually not associated with panic attacks. However, adolescents with agoraphobia symptoms and those with panic disorder have similar clinical correlates consistent with a panic/agoraphobia spectrum model.

Acceptance Mediates the Relationship Between Tinnitus-Related Cognitions and Anxiety Sensitivity

2015 ◽  
Vol 24 (2) ◽  
pp. 235-242 ◽  
Author(s):  
John Moring ◽  
Anne Bowen ◽  
Jenifer Thomas ◽  
Jeremy Joseph
Keyword(s):  
Emotional Distress ◽  
Anxiety Sensitivity ◽  
Emotional Responses ◽  
Hierarchical Regression ◽  
Sensitivity Index ◽  
Negative Cognitions ◽  
Acceptance And Action Questionnaire ◽  
Bodily Sensations ◽  
The Relationship ◽  
Online Measures

Purpose Negative cognitions related to tinnitus sensation have been previously shown to affect the level of emotional distress. Anxiety sensitivity is another psychological factor that influences individuals to more closely monitor their own bodily sensations, resulting in increased negative cognitions and negative emotional responses among tinnitus patients. However, increasing acceptance of tinnitus sensation may attenuate emotional distress. The goal of this research was to investigate the relationship between negative tinnitus-related cognitions, acceptance, and anxiety sensitivity. Method Two hundred sixty-seven participants completed online measures of the Tinnitus Handicap Inventory (Newman, Jacobson, & Spitzer, 1996), Acceptance and Action Questionnaire (Hayes, Follette, & Linehan, 2004), and the Anxiety Sensitivity Index–3 (Taylor et al., 2007). Results Hierarchical regression analyses indicated that acceptance fully mediated the relationship between negative tinnitus-related cognitions and anxiety sensitivity. Conclusions On the basis of these results, it is suggested that practitioners improve acceptance of tinnitus sensation, duration, and intensity. More research is warranted on the clinical techniques to improve acceptance.

scholarly journals Panic attacks simulate presence of somatic illnesses

2009 ◽  
Vol 62 (3-4) ◽  
pp. 165-170 ◽  
Author(s):  
Milan Latas ◽  
Ivan Soldatovic ◽  
Marko Stamenovic ◽  
Vladan Starcevic
Keyword(s):  
Panic Disorder ◽  
Respiratory Symptoms ◽  
Somatic Symptoms ◽  
Primary Diagnosis ◽  
Panic Attacks ◽  
Study Results ◽  
Somatic Illness ◽  
Specific Association ◽  
Cardio Vascular ◽  
Relationship Of

Introduction. Panic attacks are characterized with sudden attacks of anxiety with numerous somatic symptoms, such as palpitations, tachycardia, tachypnea, nausea, vertigo. The objective of this study was to analyze symptoms of panic attacks in patients with panic disorder, especially, to determine the specific relationship of somatic and neurological symptoms of panic attacks in boundaries of somatic systems. Material and methods. The study sample consisted of 97 patients with primary diagnosis of panic disorder, without any acute, severe and unstable somatic illness. The presence and frequency of symptoms of panic attacks were estimated by the Panic Disorder Questionnaire. Results. The study results indicate that the most frequent symptoms of panic attacks were cardiological signs (heart pounding or racing) and trembling, followed by unsteady and fainting feeling symptoms, sweating, respiratory symptoms and gastroenterological symptoms. The results of correlation analyses indicate that symptoms of panic attacks classified into cardio-vascular, gastro-enterological, respiratory and neuro-otological systems show statistically significant correlations. Conclusion. The results of analyses of symptoms of panic attacks point to their intercorrelation. This specific association of the symptoms, if they are examined on their own in the patients, could lead to false clinical manifestation of some somatic illness. Therefore, it is necessary to analyze adequately and make the proper differential diagnosis of patients with panic disorder.

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