Anxiety sensitivity

Anxiety sensitivity (AS) refers to the fear of sensations experienced in anxiety-related situations. In other terms, bodily sensations related to anxiety are misattributed as a negative experience causing more intense sensations. For example, a person may fear having an increased heart rate because they believe that will increase their chance of having a heart attack.

History
Anxiety sensitivity was introduced by Reiss and McNally in 1985. In years prior, many theorists had developed their own constructs of anxiety sensitivity. Sigmund Freud stated, “What the patient actually fears is the occurrence of such an attack under the special conditions in which he cannot escape it.” In 1987 Otto Fenichel agreed when he proposed, “Many anxiety hysterias develop out of such an experience, a fear of anxiety, and simultaneously a readiness to become frightened very easily, which may create a vicious cycle.” These concepts led Reiss and McNally to take the forefront on anxiety sensitivity research.

Method of Measurement
Today, a comprehensive test, known as the ASI-R, Anxiety Sensitivity Index Revised, is used to understand the basic dimensions and hierarchic structure of anxiety sensitivity. It includes 36 questions to be answered using a scale from 1 to 5 where 1 represents strong disagreement and 5 represents strong agreement. The middle of the scale signifies neither agreement nor disagreement. The ASI-R contains 6 subscales assessing the following domains:


 * 1) fear of cardiovascular symptoms
 * 2) fear of respiratory symptoms
 * 3) fear of gastrointestinal symptoms
 * 4) fear of publicly observable anxiety reactions
 * 5) fear of dissociative and neurological symptoms
 * 6) fear of cognitive dyscontrol

The subscales assess each of the domains of anxiety sensitivity. The hierarchy of these domains has been demonstrated using factor analysis. This hierarchy is important because it supports the idea that anxiety sensitivity can be deconstructed into simpler, independent factors that each contribute to the overall phenomenon of anxiety sensitivity. Fear of gastrointestinal symptoms and fear of dissociative and neurological symptoms failed to form distinct factors.

Potential Limitations
As of 1999, the limitations of the ASI-R questionnaire were :


 * 1) It is unknown whether or not the ASI-R scale is appropriate for comparing clinical and nonclinical populations.
 * 2) Test-retest reliability of the ASI-R and its factors.

Studies
Anxiety sensitivity may be linked to anxiety disorders such as panic disorder. One study has indicated that smoking decreased anxiety in people who smoked during stressful situations. There is still much to be learned about anxiety sensitivity as there are continuous studies revealing new, in depth and informative information.