The hypothesis that anxiety sensitivity (AS) is a risk factor for panic genesis has obtained compelling support, but the clinical/practical importance of AS in panic genesis has been questioned. In addition, the association between panic experience and AS increase has not been clearly demonstrated. Through this 1-year longitudinal study among college students, the authors replicated the vulnerability effect of AS on panic onset. By measuring AS according to its hierarchical structure, the authors found an AS subfactor—AS-Mental Incapacitation Concerns—to be a significant predictor of panic onset. The authors also demonstrate that AS is not only statistically significant but also clinically/pragmatically important for the onset of panic. The association between panic and increased AS was confirmed in this study, although it remains for future research to conclude whether this association should be attributed to a “scar effect” of panic. Theoretical and methodological issues regarding tests of the scar effect hypothesis are discussed.
Barlow, D. (1988). Anxiety and its disorders (1st ed.). New York: Guilford.
2.
Barlow, D. (2002). Anxiety and its disorders (2nd ed.). New York: Guilford.
3.
Beck, A., & Emery, G. (1985) Anxiety disorders & phobias: A cognitive perspective. New York: Basic.
4.
Bernstein, A., Zvolensky, M. J., Weems, C., Stickle, T., & Leen-Feldner, E. W. (2005). Taxonicity of anxiety sensitivity: An empirical test among youth. Behaviour Research and Therapy, 43, 1131-1155.
5.
Blais, M. A., Otto, M. W., Zucker, B. G., McNally, R. J., Schmidt, N. B., Fava, M., et al. (2001). The anxiety sensitivity index: item analysis and suggestions for refinement. Journal of Personality Assessment, 77, 272-294.
6.
Bouton, M., Mineka, S., & Barlow, D. (2001). A modern learning theory perspective on the etiology of panic disorder. Psychological Review, 108, 4-32.
7.
Brown, T. A., & Cash, T. F. (1989). The phenomenon of panic in nonclinical populations: Further evidence and methodological considerations. Journal of Anxiety Disorders, 3, 139-148.
8.
Bruce, T. J., Spiegel, D. A., Gregg, S. F., & Nuzzarello, A. (1995). Predictors of alprazolam discontinuation with and without cognitive behavior therapy in panic disorder. American Journal of Psychiatry, 152, 1156-1160.
9.
Carver, C. S., & White, T. L. (1994). Behavioral inhibition, behavioral activation, and affective responses to impending reward and punishment: The BIS/BAS scales. Journal of Personality and Social Psychology, 67, 319-333.
10.
Clark, D. M. (1986). A cognitive approach to panic disorder. Behaviour Research and Therapy, 24, 461-470.
11.
Cohen, J., Cohen, P., West, S. G., & Aiken, L. S. (2003). Applied multiple regression/correlation analysis for the behavioral sciences. Mahwah, NJ: Lawrence Erlbaum.
12.
Cox, B. J. (1996). The nature and assessment of catastrophic thoughts in panic disorder. Behavioural Research and Therapy, 34, 363-374.
13.
Cronbach, L. J. (1956). Assessment of individual differences. Annual Review of Psychology, 7, 173-196.
14.
Elder, G. H. (1969). Occupational mobility, life patterns, and personality. Journal of Health and Social Behavior, 10, 308-323.
15.
Fowles, D. C. (1987). Application of a behavioral theory of motivation to the concepts of anxiety and impulsivity. Journal of Research in Personality, 21, 417-435.
16.
Gerrits, M. H., van den Oord, E., & Voogt, R. (2001). An evaluation of nonresponse bias in peer, self, and teacher ratings of children’s psychosocial adjustment. Journal of Child Psychology and Psychiatry, 42, 593-602.
17.
Goldstein, A. J., & Chambless, D. L. (1978). A reanalysis of agoraphobia. Behaviour Therapy, 9, 47-59.
18.
Hayward, C., Killen, J. D., Kraemer, H. C., Blair-Greiner, A., Strachowski, D., Cunning, D., et al. (1997). Assessment and phenomenology of nonclinical panic attacks in adolescent girls. Journal of Anxiety Disorders, 11, 17-32.
19.
Hayward, C., Killen, J. D., Kraemer, H. C., & Taylor, C. B. (2000). Predictors of panic attacks in adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 39, 207-214.
20.
Hirschfeld, R. M., Klerman, G. L., Lavori, P., Keller, M. B., Griffith, P., & Coryell, W. (1989). Premorbid personality assessments of first onset of major depression. Archive of General Psychiatry, 46, 345-350.
21.
Kazdin, A. E., Kraemer, H. C., Kessler, R. C., Kupfer, D. J., & Offord, D. R. (1997). Contributions of risk-factor research to developmental psychopathology. Clinical Psychology Review, 17, 375-406.
22.
Kendler, K. S., Neale, M. C., Kessler, R. C., Heath, A. C., & Eaves, L. J. (1993). A longitudinal twin study of personality and major depression in women. Archives of General Psychiatry, 50, 853-862.
23.
Lilienfeld, S. O. (1997). The relation of anxiety sensitivity to higher and lower order personality dimensions: Implications for the etiology of panic attacks. Journal of Abnormal Psychology, 106, 539-544.
24.
Maier, W., Lichtermann, D., Klingler, T., Heun, R., & Hallmayer, J. (1992). Prevalences of personality disorders (DSM-III-R) in the community. Journal of Personality Disorder, 6, 187-196.
25.
McDonald, R. P. (1999). Test theory: A unified treatment. Mahwah, NJ: Lawrence Erlbaum.
26.
Nagelkerke, N. J. D. (1991). A note on general definition of the coefficient of determination. Biometrika, 78, 691-692.
27.
Norton, G. R., Harrison, B., Hauch, J., & Rhodes, L. (1985). Characteristics of people with infrequent panic attacks. Journal of Abnormal Psychology, 94, 216-221.
28.
Peterson, R. A., & Reiss, S. (1992). Anxiety sensitivity index manual (2nd ed.). Worthington, OH: International Diagnostic Systems.
29.
Reiss, S., & McNally, R. J. (1985). Expectancy model of fear. In S. Reiss & R. R. Bootzin (Eds.), Theoretical issues in behavior therapy (pp. 107-121). San Diego, CA: Academic Press.
30.
Reiss, S., Peterson, R. A., Gursky, D. M., & McNally, R. J. (1986). Anxiety sensitivity, anxiety frequency and the predictions of fearfulness. Behaviour Research and Therapy, 24, 1-8.
31.
Revelle, W. (1979). Hierarchical cluster analysis and the internal structure of tests. Multivariate Behavioral Research, 14, 57-74.
32.
Roberts, B. W., Caspi, A., & Moffitt, T. (2003). Work experiences and personality development in young adulthood. Journal of Personality and Social Psychology, 84, 582-593.
33.
Roy, A. (2002). Childhood trauma and neuroticism as an adult: Possible implication for the development of the common psychiatric disorders and suicidal behaviour. Psychological Medicine, 32, 1471-1474.
34.
Schmidt, N. B., Lerew, D. R., & Jackson, R. J. (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.
35.
Schmidt, N. B., Lerew, D. R., & Jackson, R. J. (1999). Prospective evaluation of anxiety sensitivity in the pathogenesis of panic: Replication and extension. Journal of Abnormal Psychology, 108, 532-537.
36.
Schmidt, N. B., Lerew, D. R., & Joiner, T. E., Jr. (2000). Prospective evaluation of the etiology of anxiety sensitivity: Test of a scar model. Behaviour Research and Therapy, 38, 1083-1095.
37.
Spielberger, C. D. (1983). Manual for the State-Trait Anxiety Inventory (STAI). Palo Alto, CA: Consulting Psychologists Press.
38.
Stewart, S. H., Taylor, S., & Baker, J. M. (1997). Gender differences in dimensions of anxiety sensitivity. Journal of Anxiety Disorders, 11, 179-200.
39.
Taylor, J. A. (1953). A personality scale of manifest anxiety. Journal of Abnormal and Social Psychology, 48, 285-290.
40.
Watson, D., & Clark, L. (1992). Affects separable and inseperable: On the hierarchical arrangement of the negative affects. Journal of Personality and Social Psychology, 62, 489-505.
41.
Weems, C. F., Hayward, C., Killen, J., & Taylor, C. B. (2002). A longitudinal investigation of anxiety sensitivity in adolescence. Journal of Abnormal Psychology, 111, 471-477.
42.
Wonderlich, S. A., Crosby, R. D., Mitchell, J. E., Thompson, K. M., Redlin, J., Demuth, G., et al. (2001). Eating disturbance and sexual trauma in childhood and adulthood. International Journal of Eating Disorders, 30, 401-412.
43.
Zinbarg, R. E., & Barlow, D. H. (1996). The structure of anxiety and the anxiety disorders: A hierarchical model. Journal of Abnormal Psychology, 105, 181-193.
44.
Zinbarg, R. E., Barlow, D. H., & Brown, T. A. (1997). The hierarchical structure and general factor saturation of the Anxiety Sensitivity Index: Evidence and implications. Psychological Assessment, 9, 277-284.
45.
Zinbarg, R. E., Brown, T. A., Barlow, D. H., & Rapee, R. M. (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, 110, 372-377.
46.
Zinbarg, R. E., & Mohlman, J. (1998). Individual differences in the acquisition of affectively valenced associations. Journal of Personality and Social Psychology, 74, 1024-1040.
47.
Zinbarg, R. E., Mohlman, J., & Hong, N. N. (1999). Dimensions of anxiety sensitivity. In S. Taylor (Ed.), Anxiety sensitivity: Theory, research, and treatment of the fear of anxiety (pp. 83-114). Mahwah, NJ: Lawrence Erlbaum.
48.
Zinbarg, R., Revelle, W., Yovel, I., & Li, W. (2005). Cronbach’s α, Revelle’s β, and McDonald’s ωh: Their relations with each other and two alternative conceptualizations of reliability. Psychometrika, 70, 1-11.
