Anxiety Sensitivity and Panic-Related Symptomatology in a Representative Community-Based Sample: A 1-Year Longitudinal Analysis
Cox, Brian J., Taylor, Steven, Clara, Ian P., Roberts, Lance, Enns, Murray W., Journal of Cognitive Psychotherapy
Anxiety sensitivity is the fear of anxiety sensations based on beliefs that they have harmful physical, psychological, or social consequences. Anxiety sensitivity may represent a psychological vulnerability for panic attacks, but much of the research to date has been limited to selective college student or treatment-seeking samples. There is a paucity of research based on representative community-based samples. There is also a lack of longitudinal research in this regard. The current study addressed both of these issues by investigating the impact of anxiety sensitivity in a large community sample (N = 585) assessed longitudinally over a 1-year period. A hierarchical regression model was used to determine whether baseline scores on the Anxiety Sensitivity Index (ASI) could prospectively predict scores on the Beck Anxiety Inventory (BAI), a continuous scale that is largely a measure of panic-related symptomatology. Baseline BAI scores, neuroticism and stressful life events' main effects, their interaction, and the ASI were all significant predictors of Time 2 BAI scores. The results thereby show that anxiety sensitivity predicts subsequent panic-related symptomatology even after adjusting for the effects of neuroticism, stressful life events, and their interaction.
Keywords: anxiety sensitivity; panic attacks; neuroticism; stressful life events; anxiety
Anxiety sensitivity is defined as the fear of anxiety-related internal sensations based on the belief that these sensations have harmful physical, cognitive, or social consequences (Reiss, Peterson, Gursky, & McNally, 1986). A wealth of information has accumulated on the importance of anxiety sensitivity in understanding panic disorder and other emotional disorders (Taylor, 1995). Anxiety sensitivity is believed to represent a psychological vulnerability factor that is particularly important in panic disorder (Cox, 1996). However, most of the studies that attest to the role of anxiety sensitivity are cross-sectional in nature (Cox, Borger, & Enns, 1999; Zvolensky, Kotov, Antipova, & Schmidt, 2005), and the few longitudinal studies that are available (e.g., Hayward, Killen, Kraemer, & Taylor, 2000; Maller & Reiss, 1992) have relied on student and clinical samples rather than on representative community samples.
There are some noteworthy exceptions in regard to the cross-sectional design limitation. Schmidt, Lerew, and Jackson (1997) found that baseline anxiety sensitivity predicted the subsequent onset of panic attacks in air force cadets undergoing basic training. Schmidt, Lerew, and Jackson (1999) replicated these findings in a second independent sample of cadets. Another important exception is a study by Weems, Hayward, Killen, Barr, and Taylor (2002), who followed high school students over a 4-year period and found that anxiety sensitivity again predicted anxiety-related emotional distress.
The current study sought to build on this research literature and followed the methodology and design used in our previous research on psychological vulnerabilities and emotional distress (specifically, perfectionism, neuroticism, and depression-related outcome variables using the Winnipeg Area Study [WAS]). The WAS is an annual household survey of 750 community-dwelling adults conducted by the Department of Sociology at the University of Manitoba. It has proven to be a valuable research vehicle and it has been utilized in several previous studies of psychopathology (Cox, Kwong, Michaud, & Enns, 2000; Stein, Torgrud, & Walker, 2000; Stein, Walker, & Forde, 1996; Stein, Walker, & Forde, 2000; Stein, Walker, Hazen, & Forde, 1997). The purpose of the present study was to follow a large sample of community-dwelling residents in the WAS over a 1-year period. We also sought to test whether the specific psychological vulnerability of anxiety sensitivity could demonstrate a significant association with panic-related symptomatology even after adjusting for the broad personality domain or proneness to anxiety and other negative emotionality, namely neuroticism. …