Anxiety Sensitivity and Panic Symptomatology: The Mediator Role of Hypochondriacal Concerns

Article excerpt

The present study tests the mediating role of hypochondriasis to explain the relation between anxiety sensitivity and panic symptomatology. Fifty-seven outpatients with clinically significant levels of panic symptomatology were selected to participate in the study. Measures of anxiety sensitivity, hypochondriasis, and panic symptomatology were obtained from standardized, selfadministered questionnaires: the Anxiety Sensitivity Index (ASI; Reiss, Peterson, Gursky, & McNally, 1986), the Whiteley Index of Hypochondriasis (WI; Pilowsky, 1967), and the Panic- Agoraphobic Spectrum Self-Report (PAS-SR; Cassano et al., 1997; Shear et al., 2001). Regression analyses were performed to test for the mediation models. The results show that the effect of anxiety sensitivity on panic symptomatology is not significant when controlling the hypochondriacal concerns, whereas the latter predicted panic symptoms. This result holds for the overall ASI as well as for the Physical Concerns and the Mental Incapacitation Concerns dimensions of the ASI scale. No evidence of a direct relation between the Social Concerns dimension and panic symptoms was found. The findings suggest that hypochondriacal concerns might represent the mechanism through which anxiety sensitivity is able to influence panic symptoms.

Keywords: anxiety sensitivity, hypochondriacal concerns, panic-agoraphobic symptomatology, mediators

El objetivo del presente estudio es explorar el papel mediador de las preocupaciones hipocondríacas para explicar la relación entre la sensibilidad a la ansiedad y la sintomatología de pánico. Un total de 57 pacientes con niveles clínicamente significativos de sintomatología de pánico fueron seleccionados para participar en el estudio. Se han obtenido medidas de la sensibilidad a la ansiedad, mediante el Anxiety Sensitivity Index (ASI; Reiss, Peterson, Gursky, & McNally, 1986), la sintomatología de pánico, mediante la subescala Panic-like-symptoms del Panic-Agoraphobic Spectrum Self-Report (PAS-SR; Cassano et al., 1997; Shear et al., 2001), e hipocondríasis mediante el Whiteley Index of Hypochondriasis (WI, Pilowsky, 1967) y la subsescala Illness-related Phobia del PAS-SR. Se han llevado a cabo análisis de regresión para poner a prueba los modelos mediacionales. Los resultados obtenidos indican que el efecto de la sensibilidad a la ansiedad sobre la sintomatología de pánico no es significativo cuando se controlan las puntuaciones en hipocondríasis, si bien ésta última variable predice las puntuaciones en pánico. Dichos resultados se han obtenido sea para las puntuaciones totales en el ASI que para dos de las dimensiones que conforman la escala: preocupaciones relativas a problemas físicos y preocupaciones relativas a problemas mentales. La dimensión del ASI relacionada con preocupaciones de carácter social no se asocia con la sintomatología de pánico. Los resultados sugieren que las preocupaciones hipocondríacas podrían representar el mecanismo a través del cual la sensibilidad a la ansiedad ejerce un efecto sobre los síntomas de pánico.

Palabras clave: sensibilidad a la ansiedad, preocupaciones hipocondríacas, sintomatología de pánico-agorafobia, variables mediadoras

The present study examines the relation between anxiety sensitivity and hypochondriacal concerns among patients with panic symptomatology. Panic disorder has been recognized as a chronic disease with little spontaneous improvement and high rates of relapse after remission (Keller et al., 1994). Converging evidence indicates that panic symptomatology may also co-occur with other Axis I disorders affecting the presentation, course, and response to treatment of the major conditions (Feske et al., 2000; Frank et al., 2000, 2002; Noyes, Woodman, Bodkin, & Yagla, 2004).

A number of variables have been involved in the psychopathology of panic. In particular, both anxiety sensitivity and hypochondriacal concerns play a central role in the major psychological theories of panic. …


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