Análisis psicométrico del Índice de Sensibilidad a la Ansiedad en Escolares de la Ciudad de Arequipa

Introducción: La sensibilidad a la ansiedad es un constructo poco conocido, y que sin embargo tiene un importante valor clínico, por ser un potente predictor de los trastornos de ansiedad, tanto en niños, como adolescentes y adultos. En Perú existen pocas pruebas psicométricas que evalúan la ansiedad en niños, y menos aún sobre sensibilidad a la ansiedad. Objetivo: En esta investigación se realiza un análisis psicométrico del Índice de Sensibilidad para Niños con la finalidad de estimar la validez y la confiabilidad de esta prueba que no ha sido aplicada en población peruana. Método: Se tomó una muestra no probabilística de 568 escolares de entre 8 y 12 años de cinco instituciones educativas de la ciudad de Arequipa, en Perú. Los datos se procesaron mediante el Análisis Factorial Confirmatorio de Grupo Múltiple utilizando el programa R. Resultados: Los resultados confirmaron una estructura de dos factores: Miedo a las sensaciones corporales y Miedo a síntomas mentales y sociales, con índices de confiabilidad aceptables calculados mediante la prueba Omega de McDonald. Conclusión: Se concluye que la prueba es válida y confiable, pero se sugiere profundizar en el análisis psicométrico de este instrumento.

Introduction: The anxiety sensitivity is a few known theoretical construct, although it has a relevant clinical worth, because it is a powerful predictor of the anxiety disorders, so as in children, as in adolescents and adults. Moreover, in Peru there are few psychometric tests that assess children anxiety, and even fewer about anxiety sensitivity. Objective: In this research, it was made a psychometric analysis of the Childhood Anxiety Sensitivity Index (CASI) with the aim to estimate the validity and reliability of this test that has not been applied in Peruvian population. Method: A non-probabilistic sample of 568 students among 8 and 12 years old was assessed of five elementary school from Arequipa City, in Peru. The data was processed with multiple group confirmatory factor analysis by R program. Results: The results confirm a two factors structure: Fear of body sensations and Fear of mental and social symptoms, with acceptable reliability indexes calculated by McDonald's Omega Test. Conclusion: The conclusion is that the CASI is valid and reliable; perhaps it is suggested to investigate another psychometric properties of this test.

Analysis of Influencing Factors of Perceived Stress among Frontline Nurses under the Background of COVID-19 / 中国医学伦理学

To explore the influencing factors of perceived stress among frontline nurses during COVID-19, and the role of positive psychological capital in anxiety sensitivity and stress perception, so as to provide evidence for reducing the perceived stress of frontline nurses. From December 2021 to January 2022, 475 frontline nurses from 8 hospitals in X city were investigated by general data questionnaire, positive psychological capital, anxiety sensitivity index and perceived stress scale. The results showed that there were significant differences in nurses’ perceived stress in age, working years, professional title and salary. Perceived stress was positively correlated with anxiety sensitivity, negatively correlated with positive psychological capital, and anxiety sensitivity was negatively correlated with positive psychological capital. Anxiety sensitivity can not only directly predict perceived stress, but also negatively affect perceived stress through positive psychological capital. Therefore, during the epidemic prevention and control in COVID-19, nurses can obtain effective stress coping strategies by strengthening their positive psychological capital, thus reducing their anxiety and perceived stress, and better providing high-quality nursing services for patients.

Transdiagnostic Model of Anxiety and Depression According to the Relationship with Affect, Intolerance of Uncertainly, and Anxiety Sensitivity / Modelo transdiagnóstico de ansiedad y depresión según la relación con el afecto, intolerancia a la incertidumbre y sensibilidad a la ansiedad

Abstract The transdiagnostic model allows explaining and developing treatments based on the etiology and maintenance factors of comorbid psychopathologies; however, the relationships between its explanatory variables still require investigation. The purpose of this paper was to develop a structural model that includes these transdiagnostic variables: positive and negative affect, intolerance to uncertainty and anxiety sensitivity, in emotional problems such as anxiety and depression. Quantitative research was carried out with an explanatory cross-sectional design in which a structural network of relationships between constructs was defined using a diagram of paths and structural equations. 486 Colombians between the ages of 20 and 40 were intentionally randomly sampled. The following instruments were used to assess the fitting of the model: Positive and Negative Affect Scale (PANAS), Anxiety Sensitivity Index-3 (ASI-3), Intolerance of Uncertainty Scale (IUS), Beck Anxiety Inventory (BAI) and Beck Depression Inventory, second edition, Spanish version (BDI-II). The results showed significant correlations between transdiagnostic and symptomatic variables (depression and anxiety symptoms), using an adjusted model that explained the predictive capacity of anxiety sensitivity with anxiety symptoms, and intolerance of uncertainty with depression symptoms, both transdiagnostic variables associated with positive and negative affect as predictors of anxious and depressive emotional symptoms (R2 = .74).

Resumen El modelo transdiagnóstico permite explicar y desarrollar tratamientos basados en la etiología y factores mantenedores de las psicopatologías comórbidas, no obstante, las relaciones entre sus variables explicativas aún requieren investigación. El objetivo del presente trabajo fue desarrollar un modelo estructural que incluye las variables transdiagnósticas: afecto positivo y negativo, intolerancia a la incertidumbre y sensibilidad a la ansiedad, en problemas emocionales como ansiedad y depresión. Se llevó a cabo una investigación cuantitativa con un diseño transversal explicativo en el cual se definió una red estructural de relaciones entre constructos mediante un diagrama de senderos y ecuaciones estructurales. Se conformó una muestra no probabilística intencional de 486 colombianos entre 20 y 40 años. Para evaluar el ajuste del modelo se utilizaron los siguientes instrumentos: Positive and Negative Affect Scale (PANAS), Anxiety Sensitivity Index-3 (ASI-3), Intolerance Uncertainty Scale (IUS), Beck Anxiety Inventory (BAI) y Beck Depression Inventory, second edition, Spanish version (BDI-II). Los resultados indicaron correlaciones significativas entre las variables transdiagnósticas y las sintomáticas (síntomas de depresión y ansiedad), mediante un modelo ajustado que permitió explicar la capacidad predictiva de la sensibilidad a la ansiedad con los síntomas de ansiedad, y la intolerancia a la incertidumbre con los síntomas de depresión, ambas variables transdiagnósticas asociadas al afecto positivo y negativo como predictores de los síntomas emocionales ansiosos y depresivos (R2 = .74).

Psychometric properties of the Iranian version of the Anxiety Sensitivity Index-3 (ASI-3) / Propriedades psicométricas da versão iraniana da Anxiety Sensitivity Index-3 (ASI-3)

Abstract Introduction: Anxiety sensitivity plays a prominent role in the etiology of anxiety disorders. This construct has attracted widespread interest from experts and researchers. The Anxiety Sensitivity Index (ASI-3) is the most common scale for measuring anxiety sensitivity. Objective: To analyze the psychometric properties and factor structure of the ASI-3 in Iranian student samples. Methods: 220 students (135 women, 85 men) from Kermanshah University of Medical Sciences were selected by the convenience sampling method to evaluate the psychometric properties and analyze the factor structure of the ASI-3. The subjects were also asked to complete the Acceptance and Action Questionnaire-II (AAQ-II), Whiteley Index, Intolerance of Uncertainty, and Neuroticism scales. LISREL and SPSS were used to analyze the data. Cronbach's alpha and correlation coefficients were calculated and confirmatory factor analysis was conducted. Results: The results of the confirmatory factor analysis revealed a three-factor structure with physical, cognitive, and social components (comparative fit index = 0.94; normed fit index = 0.91; root mean square error of approximation = 0.09). The ASI-3 had positive and significant correlations with health anxiety (0.59), intolerance of uncertainty (0.29), and neuroticism (0.51). Furthermore, the ASI-3 had a negative and significant correlation with the AAQII (-0.58). Cronbach's alpha coefficients for the whole scale and for the physical, cognitive, and social concerns factors were 0.90, 0.74, 0.79, and 0.78, respectively. The invariance of the index was significant compared to the original English version. Conclusion: In general, the results support the adequacy of the psychometric properties of the Persian version of the ASI-3. Theoretical and applied implications will be discussed.

Resumo Introdução: A sensibilidade à ansiedade desempenha um papel proeminente na etiologia dos transtornos de ansiedade. Esse construto tem atraído grande interesse entre especialistas e pesquisadores. O Anxiety Sensitivity Index (ASI-3; em português, Escala de Sensibilidade à Ansiedade) é a medida mais utilizada para medir sensibilidade à ansiedade. Objetivo: Analisar as propriedades psicométricas e a estrutura fatorial do ASI-3 em estudantes iranianos. Métodos: Para avaliar as propriedades psicométricas e analisar a estrutura fatorial do ASI-3, 220 estudantes (135 mulheres, 85 homens) da Kermanshah University of Medical Sciences, Irã, foram selecionados via amostragem por conveniência. Eles foram solicitados a completar os seguintes instrumentos: Acceptance and Action Questionnaire-II (AAQ-II), Whiteley Index, Intolerance of Uncertainty e Neuroticism. Os programas LISREL e SPSS foram utilizados para analisar os dados. Alfa de Cronbach e coeficientes de correlação foram calculados, e foi realizada análise fatorial confirmatória. Resultados: Os resultados da análise fatorial confirmatória revelaram uma estrutura de três fatores, incluindo componentes físicos, cognitivos e sociais [comparative fit index (CFI) = 0,94; normed fit index (NFI) = 0,91; root mean square error of approximation (RMSEA) = 0,09]. O ASI-3 demonstrou correlações positivas e significativas com ansiedade em relação à saúde (0,59), intolerância à incerteza (0,29) e neuroticismo (0,51). Além disso, o ASI-3 teve uma correlação negativa e significativa com o AAQII (-0,58). Os coeficientes alfa de Cronbach para toda a escala e para os fatores preocupação física, cognitiva e social foram 0,90, 0,74, 0,79 e 0,78, respectivamente. A invariância do índice foi significativa em relação à versão original. Conclusão: Em geral, os resultados sugerem que as propriedades psicométricas da versão persa do ASI-3 são adequadas. Implicações teóricas e práticas serão discutidas.

Clinical Characteristics of Female Panic Disorder Patients with Abortion History

OBJECTIVES: The objective of this study is to investigate differences in clinical characteristics between female panic disorder (PD) patients with abortion history (PD+A) and without abortion history (PD−A).METHODS: We examined data from 341 female patients diagnosed with PD. We divided the patients with PD into PD+A (82 patients) and PD−A (259 patients) to compare demographic and clinical characteristics. The following instruments were applied : stress coping strategies, NEO-neuroticism, the Anxiety Sensitivity Index-Revised (ASI-R), the Albany Panic and Phobia Questionnaire (APPQ), the Beck Depression Inventory, the Beck Anxiety Inventory (BAI) and the Sheehan Disability Scale.RESULTS: Compared to the PD−A, the PD+A group showed no significant difference in coping strategies. However, significantly higher scores in neuroticism, the ASI-R, the APPQ and the BAI were observed. In terms of health-related disability, the PD+A group did not show significant difference.CONCLUSIONS: Our results suggest that the PD+A group may differ from the PD−A group in trait markers such as neuroticism and anxiety sensitivity, and abortion history may be associated with panic-related symptom severity. Our study suggests that further consideration is needed on such clinical characteristics in PD patients with abortion history.

Anxiety Sensitivity and Quality of Life in Patients with Acne

BACKGROUND: Anxiety sensitivity (AS) is a continuous fundamental fear and defined as extreme fear of anxiety sensations and symptoms. High AS can cause tendency to anxiety disorders. There are many studies evaluating the anxiety in patients with acne; however, AS has not been investigated. OBJECTIVE: We aimed to investigate AS in patients with acne. METHODS: Two hundred and fourteen acne patients and 117 healthy control subjects, aged older than 16 years were enrolled in the study. Severity of acne was evaluated by Global Acne Grading System. The acne patients and healthy controls were asked to complete the anxiety sensitivity index-3 (ASI-3), the Beck anxiety inventory (BAI) and the Turkish version of acne quality of life index. RESULTS: Anxiety and AS levels in acne patients were significantly higher than healthy controls (p<0.001). Quality of life was impaired in acne patients. Quality of life was negatively correlated with anxiety and AS levels in acne patients (p=0.014, p=0.019, respectively). There was no correlation between quality of life and disease severity (p=0.556) and also there was no correlation between psychiatric scale scores (ASI-3, BAI) and disease severity (p=0.147, p=0.871, respectively). CONCLUSION: To our knowledge, our study is the first to report that AS is high in acne patients. Clinically, our results suggest that there might be a relationship between AS and acne. We conclude that further studies are needed in order to clarify the relationship between acne and AS and to investigate the efficacy of cognitive behavioral treatments in acne patients.

The relationships among impulsivity, anxiety sensitivity and nonsuicidal self-injury characteristics in patients with phobias

Abstract Background: The relationship between impulsivity and nonsuicidal self-injury (NSSI) has been revealed in several mental disorders other than phobias. Objectives: The purpose of this study was to examine the relationships among impulsivity, anxiety sensitivity, and NSSI characteristics in patients with phobias, and to compare these relationships with healthy controls. Methods: The sample of this study consisted of outpatients (n = 109) who had been diagnosed with social phobia, agoraphobia or simple phobia in addition to healthy individuals (n = 51) serving as the control group. Data collection tools were the socio-demographic form, the Barratt Impulsivity Scale (BIS-11), the Inventory of Statements About Self-Injury (ISAS), and the Anxiety Sensitivity Index (ASI-3). Results: Mean BIS-11 and ASI-3 scores in the social phobia and agoraphobia groups were found to be significantly higher than those in the control group. In addition, a positive correlation was found between ISAS and cognitive anxiety sensitivity scores in the agoraphobia and simple phobia groups. Discussion: The study revealed a positive correlation between cognitive anxiety sensitivity and NSSI in both the agoraphobia and simple phobia groups. The results of this study indicate that anxiety sensitivity may play a regulatory role between impulsivity and NSSI in some sub-groups of phobia.

Sensibilidade à ansiedade e transtorno de pânico: avaliação do impacto da terapia cognitivo-comportamental em grupo / Anxiety sensitivity and panic disorder: assessment of the impact of group cognitive behavioral therapy

O transtorno de pânico (TP) é caracterizado pela presença de ataques súbitos de ansiedade e sensação de medo intenso. Embora haja tratamento efetivo com medicações e terapia cognitivo-comportamental (TCC), muitos pacientes tratados apresentam resposta parcial e tendem à cronicidade. A sensibilidade à ansiedade (SA) é um constructo multidimensional que expressa preocupações físicas, sociais e cognitivas da ansiedade, considerada uma tendência específica a reagir com medo aos sintomas de ansiedade. A SA tem sido associada à gênese e à manutenção dos sintomas do TP, porém ainda são escassos estudos que avaliam se a TCC em grupo (TCCG) modifica tal condição. Os objetivos deste estudo foram: 1) avaliar o impacto da TCCG na SA em pacientes com TP; 2) verificar a associação entre as características sociodemográficas e clínicas (comorbidades, uso de medicação, gravidade do TP) relacionadas à SA; 3) verificar as variáveis clínicas relacionadas à mudança da SA após a TCCG; 4) analisar a SA e suas dimensões como preditor de resposta à TCCG. Trata-se de um ensaio clínico controlado para avaliação da SA em pacientes com TP que realizaram 12 sessões de TCCG comparados ao grupo controle sem a intervenção. A gravidade dos sintomas foi avaliada antes e depois da TCCG no grupo intervenção e uma vez no grupo controle. Utilizou-se a Escala de gravidade do TP (PDSS), a Impressão Clínica Global (CGI), a Hamilton Ansiedade (HAM-A), o Inventário de Ansiedade de Beck (BAI) e o Inventário de Depressão de Beck (BDI). Para avaliar a SA, foi utilizada a Escala de Sensibilidade à Ansiedade-Revisada (ESA-R) com quatro fatores: fator 1 − medo de sintomas respiratórios e cardiovasculares; fator 2 − medo de descontrole cognitivo; fator 3 − medo de que as reações à ansiedade sejam observadas publicamente; fator 4 − medo de sintomas gastrintestinais. O estudo foi aprovado pelo Comitê de Ética em Pesquisa do Hospital de Clínicas de Porto Alegre (nº 14-0379). Os pacientes assinaram o termo de consentimento livre e esclarecido (TCLE). A amostra foi composta por 89 sujeitos, com média de idade de 37,9 (DP=10,6) anos. Observou-se associação significativa entre a SA mais elevada em pacientes com comorbidade com agorafobia e sintomas mais elevados de ansiedade e de depressão. Um total de 37 (42%) pacientes participou do grupo intervenção e 52 (58%) pacientes do grupo controle. Houve melhora significativa em todos os sintomas específicos do TP, da ansiedade geral e dos sintomas depressivos. A SA também sofreu redução significativa em todos os fatores após a intervenção quando comparada aos escores iniciais, com tamanho de efeito (TE) de moderado a grande. Quando comparada a SA do grupo controle e do grupo intervenção após a TCCG, os escores da ESA-R diminuíram significativamente em todos os fatores e no total. Ou seja, a SA modifica-se com a TCCG tanto em termos de intragrupo intervenção quanto em termos de escores do grupo controle. Os resultados deste estudo confirmaram que a relação entre a SA é maior em pacientes com TP mais graves. Também foi evidenciada a eficácia da TCCG na redução das dimensões física, cognitiva e social da SA, confirmando a hipótese do impacto positivo da TCCG para a modificação desse quadro.

Panic disorder (PD) is characterized by the presence of sudden attacks of anxiety and intense fear sensation. Although there are effective treatments with medications and cognitivebehavioral therapy (CBT), many treated patients present partial response and tend to chronicity. Anxiety sensitivity (AS) is a multidimensional construct that expresses physical, social and cognitive anxiety concerns, considered a specific tendency to react with fear to the symptoms of anxiety. AS has been associated with the genesis and maintenance of PD symptoms, but there are still few studies evaluating whether CBT in group (CBT-G) modifies such condition. The objectives of this study were: 1) to evaluate the impact of CBT-G on AS in patients with PD; 2) to verify the association between sociodemographic and clinical characteristics (comorbidities, medication use, severity of PD) related to AS; 3) to verify the clinical variables related to the change in AS after CBT-G; 4) to analyze AS and its dimensions as a predictor of response to CBT-G. This is a controlled clinical trial for the evaluation of AS in patients with PD who performed 12 sessions of CBT-G compared to the control group without the intervention. The severity of the symptoms was evaluated before and after the CBT-G in the intervention group and once in the control group. We used the PD Severity Scale (PDSS), Clinical Global Impression (CGI), Hamilton Anxiety (HAM-A), Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). In order to evaluate the AS, the Anxiety Sensitivity Index-Revised (ASI-R) was used with four factors: factor 1 - fear of respiratory and cardiovascular symptoms; factor 2 - fear of cognitive uncontrol; factor 3 - fear that reactions to anxiety could be publicly observed; factor 4 - fear of gastrointestinal symptoms. The study was approved by the Research Ethics Committee of the Hospital de Clínicas of Porto Alegre (nº 14-0379). Patients signed the informed consent form (TCLE). The sample consisted of 89 subjects, with a mean age of 37.9 (SD = 10.6) years. A significant association was observed between the highest AS in patients with comorbidity with agoraphobia and higher anxiety and depression symptoms. A total of 37 (42%) patients participated in the intervention group and 52 (58%) patients in the control group. There was a significant improvement in all the specific symptoms of PD, general anxiety and depressive symptoms. AS also had a significant reduction in all factors after the intervention when compared to the initial scores, with moderate to large effect size (ES). When compared to AS of the control group and the intervention group after the CBT-G, ASI-R scores decreased significantly in all factors and in the total. That is to say, AS is modified with CBT-G both in terms of intragroup intervention and in terms of scores of the control group. The results of this study confirmed that the relationship between AS is higher in patients with more severe PD. The effectiveness of CBT-G in reducing the physical, cognitive and social dimensions of AS was also evidenced, confirming the hypothesis of the positive impact of CBT-G for the modification of this condition.

Effects of Anxiety Sensitivity and Hearing Loss on Tinnitus Symptom Severity

OBJECTIVE: The aim of the present study was to examine the relative role of anxiety sensitivity and hearing loss on the tinnitus symptoms severity in a large clinical sample of patients with tinnitus. METHODS: A total of 1,705 patients with tinnitus who visited the tinnitus clinic underwent the pure-tone audiometric testing and a battery of self-report questionnaires. Multiple linear regression analyses were performed to identify the relationship of anxiety sensitivity and hearing loss to tinnitus symptoms severity. RESULTS: Both anxiety sensitivity and hearing loss were a significant association with of annoyance (anxiety sensitivity β=0.11, p=0.010; hearing loss β=0.09, p=0.005) and THI score (anxiety sensitivity β=0.21, p < 0.001; hearing loss β=0.10, p < 0.001) after adjusting for confounding factors. Meanwhile, the awareness time (β=0.19, p < 0.001) and loudness (β=0.11, p < 0.001) of tinnitus was associated with only the hearing loss but not with anxiety sensitivity CONCLUSION: Our results indicate that both hearing loss and anxiety sensitivity were associated with increased tinnitus symptom severity. Furthermore, these associations could be different according to the characteristics of tinnitus symptoms.

RORA Polymorphism Interacts with Childhood Maltreatment in Determining Anxiety Sensitivity by Sex: A Preliminary Study in Healthy Young Adults

OBJECTIVE: Recent studies have reported associations of retinoid-related orphan receptor alpha (RORA) gene single nucleotide polymorphisms (SNPs) with depression and anxiety disorders. Based on these, we attempt to test whether RORA polymorphism is associated with anxiety sensitivity (AS), the intermediate phenotype of depression and anxiety disorders. Considering gene-environment interactions and sex differences in AS, childhood maltreatment (CM) and sex were considered as confounders. METHODS: Two-hundred and five healthy young Korean adults (female: 98, male: 107; age, 23.0±3.2 years) completed genotyping for the RORA SNP rs11071547, as well as measures for AS and CM. Generalized linear models were used to examine the main and interaction effects of RORA genotype, CM, and sex in determining AS. RESULTS: The main effect of RORA polymorphisms was not found (p=0.760) whereas the main effect of CM and interaction effects among sex, genotype, and maltreatment were significant on AS. In separate analyses by sex, the interaction effect between RORA genotype and maltreatment was significant only in males (p < 0.001). In females, the main effects of genotype and CM were significant (both were p < 0.001), in which both a history of CM and C genotype tended to be associated with higher AS. CONCLUSION: The association between RORA polymorphism and AS might differ by sex. The interaction between RORA polymorphism and CM was significant only in males whereas RORA genotype and CM independently associated with AS in females. Further studies are encouraged to confirm the relationship between RORA polymorphism and AS.

Variables relacionadas con ansiedad social en adolescentes: un modelo de regresión lineal múltiple / Variables related to socialanxiety in adolescents: a multiple linear regression model

El objetivo fue construir un modelo de regresión múltiple para investigar la relación entre ansiedad social, sensibilidad a la ansiedad, rasgo de ansiedad y miedo a la evaluación negativa, y comparar hombres con mujeres. La investigación fue cuantitativa, no experimental, correlacional y transversal. Se evaluó a 689 adolescentes entre 14 y 19 años (M=16.45; DE=1.11), a través de la escala de Ansiedad Social para Adolescentes (SAS-A), la subescala Ansiedad-Rasgo del Inventario de Ansiedad Rasgo-Estado (STAI), la versión breve de escala de Miedo a la Evaluación Negativa (BFNE) y el Índice de Sensibilidad a la Ansiedad-3 (ASI-3). El género femenino presentó mayor media en ansiedad rasgo con tamaño de efecto pequeño (d=-.27). Las correlaciones fueron positivas entre bajas y moderadas. La correlación parcial y semiparcial más alta fue entre SAS-A y ASI. Se construyó un modelo de regresión válido y estadísticamente significativo y explicó el 41.2% de la varianza de la ansiedad social (R2=.412) con tamaño de efecto grande.

The objective was to build a multiple regression model to investigate the relationship between social anxiety, anxiety sensitivity, trait anxiety and fear of negative evaluation, and to compare men and women. The research was quantitative, not experimental, correlational and cross-sectional. 689 adolescents between 14 and 19 years (M=16.45; SD=1.11) were evaluated, through the Social Anxiety Scale for Adolescents (SAS-A), the trait subscale of the Trait Anxiety Inventory-State (STAI), the Brief Fear of Negative Evaluation Scale (BFNE) and Anxiety Sensitivity Index-3 (ASI-3) were applied. Female gender showed higher mean in trait anxiety with small effect size (d=-.27). Correlations were positive from low to moderate. The higher partial and semipartial correlation was between SAS-A and ASI. A valid regression model and statistically significant was constructed and explained 41.2% of the variance of social anxiety (R2=.412) with large effect size.

Anxiety Sensitivity and Comorbid Psychiatric Symptoms over the Course of Cognitive Behavioural Therapy for Panic Disorder.

Aims: Anxiety sensitivity (AS) might be the core vulnerability in the pathogenesis of AXIS I diagnosis and might be the important transdiagnostic target for the interventions for comorbid psychiatric symptoms in panic disorder (PD). This study aimed to examine the relationship of changes in the three factors of AS and changes in comorbid psychiatric symptoms over the course of cognitive behavioural therapy (CBT) for PD. Methodology: One hundred eighteen patients with PD were treated with manualized group CBT. Using multiple regression analysis, we examined the associations between the changes in subscales of Symptom Checklist-90 Revised (SCL-90-R) and the changes in factors of the Anxiety Sensitivity Index (ASI) involving Physical Concerns, Mental Incapacitation Concerns, and Social Concerns over the course CBT. Results: Reductions in Mental Incapacitation Concerns of ASI were related to decreases in 8 SCL-90-R scales, including Obsessive-Compulsive, Interpersonal Sensitivity, Depression, Hostility, Phobic Anxiety, Paranoid Ideation, Psychoticism, and GSI. Reductions in Physical Concerns were related to decreases in 5 SCL-90-R scales, including Somatization, Depression, Anxiety, Phobic Anxiety, and GSI. Discussion: The present study suggests that reductions in AS, especially mental and physical dimensions, predict comorbid psychiatric symptoms reduction over the course of CBT for PD.

The characteristics of attentional bias in high anxiety sensitivity individuals / 中华行为医学与脑科学杂志

Objective To investigate the characteristics and mechanisms of attentional bias in anxiety sensitivity individuals.Methods By using Anxiety Sensitivity Index (ASI),23 participants were included in the high score group and 20 participants were included in the low score group.Then,2 (between-subject factor:the high and low score group) ×2 (within-subject factor:the positive and negative picture) mixed design experiments were adopted.Emotional faces picture pairs were chosen as stimuli.Picture pairs were presented 100 ms in experiment 1 and 1 250 ms in experiment 2.Dot-probe task was adopted to inspect the attentional bias and the response time and correct rate were recorded.Results Experiment 1 implied the main effect of type of pictures was found in mixed design experiments(F(1,41)=4.40,P＜0.05).The reaction time of two groups in positive pictures was greater than zero((12.22±30.24) ms vs (10.07±21.55) ms).It showed input effect to positive pictures.An input effect due to the reaction time of the high score group was greater than zero to negative pictures((4.81± 17.88)ms),while the low score group tended to avoid the negative pictures ((-6.81 ±21.33) ms).Experiment 2 implied positive score was not significant between two groups (F(1,41) =0.29,P＞0.05).And positive score showed the attentional bias to some certain extent.Significant outcome was found by negative score between two groups (F(1,41) =6.41,P＜0.05).It implied that the high score group tended to avoid the negative pictures and the low score group had the tendency of input effect.Conclusion At the initial stage of attention,anxiety sensitivity individuals had the attentional bias to negative emotional faces and avoidance in the late stage of attention.It suggests that the attentional bias of anxiety sensitivity individuals may have an important effect on the development of the mental disorders.

Factors Associated with Treatment Outcomes in Mindfulness-Based Cognitive Therapy for Panic Disorder

PURPOSE: Although the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for panic disorder (PD) has been studied previously, data on the predictors of treatment outcomes in MBCT for PD are scarce. MATERIALS AND METHODS: Eighty patients with PD were screened to analyze treatment outcomes such as MBCT completion, treatment response, and remission after undergoing MBCT for PD. Sociodemographic characteristics, comorbid personality disorders, and baseline medication doses were examined. The study administered the Panic Disorder Severity Scale, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale and Anxiety Sensitivity Inventory-Revised to patients at baseline and at eight weeks. RESULTS: Sixty-five participants were enrolled in the present study. Comorbid personality disorder was significantly associated with MBCT non-completion. We found that anxiety sensitivity (AS) improvement after an eight week MBCT program was a statistically significant factor associated with treatment response. Using logistic regression analysis, AS improvement after MBCT showed significant association with PD remission after MBCT. CONCLUSION: Comorbid personality disorders of participants could be a potential predictor of MBCT non-completion. Furthermore, AS improvement after MBCT may predict treatment response and remission after MBCT for PD. However, better designed studies with a larger number of patients are needed to confirm our findings.

Reliability and convergent validity of the Childhood Anxiety Sensitivity Index in children and adolescents / Confiabilidade em validade convergente da Childhood Anxiety Sensitivity Index em crianças e adolescentes

OBJECTIVE: The purpose of this study was to examine the reliability and the convergent validity of the Children Anxiety Sensitivity Index (CASI) with DSM-IV anxiety disorder symptoms, by comparison with the Screen for Child Anxiety Related Emotional Disorders (SCARED), in a community sample of Brazilian children and adolescents. METHODS: Children and adolescents from five schools were selected from a larger study that aimed to assess different aspects of childhood anxiety disorders. All participants completed the CASI and the SCARED. RESULTS: This study supported the reliability of the CASI total score. Girls reported higher total anxiety sensitivity scores than boys and there were no differences in total anxiety sensitivity scores between children and adolescents. This study showed moderate to high correlations between the CASI scores with SCARED scores, all correlations coefficients being positive and significant. CONCLUSIONS: Our findings demonstrate an appropriate reliability and evidence of convergent validity in the CASI in a sample of Brazilian children and adolescents.

OBJETIVO: O objetivo deste estudo foi examinar a confiabilidade e a validade convergente da Children Anxiety Sensitivity Index (CASI) com sintomas de transtornos de ansiedade de acordo com o DSM-IV, por meio da comparação com a Screen for Child Anxiety Related Emotional Disorders (SCARED). MÉTODOS: Crianças e adolescentes provenientes de cinco escolas foram selecionados de uma amostra de um estudo maior que avaliava diferentes aspectos dos transtornos de ansiedade. Todos os participantes completaram a CASI e a SCARED. RESULTADOS: Esse estudo demonstrou a confiabilidade do escore total da CASI. Meninas apresentaram escores de sensibilidade à ansiedade mais altos do que meninos e não houve diferença nos escores totais de sensibilidade de ansiedade entre crianças e adolescentes. Esse estudo encontrou correlações de moderada a alta entre os escores da CASI e os escores da SCARED, sendo todas as correlações positivas e significativas. CONCLUSÕES: Nossos achados demonstraram uma confiabilidade apropriada e evidência de validade convergente da CASI em uma amostra de crianças e adolescentes brasileiros.

Reliability and validity of Chinese revision of anxiety sensitivity index-revised among patients with anxiety disorders / 第二军医大学学报

Objective To evaluate the reliability and validity of the Chinese version of the anxiety sensitivity index-revised(ASI-CR) among patients with anxiety disorders. Methods A total of 68 patients with anxiety disorders were interviewed using anxiety sensitivity index-revised (ASI-R), trait anxiety inventory (T-AI), Hamilton anxiety scale (HAMA) and ASI-CR; the reliability and validity of ASI-CR were examined. Results Internal consistency of ASI-CR and each factor was 0.77-0.89 and the split-half reliability was 0.67-0.88. The internal correlation coefficient between factors was 0.51-0.65, the correlation coefficient between factors and the total score was 0.83-0.89, and internal correlation coefficient among factors was 0.60-0.90. The correlation coefficient between the total score and factor scores of ASI-CR and total score of ASI-R was 0.76-0.97, and the correlation coefficient between factor scores of ASI-CR and corresponding factor score of ASI-R was 0.78-0.97. The total score and two factor (physical concern and cognitive concern) score of ASI-CR in anxiety patients were significantly higher than the norm (P<0.01). Exploratory factor analysis revealed that the three lower-order ASI-CR factors contributed 65.06% of the total variance. Factor loading of items was 0.51-0.88, but the items were unevenly distributed among factors. Two items had low loading to cognitive concern factor (0.22, 0.48). Conclusion The ASI-CR displays satisfactory reliability, criterion validity and content validity among anxiety patients, but further research is needed to improve its structural validity.

Korean Anxiety Sensitivity Index-3: Its Factor Structure, Reliability, and Validity in Non-Clinical Samples

OBJECTIVE: The aim here is to examine the factorial structure, internal consistency, and concurrent validity of the Korean version of the Anxiety Sensitivity Index-3 (K-ASI-3) in student samples in Korea. Also, we investigated the cross-cultural differences in the Social Concerns factor. METHODS: K-ASI-3 was administered to non clinical samples in Korea. Internal consistency, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) were undertaken to examine the factorial structure and reliability of the K-ASI-3. RESULTS: Results from CFA comparing our data to factor solutions commonly reported as representative of European-American samples indicated an adequate fit. The K-ASI-3 showed good performance on the indices of internal consistency and concurrent validity. In addition, using regression analyses, we found the Social Concerns factor is most strongly related to life satisfaction and worry. However, we found no evidence that Korean college students express more Social Concerns than their European Caucasian counterparts. CONCLUSION: The authors demonstrate that the K-ASI-3 has highly internally consistent and psychometrically sound items, and that it reliably measures three lower-order domains assessing Physical, Social, and Cognitive Concerns.

Difference in Anxiety Sensitivity Among Anxiety Disorder Groups / 신경정신의학

OBJECTIVES : The present study aimed to compare anxiety sensitivity among anxiety disorder groups, and to examine the relationships between lower-order factors of anxiety sensitivity and each anxiety disorder. METHODS : Three hundred and twenty four normal control subjects and 212 patients with anxiety disorders were enrolled in this study. All subjects completed a psychometric assessment package including the Korean Anxiety Sensitivity Index-Revised (ASI-R) test. Statistical analysis of the two groups was performed using the Mann-Whitney U test, and comparison of anxiety sensitivity amongthe anxiety-disorder groups (panic disorder-PD, general anxiety disorder-GAD, social phobia- SP, obsessive-compulsive disorder-OCD) was investigated using Kruskal-Wallis test. RESULTS : All anxiety disorder groups showed higher total scores of the ASI-R than did the normal control group (Z=-13.724, pSP,OCD), fear of respiratory symptoms (PD>GAD, SP,OCD), and fear of publicly observable anxiety reactions (SP>PD,OCD) among the anxiety disorder groups. CONCLUSION : These results suggest that anxiety sensitivity reflects vulnerability to anxiety disorders, and that lower-order factors of the ASI-R may help in the differential diagnosis of anxiety disorders.

Difference in Anxiety Sensitivity Among Anxiety Disorder Groups / 신경정신의학

OBJECTIVES : The present study aimed to compare anxiety sensitivity among anxiety disorder groups, and to examine the relationships between lower-order factors of anxiety sensitivity and each anxiety disorder. METHODS : Three hundred and twenty four normal control subjects and 212 patients with anxiety disorders were enrolled in this study. All subjects completed a psychometric assessment package including the Korean Anxiety Sensitivity Index-Revised (ASI-R) test. Statistical analysis of the two groups was performed using the Mann-Whitney U test, and comparison of anxiety sensitivity amongthe anxiety-disorder groups (panic disorder-PD, general anxiety disorder-GAD, social phobia- SP, obsessive-compulsive disorder-OCD) was investigated using Kruskal-Wallis test. RESULTS : All anxiety disorder groups showed higher total scores of the ASI-R than did the normal control group (Z=-13.724, pSP,OCD), fear of respiratory symptoms (PD>GAD, SP,OCD), and fear of publicly observable anxiety reactions (SP>PD,OCD) among the anxiety disorder groups. CONCLUSION : These results suggest that anxiety sensitivity reflects vulnerability to anxiety disorders, and that lower-order factors of the ASI-R may help in the differential diagnosis of anxiety disorders.

Comparison of Claustrophobia, Noise Sensitivity and Vital Signs according to Anxiety Sensitivity Level before and after MRI / 성인간호학회지

PURPOSE: The present study was conducted in order to examine claustrophobia, noise sensitivity and vital signs according to anxiety sensitivity level in patients who have Magnet Resonance Imaging(MRI). METHODS: With 100 outpatients, we measured anxiety sensitivity, claustrophobia, noise sensitivity and vital sign before and after MRI. Measuring tools were ASI, CLQ-M, and NSI. Data were collected from February to March, 2008. RESULTS: The ASI score was higher in women than in men(p < .05), and no statistically significant difference was observed according to age, region of scanning, experience in MRI, and the use of contrast agent. Both men and women patients showed the same ASI score and decrease in CLQ-M and NSI between before and after MRI. In women, ASI, CLQ-M and NSI were in positive correlation with one another(p < .001), and in men, there was no correlation between ASI and CLQ-M, and positive correlation was observed with NSI(p < .05). In comparison according to ASI level, blood pressure and pulse rate were not different in men and women. CLQ-M was not different in men, but was different in women(p < .001). NSI was different in both men and women(men p < .05; women p < .001). CONCLUSION: MRI may cause claustrophobia in patients with high anxiety sensitivity, and noise appears to aggravate anxiety. In particular, claustrophobia was more serious in women than in men. Therefore, it is necessary to develop nursing interventions to reduce anxiety sensitivity particularly for female patients, and to make plans to educate and lower noise before MRI in order to reduce claustrophobia.