Thesis (Ph. D.)--University of Texas at Austin, 2002. / Vita. Includes bibliographical references. Available also from UMI Company.

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Thesis (Ph.D.) in Psychology--University of Maine, 2009. / Includes vita. Includes bibliographical references (leaves 142-178).

Obesity has reached epidemic proportions, highlighting the need to better understand contributors to under-exercise and overeating. Anxiety Sensitivity (AS) is hypothesized to amplify negative affect and avoidance motives, and has been linked to maladaptive coping behaviors such as eating pathology as well as distress during and avoidance of exercise. The current series of studies was designed to extend research that relied on self-report assessments, and investigate the role of AS in objectively-assessed eating and exercise behavior across three community samples. The first two studies examined eating in the context of experimentally-induced negative affect in a sample representing all weight categories (N = 57); and distress, perceived exertion, and affect changes during exercise in normal and obese weight groups (N = 38). The third study extended this investigation to a naturalistic setting, using actigraphy, affect, and dietary monitoring across a three-day period in normal and obese weight groups (N = 32). The hypotheses were that AS would predict more eating in the context of negative affect; greater perceived exertion and distress during exercise, as well as avoidance of exercise, with findings most pronounced in obese participants. Results were as follows. In the first study, more calories consumed following a negative affect induction was predicted by the interaction between a dimension of AS (mental concern) and the expectancy of loss of control from eating in overweight/obese participants. In the second study, there was no significant association between AS and ratings of exertion or distress during exercise; however, a trend suggested the expected affective benefits of acute exercise were not evident in obese participants with greater AS and exertion. The final study found that AS was associated with more calories consumed across the monitoring period in women but not men (who were equally represented across AS and weight groups), and was also predictive of more calories consumed in the context of negative affect. Additionally, high AS predicted less engagement in moderate-intensity exercise in obese participants and more in normal weight participants. Overall, these studies provide support for the hypothesis that AS is a predictor of both exercise avoidance and overeating behavior.

Dissociation may be broadly described as a subjective experience in which information from the individual's internal or external environment is not appropriately integrated into conscious awareness, memory or identity. A number of studies have found an association between dissociative experience and anxious arousal, and in particular, between dissociation and trauma. Recent reviews suggest the existence of an unspecified mediating variable that accounts for these associations. The present study compared dissociative experiences reported by a community sample (N = 74) and a sample of individuals with a range of anxiety disorders (N = 20). The potential influence of anxiety sensitivity was a particular focus. Participants completed a battery of measures assessing dissociative experience, anxious arousal, social anxiety, generalised anxiety, panic and agoraphobia, traumatic experience and posttraumatic stress in addition to measures of anxiety sensitivity and substance use. Participants in the anxiety group reported a greater variety and frequency of dissociative experiences, particularly of experiences considered to be pathological in nature. Elevated dissociation scores were associated with somatic symptoms of anxiety, social anxiety, generalised anxiety, agoraphobia and posttraumatic stress. No association between trauma exposure and dissociation was evident; however, trauma intensity was associated with dissociation in the anxiety group. Symptoms of depersonalisation / derealisation and absorption were most strongly associated with increased anxiety. Anxiety Sensitivity accounted for more of the variance in dissociation scores than did measures of expressed anxiety. These results suggest that anxiety sensitivity may account for the relationship between trauma anxiety and dissociation. Therapeutic intervention directed at anxiety sensitivity, particularly fear of cognitive discontrol, may prove helpful in treating dissociative detachment.

Anxiety sensitivity is a cognitive, individual difference variable that is differentiated by an individual's fear of anxiety sensations and centred on the belief that such sensations result in harmful consequences. In order to test anxiety sensitivity, Reiss, Peterson, Gursky, and McNally (1986) developed the Anxiety Sensitivity Index (ASI). However, one contentious issue in the area concerns the factor analytic structure of anxiety sensitivity and this has important consequences for the construct. Numerous investigations have been conducted using the ASI, and the results have varied appreciably with some researchers arguing for a unidimensional construct. However the general consensus now is that anxiety sensitivity is multidimensional. It has been argued that the repeated attempts to clarify the dimensionality of anxiety sensitivity, using the 16-item ASI, is problematic because the scale was never designed to measure a multidimensional construct in the first instance. Thus, the objective of the dissertation was to critically examine the anxiety sensitivity construct by using an expanded, multidimensional measure of anxiety sensitivity referred to as the Anxiety Sensitivity Index - Revised ([ASI-R] Taylor & Cox, 1998) and establish the psychometric properties of the measure by conducting a series of empirical investigations to assess the clinical utility of the measure. A series of three empirical investigations are presented in the current dissertation. The first investigation aimed to critically examine the factor structure and psychometric properties of the ASI-R. Confirmatory factor analysis using a clinical sample of adults revealed that the ASI-R could be improved substantially through the removal of 15 problematic items in order to account for the most robust dimensions of anxiety sensitivity. The modified measure was re-named the 21-item Anxiety Sensitivity Index (21-item ASI) and re-analysed with a large sample of nonclinical adults, revealing configural and metric invariance across groups. Further, comparisons with other alternative models that also include comparisons with previous published ASI models indicated the 21-item ASI to be the best fitting model for both groups. There was also evidence of internal consistency, test-retest reliability, and construct validity for both samples. The aim of the second investigation was to critically examine differences between and within various anxiety classifications, a mood disorder classification, and a nonclinical control sample, with respect to both general and specific dimensions of anxiety sensitivity as identified by the 21-item ASI. In most instances, the results revealed that the differences between and within the diagnostic groups were consistent with theoretical expectations. Finally, the third investigation aimed to examine differences within each diagnostic category before and after cognitive behavioural therapy in order to provide a further test of validity for the revised 21-item ASI. The results revealed significant differences within all but one diagnostic group on the pre and post-treatment scores, using the global and specific dimensions of the 21-item ASI. The strengths, theoretical contribution, limitations, and directions for future research are discussed. It is concluded that the overall findings relating to the series of empirical investigations presented in the current dissertation make a significant and valid theoretical contribution to the field of anxiety sensitivity in particular, and anxiety research in general, by enhancing our understanding of anxiety sensitivity and how the 21-item ASI can be used to improve therapeutic interventions in clinical practice.

Dissociation may be broadly described as a subjective experience in which information from the individual's internal or external environment is not appropriately integrated into conscious awareness, memory or identity. A number of studies have found an association between dissociative experience and anxious arousal, and in particular, between dissociation and trauma. Recent reviews suggest the existence of an unspecified mediating variable that accounts for these associations. The present study compared dissociative experiences reported by a community sample (N = 74) and a sample of individuals with a range of anxiety disorders (N = 20). The potential influence of anxiety sensitivity was a particular focus. Participants completed a battery of measures assessing dissociative experience, anxious arousal, social anxiety, generalised anxiety, panic and agoraphobia, traumatic experience and posttraumatic stress in addition to measures of anxiety sensitivity and substance use. Participants in the anxiety group reported a greater variety and frequency of dissociative experiences, particularly of experiences considered to be pathological in nature. Elevated dissociation scores were associated with somatic symptoms of anxiety, social anxiety, generalised anxiety, agoraphobia and posttraumatic stress. No association between trauma exposure and dissociation was evident; however, trauma intensity was associated with dissociation in the anxiety group. Symptoms of depersonalisation / derealisation and absorption were most strongly associated with increased anxiety. Anxiety Sensitivity accounted for more of the variance in dissociation scores than did measures of expressed anxiety. These results suggest that anxiety sensitivity may account for the relationship between trauma anxiety and dissociation. Therapeutic intervention directed at anxiety sensitivity, particularly fear of cognitive discontrol, may prove helpful in treating dissociative detachment.

Dental anxiety is a major public health problem that leads to underutilization of dental care and poor oral health. Much research has demonstrated an association between the expectation of pain during dental treatment and dental anxiety; however, not all patients with high pain expectancy develop dental anxiety, suggesting that other factors may impact the degree to which pain expectancy increases dental anxiety. The present study examined whether anxiety sensitivity (AS; the fear of negative consequences of anxiety-related symptoms and sensations) increases the strength of the relationship between pain expectancy and dental anxiety. Participants were 104 adult patients of Temple University Kornberg School of Dentistry clinics. Baseline levels of AS and pain expectancy were assessed using self-report questionnaires. Baseline dental anxiety was assessed using self-report questionnaires and measures of psychological/physiological stress reactivity to films of dental procedures. Participants also underwent a pain expectancy induction, and all indices of dental anxiety were re-assessed following the pain expectancy induction. Linear regression analyses revealed that, in contrast to expectations, AS did not strengthen the relationship between self-reported or laboratory-induced pain expectancy and any indicators of dental anxiety. On the contrary, there was limited evidence that AS may weaken the pain expectancy-dental anxiety relationship. Consistent with previous studies, there was a strong pattern of findings supporting a direct association between pain expectancy and dental anxiety, but limited evidence of a direct association between AS and dental anxiety. AS may not be a strong risk candidate for dental anxiety, and future studies examining other theoretically-relevant vulnerability factors are needed to elucidate pathways through which pain expectancy leads to greater dental anxiety. / Psychology

Anxiety Sensitivity (AS) consists of beliefs that the experience of anxiety symptoms leads to illness or additional anxiety. The aim of the present study was to examine the factor structure of the Turkish version of Anxiety Sensitivity Index&amp / #8211 / Revised (ASI-R), and to investigate associations among AS, alcohol use and drinking motives in university students and alcohol dependent inpatients. The participants were 411 university students (225 females and 186 males) and 55 (3 females and 52 males) alcohol dependent inpatients. All participants were administered ASI-R, State-Trait Anxiety Inventory-Trait Form, Beck Depression Inventory, Drinking Motives Questionnaire-Revised, and Demographic Information Form. Exploratory factor analyses revealed four lower order factors of the ASI-R: (1) fear of respiratory symptoms / (2) fear of cardiovascular symptoms / (3) fear of cognitive dyscontrol / and (4) fear of publicly observable anxiety symptoms. ANOVA revealed that the frequency and amount of alcohol use were significantly higher in male students than females. Males reported more alcohol use for Coping and Conformity Motives than did females. Regression analyses revealed that only fear of cognitive dyscontrol significantly predicted hazardous alcohol use of students. Coping Motives significantly predicted alcohol use after controlling the effects of demographics, depression and ASI-R lower order factors in students using alcohol. Fear of publicly observable anxiety symptoms significantly predicted frequency of alcohol use in students using alcohol. Students reported using alcohol mostly for Enhancement, Social, Coping, and Conformity Motives, respectively. Students with high AS reported more alcohol use for Coping, Social and Conformity Motives than those with moderate and low AS. Fear of cognitive dyscontrol and fear of publicly observable anxiety symptoms explained a significant variance of drinking motives in students. In alcohol dependent inpatients, only fear of respiratory symptoms had a significant correlation with Coping Motives. Patients reported having used alcohol mostly for Coping, Enhancement, Social, and Conformity Motives, respectively. Coping and Enhancement Motives were significantly correlated with alcohol use. Results were discussed within the findings in the literature.

The aim of the present investigation was to evaluate the moderating role of the physical concerns domain of anxiety sensitivity (AS) in the relation between smoking rate and panic vulnerability variables, both concurrently and prospectively, among a community-based sample of 125 daily smokers (60 females; Mage = 26.02 years, SD = 10.98). As hypothesized, there was a significant interaction between AS Physical Concerns and smoking rate in relation to agoraphobic avoidance, such that at higher levels of AS Physical Concerns and higher smoking rates, there was a risk for increased agoraphobic avoidance (3.6% unique variance). Contrary to prediction, however, the interaction between AS Physical Concerns and smoking rate did not significantly predict the tendency to catastrophize about bodily sensations, body vigilance, or lifetime history of panic attacks. In regard to the prospective analyses, there was a significant interaction between AS Physical Concerns and smoking rate in relation to Time 2 anticipatory anxiety, such that at higher levels of AS Physical Concerns and higher rates of smoking, there was a significant risk for an increase in anticipatory anxiety over the three-month follow-up period (5% unique variance). Contrary to prediction, the interaction between AS Physical Concerns and smoking rate did not significantly predict the occurrence of panic attacks during the three month follow-up period. The current findings suggest that daily smokers smoking at higher rates with high AS Physical Concerns may be more prone to engage in avoidance (Time 1 findings) and show increases in worry about potentially threatening events in the future (Time 2 anticipatory anxiety findings). This interaction appears to be relatively specific to only some aspects of panic-relevant vulnerability factors. This pattern of findings may be used to conceptually guide the refinement of etiological models of panic vulnerability that involve smoking behavior.