Thesis (M.A.)--West Virginia University, 2001. / Title from document title page. Document formatted into pages; contains v, 51 p. Includes abstract. Includes bibliographical references (p. 37-41).

Despite the existence of evidence-based interventions for anxiety disorders, many barriers impede access to effective treatment services (e.g., distance from services, comorbidity). This dissertation aimed to investigate ways to overcome some of these barriers by exploring (1) the efficacy of therapist-supported distance cognitive behavior therapy (CBT) for anxiety disorders in adults, (2) the suitability of anxiety sensitivity (AS; a fear of arousal-related physiological sensations) as a target for transdiagnostic treatment, and (3) the efficacy of a distance CBT intervention for reducing high AS and its associated mental health and substance use symptoms. In Study 1, a systematic review showed that therapist-supported distance CBT was more efficacious than a waiting list and as efficacious as face-to-face CBT in reducing anxiety symptoms, increasing the likelihood of diagnostic remission, and improving quality of life. In Study 2, AS was associated with panic, posttraumatic stress, social phobia, and depressive symptoms. Of its lower order subscales, physical concerns predicted unique variance in panic, cognitive concerns predicted unique variance in depressive symptoms, and social phobia was predicted by social concerns. Together, Studies 1 and 2 suggest that distance CBT for anxiety is efficacious and that AS may be a suitable target for transdiagnostic interventions. As such, Studies 3 and 4 report on a randomized controlled trial investigating the efficacy and transdiagnostic implications of a telephone-delivered CBT intervention for high AS. The treatment significantly reduced AS relative to a waiting list and led to significant reductions in panic, posttraumatic stress, and social phobia symptoms (though not generalized anxiety or depressive symptoms). Treatment-related reductions in AS mediated these anxiety symptom changes. Participants in the treatment, vs. control, group also showed a significantly greater reduction in number of mental health diagnoses and in functional disability. Treatment also significantly reduced coping-with-anxiety drinking motives and physical alcohol-related problems for the treatment but not waiting list group. Reductions in AS mediated changes in coping-with-anxiety motives, while coping-with-anxiety motives mediated changes in physical alcohol-related problems. Taken together, findings from this dissertation provide evidence that distance-based and transdiagnostic AS-focused interventions may be two important and efficacious ways to overcome several barriers to anxiety treatment.

Thesis (M.A.)--University of Toronto, 2004. / Adviser: Jeanne Watson.

Misophonia is a decreased sound tolerance condition (DST) that is not yet well-established in the literature. However, the existing research on misophonia shows that it is occurring at substantial levels in the population. The majority of the existing literature has focused on the clinical correlates of misophonia. Although the correlates have been investigated, there is no accepted mechanism behind misophonia etiology or maintenance. The present study examined three hypotheses in order to start to identify potential mechanisms behind misophonia: how emotional predilections are related to the emotional response, how obsessive-compulsive disorder (OCD) symptoms and misophonia are related, and the possibility that the relationship between anxiety sensitivity (AS) and misophonia may be explained in part by the presence of OCD symptoms. Data were collected by Cash (2015) using both undergraduate students (N=451) and community participants (N = 377) using Amazon’s MTurk. Participants completed an online cross-sectional survey assessing for a number of decreased sound tolerance conditions, individual differences variables, and clinical variables. The current study specifically used measures of anxiety sensitivity, OCD, misophonia symptom severity, trait anger, and trait anxiety. Consistent with the literature on state-trait theory, trait emotion was predictive of state levels, such that trait anger was most predictive of an angry misophonic response and trait anxiety was most predictive of an anxious reaction to misophonic stimuli. Misophonia was more strongly related to obsessive than to compulsive components of OCD, consistent with case reports of obsessive thoughts in misophonia. Lastly, OCD symptoms partially mediated the relationship between AS symptom severity and misophonia symptom severity. These results supported our hypotheses, and align with the theorized role of anxiety sensitivity in OCD and in misophonia. Although the data are cross-sectional in nature, and causality cannot be confirmed, the current study provides a strong basis for future research into the mechanisms of misophonia.

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Anxiety is a mental illness that can have significant deleterious impacts on an individual’s functioning. Although anxiety has been studied in older adults, there is conflicting evidence on differences in anxiety as a function of age. Anxiety sensitivity is a construct that is positively related to anxiety but has limited research in older adults. Extant literature suggests that older adults experience less anxiety sensitivity than do younger adults. According to Socioemotional Selectivity Theory, this may be due to older adults letting go of the things that make them anxious. The current study proposed that age impacts self-rated anxiety such that it is lower in older adults than it is in middle-aged adults and posits that anxiety sensitivity may mediate the relationship between anxiety and age. The results suggested a significant indirect effect but no direct effect, precluding the presence of mediation. There was a significant relationship between age and anxiety sensitivity. Further examination revealed that the relationship between age and anxiety sensitivity was not significant for people under 60 years old, but it remained significant for participants 60 years and older.

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