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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 current investigation examined the singular and interactive effects of anxiety sensitivity (AS) and perceived control over anxiety-related events in the prediction of panic symptoms using a biological challenge paradigm. Two hundred and twenty-nine participants (mage = 21.02, SD = 7.55, 124 females) were recruited from the greater Burlington, Vermont community. Results indicated that pre-challenge AS, but not perceived control over anxiety-related events, significantly predicted post-challenge panic attack symptoms, anxiety focused on bodily sensations, and interest in returning for another challenge (behavioral avoidance). There were no interactive effects between AS and perceived control over anxiety-related events. For the physiological measures, pre-challenge AS was predictive of change in skin conductance level (pre-post challenge), and pre-challenge perceived control over anxiety-related events was predictive of change in respiration rate (breathes per minute). No significant effects were evident for heart rate and there were no significant interactive effects between AS and perceived control over anxiety-related events for any of the physiological variables. Findings of the investigation are discussed in relation to the role of AS and perceived control over anxiety-related events in terms of vulnerability for panic psychopathology.

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.

Anxiety sensitivity (AS) is associated with health behaviors such as low rates of physical activity, overeating, alcohol use, and poor sleep; however, interventions targeting AS via exercise-based interoceptive exposure have not assessed these as outcomes. In addition, previous studies are limited by brief follow-up periods. This study aimed to replicate previous aerobic exercise interoceptive exposures with an extended (6-week) follow-up and measurement of health behaviors. Participants were 44 sedentary young adults with elevated AS randomized to intervention (6 20-minute sessions of moderate-intensity treadmill walking) or assessment-only control. Assessments took place at baseline, week 2 (post-treatment), week 4, and week 8 with measurements of AS (ASI-3), physical activity (7-Day PAR), sleep (ISI), binge eating, alcohol use, depression (PHQ-8), anxiety (GAD-7), and stress (PSS-4). The intervention condition demonstrated a marginally significant reduction in AS compared to control at week 4 which eroded by week 8. There were no significant between-group differences for health behavior change. The intervention condition demonstrated decreases in depression, general anxiety, and perceived stress compared to control, but these effects eroded by week 4. There was no difference in findings for participants with BMI<25 vs. those with BMI>=25. Findings indicate that a brief intervention might not be sufficient to produce lasting changes in AS without additional treatment. Intervention effects were not as strong in this study compared to previous reports, which may be due to the size and greater racial/ethnic diversity of the current sample. Future research should objectively measure physical activity and explore individual variability in treatment response.

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).

Anxiety sensitivity, defined as the fear of anxiety-related sensations and their consequences (Reiss & McNally, 1985), has been consistently shown to be associated with risk for anxiety psychopathology as well as other mental health problems. The primary objective of the present secondary prevention trial sought to examine strategies to reduce anxiety sensitivity among persons with elevated anxiety sensitivity by testing the singular and combined efficacy of two commonly used strategies in multi-component interventions for reducing anxiety sensitivity: (a) anxiety psychoeducation emphasizing the benign nature of stress and (b) interoceptive exposure (i.e. repeated inhalations of 35% CO₂ gas mixture). To provide a stringent control for non-specific effects associated with anxiety psychoeducation and interoceptive exposure with CO₂, two control strategies were included in the study design: general health and nutrition education and repeated inhalations of regular room air. Utilizing a 2X2 design, participants were randomly assigned to receive an education component and intervention sessions consisting of one of two gas mixtures. The current study did not support the relative efficacy of hypothesized active intervention strategies. Rather, all conditions led to significant reductions in anxiety sensitivity. In addition, within-condition effect sizes for conditions in the present study were comparable to effect sizes of active interventions that were efficacious in previous research. Findings from the present study support that anxiety sensitivity is malleable following brief, cost-efficient interventions and these reductions are maintained over a one-month follow-up period. Data from the present study suggest that in the presence of stringent control conditions, hypothesized active intervention strategies provided little additional benefit. The present study has implications for methodological considerations for future secondary prevention trials for the reduction of anxiety sensitivity. The absence of stringent control groups might lead to premature conclusions that reductions in anxiety sensitivity are due to the specific effects of active interventions. Further research is needed to elucidate specific effects of intervention strategies for the reduction of anxiety sensitivity in at risk populations in order to refine secondary prevention interventions aimed to reduce risk for psychopathology. / text

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.