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Cognitive Therapy and Research

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27.02.2024 | Original Article

What Does ‘High Anxiety Sensitivity’ Look Like? Using Cluster Analysis to Identify Distinct Profiles of High Anxiety Sensitive Treatment-Seekers

verfasst von: Janine V. Olthuis, Emma M. Connell, Margo C. Watt, Sherry H. Stewart

Erschienen in: Cognitive Therapy and Research | Ausgabe 2/2024

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Abstract

Background/Purpose

Anxiety sensitivity (AS) is a transdiagnostic risk factor for mental health disorders. While its lower order factors – social, physical, and cognitive concerns – and their associations with emotional disorders have been examined independently of each other, research has not fully appreciated that these factors might appear to different degrees in individuals, with psychopathology implications.

Methods

We used cluster analysis to investigate how the lower order AS factors appear in treatment-seekers with high AS and how these manifestations of AS (i.e., the different clusters) are uniquely associated with psychopathology. Participants (N = 154; from two studies) were high AS treatment-seeking adults with anxiety and/or depressive disorders who completed a diagnostic interview and self-report measures of AS and anxiety and depression symptoms.

Results

A four-cluster solution emerged including a Multidimensional cluster (33.8% of the sample) and Social (28.6%), Physical (21.4%), and Cognitive (16.2%) clusters. Validation analyses revealed cross-cluster differences in age, gender, ethnicity, and psychopathology, the latter reflecting known associations between AS and mental health (e.g., depression symptoms were significantly highest in the Cognitive and Multidimensional clusters).

Conclusions

Results provide valuable insight into the heterogeneity of high AS as it appears clinically, with implications for best matching treatment approaches for this population.

Agresti, A. (2002). Categorical data analysis (2nd ed.). Wiley. https://doi.org/10.1002/0471249688

Allan, N. P., Capron, D. W., Raines, A. M., & Schmidt, N. B. (2014). Unique relations among anxiety sensitivity factors and anxiety, depression, and suicidal ideation. Journal of Anxiety Disorders, 28(2), 266–275. https://doi.org/10.1016/j.janxdis.2013.12.004CrossRefPubMed

Allan, N. P., Albanese, B. J., Short, N. A., Raines, A. M., & Schmidt, N. B. (2015). Support for the general and specific bifactor model factors of anxiety sensitivity. Personality and Individual Differences, 74, 78–83. https://doi.org/10.1016/j.paid/2014.10.003CrossRef

Allan, N. P., Felton, J. W., Lejuez, C. W., MacPherson, L., & Schmidt, N. B. (2016). Longitudinal investigation of anxiety sensitivity growth trajectories and relations with anxiety and depression symptoms in adolescence. Development and Psychopathology, 28(2), 459–469. https://doi.org/10.1017/S0954579415000590CrossRefPubMed

Amarneh, D. Y., Trent, E. S., Zvolensky, M. J., & Viana, A. G. (2022). The relationship between anxiety sensitivity and PTSD symptom severity among trauma-exposed inpatient adolescents. Cognitive Therapy and Research, 46(4), 827–837. https://doi.org/10.1007/s10608-022-10294-0CrossRef

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998). Psychometric properties of the 42-item and 21-item versions of the Depression anxiety stress scales (DASS) in clinical groups and a community sample. Psychological Assessment, 10(2), 176–181. https://doi.org/10.1037/1040-3590.10.2.176CrossRef

Baek, I., Lee, E., & Kim, J. (2019). Differences in anxiety sensitivity factors between anxiety and depressive disorders. Depression and Anxiety, 36(10), 968–974. https://doi.org/10.1002/da.22948CrossRefPubMed

Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory – II. Psychological Corporation.

Capron, D. W., Norr, A. M., Macatee, R. J., & Schmidt, N. B. (2013). Distress tolerance and anxiety sensitivity cognitive concerns: Testing the incremental contributions of affect dysregulation constructs on suicidal ideation and suicide attempt. Behavior Therapy, 44(3), 349–358. https://doi.org/10.1016/j.beth.2012.12.002CrossRefPubMed

Caulfield, N. M., Martin, R. L., Norr, A. M., & Capron, D. W. (2021). The association between posttraumatic stress symptoms and anxiety sensitivity in a college sample. Psychological Reports, 124(4), 1539–1558. https://doi.org/10.1177/0033294120948227CrossRefPubMed

Clark, D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24(4), 461–470. https://doi.org/10.1016/0005-7967(86)90011-2CrossRefPubMed

Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100(3), 316–336. https://doi.org/10.1037/0021-843X.100.3.316CrossRefPubMed

Conrod, P. J., Stewart, S. H., Pihl, R. O., Cote, S., Fontaine, V., & Dongier, M. (2000). Efficacy of brief coping skills interventions that match different personality profiles of female substance abusers. Psychology of Addictive Behaviors, 14(3), 231–242. https://doi.org/10.1037/0893-164X.14.3.231CrossRefPubMed

Cox, B. J., Borger, S. C., & Enns, M. W. (1999). Anxiety sensitivity and emotional disorders: Psychometric studies and their theoretical implications. In S. Taylor (Ed.), Anxiety sensitivity: Theory, research, and treatment of the fear of anxiety (pp. 115–148). Erlbaum.

Dalmaijer, E. S., Nord, C. L., & Astle, D. E. (2022). Statistical power for cluster analysis. Bmc Bioinformatics, 23, 205. https://doi.org/10.1186/s12859-022-04675-1CrossRefPubMedPubMedCentral

Fetzner, M. G., Collimore, K. C., Carleton, R. N., & Asmundson, G. J. G. (2012). Clarifying the relationship between AS dimensions and PTSD symptom clusters: Are negative and positive affectivity theoretically relevant constructs? Cognitive Behaviour Therapy, 41(1), 15–25. https://doi.org/10.1080/16506073.2011.621971CrossRefPubMed

First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1997). Structured clinical interview for DSM–IV Axis I disorders: Clinician version. American Psychiatric.

First, M. B., Williams, J. B. W., Karg, R. S., & Spitzer, R. L. (2015a). Structured clinical interview for DSM-5: Research version. American Psychiatric Association.

First, M. B., Williams, J. B. W., Karg, R. S., & Spitzer, R. L. (2015b). User’s guide for the SCID-5-RV. American Psychiatric Association.

Hair, J. F., Andersen, R. E., Tatham, R. L., & Black, W. C. (2006). Multivariate data analysis. Prentice Hall.

Hinton, D. E., Pich, V., Safren, S. A., Pollack, M. H., & McNally, R. J. (2006). Anxiety sensitivity among Cambodian refugees with panic disorder: A factor analytic investigation. Journal of Anxiety Disorders, 20(3), 281–295. https://doi.org/10.1016/j.janxdis.2005.02.006CrossRefPubMed

Horenstein, A., Potter, C. M., & Heimberg, R. G. (2018). How does anxiety sensitivity increase risk of chronic medical conditions? Clinical Psychology: Science and Practice, 25(3), 12248. https://doi.org/10.1037/h0101753CrossRef

IBM Corp. (2021). IBM SPSS statistics for Windows, version 27.0. IBM Corp.

Intrieri, R. C., & Newell, C. B. (2022). Anxiety sensitivity not distress tolerance as a predictor of generalized anxiety symptoms and worry. Current Psychology: A Journal for Diverse Perspectives on Diverse Psychological Issues, 41(3), 1148–1158. https://doi.org/10.1007/s12144-020-00636-0CrossRef

Judah, M. R., Hager, N. M., Nako, K., & Blanchette, D. (2019). Gaze avoidance explains the association between anxiety sensitivity social concerns and social anxiety. International Journal of Cognitive Therapy, 12(3), 205–216. https://doi.org/10.1007/s41811-019-00050-wCrossRef

Jurin, T., & Biglbauer, S. (2018). Anxiety sensitivity as a predictor of panic disorder symptoms: A prospective 3-year study. Anxiety Stress & Coping: An International Journal, 31(4), 365–374. https://doi.org/10.1080/10615806.2018.1453745CrossRef

Kauffman, B. Y., Rogers, A. H., Garey, L., & Zvolensky, M. J. (2022). Anxiety and depressive symptoms among adults with obesity and chronic pain: The role of anxiety sensitivity. Cognitive Behaviour Therapy, 51(4), 295–308. https://doi.org/10.1080/16506073.2021.2011396CrossRefPubMedPubMedCentral

Kemper, C. J., Lutz, J., Bähr, T., Rüddel, H., & Hock, M. (2012). Construct validity of the anxiety sensitivity index – 3 in clinical samples. Assessment, 19(1), 89–100. https://doi.org/10.1177/1073191111429389CrossRefPubMed

Knapp, A. A., Blumenthal, H., Mischel, E. R., Badour, C. L., & Leen-Feldner, E. W. (2016). Anxiety sensitivity and its factors in relation to generalized anxiety disorder among adolescents. Journal of Abnormal Child Psychology, 44(2), 233–244. https://doi.org/10.1007/s10802-015-9991-0CrossRefPubMed

Lebeaut, A., Leonard, S. J., Healy, N., Raines, A. M., Buser, S. J., & Vujanovic, A. A. (2022). Associations between lower-order anxiety sensitivity facets and PTSD symptomatology among trauma-exposed firefighters. Behavior Modification, 46(2), 294–320. https://doi.org/10.1177/01454455211016819CrossRefPubMed

Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the Depression anxiety stress scales. The Psychological Foundation of Australia.

Marshall, G. N., Miles, J. N. V., & Stewart, S. (2010). Anxiety sensitivity and PTSD symptom severity are reciprocally related: Evidence from a longitudinal study of physical trauma survivors. Journal of Abnormal Psychology, 119(1), 143–150. https://doi.org/10.1037/a0018009CrossRefPubMedPubMedCentral

McNally, R. J. (1999). Theoretical approaches to the fear of anxiety. In S. Taylor (Ed.), Anxiety sensitivity: Theory, research, and treatment of the fear of anxiety (pp. 3–16). Erlbaum.

Naragon-Gainey, K. (2010). Meta-analysis of the relations of anxiety sensitivity to the depressive and anxiety disorders. Psychological Bulletin, 136(1), 128–150. https://doi.org/10.1037/a0018055CrossRefPubMed

Olatunji, B. O., & Wolitzky-Taylor, K. B. (2009). Anxiety sensitivity and the anxiety disorders: A meta-analytic review and synthesis. Psychological Bulletin, 135(6), 974–999. https://doi.org/10.1037/a0017428CrossRefPubMed

Ölmez, S. B., & Ataoğlu, A. (2019). The relationships among impulsivity, anxiety sensitivity, and severity of social anxiety disorder. Klinik Psikiyatri Dergisi: The Journal of Clinical Psychiatry, 22(1), 7–15.

Olthuis, J. V., & Asmundson, G. J. G. (2018). Optimizing outcomes for pain conditions by treating anxiety sensitivity. In J. A. J. Smits, M. W. Otto, M. B. Powers, & S. O. Baird (Eds.), The clinician’s guide to anxiety sensitivity treatment and assessment (pp. 77–100). Academic.

Olthuis, J. V., Watt, M. C., Mackinnon, S. P., & Stewart, S. H. (2014a). Telephone-delivered cognitive behavioral therapy for high anxiety sensitivity: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 82(6), 1005–1022. https://doi.org/10.1037/a0037027CrossRefPubMed

Olthuis, J. V., Watt, M. C., & Stewart, S. H. (2014b). Anxiety sensitivity index (ASI-3) subscales predict unique variance in anxiety and depressive symptoms. Journal of Anxiety Disorders, 28, 115–124. https://doi.org/10.1016/j.janxdis.201304.009CrossRefPubMed

Pérez-Benitez, C. I., Shea, M. T., Raffa, S., Rende, R., Dyck, I. R., Ramsawh, H. J., Edelen, O., M., & Keller, M. B. (2009). Anxiety sensitivity as a predictor of the clinical course of panic disorder: A 1-year follow-up study. Depression and Anxiety, 26(4), 335–342. https://doi.org/10.1002/da.20423CrossRef

Pilecki, B., Arentoft, A., & McKay, D. (2011). An evidence-based causal model of panic disorder. Journal of Anxiety Disorders, 25(3), 381–388. https://doi.org/10.1016/j.janxdis.2010.10.013CrossRefPubMed

Raines, A. M., Walton, J. L., McManus, E. S., Cuccurullo, L., Chambliss, J., Uddo, J., M., & Franklin, C. L. (2017). Associations between lower order anxiety sensitivity dimensions and DSM-5 posttraumatic stress disorder symptoms. Cognitive Behaviour Therapy, 46(2), 162–173. https://doi.org/10.1080/16506073.2016.1244559CrossRefPubMed

Rayner, C., Coleman, J. R. I., Purves, K. L., Carr, E., Cheesman, R., Davies, M. R., Delgadillo, J., Hubel, C., Krebs, G., Peel, A. J., Skelton, M., Breen, G., & Eley, T. C. (2021). Sociodemographic factors associated with treatment-seeking and treatment receipt: Cross-sectional analysis of UK Biobank participants with lifetime generalised anxiety or major depressive disorder. BJPsych Open, 7, e216. https://doi.org/10.1192/bjo.2021.1012CrossRefPubMedCentral

Reiss, S. (1991). Expectancy model of fear, anxiety, and panic. Clinical Psychology Review, 11(2), 141–153. https://doi.org/10.1016/0272-7358(91)90092-9CrossRef

Reiss, S., & McNally, R. J. (1985). The expectancy model of fear. In S. Reiss, & R. R. Bootzin (Eds.), Theoretical issues in behavior therapy (pp. 107–122). Academic.

Reiss, S., Peterson, R., Taylor, S., Schmidt, N., & Weems, C. F. (2008). Anxiety sensitivity index consolidated user manual: ASI, ASI-3, and CASI. International Diagnostic Services.

Rogers, A. H., Kauffman, B. Y., Bakhshaie, J., McHugh, R. K., Ditre, J. W., & Zvolensky, M. J. (2019). Anxiety sensitivity and opioid misuse among opioid-using adults with chronic pain. The American Journal of Drug and Alcohol Abuse, 45(5), 470–478.CrossRefPubMedPubMedCentral

Sandin, B., Sànchez-Arribas, C., Chorot, P., & Valiente, R. M. (2015). Anxiety sensitivity, catastrophic misinterpretations and panic self-efficacy in the prediction of panic disorder severity: Towards a tripartite cognitive model of panic disorder. Behavior Research and Therapy, 67, 30–40. https://doi.org/10.1016/j.brat.2015.01.005CrossRef

Saulnier, K. G., Allan, N. P., Raines, A. M., & Schmidt, N. B. (2018). Anxiety sensitivity cognitive concerns drive the relation between anxiety sensitivity and symptoms of depression. Cognitive Behaviour Therapy, 47(6), 495–507. https://doi.org/10.1080/16506073.2018.1469664CrossRefPubMed

Saulnier, K. G., Koscinski, B., Flynt, S., Accorso, C., & Allan, N. P. (2023). Brief observable anxiety sensitivity treatment: Intervention development and a pilot randomized-controlled acceptability and feasibility trial to evaluate a brief intervention for anxiety sensitivity social concerns. Cognitive Behaviour Therapy. https://doi.org/10.1080/16506073.2023.2288551CrossRefPubMed

Schmidt, N. B., Capron, D. W., Raines, A. M., & Allan, N. P. (2014). Randomized clinical trial evaluating the efficacy of a brief intervention targeting anxiety sensitivity cognitive concerns. Journal of Consulting and Clinical Psychology, 82(6), 1023–1033. https://doi.org/10.1037/a0036651CrossRefPubMed

Shephard, R. J., Cox, M. H., & Simper, K. (1981). An analysis of Par-Q responses in an office population. Canadian Journal of Public Health, 72(1), 37–40.PubMed

Stewart, S. H., Taylor, S., & Baker, J. M. (1997). Gender differences in dimensions of anxiety sensitivity. Journal of Anxiety Disorders, 11(2), 179–200. https://doi.org/10.1016/s0887-6185(97)00005-4CrossRefPubMed

Talkovsky, A. M., & Norton, P. J. (2015). Anxiety sensitivity across four ethnoracial groups in an undergraduate sample. Cognitive Behaviour Therapy, 44(1), 33–43. https://doi.org/10.1080/16506073.2014.953568CrossRefPubMed

Taylor, S. (2003). Anxiety sensitivity and its implications for understanding and treating PTSD. In S. Taylor (Ed.), Advances in the treatment of posttraumatic stress disorder: Cognitive-behavioral perspectives (pp. 57–65). Springer Publishing Company.

Taylor, S., Zvolensky, M. J., Cox, B. J., Deacon, B., Heimberg, R. G., Ledley, D. R., Abramowitz, J. S., Holaway, R. M., Sandin, S., Stewart, S. H., Coles, M., Eng, W., Daly, E. S., Arrindell, W. A., Bouvard, M., & Cardenas, S. J. (2007). Robust dimensions of anxiety sensitivity: Development and initial validation of the anxiety sensitivity index – 3. Psychological Assessment, 19(2), 176–188. https://doi.org/10.1037/1040-3590.19.2.176CrossRefPubMed

Thiruchselvam, T., Patel, A., Daros, A. R., Jain, E., Asadi, S., Laposa, J. M., Kloiber, S., & Quilty, L. C. (2020). A multidimensional investigation of anxiety sensitivity and depression outcomes in cognitive-behavioral group therapy. Psychiatry Research, 293, 113446. https://doi.org/10.1016/j.psycres.2020.113446CrossRefPubMed

Yim, O., & Ramdeen, K. T. (2015). Hierarchical cluster analysis: Comparison of three linkage measures and application to psychological data. Quantitative Methods for Psychology, 11(1), 8–21. https://doi.org10.20982/tqmp.11.1.p008.CrossRef

Titel: What Does ‘High Anxiety Sensitivity’ Look Like? Using Cluster Analysis to Identify Distinct Profiles of High Anxiety Sensitive Treatment-Seekers
verfasst von: Janine V. Olthuis
Emma M. Connell
Margo C. Watt
Sherry H. Stewart
Publikationsdatum: 27.02.2024
Verlag: Springer US
Erschienen in: Cognitive Therapy and Research / Ausgabe 2/2024
Print ISSN: 0147-5916
Elektronische ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-024-10476-y

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What Does ‘High Anxiety Sensitivity’ Look Like? Using Cluster Analysis to Identify Distinct Profiles of High Anxiety Sensitive Treatment-Seekers