Skip to main content
SpringerLink
Log in

High-Risk Feedback: A Brief Intervention to Increase Motivation to Change Anxiety

  • Original Article
  • Published:
Cognitive Therapy and Research Aims and scope Submit manuscript

Abstract

Elevated levels of anxiety sensitivity (AS), the fear of anxiety and its consequences, places individuals at an increased risk for the development of anxiety disorders, especially panic disorder. Research has shown that treating AS may reduce the future development of anxiety psychopathology. However, individuals high in AS may be unaware of the risks associated with this risk factor and, therefore, may tend to be unaware or unmotivated to change AS. The purpose of the current study was to investigate the effect of providing high-risk feedback in those at-risk for developing anxiety psychopathology. Participants consisted of 55 non-treatment seeking individuals with clinically significant levels of AS. Participants completed a battery of baseline questionnaires, received high-risk feedback about their level of anxiety sensitivity, and completed post-study questionnaires. Results revealed significant increases in motivation. Specifically, there were significant increases in the importance and confidence to change anxiety after receiving the high-risk feedback. Implications of the findings and future directions are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Agostinelli, G., Brown, J. M., & Miller, W. R. (1995). Effects of normative feedback on consumption among heavy drinking college students. Journal of Drug Education, 25, 31–40. doi:10.2190/XD56-D6WR-7195-EAL3.

    Article  PubMed  CAS  Google Scholar 

  • Bein, T. H., Miller, W. R., & Tonigan, J. S. (1993). Brief interventions for alcohol problems: A review. Addiction, 88, 315–335. doi:10.1111/j.1360-0443.1993.tb00820.x.

    Article  Google Scholar 

  • Berg-Smith, S. M., Stevens, V. J., Brown, K. M., Van Horn, L., Gernhofer, N., Peters, E., et al. (1999). A brief motivational intervention to improve dietary adherence in adolescents. Health Education Research, 14, 399–410. doi:10.1093/her/14.3.399.

    Article  PubMed  CAS  Google Scholar 

  • Bernstein, A., Zvolensky, M. J., Feldner, M. T., Lewis, S. F., & Leen-Feldner, E. W. (2005). Anxiety sensitivity taxonicity: a concurrent test of cognitive vulnerability for post-traumatic stress symptomatology among young adults. Cognitive Behavior Therapy, 34, 229–241. doi:10.1080/16506070510041176.

    Article  Google Scholar 

  • Brown, J. M., & Miller, W. R. (1993). Impact of motivational interviewing on participation and outcome in residential alcoholism treatment. Psychology of Addictive Behaviors, 7, 211–218. doi:10.1037/0893-164X.7.4.211.

    Article  Google Scholar 

  • Buckner, J. D. (2007). MET for CBT for social anxiety treatment manual and research protocol. Florida State University. Unpublished manuscript.

  • Buckner, J. D., & Schmidt, N. B. (2009). A randomized pilot study of motivational enhancement therapy to increase utilization of cognitive-behavioral therapy for social anxiety. Behaviour Research and Therapy, 47, 710–715. doi:10.1016/j.brat.2009.04.009.

    Article  PubMed  Google Scholar 

  • Cohen, J. W. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates.

    Google Scholar 

  • Deacon, B., & Abramowitz, J. (2006). Anxiety sensitivity and its dimensions across the anxiety disorders. Journal of Anxiety Disorders, 20, 837–857. doi:10.1016/j.janxdis.2006.01.003.

    Article  PubMed  Google Scholar 

  • DuPont, R. L., Rice, D. P., Miller, L. S., Shiraki, S. S., Rowland, C. R., & Harwood, H. J. (1996). Economic costs of anxiety disorders. Anxiety, 2, 167–172. doi:10.1002/(SICI)1522-7154.

    Article  PubMed  CAS  Google Scholar 

  • Feldner, M. T., Zvolensky, M. J., Babson, K. A., Leen-Feldner, E. W., & Schmidt, N. B. (2008). An integrated approach to panic prevention targeting the empirically-supported risk factors of smoking and anxiety sensitivity: Theoretical basis and evidence from a pilot project evaluating feasibility and short-term efficacy. Journal of Anxiety Disorders, 22, 1227–1243. doi:10.1002/da.20281.

    Article  PubMed  Google Scholar 

  • First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1995). Structured Clinical Interview for DSM-IV Axis-I Disorders-Patient Edition (SCID I/P, version 2.0). New York, NY: Biometrics Research Department.

    Google Scholar 

  • Greenberg, P. E., Sisitsky, T., Kessler, R. C., Finkelstein, S. N., Berndt, E. R., et al. (1999). The economic burden of anxiety disorders in the 1990s. Journal of Clinical Psychiatry, 60, 427–435. doi:10.4088/JCP.v60n0702.

    Article  PubMed  CAS  Google Scholar 

  • Kessler, R. C., Chiu, W. T., Demler, O., Merikangas, K. R., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617–627. doi:10.1001/archpsyc.62.6.617.

    Article  PubMed  Google Scholar 

  • Larimer, M. E., & Cronce, J. M. (2007). Identification, prevention, and treatment revisited: Individual-focused college drinking prevention strategies 1999–2006. Addictive Behaviors, 32, 2439–2468. doi:10.1016/j.addbeh.2007.05.006.

    Article  PubMed  Google Scholar 

  • Larimer, M. E., Turner, A. P., Anderson, B. K., Fader, J. S., Kilmer, J. R., Palmer, R. S., et al. (2001). Evaluating a brief alcohol intervention with fraternities. Journal of Studies on Alcohol, 62, 370–380.

    PubMed  CAS  Google Scholar 

  • Lewis, M. A., & Neighbors, C. (2006). Who is the typical college student? Implications for personalized normative feedback interventions. Addictive Behaviors, 31, 2120–2126. doi:10.1016/j.addbeh.01.011.

    Article  PubMed  Google Scholar 

  • Lewis, M. A., Neighbors, C., Oster-Aaland, L., Kirkeby, B. S., & Larimer, M. E. (2007). Indicated prevention for incoming freshman: Personalized normative feedback and high-risk drinking. Addictive Behaviors, 32, 2495–2508. doi:10.1016/j.addbehav.2007.06.019.

    Article  PubMed  Google Scholar 

  • McNally, R. J. (2002). Anxiety sensitivity and panic disorder. Biological Psychiatry, 52, 938–946. doi:10.1016/S0006-3223(02)01475-0.

    Article  PubMed  Google Scholar 

  • Merlo, L. J., Storch, E. A., Lehmkul, H. D., Murphy, T. K., Goodman, W. K., & Geffken, G. R. (2010). Cognitive behavioral therapy plus motivational interviewing improves outcome for pediatric obsessive-compulsive disorder: A preliminary study. Cognitive Behavioral Therapy, 39, 24–27. doi:10.1080/16506070902831773.

    Article  Google Scholar 

  • Miller, W. R., & Rollnick, S. (Eds.). (2002). Motivational interviewing: Preparing people for change (Vol. 2). New York, NY: Guillford.

    Google Scholar 

  • Miller, W. R., Zeben, A., DiClemente, C. C., & Rychtarik, R. G. (1992). Motivational enhancement therapy manual: A clinical research guide for therapists treating individuals with alcohol abuse and dependence. Rockville, MD: National Institute on Alcohol Abuse and Alcoholism.

    Google Scholar 

  • Mosca, L., Jones, W. K., King, K. B., Ouyang, P., Redberg, R. F., & Hill, M. N. (2000). Awareness, perception, and knowledge or heart disease risk and prevention in the United States, An American Heart Association women’s heart disease and stroke campaign task force. Archives of Family Medicine, 9, 506–515.

    Article  PubMed  CAS  Google Scholar 

  • Otto, M. W., & Reilly-Harrington, N. A. (1999). The impact of treatment on anxiety sensitivity. In S. Taylor (Ed.), Anxiety sensitivity: Theory, research, and treatment of the fear of anxiety (pp. 321–336). Hillsdale NJ: Lawrence Erlbaum Associates.

    Google Scholar 

  • Ralf, D., & Nicolai, J. (2009). Motivation to quit smoking and to refrain from drinking in a sample of alcohol-dependent inpatients: Importance of abstinence, self-efficacy, and treatment outcome. Addictive Disorders and Their Treatment, 8, 99–110. doi:10.1097/ADT.0b013e318175916c.

    Article  Google Scholar 

  • Rector, N. A., Szacum-Shimizu, K., & Leybman, M. (2007). Anxiety sensitivity within the anxiety disorders: Disorder-specific sensitivities and depression comorbidity. Behaviour Research and Therapy, 45, 1967–1975. doi:10.1016/j.brat.2006.09.017.

    Article  PubMed  Google Scholar 

  • Reiss, S. (1997). Trait Anxiety: It’s not what you think it is. Journal of Anxiety Disorders, 11, 201–214. doi:10.1016/S0887-6185(97)00006-6.

    Article  PubMed  CAS  Google Scholar 

  • Reiss, S., & McNally, R. J. (1985). Expectancy model of fear. In S. Reiss & R. R. Bootzin (Eds.), Theoretical issues in behavioral therapy (pp. 107–121). San Diego, CA: Academic Press.

    Google Scholar 

  • Reiss, S., Peterson, R. A., Gursky, D. M., & McNally, R. J. (1986). Anxiety sensitivity, anxiety frequency and the predictions of fearfulness. Behaviour Research and Therapy, 24, 1–8. doi:10.1016/0005-7967(86)90143-9.

    Article  PubMed  CAS  Google Scholar 

  • Schmidt, N. B. (1999). Examination of differential anxiety sensitivities in panic disorder: A test of anxiety sensitivity subdomains in predicting fearful responding to a 35 % CO2 challenge. Cognitive Therapy and Research, 23, 3–19. doi:10.1023/A:1018754522981.

    Article  Google Scholar 

  • Schmidt, N. B., Eggleston, A. M., Woolaway-Bickel, K., Fitzpatrick, K. K., Vasey, M. W., & Richey, J. A. (2007). Anxiety sensitivity amelioration training (ASAT): A longitudinal primary prevention program targeting cognitive vulnerability. Journal of Anxiety Disorders, 21, 302–319. doi:10.1016/j.janxdis.2006.06.002.

    Article  PubMed  Google Scholar 

  • Schmidt, N. B., Lerew, D. R., & Jackson, R. J. (1997). The role of anxiety sensitivity in the pathogenesis of panic: Prospective evaluation of spontaneous panic attacks during acute stress. Journal of Abnormal Psychology, 106, 355–364. doi:10.1037/0021-843X.106.3.355.

    Article  PubMed  CAS  Google Scholar 

  • Schmidt, N. B., Lerew, D. R., & Jackson, R. J. (1999). Prospective evaluation of anxiety sensitivity in the pathogenesis of panic: Replication and extension. Journal of Abnormal Psychology, 108, 532–537. doi:10.1037/0021-843X.108.3.532.

    Article  PubMed  CAS  Google Scholar 

  • Schmidt, N. B., & Mallott, M. (2006). Evaluating anxiety sensitivity and other fundamental sensitivities predicting anxiety symptoms and fearful responding to a biological challenge. Behaviour Research and Therapy, 44, 1681–1688. doi:10.1016/j.brat.2005.12.001.

    Article  PubMed  Google Scholar 

  • Schmidt, N. B., Zvolensky, M. J., & Maner, J. K. (2006). Anxiety sensitivity: Prospective prediction of panic attacks and Axis I pathology. Journal of Psychiatric Research, 40, 691–699. doi:10.1016/j.jpsychires.2006.07.009.

    Article  PubMed  Google Scholar 

  • Sellman, J. D., Sullivan, P. F., Dore, G. M., Adamson, S. J., & MacEwan, I. (2001). A randomized controlled trial of motivational enhancement therapy (MET) for mild to moderate alcohol dependence. Journal of Studies on Alcohol, 62, 389–396.

    PubMed  CAS  Google Scholar 

  • Smits, J. A. J., Berry, A. C., Rosenfield, D., Powers, M. B., Behar, E., & Otto, M. W. (2008). Reducing anxiety sensitivity with exercise. Depression and Anxiety, 25, 689–699. doi:10.1002/da.20411.

    Article  PubMed  Google Scholar 

  • Smits, J. A. J., Powers, M. B., Cho, Y., & Telch, N. J. (2004). Mechanism of change in cognitive-behavioral treatment of panic disorder: Evidence for the fear of fear mediational hypothesis. Journal of Consulting and Clinical Psychology, 72, 646–652. doi:10.1037/0022-006X.72.4.646.

    Article  PubMed  Google Scholar 

  • Taylor, S., & Cox, B. J. (1998). Anxiety sensitivity: Multiple dimensions and hierarchic structure. Behaviour Research and Therapy, 36, 37–51. doi:10.1016/S0005-7967(97)00071-5.

    Article  PubMed  CAS  Google Scholar 

  • Taylor, S., Koch, D., & Crockett, D. J. (1991). Anxiety sensitivity, trait anxiety, and the anxiety disorders. Journal of Anxiety Disorders, 5, 293–311. doi:10.1016/0887-6185(91)90030-W.

    Article  Google Scholar 

  • Taylor, S., Koch, D., & McNally, R. J. (1992). How does anxiety sensitivity vary across the anxiety disorders? Journal of Anxiety Disorders, 6, 249–259. doi:10.1016/0887-6185(92)90037-8.

    Article  Google Scholar 

  • Telch, M. J., Lucas, J. A., Schmidt, N. B., Hanna, H. H., Jaimez, T. L., & Lucas, R. A. (1993). Group cognitive-behavioral treatment of panic disorder. Behaviour Research and Therapy, 31, 279–287. doi:10.1016/0005-7967(93)90026-Q.

    Article  PubMed  CAS  Google Scholar 

  • Wright, A. J., French, D. P., Weinman, J., & Martea, T. M. (2006). Can genetic risk information enhance motivation for smoking cessation? An analogue study. Health Psychology, 25, 740–752. doi:10.1037/0278-6133.25.6.740.

    Article  PubMed  Google Scholar 

  • Yahne, C. E., Miller, W. R., Irvin-Vitela, L., & Tonigan, J. S. (2002). Magdalena pilot project: motivational outreach to substance abusing women street sex workers. Journal of Substance Abuse Treatment, 23, 49–53. doi:10.1016/S0740-5472(02)00236-2.

    Article  PubMed  Google Scholar 

  • Zinbarg, R. E., Barlow, D. H., & Brown, T. A. (1997). Hierarchical structure and general factor saturation of the Anxiety Sensitivity Index: Evidence and implications. Psychological Assessment, 9, 277–284. doi:10.1037/1040-3590.9.3.277.

    Article  Google Scholar 

  • Zinbarg, R. E., Brown, T. A., Barlow, D. H., & Rapee, R. M. (2001). Anxiety sensitivity, panic, and depressed mood: A reanalysis teasing apart the contributions of the two levels in the hierarchical structure of the Anxiety Sensitivity Index. Journal of Abnormal Psychology, 110, 372–377. doi:10.1037/0021-843X.110.3.372.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Amanda S. Unruh for her assistance with data collection.

Author information

Authors and Affiliations

  1. Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL, 32306, USA

    Kristina J. Korte & Norman B. Schmidt

Authors
  1. Kristina J. Korte
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Norman B. Schmidt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kristina J. Korte.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Korte, K.J., Schmidt, N.B. High-Risk Feedback: A Brief Intervention to Increase Motivation to Change Anxiety. Cogn Ther Res 37, 332–339 (2013). https://doi.org/10.1007/s10608-012-9464-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10608-012-9464-5

Keywords

Search

Navigation