Changes in Anxiety Sensitivity Following Group Cognitive-Behavior Therapy for Social Anxiety Disorder and Panic Disorder
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The current study examined changes in anxiety sensitivity following cognitive behavior therapy as a predictor of treatment outcome in patients with social anxiety disorder (SAD) and patients with panic disorder (PD). One-hundred ninety-seven patients with a principal diagnosis of SAD (n = 108) or PD (n = 89) completed the Anxiety Sensitivity Index (ASI; Reiss et al in Behav Res Ther 24:1–8, 1986), Depression Anxiety Stress Scales (DASS-21; Lovibond and Lovibond in Behav Res Ther 33:335–343, 1995), Social Phobia Inventory (SPIN; Connor et al in Br J Psychiatry 176:379–386, 2000) and Panic Disorder Severity Scale-Self Report (PDSS-SR; Houck et al in Depress Anxiety 15:183–185, 2002; Shear et al in Am J Psychiatry 154:1571–1575, 1997) pre and post disorder specific treatment. For the SAD group, changes on ASI Physical and ASI Social subscales made significant contributions to the prediction of posttreatment social anxiety symptoms over and above pretreatment social anxiety symptoms and changes in depression scores. For the PD group, changes on the ASI Physical subscale made a significant contribution to the prediction of posttreatment panic symptoms over and above pretreatment panic symptoms and changes in depression scores. The present study provides further support that, while the global construct of anxiety sensitivity is a transdiagnostic factor across the anxiety disorders, the lower-order dimensions of anxiety sensitivity have specificity for particular anxiety disorders.
KeywordsSocial anxiety disorder Panic disorder Anxiety sensitivity Cognitive behavior therapy
The authors would like to thank Lisa Young for her assistance with data collection and data management.
The preparation of this manuscript was supported by a TD Grant in Medical Excellence Postdoctoral Fellowship awarded to the first author, and the Research Institute of St. Joseph’s Healthcare Hamilton.
Compliance with Ethical Standards
Conflict of Interest
M. Nowakowski, K. Rowa, M. Antony, and R. McCabe declare that they have no conflicts of interest.
Informed consent was obtained from all individual participants included in the study.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.Google Scholar
- Antony, M. M., & McCabe, R. E. (2004). Ten simple solutions to panic: How to overcome panic attacks, calm physical symptoms, and reclaim your life. Oakland, CA: New Harbinger Publications.Google Scholar
- Antony, M. M., & Swinson, R. P. (2000). The shyness and social anxiety workbook: Proven techniques for overcoming your fears. Oakland, CA: New Harbinger Publications.Google Scholar
- Antony, M. M., & Swinson, R. P. (2008). The shyness and social anxiety workbook: Proven techniques for overcoming your fears (2nd ed.). Oakland, CA: New Harbinger Publications.Google Scholar
- Barlow, D. H., & Craske, M. G. (2000). Mastery of your anxiety and panic: Workbook. New York, NY: Oxford University Press.Google Scholar
- Barlow, D. H., Ellard, K. K., Fairholme, C. P., Farchione, T. J., Boisseau, C. L., Allen, L. B., & Ehrenreich-May, J. (2011). The unified protocol for transdiagnostic treatment of emotional disorders: Client workbook. New York, NY: Oxford University Press.Google Scholar
- Beck, A. T., Emery, G., & Greenberg, R. (1985). Anxiety disorders and phobias: A cognitive perspective. New York, NY: Basic Books.Google Scholar
- Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In R. G. Heimberg, M. R. Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social phobia: Diagnosis, assessment, and treatment (pp. 69–93). New York, NY: Guilford Press.Google Scholar
- Field, A. (2009). Discovering statistics using SPSS (3rd ed.). London: Sage.Google Scholar
- First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1996). Structured clinical interview for DSM-IV Axis I disorders – Patient edition (SCID-I/P, version 2.0). New York, NY: Biometrics Research Department, New York State Psychiatric Institute.Google Scholar
- Heimberg, R. G., & Becker, R. E. (2002). Cognitive behavioral group therapy for social phobia: Basic mechanisms and clinical strategies. New York, NY: Guilford Press.Google Scholar
- McWilliams, L. A., Stewart, S. H., & MacPherson, P. S. R. (2000). Does the social concerns components of the anxiety sensitivity index belong to the domain of anxiety sensitivity or the domain of negative evaluation sensitivity. Behaviour Research and Therapy, 38, 985–992.CrossRefPubMedGoogle Scholar
- Peterson, R. A., & Reiss, S. (1992). Anxiety sensitivity manual (2nd ed.). Worthington, OH: International Diagnostics Systems.Google Scholar
- Reiss, S., & McNally, R. (1985). The expectancy model of fear. In S. Reiss & R. R. Bootzin (Eds.), Theoretical issues in behavior therapy (pp. 107–121). New York, NY: Academic Press.Google Scholar
- Tull, M. T., & Gratz, K. L. (2008). Further examination of the relationship between anxiety sensitivity and depression: The mediating role of experiential avoidance and difficulties engaging in goal-directed behavior when distressed. Journal of Anxiety Disorders, 22, 199–210.CrossRefPubMedGoogle Scholar
- Vujanovic, A. A., Arrindell, W. A., Bernstein, A., Norton, P. J., & Zvolensky, M. J. (2007). Sixteen-item Anxiety Sensitivity Index: Confirmatory factor analytic evidence, internal consistency, and construct validity in a young adult sample from the Netherlands. Assessment, 14, 129–143.CrossRefPubMedGoogle Scholar