Abstract
A self-report scale for the measurement of fear of fear, the Agoraphobic Cognitions Scale (ACS), was psychometrically evaluated. Two samples of inpatients satisfying DSM-III-R criteria for unipolar depressive and/or anxiety disorder were studied. Intercorrelational and factor analyses indicated that the ACS measured three dimensions of fear of fear: fear of bodily incapacitation, fear of losing control, and fear of acting embarrassingly. Three subscales were constructed to measure these dimensions. The subscales proved to have satisfactory internal consistency and criterion-related validity. However, fear of losing control was related not only to other anxiety symptoms, but also to depressive symptomatology. Agoraphobic patients reported more fear of bodily incapacitation and fear of losing control than social phobic, generally anxious, and nonanxious depressed patients. Fear of embarrassing action was higher among agoraphobic and social phobic patients than among generally anxious and nonanxious depressed patients. These results were obtained after controlling for general anxiety and depression level and, thus, support the validity of the fear of fear construct.
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References
Aasberg, M., Montgomery, S. A., Perris, C., Schalling, D., & Sedvall, G. (1978). A comprehensive psychopathological rating scale.Acta Psychiatrica Scandinavica Supplements, 271, 5–27.
American Psychiatric Association (1987).Diagnostic and Statistical Manual of Mental Disorders, 3rd ed. revised. Washington, DC: American Psychiatric Association.
Barlow, D. H., & Craske, M. G. (1988). The phenomenology of panic. In S. Rachman & J. D. Maser (Eds.)Panic. Psychological perspectives (pp. 11–35). Hillsdale, NJ: Lawrence Erlbaum Associates.
Barlow, D. H., Vermilyea, J., Blanchard, E., Vermilyea, J., Di Nardo, P. A., & Cerny, J. (1985). The phenomenon of panic.Journal of Abnormal Psychology, 92, 49–55.
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979).Cognitive therapy of depression: A treatment manual. New York: Guilford Press.
Breier, A., Charney, D. S., & Heninger, G. R. (1984). Major depression in patients with agoraphobia and panic disorder.Archives of General Psychiatry, 41, 1129–1135.
Burns, L. E., & Thorpe, G. L. (1977). The epidemiology of fears and phobias with particular reference to the rational privacy of agoraphobics.Journal of International Medical Research, 5, 1–7.
Chambless, D. L., & Gracely, E. J. (1989). Fear of fear and the anxiety disorders.Cognitive Therapy and Research, 13, 9–20.
Chambless, D. L., Caputo, G. C., Brigth, P., & Gallagher, R. (1984). Assessment of fear of fear in agoraphobics: The Body Sensations Questionnaire and the Agoraphobic Cognitions Questionnaire.Journal of Consulting and Clinical Psychology, 52, 1090–1097.
DiNardo, P. A., & Barlow, D. H. (1990). Syndrome and symptom co-occurrence in the anxiety disorders. In J. D. Maser & C. R. Cloninger (Eds.),Comorbidity in anxiety and mood disorders (pp. 205–230). Washington, DC: American Psychiatric Press.
Hinze, J. L. (1987).Number Cruncher Statistical System (Version 5.0). Kaysville, UT.
Hoffart, A., & Martinsen, E. (1990). Exposure-based integrated vs. pure psychodynamic treatment of agoraphobic inpatients.Psychotherapy, 27, 210–218.
Hoffart, A., Friis, S., & Martinsen, E. (1989). The Phobic Avoidance Rating Scale: A psychometric evaluation of an interview-based scale.Psychiatric Developments, 7, 71–81.
Lilienfeld, S. O., Jacob, & Turner, S. M. (1989). Comment on Holloway and McNally's (1987) “Effects of anxiety sensitivity on the response to hyperventilation”.Journal of Abnormal Psychology, 98, 100–102.
Martinsen, E., Friis, S., & Hoffart, A. (1989). A factor analytical study of the Comprehensive Psychopathological Rating Scale (CPRS) on patients with anxiety and depressive disorders.Acta Psychiatrica Scandinavica, 80, 492–498.
Norusis, M. J. (1988).SPSS/PC+ V3.0 for the IBM PC/AT/XT, SPSS, Chicago.
Peterson, R. A., & Heilbronner, R. L. (1987). The Anxiety Sensitivity Index: Construct validity and factor analytic structure.Journal of Anxiety Disorders, 1, 117–121.
Reiss, S., Peterson, R. A., Gursky, D. M., & McNally, R. J. (1986). Anxiety sensitivity, anxiety frequency and the prediction of fearfulness.Behavior Research and Therapy, 24, 1–8.
Spitzer, R. L., & Williams, J. B. W. (1984).Structured Clinical Interview for DSM-III (SCID 10/1/84). Biometric Research Department, New York State Psychiatric Institute, 722 West 168th Street, New York 10032.
Telch, M. J., Brouillard, M., Telch, C. F., Agras, W. S., & Taylor, C. B. (1989). Role of cognitive appraisal in panic-related avoidance.Behavior Research and Therapy, 27, 373–383.
Telch, M. J., Shermis, M. D., & Lucas, J. A. (1989). Anxiety sensitivity: Unitary personality trait or domain-specific appraisals?Journal of Anxiety Disorders, 3, 25–32.
Wolpe, J., & Rowan, V. C. (1988). Panic disorder: A product of classifical conditioning.Behavior Research and Therapy, 26, 441–450.
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Hoffart, A., Friis, S. & Martinsen, E.W. Assessment of fear of fear among Agoraphobic patients: The Agoraphobic Cognitions Scale. J Psychopathol Behav Assess 14, 175–187 (1992). https://doi.org/10.1007/BF00965173
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DOI: https://doi.org/10.1007/BF00965173