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Anxiety Sensitivity and Health Anxiety in a Nonclinical Sample: Specificity and Prospective Relations with Clinical Stress

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Abstract

The present study examines the association between anxiety sensitivity (AS) and symptoms of hypochondriasis (a pattern of intense health anxiety) in a nonclinical sample. Findings from study 1 (n = 498) revealed a significant association between AS and health anxiety even after controlling for symptoms of depression and negative affect. However, the association between AS and health anxiety was not moderated by stress levels. Subsequent analysis did reveal a specific association between AS for physical concerns and health anxiety when controlling for other AS dimensions. Contrary to predictions, AS did not significantly predict residual change in symptoms of health anxiety over a 12-week period (n = 195) in Study 2. However, exploratory analyses suggest that some AS dimensions (e.g., physical concerns) may be more predictive of some facets of health anxiety (e.g., body vigilance) than others (e.g., illness severity). Findings from this study are discussed in the context of future research on the role of AS in the development of hypochondriasis.

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Notes

  1. The magnitude of the correlation between ASI total scores and SHAI total scores for men (r = .46) and women (r = .55) were not significantly different from each other (z = 1.14, P = .12).

  2. The magnitude of the correlation between ASI total scores at Time 1 and SHAI total scores at Time 2 for men (r = .50) and women (r = .54) were not significantly different from each other (z = 0.28, P = .38).

References

  • Abramowitz, J. S., Deacon, B. J., & Valentiner, D. P. The short health anxiety inventory in an undergraduate sample: Implications for a cognitive-behavioral model of hypochondriasis. Cognitive Therapy and Research (in press).

  • Abramowitz, J. S., Olatunji, B. O., & Deacon, B. D. (2007). Health anxiety, hypochondriasis, and the anxiety disorders. Behavior Therapy, 38, 86–94.

    Article  PubMed  Google Scholar 

  • Abramowitz, J. S., Schwartz, S. A., & Whiteside, S. P. (2002). A contemporary conceptual model of hypochondriasis. Mayo Clinic Proceedings, 77, 1321–1330.

    Article  Google Scholar 

  • Abramson, L. Y., Alloy, L. B., Hankin, B. L., Haeffel, G. J., MacCoon, D. G., & Gibb, B. E. (2002). Cognitive vulnerability-stress models of depression in a self-regulatory and psychobiological context. In I. H. Gotlib & C. L. Hammen (Eds.), Handbook of depression (pp. 268–294). New York, NY: Guilford Press.

    Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington DC: Author.

  • Bach, M., Nutzinger, D. O., & Hartl, L. (1996). Comorbidity of anxiety disorders and hypochondriasis considering different diagnostic systems. Comprehensive Psychiatry, 37, 62–67.

    Article  PubMed  CAS  Google Scholar 

  • Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77–100.

    Article  Google Scholar 

  • Bernstein, A., Zvolensky, M. J., Feldner, M. T., Lewis, S. F., Fauber, A. L., Leen-Feldner, E. W., et al. (2005). Anxiety sensitivity taxon and trauma: Discriminant associations for posttraumatic stress and panic symptomatology among young adults. Depression and Anxiety, 22, 138–149.

    Article  PubMed  Google Scholar 

  • Bernstein, A., Zvolensky, M. J., Norton, P. J., Schmidt, N. B., Taylor, S., Forsyth, J. P., et al. (2007). Taxometric and factor analytic models of anxiety sensitivity: Integrating approaches to latent structural research. Psychological Assessment, 19, 74–87.

    Article  PubMed  Google Scholar 

  • Coles, M. E., & Horng, B. (2006). A prospective test of cognitive vulnerability to obsessive compulsive disorder. Cognitive Therapy and Research, 30, 723–746.

    Article  Google Scholar 

  • Cox, B. J. (1996). The nature and assessment of catastrophic thoughts in panic disorder. Behaviour Research and Therapy, 34, 363–374.

    Article  PubMed  CAS  Google Scholar 

  • 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). Mahwah, NJ: Erlbaum.

    Google Scholar 

  • Deacon, B., & Abramowitz, J. S. Is hypochondriasis related to OCD, panic disorder, or both? An empirical evaluation. Journal of Cognitive Psychotherapy (in press).

  • Deacon, B. J., Lickel, J., & Abramowitz, J. S. Medical utilization across the anxiety disorders. Journal of Anxiety Disorders (in press).

  • Feldner, M., Zvolensky, M., & Schmidt, N. (2004). Prevention of anxiety psychopathology: A critical review of the empirical literature. Clinical Psychology: Science and Practice, 11, 405–424.

    Article  Google Scholar 

  • Furer, P., Walker, J. R., Chartier, M. J., & Stein, M. B. (1997). Hypochondriacal concerns and somatization in panic disorder. Depression and Anxiety, 6, 78–85.

    Article  PubMed  CAS  Google Scholar 

  • Hiller, W., Leibbrand, R., Rief, W., & Fichter, M. M. (2005). Differentiating hypochondriasis from panic disorder. Journal of Anxiety Disorders, 19, 29–49.

    Article  PubMed  Google Scholar 

  • Noyes, R. (1999). The relationship of hypochondriasis to anxiety disorders. General Hospital Psychiatry, 21, 8–17.

    Article  PubMed  Google Scholar 

  • Noyes, R., Watson, D. B., Carney, C. P., Letuchy, E. M., Peloso, P. M., Black, D. W., et al. (2004). Risk factors for hypochondriacal concerns in a sample of military veterans. Journal of Psychosomatic Research, 57, 529–539.

    Article  PubMed  Google Scholar 

  • Olatunji, B. O., Deacon, B. J., Abramowitz, J. S., & Valentiner, D. P. (2007). Body vigilance in nonclinical and anxiety disorder samples: Structure, correlates, and prediction of health concerns. Behavior Therapy, 38, 392–401.

    Article  PubMed  Google Scholar 

  • Otto, M., Demopulos, C., McLean, N., Pollack, M., & Fava, M. (1998). Additional findings on the association between anxiety sensitivity and hypochondriacal concerns: Examination of patients with major depression. Journal of Anxiety Disorders, 12, 225–232.

    Article  PubMed  CAS  Google Scholar 

  • Otto, M., Pollack, M., Sachs, G., & Rosenbaum, J. (1992). Hypochondriacal concerns, anxiety sensitivity, and panic disorder. Journal of Anxiety Disorders, 6, 93–104.

    Article  Google Scholar 

  • Reiss, S., & McNally, R. J. (1985). Expectancy model of fear. In S. Reiss & R. R. Bootzin (Eds.), Theoretical issues in behavior 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 prediction of fearfulness. Behaviour Research and Therapy, 24, 1–8.

    Article  PubMed  CAS  Google Scholar 

  • Rief, W., Hiller, W., & Margraf, J. (1998). Cognitive aspects of hypochondriasis and the somatization syndrome. Journal of Abnormal Psychology, 107, 587–595.

    Article  PubMed  CAS  Google Scholar 

  • Salkovskis, P. M., Rimes, K. A., Warwick, H. M., & Clark, D. M. (2002). The health anxiety inventory: Development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychological Medicine, 32, 843–853.

    Article  PubMed  CAS  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.

    Article  PubMed  CAS  Google Scholar 

  • Schmidt, N. B., Lerew, D. R., & Trakowski, J. H. (1997). Body vigilance in panic disorder: Evaluating attention to bodily perturbations. Journal of Consulting and Clinical Psychology, 65, 214–220.

    Article  PubMed  CAS  Google Scholar 

  • Smith, G. R. (1994). The course of somatization and its effects on health care resources. Psychosomatics, 35, 263–267.

    PubMed  Google Scholar 

  • Stewart, S. H., Sherry, S. B., Watt, M. C., Grant, V. V., & Hadjistavropoulos, H. D. Psychometric evaluation of the Multidimensional Inventory of Hypochondriacal Traits: Factor structure and relationship to anxiety sensitivity. Journal of Cognitive Psychotherapy (in press).

  • Stewart, S. H., & Watt, M. C. (2000). Illness Attitude Scale dimensions and their associations with anxiety-related constructs in a nonclinical sample. Behaviour Research and Therapy, 38, 83–99.

    Article  PubMed  CAS  Google Scholar 

  • Walmyr Publishing Co. (1992). The Walmyr Assessment Scales scoring manual. Tempe, AZ: Author.

    Google Scholar 

  • Warwick, H. M., & Salkovskis, P. M. (1990). Hypochondriasis. Behaviour Research and Therapy, 28, 105–117.

    Article  PubMed  CAS  Google Scholar 

  • Watson, D., Clark, L., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063–1070.

    Article  PubMed  CAS  Google Scholar 

  • Watt, M. C., & Stewart, S. H. (2000). Anxiety sensitivity mediates the relationships between childhood learning experiences and elevated hypochondriacal concerns in young adulthood. Journal of Psychosomatic Research, 49, 107–118.

    Article  PubMed  CAS  Google Scholar 

  • Watt, M. C., Stewart, S. H., & Cox, B. J. (1998). A retrospective study of the learning history origins of anxiety sensitivity. Behaviour Research and Therapy, 36, 505–525.

    Article  PubMed  CAS  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.

    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.

    Article  PubMed  CAS  Google Scholar 

  • Zinbarg, R. E., Mohlman, J., & Hong, N. N. (1999). Dimensions of anxiety sensitivity. In S. Taylor (Ed.), Anxiety sensitivity: Theory, research, and treatment of the fear of anxiety (pp. 83–114). Mahwah, NJ: Erlbaum.

    Google Scholar 

  • Zvolensky, M. J., & Forsyth, J. P. (2002). Anxiety sensitivity dimensions in the prediction of body vigilance and emotional avoidance. Cognitive Therapy and Research, 26, 449–460.

    Article  Google Scholar 

  • Zvolensky, M. J., Goodie, J. L., Ruggiero, K. J., Black, A. L., Larkin, K. T., & Taylor, B. (2002). Perceived stress and anxiety sensitivity in the prediction of anxiety-related responding: A multichallenge evaluation. Anxiety, Stress, and Coping: An International Journal, 15, 211–229.

    Article  Google Scholar 

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Authors and Affiliations

  1. Vanderbilt University, 301 Wilson Hall, 111 21st Avenue South, Nashville, TN, 37203, USA

    Bunmi O. Olatunji, Bethany Gonzales & Tom Armstrong

  2. University of Texas-Austin, Austin, TX, USA

    Kate B. Wolitzky-Taylor

  3. Medical University of South Carolina, Charleston, SC, USA

    Lisa Elwood

  4. University of Mississippi Medical Center, Jackson, MS, USA

    Kevin Connolly

Authors
  1. Bunmi O. Olatunji
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  2. Kate B. Wolitzky-Taylor
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  3. Lisa Elwood
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  4. Kevin Connolly
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  5. Bethany Gonzales
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  6. Tom Armstrong
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Correspondence to Bunmi O. Olatunji.

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Olatunji, B.O., Wolitzky-Taylor, K.B., Elwood, L. et al. Anxiety Sensitivity and Health Anxiety in a Nonclinical Sample: Specificity and Prospective Relations with Clinical Stress. Cogn Ther Res 33, 416–424 (2009). https://doi.org/10.1007/s10608-008-9188-8

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  • DOI: https://doi.org/10.1007/s10608-008-9188-8

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