Richard J. McNally

Anxiety sensitivity, anxiety frequency and the prediction of fearfulness

Abstract A distinction is proposed between anxiety (frequency of symptom occurrence) and anxiety sensitivity (beliefs that anxiety experiences have negative implications). In Study 1, a newly-constructed Anxiety Sensitivity Index (ASI) was shown to have sound psychometric properties for each of two samples of college students. The important finding was that people who tend to endorse one negative implication for anxiety also tend to endorse other negative implications. In Study 2, the ASI was found to be especially associated with agoraphobia and generally associated with anxiety disorders. In Study 3, the ASI explained variance on the Fear Survey Schedule—II that was not explained by either the Taylor Manifest Anxiety Scale or a reliable Anxiety Frequency Checklist. In predicting the development of fears, and possibly other anxiety disorders, it may be more important to know what the person thinks will happen as a result of becoming anxious than how often the person actually experiences anxiety. Implications are discussed for competing views of the ‘fear of fear’.

Selective processing of threat cues in posttraumatic stress disorder.

Vietnam combat veterans with (n = 15) and without (n = 15) posttraumatic stress disorder (PTSD) performed a modified Stroop task in which they named the colors of neutral words (e.g., INPUT), positive words (e.g., LOVE), obsessive-compulsive disorder (OCD) words (e.g., GERMS), and PTSD words (e.g., BODYBAGS). In contrast to normal controls, PTSD patients took significantly longer to color-name PTSD words than to color-name neutral, OCD, and positive words. Because Stroop interference reflects involuntary semantic activation, it may provide a quantitative measure of intrusive cognitive activity--the hallmark symptom of PTSD.

Selective processing of threat cues in panic disorder

A computerized Stroop color-naming paradigm was used to investigate attentional biases for selectively processing threat information in panic-disordered patients. Subjects named the colors of neutral words (e.g. TYPICAL), fear words (e.g. PANIC), bodily sensation words (e.g. HEARTBEAT), and catastrophe words (e.g. HEART ATTACK). To control for familiarity with threat concepts, we used clinicians who treat panic disorder as normal control subjects. In contrast to normal controls, panic patients exhibited greater Stroop interference for all threat words, especially those associated with catastrophe. Stroop interference waned during the course of the experiment, thereby indicating habituation to the semantic content of the cues. These findings suggest that panic disorder, like other anxiety disorders, is associated with an attentional bias for processing threatening information.

Emotional arousal and overeating in restrained eaters.

We tested the effects of 3 mood inductions (neutral, positive, and negative) on food intake in 91 women of varying degrees of dietary restraint. Mood induction was accomplished by exposure to 1 of 3 film segments: a travelogue (neutral affect), a comedy film (positive affect), and a horror film (negative affect). In subjects exposed to the neutral film, food intake decreased with increasing levels of dietary restraint. Among subjects who viewed either the comedy film or the horror film, however, food intake increased with increasing restraint. Although the horror film appeared to be more disinhibiting than the comedy film, this effect may have resulted from a difference in the intensity of the emotions induced rather than from their valence. These results suggest that emotional arousal, regardless of valence, may trigger overeating among restrained eaters.

Sensitivity to feared stimuli in obsessive-compulsives: A dichotic listening analysis

The experiment reported here was designed to test whether fear-relevant stimuli are preceived more readily than neutral ones, and whether vigilance for the former is due to fear or to familiarity. Eleven obsessive-compulsives were administered a dichotic listening task before and after treatment by exposure and response prevention. Behavioral (button press) and physiological (skin conductance response) measures revealed that fear-relevant words were detected more than neutral words before but not after treatment. Additionally, the magnitude of the skin conductance response was greater to fearrelevant than to neutral targets before but not after treatment. These findings suggest that sensitivity to fear-relevant stimuli is due to fear and not familiarity.

Film-induced negative affect triggers overeating in restrained eaters

We tested the effects of film-induced negative affect (i.e., exposure to a frightening film) in 60 women classified as either restrained or unrestrained eaters on the basis of their responses to the Revised Restraint Scale (Herman & Polivy, 1980). Exposure to the frightening film, in contrast to a neutral film, was associated with increases in anxiety, sadness, and anger. High restraint subjects exposed to the frightening film ate more than did equally restrained subjects exposed to a neutral film or low restraint subjects exposed to either film. Thus, negative affect triggered overeating among restrained eaters. Although unrestrained eaters exposed to the frightening film ate less than those who viewed the neutral film, this difference was not statistically significant. These results suggest that negative affect may prompt overeating in persons who attempt to restrict their caloric intake.

Cognitive processing of emotional information in panic disorder.

Panic-disordered (PD) patients, obsessive-compulsive (OCD) patients, and normal control subjects were exposed to either a high (i.e. exercise) or low arousal manipulation prior to performing a computerized version of the modified Stroop color-naming paradigm. Subjects named the colors of neutral nonlexical stimuli, positive words, and threat words associated with fear, bodily sensations, and catastrophes. After the Stroop task, subjects rated the personal emotional significance of the words. Inconsistent with the emotionality hypothesis of Stroop interference, PD patients rated positive words as more emotional than catastrophe words, but took longer to color-name the latter than the former. Yet consistent with the emotionality hypothesis, PD patients took as long to color-name positive words as to color-name fear and bodily sensation words. Contrary to expectation, OCD patients resembled PD patients in terms of interference, and arousal did not enhance interference for threat words in PD patients.

Memory bias for anxiety information in patients with panic disorder

Abstract Based on Foa and Kozaks (1986) information processing theory of fear, we hypothesised that panic-disordered (PD) patients, in contrast to normal controls (NC), would exhibit a memory bias for anxiety-related information, and that physiological arousal would enhance this bias. PD subjects met DSM-III-R criteria for panic disorder. Self-report measures of mood, heart rate, and spontaneous skin conductance fluctuations were taken at baseline and at recall. After baseline, subjects rated the self-descriptiveness of anxiety (e.g. nervous) and nonanxiety (e.g. POLITE) words. Half of the subjects in each group then performed a 5-minute exercise step-task (i.e. high arousal condition); the remaining subjects relaxed for 5 minutes (i.e. low arousal condition). After this manipulation, subjects were asked to recall the rated words. Consistent with our prediction, PD subjects recalled more anxiety than nonanxiety words, whereas NC subjects recalled more nonanxiety than anxiety words. This memory bias was n...

Anxiety sensitivity and history of panic as predictors of response to hyperventilation

In this study, we examined the effects of anxiety sensitivity on the response to hyperventilation in college students with and without a history of spontaneous panic attacks. Reiss et al.s (Behav. Res. Ther. 24, 1-8, 1986) Anxiety Sensitivity Index and Norton et al.s (Behav. Ther. 17, 239-252, 1986) Panic Attack Questionnaire were used to select Ss. Following five min of voluntary hyperventilation, high anxiety sensitivity Ss reported more anxiety and more hyperventilation sensations than did low anxiety sensitivity Ss. A history of panic was only associated with enhanced responding to hyperventilation in Ss with high anxiety sensitivity; low anxiety sensitivity Ss who had experience with panic were no more responsive than low anxiety sensitivity Ss who had never had a panic attack. These findings suggest that high anxiety sensitivity may be a crucial determinant of panic attacks provoked by biological challenges (e.g. hyperventilation, sodium lactate infusion).

Anxious mood and memory

Influenced by Bower (Am. Psychol. 36, 129-148, 1981) and Lang (Anxiety and the Anxiety Disorders, Erlbaum, Hillsdale, N.J., 1985), we tested three hypotheses concerning anxious mood and memory: (1) the mood state dependent hypothesis which states that memory retrieval will be greater when mood at encoding and at recall are the same than when they are different: (2) the encoding mood congruent hypothesis which states that information semantically related to mood at encoding is retrieved more readily than information unrelated to mood at encoding; and (3) the recall mood congruent hypothesis which states that information semantically related to mood at recall is retrieved more readily than information unrelated to mood at recall. We induced anxiety in speech anxious students by informing them that they would be delivering a speech during the experiment. Mood could be either anxious or nonanxious at encoding, recall, both, or neither. Hence, there were four groups: Anxiety-Anxiety, Anxiety-Nonanxiety, Nonanxiety-Anxiety, and Nonanxiety-Nonanxiety. Subjects were asked to rate the self-descriptiveness of anxiety (e.g. NERVOUS) and nonanxiety adjective (e.g. POLITE) during the encoding phase, and to recall them later. Anxious mood was measured by self-report scales and by heart rate. No support was obtained for any of the three hypotheses. However, post-hoc analyses indicated that anxiety words were recalled least often in subjects whose heart rate increased from encoding to recall. This suggests that attention to threat information may diminish in aroused nonclinical subjects.