Steven Reiss

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’.

Expectancy model of fear, anxiety, and panic

Abstract The purposes of this article are to summarize the authors expectancy model of fear, review the recent studies evaluating this model, and suggest directions for future research. Reiss expectancy model holds that there are three fundamental fears (called sensitivities): the fear of injury, the fear of anxiety, and the fear of negative evaluation. Thus far, research on this model has focused on the fear of anxiety (anxiety sensitivity). The major research findings are as follows: simple phobias sometimes are motivated by expectations of panic attacks; the Anxiety Sensitivity Index (ASI) is a valid and unique measure of individual differences in the fear of anxiety sensations; the ASI is superior to measures of trait anxiety in the assessment of panic disorder; anxiety sensitivity is associated with agoraphobia, simple phobia, panic disorder, and substance abuse; and anxiety sensitivity is strongly associated with fearfulness. There is some preliminary support for the hypothesis that anxiety sensitivity is a risk factor for panic disorder. It is suggested that future researchers evaluate the hypotheses that anxiety and fear are distinct phenomena; that panic attacks are intense states of fear (not intense states of anxiety); and that anxiety sensitivity is a risk factor for both fearfulness and panic disorder.

Anxiety sensitivity in 1984 and panic attacks in 1987

Abstract Subjects to whom the Anxiety Sensitivity Index (ASI) was administered in 1984 were retested in 1987 for anxiety sensitivity and tested for panic attacks, state-trait anxiety, and anxiety disorder history. ASI scores in 1984 predicted the frequency and intensity of panic attacks in 1987. Compared to subjects with low 1984 ASI scores, subjects with high 1984 ASI scores were five times more likely to have an anxiety disorder during the period 1984 to 1987. Test-retest reliability for the ASI across three years was .71. The study provided evidence for the stability of anxiety sensitivity over a long period of time and for the exceptionally strong relationships over time among anxiety sensitivity, panic attacks, and panic disorder.

Pavlovian conditioning and human fear: An expectancy model

Behavior therapists have explained phobias in terms of the contiguity principle of Pavlovian conditoning, which holds that conditioning results from CS-US temporal pairings. This principle provides a problematic account of phobias because CS-US pairings are neither necessary nor sufficient for fear acquisition in humans and because it cannot explain the Kamin blocking effect, conditioned inhibition, cessation conditioning, and overexpectedness in infrahuman conditioning. An expectancy model is proposed as an alternative to the contiguity model. The expectancy model holds that what is learned in Pavlovian conditioning is an expectation regarding the occurrence or nonoccurrence of the US. The mediating expectacy process can become an elicitor of CRs, verbal reports of CS-US relations (awareness), and instrumental behavior. The Wagner-Rescorla formulas for describing the learning of CRs in Pavlovian conditioning are assumed to have important implications for stimulus expectancy learning. A four-process model of phobias is proposed: (1) danger expectancy, (2) anxiety expectancy, (3) negative reinforcement of avoidance, and (4) positive (self-) reinforcement of avoidance. Implications are discussed for CS exposure therapies, placebos, self-efficacy, and aversion-relief therapy.

Theoretical perspectives on the fear of anxiety

Abstract Many people with anxiety disorders and phobias are afraid of experiencing anxiety. Psychoanalytic, existential, conditioning, and cognitive statements of the fear of anxiety are reviewed in this article. One conclusion is that there is a surprising degree of similarity among the various schools of thought. Another conclusion is that the fear of anxiety has been related theoretically to a much wider range of phenomena than is generally realized. The list includes agoraphobia, posttraumatic stress disorders, phobias, anxiety disorders, stress-related illnesses, anxiety incubation, placebo effects, anxious worrying, relaxation-induced anxiety, avoidance motivation, and fear exposure therapy. The concept of the fear of anxiety provides a theoretical basis for unifying a number of research areas. Empirical research is needed to evaluate the validity of these theoretical suggestions.

Anxiety sensitivity, injury sensitivity, and individual differences in fearfulness

Abstract This investigation evaluated the relationship between anxiety sensitivity (the fear of anxiety) and other fears. The results are based on new analyses of previously published data for a sample of 147 college students. In the first study, a factor analysis of pooled items from the Anxiety Sensitivity Index (ASI) and the Fear Survey Schedule-II (FSS-II) found that the ASI formed its own distinct factor. In the second study, a “Dissimilar Fear Survey” (DFS) was constructed, and the technique of multiple regression analysis was used to evaluate the relationships among the DFS and the variables of general anxiety level, anxiety sensitivity, and injury sensitivity (the fear of injury). When general anxiety level was held constant, anxiety sensitivity explained a significant amount of DFS variance that was not explained by injury sensitivity, and injury sensitivity explained a significant amount of variance not explained by anxiety sensitivity. The results provided evidence for distinguishing between anxiety sensitivity and other fears. The results also suggested a concept of fear sensitivity under which it might be impossible to construct a fear survey schedule with a low degree of internal reliability.

A behavioral validation of the anxiety sensitivity index

Abstract The purpose of this study was to validate the Reiss-Epstein-Gursky Anxiety Sensitivity Index (ASI) as a measure of the fear of anxiety. College students were asked to respond to two questions about the experience of anxiety and to two questions about anxiety-irrelevant topics. Mahls speech disturbance ratio, a valid and unobtrusive indicator of anxiety, served as the primary dependent measure. Compared with the Low ASI Group, the High ASI Group showed more anxiety to anxiety-relevant than anxiety-irrelevant questions. The findings provide some behavioral evidence of the validity of the ASI as a measure of the fear of anxiety.

Generality of diagnostic overshadowing across disciplines

In a 2 X 2 experimental design, advanced students in social work and clinical psychology rated the same case description of a debilitating fear on eight scales of psychopathology and need for therapy. The fear was rated as less neurotic, less irrational, and less likely to require desensitization therapy when the client was mentally retarded vs. of average intelligence. There were no significant differences in the ratings of the students in clinical psychology vs. social work. The results suggest that diagnostic overshadowing is not specific to the discipline of psychology and point to the need for explicit training of future mental health professionals in diagnosing emotional disturbances accompanying mental retardation.

Identifying danger and anxiety expectancies as components of common fears

The hypothesis was the common fears can be analyzed into separate factors for danger and anxiety expectancies. Six scales were constructed to measure danger and anxiety expectancies for the fears of flying, heights, and public speaking. The internal reliabilities of the scales were assessed in Study 1. The unreliable items were then deleted, and the revised scales were assessed in Study 2. The revised scales were found to have a satisfactory degree of internal consistency and test/retest reliability. For each fear, the items of the danger and anxiety expectancy scales were pooled and then submitted to a factor analysis. The danger and anxiety expectancy scales formed separate factors for each fear. The results were near-perfect; 51 of 53 items had factor loadings that were consistent with the distinction between danger and anxiety expectancies. It also was found that danger and anxiety expectancies are specific for each fear; that is, a person can have one fear that is danger-based and another that is anxiety-based. The findings have implications for understanding fears. Future research is suggested to test Reiss and McNallys (1985) hypothesis that desensitization might be more effective than credible placebo in the treatment of danger-based fear but that both desensitization and credible placebo are about equally effective in the treatment of anxiety-based fear.

The preparedness theory of phobias and human safety-signal conditioning

Abstract Seligmans preparedness theory of phobias implies that fear-relevant stimuli are contraprepared for safety-signal conditioning. This means that it should be very difficult to establish a fear-relevant stimulus as a safety-signal in nonphobic subjects. This hypothesis was tested in an electrodermal conditioning experiment with a picture of a snake serving as the fear-relevant CS and a picture of a flower serving as the fear-irrelevant CS. College students received discrimination training designed to establish the snake and the flower as safety-signals by nonreinforcing each in compound with a fear-eliciting CS. Although both the snake and the flower became conditioned safety-signals, neither stimulus showed greater safety-signal properties than the other. The results are inconsistent with predictions from preparedness theory.