Fear sensitivity
Anxiety sensitivity ( AS ) is a relatively young construct within psychology and describes the (unspecific) fear or (concrete) fear of symptoms that can accompany states of activation of the sympathetic nervous system , for example fast heartbeat, fast and shallow breathing, cold and sweaty Hands, tremors, dizziness, nausea etc. (Kemper, 2010). The fear sensitivity is based on conceptual and empirical work on the older construct of fear of fear (also called phobophobia ), which can be viewed as largely congruent.
The activation of the sympathetic nervous system is usually triggered by threatening situations, but in principle can also have other triggers, such as the consumption of caffeine or physical exertion. The core of the construct is that arousal symptoms are experienced and feared as aversive. Numerous researchers, particularly from North America, have been intensively involved in empirical and conceptual considerations of fear sensitivity in recent years, including Steven Taylor, Richard McNally, Brian Cox, Scott Lilienfeld and many others. Fear sensitivity was conceptualized for the first time in the context of the expectation model of fear, anxiety and panic by Steven Reiss (Reiss, 1991).
structure
According to Reiss (1991), fear sensitivity is a one-dimensional construct. However, after more than 20 years of structural research and numerous studies (for a tabular overview of structural analysis findings, see Kemper, 2010), this idea had to be rejected. The vast majority of structural analyzes with different operationalizations of the construct suggest that fear sensitivity is a hierarchically organized construct with a general first-order factor and several specific second-order factors. So far, there is less consensus on the number and interpretation of the primary factors. Three factors are currently considered to be robust facets of the construct: "fear of somatic symptoms", "fear of social symptoms" and "fear of cognitive symptoms". Some studies with extensive item sets (e.g. with the Anxiety Sensitivity Index-Revised) suggest that a further breakdown of the somatic factor into "fear of cardiovascular symptoms" and "fear of respiratory symptoms" is possible.
In addition to this dimensional conceptualization of a construct, which is usual for personality traits, Bernstein and colleagues (2007) put forward the hypothesis that people do not differ in their degree of fear sensitivity (dimensional approach), but rather in the type of fear sensitivity (categorical approach; taxonicity hypothesis of the Fear sensitivity). These authors postulated a categorical latent structure with two qualitatively different types of anxiety sensitivity: an adaptive type, which all people should have, and a maladaptive type, which results from a split from the adaptive type and is supposed to promote the development of psychological problems. So far, this hypothesis has only been proven by studies from Amit Bernstein's working group. A comprehensive study by Kemper (2010), which addressed the question of the latent structure of the construct, produced solid evidence that speaks against a categorical structure of fear sensitivity. For the time being, inter-individual differences in fear sensitivity should therefore be viewed as differences in the degree of severity and not in the type of fear sensitivity.
Measurement
In the last 20 years, numerous self- reporting procedures have been developed and published that are more or less suitable for measuring fear sensitivity. Some procedures have been specially designed for this purpose. Others target related constructs or sub-aspects of fear sensitivity. The procedures can be classified into two categories:
The first category contains procedures that are mainly assigned to the clinical area, for example Agoraphobic Cognitions Questionnaire, Body Sensations Questionnaire, Mobility Inventory, Panic Attack Questionnaire, Panic and Agoraphobia Scale, Panic Appraisal Inventory, Panic Belief Questionnaire (for more information on these procedures see Peterson & Plehn, 1999). They are mainly used for disorder-specific diagnostics in people with panic disorder or agoraphobia. They record, for example, panic symptoms, avoidance behavior, cognitions during intense fear or beliefs about the harmfulness of arousal. The recorded contents show a moderate to high overlap with fear sensitivity. This is particularly true in the area of fear of somatic symptoms. These measures can be seen as operationalizations of closely related constructs of fear sensitivity. Some can even be described as alternative operationalizations (cf. Peterson & Plehn, 1999). However, there are well-founded doubts about the breadth with which these methods are able to depict the construct of fear sensitivity. They each capture only a partial aspect of fear sensitivity.
The second category includes self-reporting procedures based on the assumption that fear of one's own arousal symptoms is a stable personality trait and that all people are more or less sensitive to arousal symptoms (cf. Reiss, 1991). The construction of these procedures was not based on the disorder models of clinical psychology . In contrast to the disorder-specific self-reporting methods mentioned above, these methods not only capture partial aspects of fear sensitivity, such as fear of somatic symptoms, but also a general AS dimension (cf. Peterson & Plehn, 1999). This category of procedures includes Anxiety Sensitivity Index (ASI), Anxiety Sensitivity Profile (ASP), Anxiety Sensitivity Index-Revised (ASI-R), Anxiety Sensitivity Index-3 (ASI-3), Beliefs About Negative Consequences Inventory (BANCI) . German translations are available for all variants of the ASI, the psychometric quality of which has been checked and verified, e.g. B. Anxiety Sensitivity Index-3 (Kemper, Ziegler, & Taylor; 2009) or Anxiety Sensitivity Index-R (Kemper & Ziegler, 2007) (for an overview of the procedures and their psychometric quality, see Kemper, 2010). At the moment, the ASI-3 is most frequently used both nationally and internationally to record fear sensitivity.
meaning
The high relevance of fear sensitivity within psychology, but especially within clinical psychology and diagnostics, results from the role of this characteristic in the development and maintenance of mental disorders . In various studies, connections between fear sensitivity and mental disorders (e.g. diagnosed according to DSM-IV of the American Psychological Association) could be shown. In particular, anxiety and affective disorders are associated with increased levels of anxiety sensitivity: panic and agoraphobia, social phobia, obsessive-compulsive disorder, specific phobia, post-traumatic stress disorder and depression. Panics and agoraphobics usually show the highest scores compared to people with other anxiety disorders, which underlines the particular relevance of fear sensitivity or fear of fear in these disorders. The high levels of these two groups are essentially due to one of the AS facets, namely the fear of somatic symptoms of anxiety. Further findings from AS research suggest that anxiety sensitivity is not just a correlate or a consequence of anxiety disorders, but a risk factor for their development. Initial prospective studies suggest that the risk of developing an anxiety disorder in people who fear unpleasant but harmless and temporary arousal symptoms is 2-3 times higher than in people with low anxiety sensitivity (Schmidt, Zvolensky & Maner, 2006) . At present, fear sensitivity is viewed in the specialist literature as a risk factor for the development of mental disorders, especially those related to the fear spectrum (for a detailed description of the findings described in this section, see Kemper, 2010).
literature
- Bernstein, A., Zvolensky, MJ, Stewart, S., & Comeau, N .: Taxometric and factor analytic models of anxiety sensitivity among youth: Exploring the latent structure of anxiety psychopathology vulnerability . In: Behavior Therapy . tape 38 , no. 3 , 2007, p. 269-283 .
- Kemper, CJ, & Ziegler, M .: Construct validity of a questionnaire to determine fear sensitivity . In: H. Eschenbeck, U. Heim-Dreger & C.-W. Kohlmann (Ed.): Contributions to Health Psychology, Gmünder Hochschulreihe, Volume 29 . University of Education, Schwäbisch Gmünd 2007, ISBN 978-3-925555-35-0 , p. 82 .
- Kemper, CJ, Ziegler, M., & Taylor, S .: Review of the psychometric quality of the German version of the anxiety sensitivity index-3 . In: Diagnostica . tape 55 , no. 4 , 2009, p. 223-233 .
- Kemper, CJ: The Personality Trait Fear Sensitivity: Taxon or Dimension? - An analysis with the mixed distribution Rasch model . Dr. Kovac, Hamburg 2010, ISBN 978-3-8300-5119-0 .
- Peterson, RA, & Plehn, K .: Measuring anxiety sensitivity . In: S. Taylor (Ed.): Anxiety sensitivity - Theory, research, and treatment of the fear of anxiety . Erlbaum, Mahwah 1999, p. 61-82 .
- Reiss, S .: Expectancy model of fear, anxiety, and panic . In: Clinical Psychology Review . tape 11 , 1991, p. 141-153 .
- Schmidt, NB, Zvolensky, MJ, & Maner, JK: Anxiety sensitivity: Prospective prediction of panic attacks and Axis I pathology . In: Journal of Psychiatric Research . tape 40 , no. 8 , 2006, p. 691-699 .