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Wang S, Wang X, Dai H. Psychometric properties of anxiety sensitivity Index-3 among Chinese college students and its preliminary application among this population experiencing campus lockdown. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02713-2. [PMID: 38951154 DOI: 10.1007/s00127-024-02713-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 06/24/2024] [Indexed: 07/03/2024]
Abstract
PURPOSE Anxiety sensitivity (AS) refers to fear of anxiety-related sensory arousal and has been revealed to be associated with increased psychological distress and mental problems. Although Anxiety Sensitivity Index-3 (ASI-3) has been confirmed to be effective in evaluating this construct, whether it is consistently applicable in college students is still elusive. The present study aimed to examine the psychometric properties and measurement invariance of Chinese version of ASI-3 (C-ASI-3) among college students experiencing campus lockdown due to novel coronavirus disease 2019 (COVID-19) pandemic. METHODS A total of 1532 Chinese college students (397, 25.9% males) aged between 16 and 25 were included in this study. Confirmatory factor analysis (CFA) was used to verify the factor structure of C-ASI-3. Multi-group CFA was conducted for analysis of measurement invariance with regard to gender. McDonald's omega values were computed for examination of scale reliability. For criterion, convergent, and divergent validity, average variance extracted (AVE) values for C-ASI-3 subscales, difference between square root of AVE for each factor and inter-factor correlation, as well as pearson correlation and partial correlation between the C-ASI-3 and other three scales, including the Depression, Anxiety, and Stress Scale-21 (DASS-21), the State-Trait Anxiety Inventory (STAI), and the Fear of COVID-19 scale (FCV-19 S) were evaluated. RESULTS The C-ASI-3 presented a three-factor scale structure with fit indices being as follows: χ2/df = 11.590, CFI = 0.938, RMSEA = 0.083, SRMR = 0.042. Strict measurement invariance was reached across gender. Regarding convergent validity, the C-ASI-3 had a high correlation with the DASS-21 (r = 0.597, p < 0.01) and the STAI (r = 0.504, p < 0.01). All AVE values for C-ASI-3 subscales were above 0.5. In terms of divergent validity, the C-ASI-3 had medium correlation with the FCV-19 S (r = 0.360, p < 0.01). Square of root of AVE for each factor was higher that inter-factor correlation. McDonald's omega values of the three dimensions ranged from 0.898 ~ 0.958. CONCLUSION The C-ASI-3 has acceptable psychometric properties among college students. College students with different gender have consistent understanding on the scale construct.
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Affiliation(s)
- Suyan Wang
- Centre for Mental Health Guidance, Jinzhou Medical University, Jinzhou, 121001, People's Republic of China
| | - Xue Wang
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Jinzhou, Liaoning, 121001, People's Republic of China
| | - Hongliang Dai
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Jinzhou, Liaoning, 121001, People's Republic of China.
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Probert-Lindström S, Perrin S. An examination of distress tolerance, anxiety sensitivity, and intolerance of uncertainty in adults in routine psychiatric care. Acta Psychol (Amst) 2023; 235:103902. [PMID: 37004421 DOI: 10.1016/j.actpsy.2023.103902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 03/15/2023] [Accepted: 03/30/2023] [Indexed: 04/03/2023] Open
Abstract
AIM A person's ability to tolerate negative emotional states (Distress Tolerance - DT), uncertainty in their everyday lives (Intolerance of Uncertainty - IU), and a tendency to appraise their own feelings of anxiety as harmful (Anxiety Sensitivity - AS) have all been identified as vulnerability factors for anxiety and depressive disorders. However, the relationship between these variables and broader aspects of psychiatric symptom severity in participants recruited from routine care remains unclear. METHOD The Distress Tolerance Scale (DTS), Anxiety Sensitivity Scale-3 (ASI-3), and Intolerance of Uncertainty Scale-Short Form (IUS-12) were administered to 91 patients receiving treatment at the Lund Outpatient Psychiatric Clinic. Data was collected from their medical records about their psychiatric history and scores on the Brief Symptom Inventory (BSI). The relationship between total scores on the DTS, ASI-3, IUS-12 and BSI were evaluated via correlations and regression analyses. RESULTS DTS, ASI-3, and IUS-12 total scores correlated in the moderate to large range, and consistent with previous literature, were moderately to strongly correlated with the severity of self-reported depression, anxiety and overall symptoms (BSI). Regression analyses indicated that together, scores on the DTS, ASI-3 and IUS-12 explained moderate levels of variance in BSI symptom scores, with DTS scores showing the strongest associations. These findings suggest that further studies are needed to examine the construct and criterion validity of the three scales. Further validation of these Swedish-language are also warranted.
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Adams KL, Edwards A, Peart C, Ellett L, Mendes I, Bird G, Murphy J. The association between anxiety and cardiac interoceptive accuracy: A systematic review and meta-analysis. Neurosci Biobehav Rev 2022; 140:104754. [DOI: 10.1016/j.neubiorev.2022.104754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 11/25/2022]
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"Health Comes First": Action Tendencies to Health-Related Stimuli in People with Health-Anxiety as Revealed by an Emotional Go/No-Go Task. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179104. [PMID: 34501693 PMCID: PMC8431473 DOI: 10.3390/ijerph18179104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 11/16/2022]
Abstract
The processing of health-related stimuli can be biased by health anxiety and anxiety sensitivity but, at the moment, it is far from clear whether health-related stimuli can affect motor readiness or the ability to inhibit action. In this preliminary study, we assessed whether different levels of health anxiety and anxiety sensitivity affect disposition to action in response to positive and negative health-related stimuli in non-clinical individuals. An emotional go/no-go task was devised to test action disposition in response to positive (wellness-related), and negative (disease-related) stimuli in non-clinical participants who also underwent well-validated self-report measures of health anxiety and anxiety sensitivity. The main results showed that both health anxiety and anxiety sensitivity biased participants' responses. Importantly, safety-seeking and avoidance behaviors differently affected action disposition in response to positive and negative stimuli. These preliminary results support the idea that health anxiety and anxiety sensitivity could determine a hypervigilance for health-related information with a different perturbation of response control depending on the valence of the stimuli. Health anxiety and health anxiety disorder do form a continuum; thus, capturing different action tendencies to health-related stimuli could represent a valuable complementary tool to detect processing biases in persons who might develop a clinical condition.
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Hilton BT, Yusufov M, Rosellini AJ, Taghian NR, Weiss RD, Griffin ML, McHugh RK. Psychometric properties of the Anxiety Sensitivity Index-3 in adults with substance use disorders. J Subst Abuse Treat 2021; 132:108507. [PMID: 34214925 DOI: 10.1016/j.jsat.2021.108507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 11/18/2022]
Abstract
Anxiety sensitivity, or the fear of anxiety-related sensations, has demonstrated relevance to a broad range of psychiatric conditions, including substance use disorders (SUDs). Anxiety sensitivity is typically measured through self-report instruments, most commonly the Anxiety Sensitivity Index-3 (ASI-3). Despite the widespread use of the ASI-3 in studies of SUDs, little is known about its psychometric properties within this population. Patients on an inpatient detoxification unit seeking treatment for SUDs (N = 1248) completed a battery of self-report measures, including the ASI-3. Psychometric properties of the ASI-3 were examined. An exploratory factor analysis with half of the sample (n = 624) supported a 3-factor structure corresponding to the ASI-3 subscales (Social Concerns, Cognitive Concerns, Physical Concerns). Confirmatory factor analysis was used to validate this 3-dimensional structure in a separate subsample (n = 624), resulting in adequate fit when testing a second-order hierarchical model. Internal consistency and convergent and discriminant validity results also supported the use of the ASI-3 in people with SUDs. Despite its widespread use in SUD research, this is the first psychometric investigation of the ASI-3 among individuals seeking treatment for SUDs.
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Affiliation(s)
- Blake T Hilton
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States of America; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States of America.
| | - Miryam Yusufov
- Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States of America; Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, 450 Brookline Avenue, JF 707, Boston, MA 02215, United States of America
| | - Anthony J Rosellini
- Center for Anxiety and Related Disorders, Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Avenue, Boston, MA 02215, United States of America
| | - Nadine R Taghian
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States of America
| | - Roger D Weiss
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States of America; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States of America
| | - Margaret L Griffin
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States of America; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States of America
| | - R Kathryn McHugh
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States of America; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States of America
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Transdiagnostic Versus Construct-Specific Cognitive Behavioural Therapy for Emotional Disorders in Patients with High Anxiety Sensitivity: A Double-Blind Randomised Clinical Trial. BEHAVIOUR CHANGE 2021. [DOI: 10.1017/bec.2021.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractAnxiety sensitivity (AS) is a common vulnerability in emotional disorders. Due to the pathological role of AS, individuals with high AS are faced with emotional problems. Thus, cognitive behavioural interventions try to reduce these problems by targeting AS. The present study aimed to compare the efficacy of transdiagnostic cognitive behavioural therapy (T-CBT) and construct-specific CBT (CS-CBT) on AS, anxiety, depression, and positive and negative affect in these patients. To this end, 40 patients with high AS were randomly assigned to one of the three groups of T-CBT, CS-CBT, and wait list. Participants were assessed using the Anxiety and Related Disorders Interview Schedule for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Anxiety Sensitivity Index-3, Beck Anxiety Inventory, Beck Depression Inventory-II, and Positive and Negative Affect Schedule at baseline, post-treatment, 3-month follow-up, and 6-month follow-up. The findings showed that T-CBT and CS-CBT have a significant effect on AS, anxiety, and negative affect; however, contrary to T-CBT, CS-CBT is not effective for reducing depression and positive affect. T-CBT had a more promising efficacy than CS-CBT in all treatment outcomes. The results show better and more stable efficacy of T-CBT among patients with high AS. It is essential to consider AS as a target for cognitive behavioural intervention for the spectrum of emotional disorders.
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Tendency to Worry and Fear of Mental Health during Italy's COVID-19 Lockdown. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165928. [PMID: 32824152 PMCID: PMC7459855 DOI: 10.3390/ijerph17165928] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/11/2020] [Accepted: 08/11/2020] [Indexed: 11/30/2022]
Abstract
Background: We tested whether the tendency to worry could affect psychological responses to quarantine by capitalizing on the opportunity of having collected data before the COVID-19 outbreak on measures of worry, anxiety, and trait mindfulness in a group of university students. Methods: Twenty-five participants completed self-report measures assessing worry (Penn State Worry Questionnaire, PSWQ), anxiety (Anxiety Sensitivity Index, ASI-3), and trait mindfulness (Mindful Attention Awareness Scale, MAAS) at T0 (pre-lockdown, 4 November 2019–17 February 2020) and T1 (at the end of lockdown, 26 April–30 April 2020). We compared assessments at the two time points in the whole sample and in high and low worriers (defined at T0 by scores on PSWQ respectively above and below 1.5 SD from mean of the Italian normative sample). Outcomes: High worriers showed at T1 a significant increase of anxiety sensitivity and fear of mental health in comparison to low worriers. Moreover, in the whole sample, at T1 trait mindfulness was inversely related to worry and fear of mental health. Interpretation: A valuable approach to support individuals experiencing anxiety related to the COVID-19 outbreak could be represented by mindfulness-based interventions improving the ability to focus attention and awareness on the present moment.
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Melli G, Moulding R, Puccetti C, Pinto A, Caccico L, Drabik MJ, Sica C. Assessing beliefs about the consequences of not just right experiences: Psychometric properties of the Not Just Right Experience-Sensitivity Scale (NJRE-SS). Clin Psychol Psychother 2020; 27:847-857. [PMID: 32378795 DOI: 10.1002/cpp.2468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 04/20/2020] [Accepted: 05/03/2020] [Indexed: 11/07/2022]
Abstract
Although current cognitive conceptualizations of obsessive-compulsive disorder (OCD) emphasize that rituals are performed in order to avoid overtly threatening outcomes, it has also been noted that there are individuals for whom the attempt to correct "not just right experiences" (NJREs) rather than dangerous outcomes per se appear important. This article examines the idea that individuals have differing tolerances for-or sensitivity to-NJREs, in a similar manner as occurs regarding for other experience such as the distinction between disgust propensity and disgust sensitivity. In Study 1, using a nonclinical Italian sample, the NJRE-Sensitivity Scale (NJRE-SS) was created and refined. Its final version consisted of eight items loading on two subscales-an intolerance of NJREs due to their perceived interference with cognitive tasks and due to their interference with enjoyment of life. In Study 2, the factor structured was confirmed in a separate sample. The measure was found to have convergent validity with related measures including a separate measure assessing the severity and frequency of NJREs themselves. However, the NJRE-SS predicted OCD symptoms over-and-above the general NJRE measure, with particularly the interference with cognitive tasks subscale being of importance. Clinical implications are discussed.
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Affiliation(s)
- Gabriele Melli
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence, Florence, Italy
| | - Richard Moulding
- Centre for Mental Health and Wellbeing Research, Deakin University, Melbourne, Australia
| | - Camilla Puccetti
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence, Florence, Italy
| | - Antonio Pinto
- Cognitive and Behavioral Psychotherapy Center, Naples, Italy
| | - Laura Caccico
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence, Florence, Italy
| | - Marta Joanna Drabik
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence, Florence, Italy
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Metacognitive beliefs mediate the relationship between anxiety sensitivity and traits of obsessive-compulsive symptoms. BMC Psychol 2020; 8:40. [PMID: 32336292 PMCID: PMC7184693 DOI: 10.1186/s40359-020-00412-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 04/16/2020] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Metacognition has been shown as a key contributor to Obsessive Compulsive Disorder as well as other anxiety-related disorders, yet its role in the development and maintenance of these disorders remains unclear. This study aims to investigate whether anxiety sensitivity traits are related to obsessive-compulsive symptoms in the general population and whether the relationship between anxiety sensitivity and obsessive-compulsive symptoms is mediated by metacognition. METHODS Non-clinical volunteers (N = 156, mean age: 23.97, 121 females) completed measures related to state/trait anxiety, anxiety sensitivity, obsessive compulsive symptoms and metacognition. RESULTS A direct relationship between anxiety sensitivity and obsessive-compulsive symptoms was established. Further analysis revealed that metacognition was the strongest mediator of this relationship, even when accounting for state and trait anxiety. CONCLUSIONS Results suggest that the relationships between traits of anxiety sensitivity and obsessive-compulsive symptoms are partially attributable to the role of metacognition.
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Angehrn A, Krakauer RL, Carleton RN. The Impact of Intolerance of Uncertainty and Anxiety Sensitivity on Mental Health Among Public Safety Personnel: When the Uncertain is Unavoidable. COGNITIVE THERAPY AND RESEARCH 2020; 44:919-930. [PMID: 32848288 PMCID: PMC7434797 DOI: 10.1007/s10608-020-10107-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Public safety personnel (PSP; e.g., correctional workers and officers, firefighters, paramedics, police officers, public safety communications officials) are regularly exposed to potentially traumatic events and considerable uncertainty as part of their employment. Canadian PSP screen positively for mental disorders at much higher rates than the general population. Intolerance of uncertainty (IU) and anxiety sensitivity (AS) are empirically-supported vulnerability factors associated with the development and maintenance of mental disorders. METHODS The present study was designed to assess IU and AS across PSP-a population regularly encountering uncertainty-with and without mental disorders (n = 4304; 33.3% women), and across normative clinical, community, and undergraduate samples. Further, the study examined the relationship between IU and AS and mental disorders among PSP. RESULTS There were significant differences across groups on IU and AS scores (ps < .001). All PSP, with and without a positive screen for a mental disorder, reported lower IU and AS than clinical samples; however, PSP without mental disorders reported lower IU and AS than all other groups (ps < .001). CONCLUSION Increased resilience or the development of coping skills to manage regular exposures to uncertain threat may help explain why PSP reported low levels of IU and AS despite higher prevalence of mental disorders. Implications for PSP training and treatment are discussed.
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Affiliation(s)
- Andréanne Angehrn
- Anxiety and Illness Behaviour Laboratory, Department of Psychology, University of Regina, Regina, SK S4S 0A2 Canada
| | - Rachel L Krakauer
- Anxiety and Illness Behaviour Laboratory, Department of Psychology, University of Regina, Regina, SK S4S 0A2 Canada
| | - R Nicholas Carleton
- Anxiety and Illness Behaviour Laboratory, Department of Psychology, University of Regina, Regina, SK S4S 0A2 Canada
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Han Y, Zhu J, Li L, Zhou H, Li S, Zhang J, Fan J, Yang Y, Luo X, Zhu X. Psychometric Properties of the Chinese Version of Anxiety Sensitivity Index-3 in Women Diagnosed With Breast Cancer. Front Psychol 2020; 11:12. [PMID: 32116887 PMCID: PMC7019013 DOI: 10.3389/fpsyg.2020.00012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 01/06/2020] [Indexed: 12/18/2022] Open
Abstract
Background Anxiety sensitivity (AS) is a trait-like predisposing factor for the prevalence of anxiety in patients diagnosed with breast cancer. The Anxiety Sensitivity Index-3 (ASI-3) has been widely used in both general and clinical samples for measuring AS. However, the data about its psychometric properties in women with breast cancer are deficient. In addition, there is no evidence proving the measure equivalence of ASI-3 across sociodemographic variables in the specific sample. Thus, the present study examined the psychometric properties and conducted measure equivalence testing of ASI-3 in Chinese women diagnosed with breast cancer. Methods This study included 815 Chinese women diagnosed with breast cancer. Single group confirmatory factor analysis (CFA) was administrated to detect the factorial validity of ASI-3, and multigroup CFAs were conducted to test the measurement equivalence of ASI-3 across various sociodemographic variables. The reliability of ASI-3 was tested by Cronbach's alpha coefficient, Guttman split-half coefficient, McDonald's omega coefficient, and test-retest coefficient. The standardized factor loadings, construct reliability, and the average variance extracted of factors were used to measure the construct validity of ASI-3, and the partial correlations were conducted to examine the criterion-related validity of ASI-3. Results The ASI-3 had satisfactory reliability and validity in Chinese women diagnosed with breast cancer; three-factor model fitted the data well in CFA and reached partial strict invariances across age, education, and residence groups. Conclusion This study explored the psychometric properties and measurement invariance across sociodemographic variables of ASI-3 in Chinese women diagnosed with breast cancer. Our results not only proved that the ASI-3 is an appropriate instrument for measuring AS but also deepened the understanding of ASI-3 in Chinese women with malignancy.
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Affiliation(s)
- Yan Han
- Medical Psychological Center, Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China
| | - Jiang Zhu
- Medical Psychological Center, Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China
| | - Lingyan Li
- School of Nursing, Nanchang University, Nanchang, China
| | - Huan Zhou
- Medical Psychological Center, Second Xiangya Hospital, Central South University, Changsha, China
| | - Shichen Li
- Medical Psychological Center, Second Xiangya Hospital, Central South University, Changsha, China
| | - Jinqiang Zhang
- Medical Psychological Center, Second Xiangya Hospital, Central South University, Changsha, China
| | - Jie Fan
- Medical Psychological Center, Second Xiangya Hospital, Central South University, Changsha, China
| | - Yanjie Yang
- School of Public Health, Harbin Medical University, Harbin, China
| | - Xingwei Luo
- Medical Psychological Center, Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiongzhao Zhu
- Medical Psychological Center, Second Xiangya Hospital, Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China
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Is 'anxiety sensitivity' predictive of postoperative nausea and vomiting?: A prospective observational study. Eur J Anaesthesiol 2019; 36:369-374. [PMID: 30865002 DOI: 10.1097/eja.0000000000000979] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Postoperative nausea and vomiting (PONV) is an extremely distressing side effect for patients. Despite PONV prophylaxis guided by well established scoring systems, the incidence of PONV is still high. OBJECTIVE The aim of the current study was to investigate the predictive value of anxiety sensitivity as an additional independent risk factor for PONV in patients with an increased risk of PONV. DESIGN A noninterventional, observational study. SETTING A tertiary care university hospital. PATIENTS Patients with an increased risk of PONV (i.e. female, nonsmoking) undergoing elective surgery (general, gynaecological, urological, musculoskeletal or neurosurgical) under general anaesthesia. MAIN OUTCOME MEASURES The number of patients with anxiety sensitivity assessed pre-operatively with the Anxiety Sensitivity Index-3 questionnaire, the number of patients experiencing PONV, predictive value of anxiety sensitivity compared with other established risk factors for PONV. RESULTS Some 41.5% of the patients experienced PONV within the first 24 h after surgery. In these patients increased anxiety sensitivity (Anxiety Sensitivity Index-3 score higher than seven points) was associated with a five-fold increase in the odds ratio (OR) for PONV. From the regression model, the risk of PONV was increased by lack of PONV prophylaxis (OR, 3.68), the postoperative administration of opioids (OR, 3.60) and patient age (OR, 1.03), but laparoscopic surgery did not increase the risk. CONCLUSION In addition to the well established risk factors, anxiety sensitivity can help to predict the risk of PONV. It seems justifiable to add psychological factors such as anxiety sensitivity to PONV risk-scores. PONV prophylaxis should be considered when anxiety sensitivity is high. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01875120.
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Foroughi AA, Mohammadpour M, Khanjani S, Pouyanfard S, Dorouie N, Parvizi Fard AA. Psychometric properties of the Iranian version of the Anxiety Sensitivity Index-3 (ASI-3). TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2019; 41:254-261. [PMID: 31644692 DOI: 10.1590/2237-6089-2018-0078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 01/07/2019] [Indexed: 02/16/2023]
Abstract
INTRODUCTION Anxiety sensitivity plays a prominent role in the etiology of anxiety disorders. This construct has attracted widespread interest from experts and researchers. The Anxiety Sensitivity Index (ASI-3) is the most common scale for measuring anxiety sensitivity. OBJECTIVE To analyze the psychometric properties and factor structure of the ASI-3 in Iranian student samples. METHODS 220 students (135 women, 85 men) from Kermanshah University of Medical Sciences were selected by the convenience sampling method to evaluate the psychometric properties and analyze the factor structure of the ASI-3. The subjects were also asked to complete the Acceptance and Action Questionnaire-II (AAQ-II), Whiteley Index, Intolerance of Uncertainty, and Neuroticism scales. LISREL and SPSS were used to analyze the data. Cronbach's alpha and correlation coefficients were calculated and confirmatory factor analysis was conducted. RESULTS The results of the confirmatory factor analysis revealed a three-factor structure with physical, cognitive, and social components (comparative fit index = 0.94; normed fit index = 0.91; root mean square error of approximation = 0.09). The ASI-3 had positive and significant correlations with health anxiety (0.59), intolerance of uncertainty (0.29), and neuroticism (0.51). Furthermore, the ASI-3 had a negative and significant correlation with the AAQII (-0.58). Cronbach's alpha coefficients for the whole scale and for the physical, cognitive, and social concerns factors were 0.90, 0.74, 0.79, and 0.78, respectively. The invariance of the index was significant compared to the original English version. CONCLUSION In general, the results support the adequacy of the psychometric properties of the Persian version of the ASI-3. Theoretical and applied implications will be discussed.
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Affiliation(s)
- Ali Akbar Foroughi
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohsen Mohammadpour
- Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sajad Khanjani
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health, Tehran Psychiatric Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Sahar Pouyanfard
- Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nadia Dorouie
- Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Akbar Parvizi Fard
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Zainal NH, Newman MG, Hong RY. Cross-Cultural and Gender Invariance of Transdiagnostic Processes in the United States and Singapore. Assessment 2019; 28:485-502. [PMID: 31538795 DOI: 10.1177/1073191119869832] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Research Domain Criteria define cognitive and emotional processes (e.g., rumination, intolerance of uncertainty, anxiety sensitivity, emotion dysregulation) as key transdiagnostic elements of psychopathology. However, there is currently a dearth of construct equivalence studies on measures of these processes. We thus aimed to validate the latent structures of five transdiagnostic constructs using established and newer measures: two-factor Rumination-Reflection Questionnaire, six-factor Perseverative Cognitions Questionnaire, two-factor Intolerance of Uncertainty Scale, three-factor Anxiety Sensitivity Index-3, two-factor Cognitive and Behavioral Processes Questionnaire (CBPQ). Measurement equivalence was examined across 292 American and 144 Singaporean undergraduates. Cross-cultural confirmatory factor analyses revealed strict invariance for all measures, with interfactor association differences on the Perseverative Cognitions Questionnaire and CBPQ. Across gender, full invariance was found on all measures except the CBPQ. Theoretical and clinical implications are discussed.
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Lauriola M, Carleton RN, Tempesta D, Calanna P, Socci V, Mosca O, Salfi F, De Gennaro L, Ferrara M. A Correlational Analysis of the Relationships among Intolerance of Uncertainty, Anxiety Sensitivity, Subjective Sleep Quality, and Insomnia Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3253. [PMID: 31491841 PMCID: PMC6765836 DOI: 10.3390/ijerph16183253] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 08/29/2019] [Accepted: 08/31/2019] [Indexed: 02/05/2023]
Abstract
In this study, we used structural equation modeling to investigate the interplay among Intolerance of Uncertainty (IU), Anxiety Sensitivity (AS), and sleep problems. Three hundred undergraduate students completed the Intolerance of Uncertainty Scale, the Intolerance of Uncertainty Inventory, the Anxiety Sensitivity Index, the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Pittsburgh Sleep Quality Index and the Insomnia Severity Index. 68% and 40% of the students reported poor sleep quality or sub-threshold insomnia problems, respectively. Depression and anxiety levels were above the cut-off for about one-fourth of the participants. Structural equation modeling revealed that IU was strongly associated with AS, in turn influencing both insomnia severity and sleep quality via depression and anxiety. Significant indirect effects revealed that an anxious pathway was more strongly associated with insomnia severity, while a depression pathway was more relevant for worsening the quality of sleep. We discussed the results in the frameworks of cognitive models of insomnia. Viewing AS and IU as antecedents of sleep problems and assigning to AS a pivotal role, our study suggested indications for clinical interventions on a population at risk for sleep disorders.
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Affiliation(s)
- Marco Lauriola
- Department of Social and Developmental Psychology, Sapienza, University of Rome, 00185 Rome, Italy.
| | | | - Daniela Tempesta
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
| | - Pierpaolo Calanna
- Department of Dynamic and Clinical Psychology, Sapienza, University of Rome, 00185 Rome, Italy.
| | - Valentina Socci
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
| | - Oriana Mosca
- Department of Social and Developmental Psychology, Sapienza, University of Rome, 00185 Rome, Italy.
| | - Federico Salfi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
| | - Luigi De Gennaro
- Department of Psychology, Sapienza, University of Rome, 00185 Rome, Italy.
| | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
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Lauriola M, Tomai M, Palma R, La Spina G, Foglia A, Panetta C, Raniolo M, Pontone S. Intolerance of Uncertainty and Anxiety-Related Dispositions Predict Pain During Upper Endoscopy. Front Psychol 2019; 10:1112. [PMID: 31156518 PMCID: PMC6529782 DOI: 10.3389/fpsyg.2019.01112] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 04/29/2019] [Indexed: 12/16/2022] Open
Abstract
Although sedatives can defuse anxiety and relieve pain, Esophagogastroduodenoscopy (EGD) still is uncomfortable and threatening for some patients. Identifying patients who tolerate digestive endoscopy less well remains difficult. Using a prospective design and a multimodal assessment of pain, the present study evaluated how anxiety-related variables predicted subsequent pain outcomes. Sixty-two consecutive patients referred for elective EGD were assessed for intolerance of uncertainty (IU), procedure-related worries, anxiety sensitivity and health distress before endoscopy. During endoscopy, a doctor rated patients’ pain behavior. After complete recovery from sedation, the patients retrospectively rated endoscopy pain and situation specific catastrophizing thoughts. Descriptive analyses showed that patients undergoing EGD for the first time were more distressed and anxious than patients accustomed to the procedure and needed a higher sedative dose. Notwithstanding sedation, the behavioral rating of pain was above the cut-off value for probable pain for more than half of the patients. IU assessed before endoscopy predicted situational pain catastrophizing (PC) and self-reported pain after endoscopy through procedure related worries. Situational PC not only mediated the effect of worry, but also female gender and younger age were associated with self-reported pain through increased catastrophizing thoughts. Health distress and anxiety sensitivity predicted PC only for women, younger patients, and those not accustomed to the procedure. Our study showed that psychological preparation before sedation is needed especially for first-timers, women, and younger patients, addressing maladaptive cognitive beliefs and acquainting patients with the somatic sensations that they might experience during the procedure.
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Affiliation(s)
- Marco Lauriola
- Department of Social and Developmental Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Manuela Tomai
- Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Rossella Palma
- Department of Surgical Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Gaia La Spina
- Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Anastasia Foglia
- Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Cristina Panetta
- Department of Surgical Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Marilena Raniolo
- Department of Surgical Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Stefano Pontone
- Department of Surgical Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
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Cai W, Dong W, Pan Y, Wei C, Zhang S, Tian B, Yan J, Deng G. Reliability, validation and norms of the Chinese version of Anxiety Sensitivity Index 3 in a sample of military personnel. PLoS One 2018; 13:e0201778. [PMID: 30092028 PMCID: PMC6084940 DOI: 10.1371/journal.pone.0201778] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 07/23/2018] [Indexed: 12/21/2022] Open
Abstract
This study aimed to explore the properties of the Chinese version of the Anxiety Sensitivity Index– 3 (ASI-3) in a sample of military personnel. Using non-probabilistic sampling, the Chinese version of the ASI-3 was administered to 3,077 valid participants aged 16 to 36 years old (M = 22.35, SD = 3.57) from nine military units. The Depression Anxiety Stress Scales-21 (DASS-21) and The State-Trait Anxiety Inventory (STAI) were used to assess the construct validity. A one-way analysis of variance was conducted to compare the differences in the services and positions of the participants. It was found that ①The indices of confirmatory factor analysis met the standard values, which supported the hypothesis of the three-factor model of the original ASI-3; ②ASI-3 was significantly associated with DASS-21 in positive ways, which indicated the high convergent validity; on the other hand, the correlation between ASI-3 and TAI was relatively low, which indicated there was an empirical discrimination between anxiety sensitivity and trait anxiety. ③The Cronbach’s α coefficients were 0.926 for the total scale and 0.828–0.841 for the three subscales; ④At a cut-off score of 16, the sensitivity and specificity levels were 71.1% and 76.7%, respectively, where the sum of sensitivity and specificity becomes the maximum, accompanied with improvement of PPV and NPV; ⑤There were significant findings in the ASI and subscales among the five services and four positions. This study provides new evidence that the Chinese version of the Anxiety Sensitivity Index-3 has good validity and reliability and could be applied as an effective tool to assess anxiety sensitivity in military personnel. Our recommendations to researchers and practitioners are that the three factor model should be replicated across some different special forces and the items and constructs could be modified on Chinese culture.
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Affiliation(s)
- Wenpeng Cai
- Department of Psychology and Mental Health, Second Military Medical University, Shanghai, China
| | - Wei Dong
- Department of Psychology and Mental Health, Second Military Medical University, Shanghai, China
| | - Yu Pan
- Department of Medical Psychology, General Hospital of PLA, Beijing, China
| | - Cun Wei
- Department of Psychology and Mental Health, Second Military Medical University, Shanghai, China
| | - Shuimiao Zhang
- Department of Neurology, Jinan Military General Hospital of PLA, Jinan, China
| | - Bin Tian
- Department of Psychology and Mental Health, Second Military Medical University, Shanghai, China
| | - Jin Yan
- Department of Psychology and Mental Health, Second Military Medical University, Shanghai, China
| | - Guanghui Deng
- Department of Psychology and Mental Health, Second Military Medical University, Shanghai, China
- * E-mail:
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18
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Riskind JH, Sica C, Bottesi G, Ghisi M, Kashdan TB. Cognitive vulnerabilities in parents as a potential risk factor for anxiety symptoms in young adult offspring: An exploration of looming cognitive style. J Behav Ther Exp Psychiatry 2017; 54:229-238. [PMID: 27614663 DOI: 10.1016/j.jbtep.2016.08.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 08/21/2016] [Accepted: 08/22/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVES Given that anxiety runs in families, it is critical to understand the cognitive factors that may be responsible for this intergenerational transmission. The present study offers a first step by exploring the link between mother and father tendencies to view potentially threatening situations as rapidly escalating toward dreaded outcomes (i.e., looming cognitive style) and the emotional disturbances and looming cognitive styles of their adult offspring. METHODS We assessed cognitive vulnerabilities, anxiety, and depressive symptoms in a non-clinical sample (N = 382) of Italian college students and their parents. RESULTS The looming cognitive style of fathers, but not mothers, was significantly related to greater anxiety in adult offspring. This finding was obtained for both sons and daughters, and remained even after statistically controlling for the anxiety, worry, depressive symptoms, and anxiety sensitivity (AS) of parents). Notably, the association between fathers' looming cognitive style and offspring symptoms was not related to their child's depressive symptoms, and similar to prior work, served as a cognitive marker specific to anxiety. LIMITATIONS The present study relied on a cross-sectional design and did not use clients diagnosed with anxiety disorders. CONCLUSIONS The findings suggest that it may prove fruitful to consider parental vulnerabilities such as looming cognitive styles in comprehensive cognitive and interpersonal models of anxiety. The intergenerational transmission of emotional difficulties seems to extend beyond anxiety to beliefs about the escalation of threat.
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Affiliation(s)
- John H Riskind
- Department of Psychology, George Mason University, Fairfax, VA, USA.
| | - Claudio Sica
- Department of Human Health Sciences, University of Firenze, Italy
| | - Gioia Bottesi
- Department of General Psychology, University of Padova, Italy
| | - Marta Ghisi
- Department of General Psychology, University of Padova, Italy
| | - Todd B Kashdan
- Department of Psychology, George Mason University, Fairfax, VA, USA
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