Summary: "Anxiety sensitivity profile: predictive and incremental validity"
August 15, 2017
Schmidt NB, Keough ME, Timpano KR, Richey JA. Anxiety sensitivity profile: predictive and incremental validity. J Anxiety Disord. 2008 Oct;22(7):1180-9. doi: 10.1016/j.janxdis.2007.12.003. Epub 2008 Feb 1. PubMed PMID: 18242951; PubMed Central PMCID: PMC2600663.
Individuals with high levels of anxiety sensitivity (AS) tend to perceive the symptoms of stress-related autonomic arousal – symptoms such as racing heartbeat, tightened chest, rapid breathing, tense muscles, and so on – as indicators that they are about to experience unavoidable harm, thus causing those individuals to feel intense anxiety or even panic when faced with stressful situations. Evidence indicates that the degree to which someone experiences AS can be used to predict the likelihood that they will be diagnosed with an anxiety disorder at some point in the future. However, the main questionnaire used to assess AS, the ASI, treats it as more of a one-dimensional quality than it really is. In contrast, the recently developed ASP questionnaire focuses on many different elements that can lead one to experience AS; however, this test is lengthy to administer, and questions with regards to its accuracy exist. As a result, more research into its potential is necessary. Schmidt and colleagues, in a 2008 study, decided to compare the ASP to the ASI on several levels in order to test its usefulness as a clinical tool. They hypothesized that using a 22-question version of the ASP (here referred to as the ASP-22) as opposed to the full 60-question version would not affect the ASP’s reliability, and wanted to test whether the ASP was comparable to or greater than the ASI in terms of its ability to predict future occurrences of anxiety disorder diagnoses or panic attacks. To test these hypotheses, participants were given clinical interviews as well as the AS screeners, followed by a presentation on either stress or dietary effects on health. After the presentation, each participant was exposed to air that was 20% carbon dioxide (CO2), with their biological responses and psychological expectations assessed both before and after the air exposure.
Results showed that the ASP was moderately correlated to the ASI in assessing a patient’s AS, and that the ASP-22 was strongly correlated to the full ASP in terms of measured constructs, thus providing evidence as to its use as a clinical tool. The ASP-22 was more useful in determining reactions to immediate, short-term experiences: it accurately predicted the responses which participants had to the CO2 challenge. This stands in contrast to the ASI, which did not have statistically significant results when making predictions in this part of the experiment. However, when it comes to long-term predictive abilities, the ASI proved to be the more useful tool, able to predict if a participant would, during the two years between the onset of the experiment and the follow-up clinical interview, be diagnosed with any mental disorder, be diagnosed with one of the anxiety disorders, or experience a panic attack. In contrast, looking at the correlations between the ASP’s predictions for the future and actual occurrences showed that the prediction of diagnosis with an anxiety disorder was the only significant correlation, and that this correlation was weaker than that of the ASI and anxiety diagnosis. Although more research into its reliability is still necessary, for the ASP does show promise in becoming a standalone questionnaire, for now it would be worthwhile to use it as a supplement to the ASI!