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From Higher-Order to Underlying Constructs: Examining the Relationships Between Affect and Fundamental Fears

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Abstract

Targeting constructs that contribute to positive and negative affect may lead to clinically significant reductions in symptoms of principal and co-occurring psychopathology. Anxiety sensitivity, the fear of negative evaluation, and illness/injury sensitivity have been described as three fundamental fears that underlie anxiety-related disorders. Despite the contemporary relevance of the fundamental fears, positive affect, and negative affect as treatment targets, research into how these constructs relate to each other remains scant. Community participants (n = 287) completed measures of affect and the fundamental fears. Canonical correlations, regression analyses, and moderator analyses revealed strong associations between negative affect and each of anxiety sensitivity, the fear of negative evaluation, and illness/injury sensitivity and a weaker but significant inverse relationship with positive affect. The fundamental fears shared a substantive amount of variance (42 %) with positive and negative affect, and this overlap may warrant attention from researchers and clinicians focusing on specific or transdiagnostic features of anxiety.

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References

  • Allen, L. B., McHugh, R. K., & Barlow, D. H. (2008). Emotional disorders: A unified protocol. In D. H. Barlow (Ed.), Clinical handbook of psychological disorders. New York: Guildford Press.

    Google Scholar 

  • Asmundson, G. J. G., Norton, P. J., & Norton, G. R. (1999). Beyond pain: The role of fear and avoidance in chronicity. Clinical Psychology Review, 19(1), 97–119. doi:10.1016/S0272-7358(98)00034-8.

    Article  PubMed  CAS  Google Scholar 

  • Asmundson, G. J. G., Norton, P. J., & Vlaeyen, J. W. S. (2004). Fear-avoidance models of chronic pain: An overview. In G. J. G. Asmundson, J. W. S. Vlaeyen, & G. Crombez (Eds.), Understanding and treating fear of pain (pp. 3–24). Oxford: Oxford University Press.

    Google Scholar 

  • Asmundson, G. J. G., Weeks, J. W., Carleton, R. N., Thibodeau, M. A., & Fetzner, M. G. (2011). Revisiting the latent structure of the anxiety sensitivity construct: More evidence of dimensionality. Journal of Anxiety Disorders, 25(1), 138–147. doi:10.1016/j.janxdis.2010.08.013.

    Article  PubMed  Google Scholar 

  • Barlow, D. H. (2010). Unified protocol for transdiagnostic treatment of emotional disorders: Therapist guide. Oxford: Oxford University Press.

    Google Scholar 

  • Benitez, C. I., Shea, M. T., Raffa, S., Rende, R., Dyck, I. R., Ramsawh, H. J., et al. (2009). Anxiety sensitivity as a predictor of the clinical course of panic disorder: A 1-year follow-up study. Depression and Anxiety, 26(4), 335–342. doi:10.1002/da.20423.

    Article  PubMed  Google Scholar 

  • Brown, T. A. (2007). Temporal course and structural relationships among dimensions of temperament and DSM-IV anxiety and mood disorder constructs. Journal of Abnormal Psychology, 116(2), 313–328. doi:10.1037/0021-843X.116.2.313.

    Article  PubMed  Google Scholar 

  • Brown, T. A., Campbell, L. A., Lehman, C. L., Grisham, J. R., & Mancill, R. B. (2001). Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. Journal of Abnormal Psychology, 110(4), 585–599.

    Article  PubMed  CAS  Google Scholar 

  • Brown, T. A., Chorpita, B. F., & Barlow, D. H. (1998). Structural relationships among dimensions of the DSM-IV anxiety and mood disorders and dimensions of negative affect, positive affect, and autonomic arousal. Journal of Abnormal Psychology, 107(2), 179–192.

    Article  PubMed  CAS  Google Scholar 

  • Carleton, R. N., & Asmundson, G. J. (2009). The multidimensionality of fear of pain: Construct independence for the fear of pain questionnaire-short form and the pain anxiety symptoms scale-20. Journal of Pain, 10(1), 29–37. doi:10.1016/j.jpain.2008.06.007.

    Article  PubMed  Google Scholar 

  • Carleton, R. N., Asmundson, G. J. G., & Taylor, S. (2005). Fear of physical harm: Factor structure and psychometric properties of the injury/illness sensitivity index. Journal of Psychopathology and Behavioral Assessment, 27(4), 235–341.

    Article  Google Scholar 

  • Carleton, R. N., Collimore, K. C., & Asmundson, G. J. (2007a). Social anxiety and fear of negative evaluation: Construct validity of the BFNE-II. Journal of Anxiety Disorders, 21(1), 131–141. doi:10.1016/j.janxdis.2006.03.010.

    Article  PubMed  Google Scholar 

  • Carleton, R. N., Collimore, K. C., & Asmundson, G. J. (2010). “It’s not just the judgements–It’s that I don’t know”: Intolerance of uncertainty as a predictor of social anxiety. Journal of Anxiety Disorders, 24(2), 189–195. doi:10.1016/j.janxdis.2009.10.007.

    Article  PubMed  Google Scholar 

  • Carleton, R. N., Collimore, K. C., McCabe, R. E., & Antony, M. M. (2011a). Addressing revisions to the brief fear of negative evaluation scale: Measuring fear of negative evaluation across anxiety and mood disorders. Journal of Anxiety Disorders, 25(6), 822–828. doi:10.1016/j.janxdis.2011.04.002.

    Article  PubMed  Google Scholar 

  • Carleton, R. N., Park, I., & Asmundson, G. J. G. (2006). The illness/injury sensitivity index: An examination of construct validity. Depression and Anxiety, 23(6), 340–346. doi:10.1002/da.20138.

    Article  PubMed  Google Scholar 

  • Carleton, R. N., Sharpe, D., & Asmundson, G. J. (2007b). Anxiety sensitivity and intolerance of uncertainty: Requisites of the fundamental fears? Behaviour Research and Therapy, 45(10), 2307–2316. doi:10.1016/j.brat.2007.04.006.

    Article  PubMed  Google Scholar 

  • Carleton, R. N., Weeks, J. W., Howell, A. N., Asmundson, G. J., Antony, M. M., & McCabe, R. E. (2011b). Assessing the latent structure of the intolerance of uncertainty construct: An initial taxometric analysis. Journal of Anxiety Disorders, 150–157. doi:10.1016/j.janxdis.2011.10.006.

  • Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100(3), 316–336.

    Article  PubMed  CAS  Google Scholar 

  • Craske, M. G., & Barlow, D. H. (2008). Panic disorder and agoraphobia. In D. H. Barlow (Ed.), Clinical handbook of psychological disorders. New York: Guildford Press.

    Google Scholar 

  • Dugas, M. J., Freeston, M. H., & Ladouceur, R. (1997). Intolerance of uncertainty and problem orientation in worry. Cognitive Therapy and Research, 21(6), 593–606. doi:10.1023/A:1021890322153.

    Article  Google Scholar 

  • Echambadi, R., & Hess, J. D. (2007). Mean-centering does not alleviate collinearity problems in moderated multiple regression models. Marketing Science, 6, 438–445.

    Article  Google Scholar 

  • Ellard, K. K., Fairholme, C. P., Boisseau, C. L., Farchione, T. J., & Barlow, D. H. (2010). Unified protocol for the transdiagnostic treatment of emotional disorders: Protocol development and initial outcome data. Cognitive and Behavioral Practice, 17(1), 88–101. doi:10.1016/j.cbpra.2009.06.002.

    Article  Google Scholar 

  • Fetzner, M. G., Collimore, K. C., Carleton, R. N., & Asmundson, G. J. (2011). Clarifying the relationship between AS dimensions and PTSD symptom clusters: Are negative and positive affectivity theoretically relevant constructs? Cognitive Behaviour Therapy, 41(1), 15–24. doi:10.1080/16506073.2011.621971.

    Article  PubMed  Google Scholar 

  • Joiner, T. E. (1996). A confirmatory factor-analytic investigation of the tripartite model of depression and anxiety in college students. Cognitive Therapy and Research, 20(5), 521–539.

    Article  Google Scholar 

  • Jolly, J. B., & Dykman, R. A. (1994). Using self-report data to differentiate anxious and depressive symptoms in adolescents: Cognitive content specificity and global distress. Cognitive Therapy and Research, 18(1), 25–37.

    Article  Google Scholar 

  • Kashdan, T. B. (2007). Social anxiety spectrum and diminished positive experiences: Theoretical synthesis and meta-analysis. Clinical Psychology Review, 27(3), 348–365. doi:10.1016/j.cpr.2006.12.003.

    Article  PubMed  Google Scholar 

  • Leary, M. R. (1983). A brief version of the fear of negative evaluation scale. Personality and Social Psychology Bulletin, 9(3), 371–375.

    Article  Google Scholar 

  • McEvoy, P. M., Nathan, P., & Norton, P. J. (2009). Efficacy of transdiagnostic treatments: A review of published outcome studies and future research directions. Journal of Cognitive Psychotherapy, 23(1), 20–33. doi:10.1891/0889-8391.23.1.20.

    Article  Google Scholar 

  • Mineka, S., Watson, D., & Clark, L. A. (1998). Comorbidity of anxiety and unipolar mood disorders. Annual Review of Psychology, 49(1), 377–412.

    Article  PubMed  CAS  Google Scholar 

  • Mounce, C., Keogh, E., & Eccleston, C. (2010). A principal components analysis of negative affect-related constructs relevant to pain: Evidence for a three component structure. The Journal of Pain, 11(8), 710–717. doi:10.1016/j.jpain.2009.10.014.

    Article  PubMed  Google Scholar 

  • Naragon-Gainey, K., Watson, D., & Markon, K. E. (2009). Differential relations of depression and social anxiety symptoms to the facets of extraversion/positive emotionality. Journal of Abnormal Psychology, 118(2), 299–310. doi:10.1037/a0015637.

    Article  PubMed  Google Scholar 

  • Rapee, R. M., & Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in social phobia. Behaviour Research and Therapy, 35(8), 741–756.

    Article  PubMed  CAS  Google Scholar 

  • Reiss, S., & McNally, R. J. (1985). The expectancy model of fear. In S. Reiss & R. R. Bootzin (Eds.), Theoretical Issues in behaviour therapy (pp. 107–121). New York: Academic Press.

    Google Scholar 

  • Reiss, S., Peterson, R. A., Gursky, D. M., & McNally, R. J. (1986). Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behaviour Research and Therapy, 24(1), 1–8.

    Article  PubMed  CAS  Google Scholar 

  • Rodebaugh, T. L., Woods, C. M., Thissen, D. M., Heimberg, R. G., Chambless, D. L., & Rapee, R. M. (2004). More information from fewer questions: The factor structure and item properties of the original and brief fear of negative evaluation scale. Psychological Assessment, 16(2), 169–181. doi:10.1037/1040-3590.16.2.169.

    Article  PubMed  Google Scholar 

  • Schmidt, N. B., Lerew, D. R., & Jackson, R. J. (1997). The role of anxiety sensitivity in the pathogenesis of panic: Prospective evaluation of spontaneous panic attacks during acute stress. Journal of Abnormal Psychology, 106(3), 355–364.

    Article  PubMed  CAS  Google Scholar 

  • Schmidt, N. B., & Mallott, M. (2006). Evaluating anxiety sensitivity and other fundamental sensitivities predicting anxiety symptoms and fearful responding to a biological challenge. Behaviour Research and Therapy, 44(11), 1681–1688. doi:10.1016/j.brat.2005.12.001.

    Article  PubMed  Google Scholar 

  • Schützler, L., Carleton, R. N., & Witt, C. M. (2012). The Illness/Injury Sensitivity Index: Validation of a German Version of the ISI-R. Cognitive Behaviour Therapy. Advance online publication. doi:10.1080/16506073.2011.640345.

    PubMed  Google Scholar 

  • Tabachnick, B. G., & Fidell, L. S. (2012). Using multivariate statistics (6th ed.). Boston: Pearson Education.

    Google Scholar 

  • Tanay, G., Lotan, G., & Bernstein, A. (2012). Salutary proximal processes and distal mood and anxiety vulnerability outcomes of mindfulness training: A pilot preventive intervention. Behaviour Therapy, 43(3), 492–505. doi:10.1016/j.beth.2011.06.003.

    Article  Google Scholar 

  • Taylor, S. (1993). The structure of fundamental fears. Journal of Behavior Therapy and Experimental Psychiatry, 24(4), 289–299.

    Article  PubMed  CAS  Google Scholar 

  • Taylor, S. (1999). Anxiety sensitivity: Theory, research, and treatment of the fear of anxiety. Mahwah, NJ: Lawrence Erlbaum.

    Google Scholar 

  • Taylor, S., & Clark, D. A. (2009). Transdiagnostic cognitive-behavioral treatments for mood and anxiety disorders: Introduction to the special issue. Journal of Cognitive Psychotherapy, 23(1), 3–5.

    Article  Google Scholar 

  • Taylor, S., Zvolensky, M. J., Cox, B. J., Deacon, B., Heimberg, R. G., Ledley, D. R., et al. (2007). Robust dimensions of anxiety sensitivity: Development and initial validation of the Anxiety Sensitivity Index-3. Psychological Assessment, 19(2), 176–188. doi:10.1037/1040-3590.19.2.176.

    Article  PubMed  Google Scholar 

  • Utschig, A. C., Presnell, K., Madeley, M. C., & Smits, J. A. (2010). An investigation of the relationship between fear of negative evaluation and bulimic psychopathology. Eating Behaviors, 11(4), 231–238. doi:10.1016/j.eatbeh.2010.05.003.

    Article  PubMed  Google Scholar 

  • Vancleef, L. M., Peters, M. L., Roelofs, J., & Asmundson, G. J. G. (2006). Do fundamental fears differentially contribute to pain-related fear and pain catastrophizing? An evaluation of the sensitivity index. European Journal of Pain, 10(6), 527–536. doi:10.1016/j.ejpain.2005.07.006.

    Article  PubMed  Google Scholar 

  • Vujanovic, A. A., Bernstein, A., Berenz, E. C., & Zvolensky, M. J. (2012). Single-session anxiety sensitivity reduction program for trauma-exposed adults: A case series documenting feasibility and initial efficacy. Behavior Therapy, 43(3), 482–491. doi:10.1016/j.beth.2012.03.005

    Article  PubMed  Google Scholar 

  • Wald, J., Taylor, S., Chiri, L. R., & Sica, C. (2010). Posttraumatic stress disorder and chronic pain arising from motor vehicle accidents: Efficacy of interoceptive exposure plus trauma-related exposure therapy. Cognitive Behaviour Therapy, 39(2), 104–113. doi:10.1080/16506070903183570.

    Article  PubMed  Google Scholar 

  • Watson, D. (2000). Mood and temperament. New York: Guilford Press.

    Google Scholar 

  • Watson, D. (2009). Differentiating the mood and anxiety disorders: A quadripartite model. Annual Review of Clinical Psychology, 5, 221–247. doi:10.1146/annurev.clinpsy.032408.153510.

    Article  PubMed  Google Scholar 

  • Watson, D., & Clark, L. A. (1984). Negative affectivity: The disposition to experience aversive emotional states. Psychological Bulletin, 96(3), 465–490.

    Article  PubMed  CAS  Google Scholar 

  • Watson, D., & Clark, L. A. (1994). The PANAS-X: Manual for the positive and negative affect schedule—expanded form. Iowa City, IA: Authors.

    Google Scholar 

  • Watson, D., Clark, L. A., & Carey, G. (1988a). Positive and negative affectivity and their relation to anxiety and depressive disorders. Journal of Abnormal Psychology, 97(3), 346–353.

    Article  PubMed  CAS  Google Scholar 

  • Watson, D., Clark, L. A., & Tellegen, A. (1988b). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063–1070.

    Article  PubMed  CAS  Google Scholar 

  • Watson, D., & Tellegen, A. (1985). Toward a consensual structure of mood. Psychological Bulletin, 98(2), 219–235.

    Article  PubMed  CAS  Google Scholar 

  • Watt, M. C., Stewart, S. H., Lefaivre, M. J., & Uman, L. S. (2006). A brief cognitive-behavioral approach to reducing anxiety sensitivity decreases pain-related anxiety. Cognitive Behaviour Therapy, 35(4), 248–256. doi:10.1080/16506070600898553.

    Article  PubMed  Google Scholar 

  • Weeks, J. W., Heimberg, R. G., Fresco, D. M., Hart, T. A., Turk, C. L., Schneier, F. R., et al. (2005). Empirical validation and psychometric evaluation of the brief fear of negative evaluation scale in patients with social anxiety disorder. Psychological Assessment, 17(2), 179–190. doi:10.1037/1040-3590.17.2.179.

    Article  PubMed  Google Scholar 

  • Zinbarg, R. E., & Barlow, D. H. (1997). Hierarchical structure and general factor saturation of the anxiety sensitivity index: Evidence. Psychological Assessment, 9(3), 277–284.

    Article  Google Scholar 

  • Zvolensky, M. J., Bonn-Miller, M. O., Feldner, M. T., Leen-Feldner, E., McLeish, A. C., & Gregor, K. (2006). Anxiety sensitivity: Concurrent associations with negative affect smoking motives and abstinence self-confidence among young adult smokers. Addictive Behaviors, 31(3), 429–439. doi:10.1016/j.addbeh.2005.05.027.

    Article  PubMed  Google Scholar 

  • Zvolensky, M. J., Yartz, A. R., Gregor, K., Gonzalez, A., & Bernstein, A. (2008). Interoceptive exposure-based cessation intervention for smokers high in anxiety sensitivity: A case series. Journal of Cognitive Psychotherapy, 22(4), 346–365. doi:10.1891/0889-8391.22.4.346.

    Article  Google Scholar 

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Acknowledgments

The first author was supported by a Canadian Institutes of Health Research Doctoral award (FRN: 113434).

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Correspondence to Michel A. Thibodeau.

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Thibodeau, M.A., Carleton, R.N., Collimore, K.C. et al. From Higher-Order to Underlying Constructs: Examining the Relationships Between Affect and Fundamental Fears. Cogn Ther Res 37, 324–331 (2013). https://doi.org/10.1007/s10608-012-9468-1

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