Does Anxiety Sensitivity Cause Panic Symptoms? An Experimental Investigation

Abstract

Anxiety sensitivity (AS) refers to the fear of anxiety-related sensations based on beliefs about their harmful consequences. Despite a wealth of research demonstrating an association between AS and panic-related psychopathology, direct experimental evidence that AS causes panic symptoms, as hypothesized in cognitive models of panic disorder, is lacking. The present study aimed to fill this gap by testing the causal relationship between AS and panic symptoms using a false physiological feedback paradigm. Undergraduate participants without a history of panic underwent a prolonged hyperventilation challenge either with (n = 33) or without (n = 30) receiving false physiological feedback suggesting an impending loss of consciousness. As hypothesized, participants in the false feedback condition had higher peak anxiety, engaged in more avoidance, and had more catastrophic thoughts and higher body vigilance specific to fainting compared to participants in the control condition. Between-group differences on most outcome measures were fully mediated by higher concerns about fainting in the experimental condition. Baseline AS did not potentiate the effects of the experimental manipulation on fear responding. This study provides direct experimental evidence in support of the causal role of AS in panic symptoms as informed by Cox's (1996) interactional model of AS and catastrophic cognitions.