An additional factor that has been put forward to try to explain individual differences in the vulnerability to panic is anxiety sensitivity. The research on anxiety sensitivity revolves around the issue that not everybody is equally likely to misinterpret bodily sensations as catastrophic (see Taylor, 1999, for a review). The central thesis of much of this work is the suggestion that a set of pre-existing beliefs about the harmfulness of certain bodily sensations predisposes individuals to misinterpret those sensations in a catastrophic manner, thus leading to panic experiences. This has been termed the
Anxiety Sensitivity Hypothesis (Reiss & McNally, 1985). A considerable body of research has focused on the establishment of a measure of anxiety sensitivity—the Anxiety Sensitivity Index (ASI; Reiss, Peterson, Gursky, & McNally, 1986). This is a self-report measure of fear of fear and has been shown to be distinct from trait anxiety (e.g., McNally & Lorenz, 1987); the latter denotes the tendency to respond fearfully to stress in general, whereas the former denotes the tendency to respond fearfully to symptoms of fear. A number of studies have indicated that high scores on the ASI are associated with a predisposition to develop panic and other anxiety (e.g., Schmidt, Lerew, & Trakowski, 1997), and this raises the possibility that anxiety sensitivity may be a cognitive risk factor such as in the form of a "panic schema" that is a vulnerability for the development of panic disorder (e.g., Teachman, 2005).
Research suggests that anxiety sensitivity can be acquired in various ways, similar to the acquisition of common fears (e.g., Rachman, 2004). As McNally (1990) suggests, "hearing misinformation about heart disease, or watching someone die of a heart attack following complaints of cardiac distress, may establish a fear of cardiac sensations" (p. 408).
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