108 COGNITIVE THEORY AND RESEARCH ON ANXIETY
Anxiety Sensitivity and the Cognitive Model
Empirical evidence that AS is a specific predisposing factor for anxiety, especially panic,
fits with the cognitive vulnerability model of anxiety. AS is a cognitive construct that
describes individual differences in the propensity to misinterpret the bodily sensations
of anxiety in a threatening manner. It is a specific cognitive vulnerability construct that
may have relevance beyond panic to the extent that negative interpretation of subjective
anxiety and its symptoms is a consequence of automatic threat mode activation (see
Chapter 2). In Chapter 3 we discussed empirical evidence that emotional reasoning or
a tendency to interpret anxious symptoms in a negative or threatening manner is an
important cognitive phenomenon in anxiety. We expect that individuals high in AS will
more likely engage in emotional reasoning and other forms of biased interpretation of
their anxious symptoms than individuals low in AS.
Based in part on correlational analyses between the ASI and the Fear Survey Sched-
ule (see Taylor, 1995a), Rachman (2004) concluded that AS along with illness/injury
sensitivity and fear of negative evaluation are distinct lower order traits that are nested
hierarchically in the broader construct of trait anxiety. All three of these constructs
are cognitive in nature since they focus on a tendency to misinterpret physical or social
information in a negative or threatening manner. They describe specific cognitive-
personality vulnerabilities for panic and social- evaluative anxiety states. And yet, even
though there is strong empirical support that AS is a vulnerability factor in anxiety, its
ability to account for only modest variance indicates that other cognitive- personality
factors must be involved in the pathogenesis of anxiety disorder.
Clinician Guideline 4.1
Include the ASI or ASI-3 in the pretreatment assessment battery to evaluate the client’s pro-
pensity to misinterpret physical, cognitive, and social symptoms in an anxious or fearful
ma nner.Diminished Personal Control
It has been suggested that the greatest human fear is of losing control, leading many
researchers to consider impaired control a key feature of stress, anxiety, depression, and
other aspects of psychological distress (Mineka & Kihlstrom, 1978; Shapiro, Schwartz,
& Astin, 1996). In his account of the origins of anxious apprehension, Barlow (2002)
posited that a generalized psychological vulnerability interacts with a generalized bio-
logical vulnerability and particular learning experiences in the development of specific
anxiety disorders. Psychological vulnerability was defined as “a chronic inability to
cope with unpredictable uncontrollable negative events, and this sense of uncontrol-
lability is associated with negatively valenced emotional responding” (Barlow, 2002,
p. 254). Earlier Chorpita and Barlow (1998) defined control as “the ability to personally
influence events and outcomes in one’s environment, principally those related to positive
or negative reinforcement” (p. 5).
In anxiety uncertainty that one possesses the required level of control over an antic-
ipated aversive outcome is an enduring characteristic (Alloy et al., 1990). This dimin-