How does anxiety sensitivity increase risk of chronic medical conditions?

Abstract

Anxiety sensitivity (AS; fear of anxiety-related symptoms) is an established transdiagnostic risk factor for psychiatric disorders and is related to a variety of chronic medical conditions. However, AS has not been established as a risk factor for chronic medical conditions. In this study, we review studies on AS and chronic medical conditions (and symptoms/behaviors related to chronic medical conditions) and propose four pathways through which AS may increase risk of chronic medical conditions: (a) increasing fear of medical condition-specific symptoms, (b) perpetuating avoidance of healthy activities, (c) promoting engagement in unhealthy behaviors, and (d) increasing risk of detrimental pathophysiological and pathomechanical alterations. We also discuss the potential utility of using AS reduction interventions as a means of reducing risk of chronic medical conditions.

Effects of COVID-19 lockdown on university students’ anxiety disorder in Italy

“…Concerning the group of students who do not suffer from anxiety and start suffering because of the pandemic shock, a policy aimed at reducing the reasons for which they suffer from the impact of the shock could also solve their anxiety problems. Another group is composed of fragile students with anxiety problems: in this case, we could venture that, for high initial levels of anxiety, the increase in anxiety levels is induced by the fear of contagion during a lockdown (Horenstein et al, 2018 ). This group suffers from pathological anxiety and should, therefore, be protected the most from the lockdown/pandemic effect.…”

“…The nature of COVID-19 implies an even more prominent correlation between fear of contracting the virus and increase in the level of health anxiety, due to the connected particularly relevant respiratory symptoms, which is generally associated by the literature to anxiety sensitivity (see Horenstein et al, 2018 for a review of this literature).…”

Anxiety Sensitivity and Physical Inactivity in a National Sample of Adults with a History of Myocardial Infarction

“…Anxiety sensitivity is considered a transdiagnostic multi-dimensional marker of distress, psychopathology, and health risk behavior that is characterized by a fear of the negative consequences of anxiety-related sensations. [10][11][12][13][14]. There are three interrelated subdimensions of anxiety sensitivity, specifically a social concerns subdimension (e.g., fear that the visible physical manifestations of anxiety symptoms [sweating] will result in social expulsion), a physical concerns subdimension (e.g., fear that heart palpitations will result in a heart attack), and a cognitive concerns subdimension (e.g., fear that difficulties with concentration are an indication of mental incapacitation or insanity) [15].…”

“…There are three interrelated subdimensions of anxiety sensitivity, specifically a social concerns subdimension (e.g., fear that the visible physical manifestations of anxiety symptoms [sweating] will result in social expulsion), a physical concerns subdimension (e.g., fear that heart palpitations will result in a heart attack), and a cognitive concerns subdimension (e.g., fear that difficulties with concentration are an indication of mental incapacitation or insanity) [15]. Anxiety sensitivity is also considered a cognitive vulnerability because people with elevated levels of anxiety sensitivity are more likely to be vigilant to signs and cues that indicate anxious arousal, to interpret their anxiety symptoms to be catastrophic and negative, which then further increases their anxiety and leads to avoidance of behaviors or activities that mimic or generate feared sensations [11,14]. Anxiety sensitivity is associated with increased risk of various negative cardiovascular health factors, including lack of exercise, medication nonadherence, smoking, depression, unhealthy eating practices, low working memory, and poor CVD illness prognosis [9,14,[16][17][18][19][20][21][22][23].…”

“…Anxiety sensitivity is also considered a cognitive vulnerability because people with elevated levels of anxiety sensitivity are more likely to be vigilant to signs and cues that indicate anxious arousal, to interpret their anxiety symptoms to be catastrophic and negative, which then further increases their anxiety and leads to avoidance of behaviors or activities that mimic or generate feared sensations [11,14]. Anxiety sensitivity is associated with increased risk of various negative cardiovascular health factors, including lack of exercise, medication nonadherence, smoking, depression, unhealthy eating practices, low working memory, and poor CVD illness prognosis [9,14,[16][17][18][19][20][21][22][23].…”