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.

Anxiety Sensitivity as a Risk Indicator for Anxiety, Depression, and Headache Severity in Women With Migraine

“…Individuals with elevated anxiety sensitivity tend to be fearful of, or dread, the experience of arousal or bodily sensations due to the perceived potential negative or catastrophic physical, social, or cognitive consequences of such experiences . Anxiety sensitivity is primarily thought to function as an amplifier of distress, including emotional (eg, anxiety, irritability) and physical states (eg, pain) Indeed, there is robust evidence linking anxiety sensitivity to the development and persistence of anxiety disorders, and to a lesser extent depressive disorders . A separate line of research also documents the association between anxiety sensitivity with fearful appraisals of pain, lower pain tolerance and threshold, and pain‐related disability .…”

Effectiveness of Mindfulness-Based Intervention on Risky Behaviors, Resilience, and Distress Tolerance in Adolescents

“…Distress tolerance is an important factor in individual differences, which refers to the capacity for experiencing and tolerance of emotional distress (4). Those who are at a low level of distress tolerance describe emotional distress as unbearable, evaluating emotional disturbances as unacceptable, trying to relieve the negative emotional state and being able to focus their attention on a subject other than their emotional distress (5). These people struggle hard to avoid the experience of negative emo-tions.…”

Anxiety sensitivity, health behaviors, and the prevention and treatment of medical illness.

“…Thus, as new findings continue to hone our understanding of the relationship between psychopathology and health-such as the impact of anxiety and depression on inflammatory markers-AS is likely to be implicated in these process, at least indirectly. In terms of ongoing research agendas, it is important to determine whether a transdiagnostic risk factor such as AS can provide better prediction of pathomechanical alterations than is afforded by consideration of the syndromal endstage (i.e., disorder status), precisely because risk factors offer the potential for early intervention.Concerning the other, and better-supported, pathways discussed by Horenstein et al (2018), there is ample evidence that AS is linked to fears of medical condition-specific symptoms. This linkage is best documented for cardiac, respiratory, pain, and select gastrointestinal symptoms.…”

“…Concerning the second and third processes reviewed by Horenstein et al (2018), AS appears to both reduce engagement in certain healthy behaviors as well as increasing engagement in select unhealthy behaviors. A prominent example of how these two processes may work together is found for the role of AS in both reducing engagement in exercise and predicting mood-induced eating patterns (see Otto et al, 2016).…”

“…In summary, Horenstein et al (2018) have effectively illustrated the scope of associations between AS and health-related concerns, and have underscored the importance of attending to the potential of AS assessment and intervention for understanding and ameliorating medical conditions. As we further detail here, the range of applications of AS intervention and prevention includes the top three preventable risks of mortality in the United States.…”