Anxiety sensitivity: prospective prediction of panic attacks and Axis I pathology

Emerging evidence suggests that anxiety sensitivity (AS) predicts subsequent development of anxiety symptoms and panic attacks. However, evidence regarding whether AS serves as a premorbid risk factor for the development of clinical syndromes is lacking. The primary aim of the present study was to determine whether AS acts as a vulnerability factor in the pathogenesis of psychiatric diagnoses. A large nonclinical sample of young adults (N=404) was prospectively followed over two years. The Anxiety Sensitivity Index (ASI: Reiss S, Peterson RA, Gursky DM, McNally RJ. Anxiety sensitivity, anxiety frequency, and the prediction of fearfulness. Behaviour Research and Therapy 1986; 24: 1-8.) and trait anxiety served as predictors. Consistent with prior reports, AS predicted the development of spontaneous panic attacks in those with no history of panic. Importantly, AS was found to predict the incidence of anxiety disorder diagnoses and overall Axis I diagnoses in those with no history of Axis I diagnoses at study entry. These are the first data to provide strong prospective evidence for AS as a risk factor in the development of anxiety disorders.