The General and Specific vulnerability factors of anxiety disorders: Evaluation of a structural model

Document Type : Original Article

Authors

1 Doctorate in Health Psychology, Department of Psychology, University of Tehran, Tehran, Iran

2 Associate Professor, Department of Psychology, University of Tehran, Tehran, Iran

Abstract


Introduction
Anxiety disorders are the most common psychiatric disorders that impose a lot of suffering for patients and costs for communities. Thus, identifying the vulnerability factors of these disorders is necessary. The aim of this study was to evaluation of General and Specific vulnerability factors of anxiety disorders within the framework of a structural model.

Methods
420 students from universities in Tehran were selected by convenience sampling and responses to NEO Five-Factor Inventory, Anxiety Control Questionnaire-revised, Intolerance of Uncertainty Scale, Anxiety Sensitivity Index, disgust sensitivity scale, Brief Fear of Negative Evaluation Scale, Generalized anxiety disorders questionnaire-IV, Albany Panic and Phobia Questionnaire and fear survey schedule-II. Data analysis was performed using path analysis.

Results
Based on the findings of this study, neuroticism can be described as a biological vulnerability (β = 0.17, 0.10, 0.05, 0.10 ) and the lack of perceived control as General psychological vulnerability (β = 0.15, 0.10, 0.04, 0.16 ) factor. for anxiety disorders. On the other hand, extraversion can be considered as a biological vulnerability to social anxiety disorder (β = - 0.23). As well as the results of this study led to the identification of specific vulnerability factor of each of the anxiety disorders.

Conclusion
Based on the findings of this study can be considered the Triple Vulnerability Model suitable framework to explain the etiology of anxiety disorders.

Keywords: Anxiety disorders, General and Specific vulnerability factors, path analysis

Keywords


  1. منابع

    1. Ninan PT. Dissolving the burden of generalized anxiety disorder. J Clin Psychiatry. 2001; 62: 5–10.
    2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5nd Ed.). 2013; Washington, DC: Author.
    3. Barlow DH. Anxiety and its disorders: The nature and treatment of anxiety and panic (2nd Ed.). 2002; New York: Guilford Press.
    4. Gershuny BS, Sher KJ. The relation between personality and anxiety: Findings from a 3-year prospective study. J Abnorm Psychol. 1998; 107(2): 252–62.
    5. Treat AT, Bootzin RR, Baker TB. Psychological clinical science (1nd Ed.). 2007; New York: Psychology Press.
    6. Dugas MJ, Schwartz A, Francis K. Intolerance of uncertainty, worry, and Cognit Ther Res. 2004; 28: 835–42.
    7. Reiss S, McNally R J. the expectancy model of fear. 1th 1985; New York: Academic Press.
    8. Watson D, Friend R. Measurement of social-evaluative anxiety. J Consult Clin Psychol. 1969; 33(4): 448–57.
    9. Haidt J, McCauley C, Rozin P. Individual differences in sensitivity to disgust: a scale sampling seven domains of disgust Pers Indiv Differ. 1994; 16(5): 701–13.
    10. Furukawa T, Hori S, Yoshida S, Tsuji M, Nakanishi M, hamanaka T. Premorbid personality traits of patients with organic, schizophrenic, mood, and neurotic disorders according to the five-factor model of Psychiatr Res. 1998; 78(3): 179-87.
    11. Brown TA, White KS, Barlow DH. A psychometric reanalysis of the Albany Panic and Phobia Questionnaire Behav Res Ther. 1995; 43: 337-5.
    12. Buhr K, Dugas MJ. The intolerance of uncertainty scale: psychometric properties of the English version. Behav Res Ther. 2002; 40: 931-45.
    13. Zinbarg RE, Brown TA, Barlow DH, Rapee RM. Anxiety sensitivity, panic, and depressed mood: A reanalysis teasing apart the contributions of the two levels in the hierarchical structure of the Anxiety Sensitivity Index. J Abnorm Psychol. 2001; 110(3): 372-7.
    14. Reiss S, Peterson RA, Gursky DM, McNally RJ. Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behav Res Ther. 1986; 24(1): 1–8.
    15. Leary MR. A brief version of the Fear of Negative Evaluation Scale. Pers Soc Psychol Bull. 1983; 9: 371–5.
    16. Weeks JW, Heimberg RG, Rodebaugh TL, Norton PJ. Exploring the relationship between fear of positive evaluation and social anxiety. J Anxiety Disord. 2008; 22: 386–400.
    17. Newman MG, Zuellig AR, Kachin KE, Constantino MJ, Przeworski A, Erickson T, et al. Preliminary reliability and validity of the GAD-Q-IV: A revised self-report diagnostic measure of generalized anxiety disorder. Behav Res Ther. 2002; 33(2): 215-33.
    18. Rapee RM, Craske MG, & Barlow DH. Assessment instrument for panic disorder that includes fear of sensation-producing activities: the Albany Panic and Phobia Questionnaire. 1995; 1: 114–22.
    19. Zinbarg RE, Barlow DH. Structure of anxiety disorders: A hierachical model. J Abnorm Psychol. 1996; 105: 181-93.
    20. Kotov R, Gamez W, Schmidt F, Watson D. Linking big personality traits to anxiety, depressive, and substance use disorders: a meta-analysis. Psychol Bull. 2010; 136: 768–821.
    21. Brown TA. Temporal course and structural relationships among dimensions of temperament and DSM-IV anxiety and mood disorder constructs. J Abnorm Psychol. 2007; 116: 313–28.
    22. Martin NG, Jardine R, Andrews G, Heath AC. Anxiety disorders and neuroticism: are there genetic factors specific to panic? Acta Psychiatr Scand. 1988; 77(6): 698-706.
    23. Freire RC, Lopes FL, Veras AB, Valenca AM, Mezzasalma MA, Nascimento I, et al. Personality traits spectrum in panic disorder and major depression. Revista Brasileira de Psiquiatria. 2007; 29: 31–4.
    24. Kashdan T, Shipherd J, Beck JG. The effects of extraversion on panic sensations and panic-fear cognitions induced by a 35% CO2 challenge. Presentation given to the Association for Advancement of Behavior Therapy annual meeting. November 1999; Toronto, Ontario.
    25. Dugas MJ, Robichaud M. Cognitive–behavioral treatment for generalized anxiety disorder: From science to practice. 2007; New York: Routledge.
    26. McNally RJ, Eke M. Anxiety sensitivity, suffocation fear, and breath-holding duration as predictors of response to carbon dioxide challenge. J Abnorm Psychol. 1996; 105: 146–9.
    27. White KS, Brown TA, Somers TJ, Barlow DH. Avoidance behavior in panic disorder: the moderating influence of perceived control. Behav Res Ther. 2006; 44: 147–57.
    28. Naragon-Gainey K. Meta-analysis of the relations of anxiety sensitivity to the depressive and anxiety disorders. Psychol Bull. 2010; 136(1): 128–50.
    29. Zvolensky MJ, Feldner MT, Eifert GH, Stewart SH. Evaluating differential predictions of emotional reactivity during repeated 20% carbon dioxide-enriched air challenge. Cognit Emot. 2001; 15: 767–86.
    30. Smits JAJ, Berry AC, Tart CD, Powers MB. The efficacy of cognitive-behavioral interventions for reducing anxiety sensitivity: a meta-analytic review. Behav Res Ther. 2008; 46: 1047–54.
    31. Plehn K, Peterson RA. Anxiety sensitivity as a predictor of the development of panic symptoms, panic attacks, and panic disorder: a prospective study. J Anxiety Disord. 2002; 16: 455–74.
    32. Drost, J. J., Van der Does, A. W., Antypa, N. N., Zitman, F. G., Van Dyck, R. R., & Spinhoven, P. h. (2012). General, specific and unique cognitive factors involved in anxiety and depressive disorders. Cognitive Therapy and Research, 36, 621–633.
    33. Collins HA, Westra HA, Dozois DJ A, Stewart SH. The validity of the brief version of the fear of negative evaluation scale. J Anxiety Disord. 2005; 19: 345–59.
    34. Kocovski N, Endler NS. Social anxiety, self-regulation, and fear of negative Eur J Pers. 2000; 14: 347–58.
    35. Weeks JW, Heimberg RG, Fresco DM, Hart TA, Turk CL, Schneier FR, et al. Empirical validation and psychometric evaluation of the Brief Fear of Negative Evaluation Scale in patients with social anxiety disorder. Psychol Assess. 2005; 17: 179–90.
    36. Kotov R, Watson D, Robles JP, Schmid NB. Personality traits and anxiety symptoms: the multilevel trait predictor model. Behav Res Ther. 2007; 45: 1485–503.
    37. Haikal M, Hong RY. The effects of social evaluation and looming threat on self-attentional biases and social anxiety. J Anxiety Disord. 2010; 24: 345–52.
    38. Olatunji BO, Lohr JM, Sawchuk CN, Westendorf D. Using facial expressions as CSs and fearsome and disgusting pictures as UCSs: Affective Responding and evaluative learning of fear and disgust in BII Phobia. J Anxiety Disord. 2005; 19: 539–55.
    39. Sawchuk CN, Lohr JM, Westendorf DA, Meunier SA, Tolin DF. Emotional responding to fearful and disgusting stimuli in specific phobia. Behav Res Ther. 2002; 40: 1031–46.
    40. Fredrikson M, Annas P, Fischer H, Wik G. Gender and age differences in the prevalence of specific fears and phobias. Behav Res Ther. 1996; 34: 33–9.

    De Jong PJ, Merckelbach H. Blood–injection–injury phobia and fear of spiders: Domain specific individual differences in disgust sensitivity. Pers Indiv Differ. 1998;