One of the things that individuals who suffer from anxiety have in common is being anxious about experiencing anxiety and its associated symptoms, which in professional terms is named anxiety sensitivity. In simple terms, it is having fears about fear.  Individuals with high anxiety sensitivity believe that the physical sensations, which they experience such as increased heart rate, dizziness, sweating etc, are dangerous, harmful and will lead to catastrophic outcomes (Walsh, Stewart, McLaughlin, & Comeau, 2004). Psychologically, the physical sensations are misinterpreted as a sign of becoming crazy, losing control and becoming mentally sick. Physically, the bodily symptoms are believed to originate from a serious life-threatening and undiagnosed illness (e.g. heart attack, stroke). Socially, it is believed to be disastrously embarrassing that others will notice the anxious arousal, which might lead to, criticism, ridicule, rejection and social isolation (Zinbarg, Barlow, & Brown, 1997).

Anxiety rises even more when the physical sensations are being perceived as a threat, which in turn increases the intensity and frequency of the physical symptoms and reinforces the catastrophic misinterpretations of these symptoms. Individuals with high anxiety sensitivity start to overly focus and monitor their physical sensations. Harmless physical sensations that previously went unnoticed suddenly become constantly and excessively present. In addition, high anxiety sensitive individuals possess a clear cognitive bias in the interpretation of information as they tend to interpret ambiguous information as threatening(Teachman, 2005).

There are differences in the levels of anxiety sensitivity between individuals. The higher the anxiety sensitivity becomes, the more that individual interprets the anxiety symptoms as distressing and dangerous. Anxiety sensitivity is a stable trait- like attribute, which forms a risk factor to many anxiety disorders, such as social anxiety, specific phobias, health anxiety, panic disorder and PTSD. It has also been linked in past research to various depressive disorders, chronic pain and substance abuse (Taylor, 1992; Taylor, et al., 2007). Substances such as alcohol, cigarettes and drugs are used in attempt to slow down the sympathetic nervous system, reduce anxiety and regulate negative emotions. Avoidance of anxiety provoking triggers (e.g. activities, people, objects, places) is another coping strategy, which is often used by highly anxious individuals. High anxiety sensitivity individuals hinder the possibility of realizing that the physical symptoms are not dangerous physically or mentally by not exposing themselves to the anxiety provoking triggers and by not confronting the physical sensations.  When high anxiety sensitivity is left untreated, the probability of developing severe anxiety as well as related disorders increases drastically.

During therapy sessions, clients receive psycho- education about anxiety sensitivity and its implications as well as learn to practice relaxation techniques. Furthermore, common CBT techniques of cognitive reconstruction and exposure are applied. Cognitive reconstruction aims to identify, challenge and reconstruct irrational and catastrophic thoughts that raise anxiety i.e. the belief in the high probability and a high catastrophic level of outcome that the physical symptoms can cause. Exposure helps clients to directly face the fear inducing and stressful stimuli, as well as to learn to eliminate safety behaviors.  Repeated exposure produces habituation that gradually reduces anxiety felt from the trigger. It has been found that the combination of these CBT techniques helps to treat anxiety sensitivity successfully.

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Taylor, S., Zvolensky, M. J., Cox, B.J., Deacon, B., Heimberg, R.G., Ledley, D.R. …. Cardenas , S.J. (2007). Robust Dimensions of Anxiety Sensitivity: Development and Initial Validation of the Anxiety Sensitivity Index—3. Psychological Assessment 2007, Vol. 19, No. 2, 176–188.

Taylor, S., Koch, D.,& NcNally, R. J.(1992). How does anxiety sensitivity vary across the anxiety disorders? Journal Anxiety Disorders, 6, 249–259.

Teachman, B.A. (2005). Information processing and anxiety sensitivity: Cognitive vulnerability to panic reflected in interpretation and memory bias. Cognitive Therapy and Research, 29, 4,479–499.

Walsh, T.M., Stewart, S.H., McLaughlin, E., & Comeau, N. ( 2004). Gender differences in childhood anxiety sensitivity index (CASI) dimensions. Journal of Anxiety Disorders,18, 695–706.

Zinbarg R.E., Barlow, D.H., & Brown, T. A.(1997). Hierarchical structure and general factor saturation of the Anxiety Sensitivity Index: Evidence and implications. Psychological Assessment., 9, 277–284.