Anxiety Sensitivity (AS) is the fear of bodily sensations related to anxiety due to beliefs that they are harmful. While considerable attention has focused on the link between AS and panic disorder, less research has examined AS in OCD. Calamari and colleagues (2008) found that AS was significantly associated with OCD severity, even after controlling for cognitive risk factors. The present study examined changes in AS over the course of treatment in 337 individuals with an OCD diagnosis and Y-BOCS-SR score of 16 or higher. Multiple regression analysis demonstrated that all variables significantly decreased from admission to discharge. Adding the ASI change over treatment to the multiple regression increased variance accounted for significantly, suggesting that changes in AS may play an important role in the treatment of OCD, and that targeting AS may be beneficial. Limitations and future directions are discussed.
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The Role of Anxiety Sensitivity in Obsessive-Compulsive Disorder Treatment Outcome
1. The Role of Anxiety Sensitivity in Obsessive-Compulsive Disorder Treatment Outcome
Rachel C. Leonard, Ph.D., Kimberly A. Kinnear, B.S., and Bradley C. Riemann, Ph.D.
Abstract Methods Results Conclusions
Anxiety Sensitivity (AS) is the fear of bodily sensations Participants Participants with a comorbid PD diagnosis had significantly higher These results suggest that changes in AS over the
related to anxiety due to beliefs that they are harmful. Participants included 320 adults between the ages of 18 admission ASI scores (M = 34.27, SD = 13.86) than those without a course of treatment may play an important role in OCD
While considerable attention has focused on the link and 70 (M = 31.33, SD= 12.15; females = 168, 52.5%). PD diagnosis (M = 26.20, SD = 12.40), t(318) = -2.115, p = .035. symptom severity reduction. In addition to exposure
between AS and panic disorder, less research has All participants had a primary diagnosis of OCD There were no significant differences in all other variables at and response prevention treatment, targeting AS
examined AS in OCD. Calamari and colleagues (2008) established by a psychiatrist who specializes in anxiety admission or discharge based on the presence of a comorbid through interoceptive exposures and thought
found that AS was significantly associated with OCD disorder diagnosis and treatment and had a Y-BOCS-SR diagnosis of PD. The mean ASI score in our sample (26.48, SD = challenging regarding the meaning of aversive physical
severity, even after controlling for cognitive risk factors. score of 16 or higher. Comorbidity was common, with 12.51) is in line with ASI scores reported in other OCD samples sensations may be beneficial in the treatment of OCD.
The present study examined changes in AS over the 71.6% of participants having at least one additional (Calamari et al., 2004; Calamari et al., 2008; Taylor et al., 1992). Limitations and Future Directions
course of treatment in 337 individuals with an OCD diagnosis and 34.7% having at least two additional
In order to examine changes over the course of treatment, residual This study has several limitations. First, data on
diagnosis and Y-BOCS-SR score of 16 or higher. diagnoses. Of note, only 11 participants (3.4% of the gain scores (RG) were calculated, which corrects for problems in specific medications prescribed to participants
Multiple regression analysis demonstrated that all sample) had a diagnosis of Panic Disorder (PD) in
using raw change scores (see Steketee & Chambless, 1992). Then, throughout the course of treatment were not available.
variables significantly decreased from admission to addition to OCD.
we examined whether the ASI-RG or BDI-II RG significantly Second, we do not have data on individuals who did
discharge. Adding the ASI change over treatment to the
Treatment interacted with the type of program (RTC or IOP) in predicting Y- not complete the BDI-II, ASI, and Y-BOCS-SR at both
multiple regression increased variance accounted for
BOCS-SR RG in order to determine whether data could be admission and discharge; therefore, it is possible that
significantly, suggesting that changes in AS may play an The majority of patients (n = 265, 82.8%) were in a
collapsed across programs or would need to be analyzed individuals who did not complete these measures at
important role in the treatment of OCD, and that residential treatment center (RTC), with the remaining 55
separately. This interaction was not significant; therefore, data were both time points (for instance, due to a sudden
targeting AS may be beneficial. Limitations and future (17.2%) in an intensive outpatient program (IOP).
collapsed across programs for all subsequent analyses. insurance denial) may be significantly different from
directions are discussed. Participants admitted between May, 28, 2001 and
Initial examination of the data using paired-samples t-tests revealed those who did.
October 25, 2011 and had an average length of stay of
62.02 days (SD = 32.39, range = 6 - 231), with that scores on the ASI, BDI-II, and Y-BOCS-SR significantly Future research comparing exposure and response
Introduction participants in the RTC program having an average decreased from admission to discharge, indicating less severe prevention plus interventions targeting AS and
Anxiety Sensitivity (AS) is defined as the fear of bodily length of stay of 63.48 days (SD = 32.16, range = 8 - symptom severity. traditional exposure and response prevention that does
sensations related to anxiety due to beliefs that these 231) and participants in the IOP program having an not target AS within a sample of individuals with OCD
sensations are harmful (Reiss, Peterson, Gursky, & average length of stay of 31.43 sessions (SD = 18.37, but not panic disorder may yield additional insights into
McNally, 1986). While considerable research attention range = 3.43 – 81.14 sessions). Treatment in both the role of AS in OCD treatment response.
has focused on the link between high levels of AS and programs primarily consisted of exposure and response
panic disorder (e.g., McNally, 2002), less research has prevention (ERP), with cognitive restructuring and References
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