Anxiety sensitivity: An examination of theoretical and methodological issues

The construct of anxiety sensitivity (AS) has occupied an increasingly important place in theorizing and research on anxiety and anxiety disorders. Although a number of recent studies have provided support for the construct validity of the principal operationalization of AS, the Anxiety Sensitivity Index (ASI), the relation of the AS construct and the ASI to trait anxiety continues to be a source of controversy. Key issues in the AS-trait anxiety debate include the assimilative nature of traits and the concept of incremental validity. Recent research on AS lends some support to the claim that trait anxiety cannot fully account for AS findings. Important areas for future AS research include (1) demonstrating that AS is a risk factor for panic disorder and related conditions, lather than simply a consequence of these conditions, (2) developing and utilizing multiple operationalizations of constructs, (3) minimizing the impact of potentially inapplicable items, (4) testing for interactions between AS and other variables, and (5) testing hierarchical factor models that allow trait anxiety and AS to coexist as higher- and lower-order factors, respectively. Researchers in this area will need to develop alternative measures of the AS construct, recognize the distinction between different levels of trait specificity, clarify a number of theoretical issues relevant to the AS construct, and continue to subject predictions to stringent theoretical risks.