Anxiety sensitivity and interoceptive exposure: a transdiagnostic construct and change strategy

Abstract

Recent findings support the relevance of anxiety sensitivity (AS) and interoceptive exposure (IE) across emotional disorders. This study (a) evaluated levels of AS across different anxiety disorders, (b) examined change in AS over the course of transdiagnostic psychological intervention, and its relationship with outcome, and (c) described the implementation of IE to address AS with patients with different anxiety disorders. Participants (N=54) were patients who received treatment with the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) in two consecutive treatment trials. Participants completed a measure of AS at pre- and posttreatment, and multiple occasions during treatment. Symptom severity was assessed at pre- and posttreatment, and clinical information related to physical symptoms and IE were collected as part of routine clinical practice. Elevated AS was observed at pretreatment across diagnoses and decreases in AS were observed from pre- to posttreatment. Similar changes occurred across the diagnostic categories, notably coinciding with the introduction of IE. Change in AS was correlated with reduced symptom levels at posttreatment and 6-month follow-up. Patients with different anxiety disorders endorsed similar physical symptoms and practiced similar IE exercises with similar effects. Results provide preliminary support for the usefulness of IE as a treatment strategy across the spectrum of anxiety disorders, and additional support for the transdiagnostic relevance of AS.

Copyright © 2013. Published by Elsevier Ltd.

Figures

FIGURE 1

Mean Anxiety Sensitivity Index (ASI) total scores over the course of treatment.

FIGURE 2

Mean Anxiety Sensitivity Index (ASI) total scores for each principal diagnosis over the course of treatment. GAD = generalized anxiety disorder; Panic = panic disorder with agoraphobia; Social = social phobia; OCD = obsessive-compulsive disorder; Other = posttraumatic stress disorder and anxiety disorder NOS.