OBJECTIVE: Research in the psychopathology of panic and anxiety
disorders, particularly agoraphobia, suggests that fear of fear may be the
basis of these conditions. However, there is little empirical research on
the definition and validity of the concept of fear of fear in a clinical
study group. The authors' aims are 1) to determine empirically if
particular associations between symptoms and beliefs exist in a group of
patients with anxiety disorders and what underlying dimensions of perceived
threat they represent and 2) to assess the relative importance of these
associations in agoraphobia with panic attacks, panic disorder, social
phobia, and generalized anxiety disorder. METHOD: In an anxiety disorders
treatment unit, 390 outpatients with anxiety disorders diagnosed according
to DSM-III criteria completed the Anxiety Symptoms and Beliefs Scale.
RESULTS: A principal components analysis of the patients' ratings on the
Anxiety Symptoms and Beliefs Scale produced a four-factor solution in which
specific sets of anxiety symptoms loaded with specific beliefs. These four
factors were interpreted as respiratory symptoms, vestibular symptoms,
autonomic arousal, and psychological threat. Respiratory and vestibular
symptoms were more associated with panic disorder diagnoses than with
social phobia and generalized anxiety disorder diagnoses. CONCLUSIONS:
These findings support a conception of fear of fear in anxiety disorders as
fearful beliefs concerning the experience of anxiety symptoms. Associations
between symptoms and fear of fear are present across anxiety disorders but
are most pronounced in agoraphobia with panic attacks.
Abstract Teaser