Am J Psychiatry 1992; 149:1058-1061
Copyright © 1992 by American Psychiatric Association
The latent structure of anxiety symptoms in anxiety disorders
J Kenardy, L Evans and TP Oei
Department of Psychology, University of Newcastle, New South Wales, Australia.
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.
