Today we will know a model that explains various anxiety disorders: the S. Reiss model of anxiety expectation . The key concept of his theory is anxiety sensitivity, that is, the fear of sensations of anxiety.

.

But what is the relationship between this anxiety sensitivity and anxiety disorders? What other key concepts does the theory present? Let’s get to know it in detail.

S. Reiss’ Anxiety Expectation Model

The expectation model of anxiety was proposed by S. Reiss (1991), and it is a model about fear, anxiety and panic .

.

It is based on Pavlovian conditioning and maintains the idea of “no need for association by contiguity conditioned stimulus-conditioned stimulus” to explain the acquisition of fear. In addition, it gives an important role to expectations, i.e., what is feared.

It is a Pavlovian and cognitive model and, according to Sandín (1996), it is one of the models that has had the greatest impact on the current psychopathology of anxiety. Furthermore, it integrates operative aspects such as negative reinforcement and self-reinforcement.

Model components

The S. Reiss model of anxiety expectation is composed of several elements, as we will see below.

In the first review of the model, Reiss and McNally introduce the anxiety sensitivity variable (SA). This is an essential concept in the model, which defines the fears of anxiety symptoms or sensations, which arise from the belief that these symptoms have negative somatic, social or psychological consequences.

The model assumes anxiety sensitivity as a one-dimensional personality variable and distinct from trait anxiety , although related concepts could be considered.

In the latest version of the S. Reiss Anxiety Expectation Model, fear of a certain stimulus or situation is presented as a function of two components: expectations and sensitivities (also called “fundamental fears”).

Let’s get to know these new concepts.

Expectations

They refer to what the subject is afraid of (the feared stimulus or situation). There are three types of expectations:

1. Expectation of damage/hazard

Expectation of a hazard/damage to the external physical environment (e.g. “we are likely to have an accident with the car”).

2. Expectation of anxiety

Expectation about the possibility of experiencing anxiety or stress (for example: “even if I know that driving is safe, I may have a panic attack during the journey”).

3. Expectation of social evaluation

Expectation to react in such a way that it leads to a negative evaluation by others (e.g. “I won’t be able to control my fear of having an accident”)

Sensitivities

Let’s look at the other type of component in the model, already mentioned. It’s about why the subject is afraid of certain stimuli or situations. As in the previous case, three types of sensitivity are differentiated:

1. Sensitivity to damage/hazard

Sensitivity to personal physical harm (e.g., “they’ll hurt me and I won’t be able to take it”)

2. Anxiety sensitivity:

Sensitivity to experiencing anxiety (e.g., “I may have a heart attack if I panic”)

3. Sensitivity to social evaluation

Sensitivity to negative evaluation (e.g., “I feel embarrassed when I make a mistake in front of others”)

Anxiety disorders: model hypothesis

One of the hypotheses derived from S. Reiss’ model of anxiety expectation, which has received sufficient empirical evidence, is that anxiety sensitivity is a risk factor for anxiety disorders .

On the other hand, a second hypothesis establishes that there is an association between having sensitivity to anxiety and the tendency to experience fear .

A third hypothesis was that the high presence of sensitivity to anxiety was proper only of agoraphobia or panic (this had always been thought), although it has been seen that this is not the case.

High anxiety sensitivity also appears in generalized anxiety disorder, social phobia, post-traumatic stress disorder and obsessive-compulsive disorder .

.

In summary, high anxiety sensitivity is present in most anxiety disorders (with the exception of specific phobias, where there are more doubts).

Laboratory results

Through S. Reiss’ model of anxiety expectation , different laboratory hypotheses have also been tested , which relate anxiety sensitivity to the response to anxious stimuli.

It is believed that sensitivity to anxiety may explain the increased response shown by subjects with panic disorder in laboratory tests, where the subject is exposed to an anxiety-inducing stimulus.

The most commonly used anxiety-reducing procedure to determine these results has been hyperventilation , although other anxiety-reducing stimuli such as carbon dioxide inhalation, high-dose caffeine intake or cholecystokinin injection have also been used.

It has also been shown that subjects with high anxiety sensitivity show more intense subjective and physiological anxiety responses than subjects with low SA.

How do you measure anxiety sensitivity?

From S. Reiss’ model of anxiety expectation, we found a validated instrument to evaluate the key concept of the theory: anxiety sensitivity.

The most widely used instrument for assessing SA is the Anxiety Sensitivity Index (ASI, Peterson & Reiss, 1992), which has good psychometric properties. It is an evaluation instrument that consists of 16 items to be answered according to a Likert type scale, which can vary between “Nothing at all” (0) and “Very much” (4).

Bibliographic references:

  • Sandin, B., Chorot, P. and McNally, R. J. (1996). Validation of the Spanish version of the anxiety sensitivity index in a clinical sample. Behaviour Research and Therapy, 34, 283-290.
  • Fullana, M.A. and Tortella-Feliu, M. (2000). Relationship between anxiety sensitivity and fear of flying. Behavioral psychology, 8(1), 5-25.
  • Fullana, M.A., Casas, M. and Farré, J.M. (2001). Anxiety sensitivity in clinical samples: A pilot study. C. Med. Psicosom, 57, 9-17.