Journal of Psychopathology and Behavioral Assessment, 2012
ABSTRACT Natural Environment phobia include fears cued by events such as severe weather. Given th... more ABSTRACT Natural Environment phobia include fears cued by events such as severe weather. Given the limited research in this area, the present study sought to assess the prevalence and learning history origins of these fears, as well as their relation to anxiety sensitivity (AS). Study One participants included 533 (66%F) undergraduates who completed the Weather Experiences Questionnaire. Overall, 42 % reported exposure to a severe weather event (e.g., hurricanes); 16 % reported high- and 44 % low-fear about weather. Thirty-three from each group participated in Study Two, wherein one high-fear participant approximated the diagnostic criteria for severe weather phobia. High-fear participants cited direct conditioning (43 %) followed by vicarious conditioning (39 %) as the most common learning pathways. The remaining18% could not recall the source of their fear and none identified operant conditioning. One-third cited mothers (versus 8 % fathers) as sharing similar fears. Most had not witnessed parents hurt, frightened, or distressed by severe weather but claimed parents had warned them about severe weather. High- (vs. low-) fear participants revealed more AS-somatic versus AS-cognitive or AS-social concerns. The importance of such research in light of the increasing frequency of severe weather events is discussed.
High anxiety sensitivity (AS) has been associated with elevated pain-related anxiety in anxiety a... more High anxiety sensitivity (AS) has been associated with elevated pain-related anxiety in anxiety and pain samples. The present study investigated (a) the associations among the lower order dimensions of AS and pain-related anxiety, using a robust measure of AS, and (b) the pain-related anxiety outcomes of a telephone-delivered cognitive behavioural treatment (CBT) designed to reduce high AS. Participants were 80 anxiety treatment-seeking participants with high AS (M age = 36 years; 79% women). After providing baseline data on AS and pain-related anxiety, participants were randomly assigned to an eight-week telephone CBT or a waiting list control. At baseline, bivariate correlations showed AS physical and cognitive, but not social, concerns were significantly associated with pain-related fear and arousal but not escape/avoidance behaviours. Multiple regression revealed that after accounting for emotional distress symptoms, AS physical, but not cognitive or social, concerns uniquely pr...
A brief, group cognitive behavioural therapy with running as the interoceptive exposure (IE; expo... more A brief, group cognitive behavioural therapy with running as the interoceptive exposure (IE; exposure to physiological sensations) component was effective in decreasing anxiety sensitivity (AS; fear of arousal sensations) levels in female undergraduates (Watt et al., Anxiety and Substance Use Disorders: The Vicious Cycle of Comorbidity, 201-219, 2008). Additionally, repeated exposure to running resulted in decreases in cognitive (i.e., catastrophic thoughts) and affective (i.e., feelings of anxiety) reactions to running over time for high AS, but not low AS, participants (Sabourin et al., "Physical exercise as interoceptive exposure within a brief cognitive-behavioral treatment for anxiety-sensitive women", Journal of Cognitive Psychotherapy, 22:302-320, 2008). A follow-up study including the above-mentioned intervention with an expanded IE component also resulted in decreases in AS levels (Sabourin et al., under review). The goals of the present process study were (1) to ...
ABSTRACT High anxiety sensitivity (AS; fear of arousal-related bodily sensations) is a known risk... more ABSTRACT High anxiety sensitivity (AS; fear of arousal-related bodily sensations) is a known risk factor for psychopathology and medical pathology. High AS individuals tend to avoid activities that induce feared arousal-related sensations; yet, few studies have examined AS and sexual activity, those that did have produced mixed results, and no study to date has examined AS and sexual avoidance. In Study 1, 296 young adult women completed the Anxiety Sensitivity Index-3 (ASI-3) and the Female Sexual Distress Scale-Revised, which were positively correlated, r = 0.34, p < .001. Women scoring in the highest and lowest quartiles on the ASI-3 were recruited for Study 2. As predicted, high (vs. low) AS women reported significantly more sexual distress, impairments in sexual functioning (including sexual pain), and avoidance of sexual activity, and less sexual satisfaction. Results suggest that high AS can limit the frequency and quality of sexual functioning in young adult women, or lead to avoidance of sexual activity altogether. Reducing AS via empirically validated cognitive-behavioural approaches could improve women's sexual and relationship well-being.
Mindfulness (tendency to attend to present experience without expectation or judgment) is general... more Mindfulness (tendency to attend to present experience without expectation or judgment) is generally considered to be an adaptive way of responding to emotional experience. Anxiety sensitivity can be conceptualized as a maladaptive response (fear) to arousal-related somatic sensations commonly associated with anxiety. Emotion regulation strategies are learned in the context of early attachment relationships, and adult attachment styles have been linked to both mindfulness and anxiety sensitivity. This study examined whether mindfulness facets (observe, describe, act with awareness, accept without judgment) would mediate associations between attachment and the dimensions of anxiety sensitivity (physical, social, cognitive concerns). Multiple mediation analyses showed that observe mediated the relation between attachment anxiety and physical concerns, and accept mediated the relation between attachment anxiety and social concerns. Accept, aware, and observe each mediated the relation between attachment anxiety and cognitive concerns. Only accept mediated the association between attachment avoidance and the three anxiety sensitivity dimensions. Findings suggest the importance of measuring mindfulness as a multidimensional construct, and the value of assessing attachment style and incorporating mindfulness elements in interventions designed to reduce anxiety sensitivity.
• Cognitive behavioral therapy (vs. a waiting list) reduced anxiety sensitivity. • Treatment also... more • Cognitive behavioral therapy (vs. a waiting list) reduced anxiety sensitivity. • Treatment also specifically reduced drinking to cope with anxiety. • Physical and intrapersonal alcohol-related problems were also reduced. • Change in anxiety sensitivity mediated reductions in drinking to cope with anxiety. • Reductions in drinking to cope with anxiety mediated changes in alcohol problems.
Anxiety sensitivity refers to the fear of anxiety-related physical sensations arising from belief... more Anxiety sensitivity refers to the fear of anxiety-related physical sensations arising from beliefs that these sensations have harmful consequences (Reiss & McNally, 1985). The present study examined whether individuals with high (vs. low) anxiety sensitivity show stronger implicit associations in memory between anxiety-related symptoms, as opposed to neutral body parts, and harmful, as compared to harmless, consequences. A total of 22 undergraduate students (14 F, 8 M) completed the Extrinsic Affective Simon Task (EAST; De Houwer, 2003). Results indicated that high anxiety sensitive individuals (n = 10) tended to implicitly associate harmful consequences with anxiety-related symptoms. Their performance was significantly faster on trials where target words related to anxiety symptoms were mapped on to the same response key as harmful consequences. No significant difference in performance was found for low anxiety sensitive individuals (n = 12) or when target words were body parts unlikely related to diseases. Between-group differences persisted after controlling for trait anxiety and history of panic attacks, but not when illness-related beliefs were introduced as a covariate. Identifying this implicit association bias provides additional empirical support for the concept of anxiety sensitivity.
Introduction: The present pilot study was designed to explore interpersonal process (IP) group th... more Introduction: The present pilot study was designed to explore interpersonal process (IP) group therapy for post-traumatic stress disorder (PTSD); a novel and relatively untested treatment approach for PTSD. IP groups seek to normalize patients’ symptoms and enhance functioning by creating a safe environment wherein participants can engage with others who share similar experiences and symptoms. Methods: Present IP groups met weekly for 12 weeks. Participants included 20 Canadian male Veterans and RCMP officers (10 per treatment group) with a primary diagnosis of PTSD. All participants had previously received first-line treatments for PTSD but continued to experience serious limitations in functioning. Key measures of interest (i.e., PTSD, negative affect, moral injury) were administered immediately pre- and post-intervention. Qualitative data was collected from a subset of participants ( n = 6). Results: Baseline scores revealed significantly elevated symptom levels compared to normative and clinical samples. Retention rate over the course of therapy was 100%, a rare and important finding in clinical research generally, and in the PTSD population more specifically. Qualitative feedback was consistently positive; feedback also suggested future potential improvements for the therapeutic intervention. There was a significant reduction in anxiety (specifically, physiological hyperarousal) pre- to post-intervention, with a partial eta squared ( n2 p) value of 0.26, indicating a large effect size. Discussion: Examination of individual scores showed that fully one-third of participants demonstrated a reliable improvement in both physiological anxiety and anxiety sensitivity (AS), both of which have been implicated in the exacerbation and maintenance of other PTSD symptoms. Results support a randomized controlled trial of group IP for PTSD.
Pain research & management: the journal of the Canadian Pain Society = journal de la societe canadienne pour le traitement de la douleur
Behavioural conceptualizations of chronic pain posit that solicitous responses to pain behaviours... more Behavioural conceptualizations of chronic pain posit that solicitous responses to pain behaviours are positively reinforcing and play a role in the development of chronic pain and disability. Recent research suggests that studies investigating this model were likely limited by the use of only a few narrowly defined categories of responses to pain behaviour. A measure of preferences regarding pain-related social support has the potential to improve behavioural models of chronic pain by identifying other potentially reinforcing responses to pain behaviour. The Pain Response Preference Questionnaire (PRPQ) was created to assess preferences regarding pain-related social support. The purpose of the present study was to empirically develop PRPQ scales and examine their psychometric properties. A large university student sample (n=487) free of chronic pain completed the 39-item PRPQ. Factor analysis was applied to the data from the present sample to empirically develop PRPQ scales. Using a...
Anxiety sensitivity (AS: fear of anxiety-related arousal sensations) predicts anxiety psychopatho... more Anxiety sensitivity (AS: fear of anxiety-related arousal sensations) predicts anxiety psychopathology, notably panic disorder (Olatunji & Wolitzky-Taylor, 2009). High-AS individuals respond to arousal with a pattern of low distress tolerance and acceptance, high avoidance, and catastrophic thinking (Bernstein et al., 2009; Kashdan et al., 2008). Conversely, a mindful approach to experience entails non-reactivity, non-judgment, and acceptance (Baer, 2003). Both mindfulness training (Tanay et al., 2011) and interoceptive exposure (e.g., aerobic exercise; Smits et al., 2008; Watt et al., 2006) have been found to reduce AS. The present study explored the comparative benefits of mindfulness meditation and hatha yoga (i.e., interoceptive exposure integrated with mindfulness) for AS reduction. High-AS females were randomly assigned to mindful yoga (MY, n=7), mindfulness meditation (MM, n=7), or a health education control group (HEC, n=7). Over three weekly one-hour group sessions, the MM a...
Journal of Psychopathology and Behavioral Assessment, 2012
ABSTRACT Natural Environment phobia include fears cued by events such as severe weather. Given th... more ABSTRACT Natural Environment phobia include fears cued by events such as severe weather. Given the limited research in this area, the present study sought to assess the prevalence and learning history origins of these fears, as well as their relation to anxiety sensitivity (AS). Study One participants included 533 (66%F) undergraduates who completed the Weather Experiences Questionnaire. Overall, 42 % reported exposure to a severe weather event (e.g., hurricanes); 16 % reported high- and 44 % low-fear about weather. Thirty-three from each group participated in Study Two, wherein one high-fear participant approximated the diagnostic criteria for severe weather phobia. High-fear participants cited direct conditioning (43 %) followed by vicarious conditioning (39 %) as the most common learning pathways. The remaining18% could not recall the source of their fear and none identified operant conditioning. One-third cited mothers (versus 8 % fathers) as sharing similar fears. Most had not witnessed parents hurt, frightened, or distressed by severe weather but claimed parents had warned them about severe weather. High- (vs. low-) fear participants revealed more AS-somatic versus AS-cognitive or AS-social concerns. The importance of such research in light of the increasing frequency of severe weather events is discussed.
High anxiety sensitivity (AS) has been associated with elevated pain-related anxiety in anxiety a... more High anxiety sensitivity (AS) has been associated with elevated pain-related anxiety in anxiety and pain samples. The present study investigated (a) the associations among the lower order dimensions of AS and pain-related anxiety, using a robust measure of AS, and (b) the pain-related anxiety outcomes of a telephone-delivered cognitive behavioural treatment (CBT) designed to reduce high AS. Participants were 80 anxiety treatment-seeking participants with high AS (M age = 36 years; 79% women). After providing baseline data on AS and pain-related anxiety, participants were randomly assigned to an eight-week telephone CBT or a waiting list control. At baseline, bivariate correlations showed AS physical and cognitive, but not social, concerns were significantly associated with pain-related fear and arousal but not escape/avoidance behaviours. Multiple regression revealed that after accounting for emotional distress symptoms, AS physical, but not cognitive or social, concerns uniquely pr...
A brief, group cognitive behavioural therapy with running as the interoceptive exposure (IE; expo... more A brief, group cognitive behavioural therapy with running as the interoceptive exposure (IE; exposure to physiological sensations) component was effective in decreasing anxiety sensitivity (AS; fear of arousal sensations) levels in female undergraduates (Watt et al., Anxiety and Substance Use Disorders: The Vicious Cycle of Comorbidity, 201-219, 2008). Additionally, repeated exposure to running resulted in decreases in cognitive (i.e., catastrophic thoughts) and affective (i.e., feelings of anxiety) reactions to running over time for high AS, but not low AS, participants (Sabourin et al., "Physical exercise as interoceptive exposure within a brief cognitive-behavioral treatment for anxiety-sensitive women", Journal of Cognitive Psychotherapy, 22:302-320, 2008). A follow-up study including the above-mentioned intervention with an expanded IE component also resulted in decreases in AS levels (Sabourin et al., under review). The goals of the present process study were (1) to ...
ABSTRACT High anxiety sensitivity (AS; fear of arousal-related bodily sensations) is a known risk... more ABSTRACT High anxiety sensitivity (AS; fear of arousal-related bodily sensations) is a known risk factor for psychopathology and medical pathology. High AS individuals tend to avoid activities that induce feared arousal-related sensations; yet, few studies have examined AS and sexual activity, those that did have produced mixed results, and no study to date has examined AS and sexual avoidance. In Study 1, 296 young adult women completed the Anxiety Sensitivity Index-3 (ASI-3) and the Female Sexual Distress Scale-Revised, which were positively correlated, r = 0.34, p < .001. Women scoring in the highest and lowest quartiles on the ASI-3 were recruited for Study 2. As predicted, high (vs. low) AS women reported significantly more sexual distress, impairments in sexual functioning (including sexual pain), and avoidance of sexual activity, and less sexual satisfaction. Results suggest that high AS can limit the frequency and quality of sexual functioning in young adult women, or lead to avoidance of sexual activity altogether. Reducing AS via empirically validated cognitive-behavioural approaches could improve women's sexual and relationship well-being.
Mindfulness (tendency to attend to present experience without expectation or judgment) is general... more Mindfulness (tendency to attend to present experience without expectation or judgment) is generally considered to be an adaptive way of responding to emotional experience. Anxiety sensitivity can be conceptualized as a maladaptive response (fear) to arousal-related somatic sensations commonly associated with anxiety. Emotion regulation strategies are learned in the context of early attachment relationships, and adult attachment styles have been linked to both mindfulness and anxiety sensitivity. This study examined whether mindfulness facets (observe, describe, act with awareness, accept without judgment) would mediate associations between attachment and the dimensions of anxiety sensitivity (physical, social, cognitive concerns). Multiple mediation analyses showed that observe mediated the relation between attachment anxiety and physical concerns, and accept mediated the relation between attachment anxiety and social concerns. Accept, aware, and observe each mediated the relation between attachment anxiety and cognitive concerns. Only accept mediated the association between attachment avoidance and the three anxiety sensitivity dimensions. Findings suggest the importance of measuring mindfulness as a multidimensional construct, and the value of assessing attachment style and incorporating mindfulness elements in interventions designed to reduce anxiety sensitivity.
• Cognitive behavioral therapy (vs. a waiting list) reduced anxiety sensitivity. • Treatment also... more • Cognitive behavioral therapy (vs. a waiting list) reduced anxiety sensitivity. • Treatment also specifically reduced drinking to cope with anxiety. • Physical and intrapersonal alcohol-related problems were also reduced. • Change in anxiety sensitivity mediated reductions in drinking to cope with anxiety. • Reductions in drinking to cope with anxiety mediated changes in alcohol problems.
Anxiety sensitivity refers to the fear of anxiety-related physical sensations arising from belief... more Anxiety sensitivity refers to the fear of anxiety-related physical sensations arising from beliefs that these sensations have harmful consequences (Reiss & McNally, 1985). The present study examined whether individuals with high (vs. low) anxiety sensitivity show stronger implicit associations in memory between anxiety-related symptoms, as opposed to neutral body parts, and harmful, as compared to harmless, consequences. A total of 22 undergraduate students (14 F, 8 M) completed the Extrinsic Affective Simon Task (EAST; De Houwer, 2003). Results indicated that high anxiety sensitive individuals (n = 10) tended to implicitly associate harmful consequences with anxiety-related symptoms. Their performance was significantly faster on trials where target words related to anxiety symptoms were mapped on to the same response key as harmful consequences. No significant difference in performance was found for low anxiety sensitive individuals (n = 12) or when target words were body parts unlikely related to diseases. Between-group differences persisted after controlling for trait anxiety and history of panic attacks, but not when illness-related beliefs were introduced as a covariate. Identifying this implicit association bias provides additional empirical support for the concept of anxiety sensitivity.
Introduction: The present pilot study was designed to explore interpersonal process (IP) group th... more Introduction: The present pilot study was designed to explore interpersonal process (IP) group therapy for post-traumatic stress disorder (PTSD); a novel and relatively untested treatment approach for PTSD. IP groups seek to normalize patients’ symptoms and enhance functioning by creating a safe environment wherein participants can engage with others who share similar experiences and symptoms. Methods: Present IP groups met weekly for 12 weeks. Participants included 20 Canadian male Veterans and RCMP officers (10 per treatment group) with a primary diagnosis of PTSD. All participants had previously received first-line treatments for PTSD but continued to experience serious limitations in functioning. Key measures of interest (i.e., PTSD, negative affect, moral injury) were administered immediately pre- and post-intervention. Qualitative data was collected from a subset of participants ( n = 6). Results: Baseline scores revealed significantly elevated symptom levels compared to normative and clinical samples. Retention rate over the course of therapy was 100%, a rare and important finding in clinical research generally, and in the PTSD population more specifically. Qualitative feedback was consistently positive; feedback also suggested future potential improvements for the therapeutic intervention. There was a significant reduction in anxiety (specifically, physiological hyperarousal) pre- to post-intervention, with a partial eta squared ( n2 p) value of 0.26, indicating a large effect size. Discussion: Examination of individual scores showed that fully one-third of participants demonstrated a reliable improvement in both physiological anxiety and anxiety sensitivity (AS), both of which have been implicated in the exacerbation and maintenance of other PTSD symptoms. Results support a randomized controlled trial of group IP for PTSD.
Pain research & management: the journal of the Canadian Pain Society = journal de la societe canadienne pour le traitement de la douleur
Behavioural conceptualizations of chronic pain posit that solicitous responses to pain behaviours... more Behavioural conceptualizations of chronic pain posit that solicitous responses to pain behaviours are positively reinforcing and play a role in the development of chronic pain and disability. Recent research suggests that studies investigating this model were likely limited by the use of only a few narrowly defined categories of responses to pain behaviour. A measure of preferences regarding pain-related social support has the potential to improve behavioural models of chronic pain by identifying other potentially reinforcing responses to pain behaviour. The Pain Response Preference Questionnaire (PRPQ) was created to assess preferences regarding pain-related social support. The purpose of the present study was to empirically develop PRPQ scales and examine their psychometric properties. A large university student sample (n=487) free of chronic pain completed the 39-item PRPQ. Factor analysis was applied to the data from the present sample to empirically develop PRPQ scales. Using a...
Anxiety sensitivity (AS: fear of anxiety-related arousal sensations) predicts anxiety psychopatho... more Anxiety sensitivity (AS: fear of anxiety-related arousal sensations) predicts anxiety psychopathology, notably panic disorder (Olatunji & Wolitzky-Taylor, 2009). High-AS individuals respond to arousal with a pattern of low distress tolerance and acceptance, high avoidance, and catastrophic thinking (Bernstein et al., 2009; Kashdan et al., 2008). Conversely, a mindful approach to experience entails non-reactivity, non-judgment, and acceptance (Baer, 2003). Both mindfulness training (Tanay et al., 2011) and interoceptive exposure (e.g., aerobic exercise; Smits et al., 2008; Watt et al., 2006) have been found to reduce AS. The present study explored the comparative benefits of mindfulness meditation and hatha yoga (i.e., interoceptive exposure integrated with mindfulness) for AS reduction. High-AS females were randomly assigned to mindful yoga (MY, n=7), mindfulness meditation (MM, n=7), or a health education control group (HEC, n=7). Over three weekly one-hour group sessions, the MM a...
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Papers by Margo Watt