Today we will learn about a model that explains various anxiety disorders: S. Reiss’s expectation model of anxiety The key concept of his theory is anxiety sensitivity, that is, the fear of anxious sensations.
But what is the relationship between this sensitivity to anxiety and anxiety disorders? What other key concepts does the theory present? Let’s get to know it in detail.
The expectancy model of anxiety It 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 due to conditioned stimulus-unconditioned stimulus contiguity” to explain the acquisition of fear. In addition, it gives an important role to expectations, that is, what is feared.
It is a Pavlovian and cognitive model and, according to Sandín (1996), it is one of those that has had the greatest impact on the current psychopathology of anxiety. Furthermore, it integrates operant aspects such as negative reinforcement and self-reinforcement.
Model components
S. Reiss’s anxiety expectancy model is made up 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 fears of anxiety symptoms or sensations, which arise from the belief that these symptoms have negative somatic, social or psychological consequences.
The model assumes sensitivity to anxiety as a unidimensional personality variable distinct from trait anxiety although they could be considered related concepts.
In the latest version of S. Reiss’s Anxiety Expectancy Model, the 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 fears (the feared stimulus or situation). There are three types of expectations:
1. Expectation of harm/danger
Expectation about a danger/damage from the external physical environment (for example: “it is likely that we will have an accident with the car”).
2. Expectation 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 a way that leads to a negative evaluation by others (for example “I won’t be able to control my fear of having an accident”).
Sensitivities
We are going to analyze the other type of component of the model, already mentioned. It is about why the subject is afraid of certain stimuli or situations. As in the previous case, there are three types of sensitivities:
1. Sensitivity to damage/danger
Sensitivity to personal physical harm (for example: “they will hurt me and I won’t be able to bear it”).
2. Sensitivity to anxiety:
Sensitivity to experiencing anxiety (for example: “I can have a heart attack if I experience panic”).
3. Sensitivity to social evaluation
Sensitivity to negative evaluation (for example: “I feel embarrassed when I make a mistake in front of others”).
One of the hypotheses derived from S. Reiss’s anxiety expectancy model, and which has received sufficient empirical evidence, is the one that states that sensitivity to anxiety 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 stated that the high presence of sensitivity to anxiety was typical only of agoraphobia or panic (this had always been thought), although it has been seen that this is not the case.
A high sensitivity to anxiety also appears in generalized anxiety disorder, social phobia, post-traumatic stress disorder, and obsessive-compulsive disorder (OCD)
In summary, the elevated presence of anxiety sensitivity appears in most anxiety disorders (with the exception of specific phobias, where there are more doubts about it).
Lab results
Through S. Reiss’s expectation model of anxiety also different laboratory hypotheses have been tested which relate sensitivity to anxiety with the response to anxiety-producing stimuli.
It is believed that sensitivity to anxiety could explain the increased response that subjects with panic disorder show in laboratory tests, where the subject is exposed to an anxiety-producing stimulus.
The anxiogenic procedure most used to determine these results has been hyperventilation although other anxiogenic stimuli have also been used such as inhalation of carbon dioxide, ingestion of high doses of caffeine or injection of cholecystokinin.
It has also been proven that subjects with high sensitivity to anxiety show more intense subjective and physiological anxiety responses than subjects with low SA.
From S. Reiss’s anxiety expectancy model, we find a validated instrument to evaluate the key concept of the theory: sensitivity to anxiety.
The most used instrument to evaluate SA is the Anxiety Sensitivity Index (Anxiety Sensitivity Index, ASI, Peterson and Reiss, 1992), which has good psychometric properties. It is an evaluation instrument that consists of 16 items that are answered according to a Likert-type scale, which can vary between “Not at all” (0) and “Very much” (4).
