Dysfunctional Attitudes and Anxiety Sensitivity in the Manifestation and First Onset of Social Anxiety Disorder versus Specific Phobia and Healthy: A Prospective Longitudinal Study

Abstract

This study evaluated the role of two cognitive vulnerability factors, anxiety sensitivity and dysfunctional attitudes, in the prediction of the manifestation and onset of social anxiety disorder relative to specific phobia and relative to healthy controls. Women, aged between 18 and 24 years, were studied at baseline and 18 months later using the Anxiety Disorders Interview Schedule-Lifetime-ADIS-IV-L and the Anxiety Sensitivity Index-ASI and the Dysfunctional Attitude Scale-DAS. First, 52 women with current social anxiety disorder were compared to 97 women with current specific phobia and 1124 healthy controls (cross-sectional analysis). Second, 24 women with a first incidence of social anxiety disorder were compared to 55 women with a first incidence of specific phobia and 684 healthy controls (longitudinal analysis). Multiple logistic regression analyses, adjusted for baseline anxiety and depressive severity, revealed that a) dysfunctional attitudes were elevated in women with current social anxiety disorder versus healthy controls as well as women with current specific phobia in the cross-sectional analysis and b) dysfunctional attitudes were elevated in women who subsequently developed social anxiety disorder versus healthy controls in the longitudinal analysis. However, dysfunctional attitudes were not predictive for women who developed social anxiety disorder during the study relative to women who developed specific phobia. The results suggest that dysfunctional attitudes are a marker of severity for social anxiety disorder relative to other phobias and a risk factor for phobias more generally. Anxiety sensitivity seems not to contribute to the manifestation and onset of social anxiety disorders.