Today we will know a model that explains several anxiety disorders: S. Reiss’s Anxiety Waiting Model. The key concept of his theory is anxiety sensitivity, that is, the fear of feelings of anxiety.
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 him in detail.
S. Reiss Anxiety Expectancy Model
The Anxiety Waiting Model was proposed by S. Reiss (1991), and is a model of fear, anxiety and panic.
It is based on Pavlovian conditioning and maintains the idea of ”no need for adjacency for conditioned adjacency-unconditioned stimulus” to explain fear acquisition. In addition, it gives an important role to expectations, that is to say to what they fear.
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. In addition, it incorporates aspects that operate such as negative reinforcement and self-reinforcement.
S. Reiss’s Anxiety Expectancy Model is made up of several elements, as we will see below.
During the first revision of the model, Reiss and McNally introduce varying sensitivity to anxiety (HER). This is an essential concept of the model, which defines fears of symptoms or feelings of anxiety, which arise from the belief that these symptoms have negative somatic, social or psychological consequences.
The model assumes an anxiety sensitivity as a one-dimensional personality variable different from trait anxiety, Although they can be considered as related concepts.
In the latest version of S. Reiss’s Anxiety Expectation Model, fear of a stimulus or a given situation is evoked as a function of two components: expectations and sensitivities (also called “fundamental fears”).
Let’s get to know these new concepts.
They refer to what the subject is afraid of (the stimulus or the feared situation). There are three types of expectations:
1. Expectation of damage / danger
Expectation of danger / damage to the external physical environment (For example: “we are likely to have a car accident”).
2. Anxiety expectation
Waiting on the possibility of experiencing anxiety or stress (For example: “Even though I know it is safe to drive, I can have a panic attack along the way”).
3. Waiting for a social assessment
Waiting to react in such a way as to negative feedback by others (For example, “I will not be able to control my fear of having an accident”).
We will analyze the other type of component of the model, already mentioned. It is a question of knowing why the subject is afraid of certain stimuli or situations. As in the previous case, three types of sensitivities are differentiated:
1. Sensitivity to damage / danger
Sensitivity to personal physical damage (for example, “they will hurt me and I will not be able to take it”).
2. Sensitivity to anxiety:
Sensitivity to anxiety (for example, “I may have a heart attack if I panic”).
3. Sensitivity to social assessment
Sensitivity to negative feedback (eg, “I’m ashamed when I make a mistake in something in front of others”).
Anxiety disorders: the model hypothesis
One of the hypotheses that derives from S. Reiss’ anxiety expectancy model, and which has received sufficient empirical evidence, is that it increases anxiety sensitivity. it is a risk factor for anxiety disorders.
On the other hand, a second hypothesis states that there is an association between sensitivity to anxiety and the tendency to feel fear.
A third hypothesis suggested that the high presence of sensitivity to anxiety was only peculiar to agoraphobia or panic (this had always been thought), although it has been seen that this is not the case.
There is also a strong sensitivity to anxiety in generalized anxiety disorder, social phobia, post-traumatic stress disorder and obsessive-compulsive disorder (OCD).
In summary, the strong presence of anxiety sensitivity appears in most anxiety disorders (with the exception of specific phobias, where there is more doubt about this).
Also using S. Reiss’s anxiety expectancy model different laboratory hypotheses were tested, Which link anxiety sensitivity to the response to anxious stimuli.
It is believed that anxiety sensitivity could explain the increased response of subjects with panic disorder in laboratory tests, where the subject is exposed to an anxious stimulus.
The most widely used anxiety-inducing procedure to determine these results is hyperventilation., Although other anxiety stimuli have also been used such as inhaling carbon dioxide, ingesting high doses of caffeine, or injecting cholecystokinin.
Highly sensitive subjects have also been shown to exhibit more intense subjective and physiological responses to anxiety than subjects with low AS.
How is anxiety sensitivity measured?
From S. Reiss’ anxiety anticipation model, we find a validated instrument to assess the key concept of the theory: anxiety sensitivity.
The most widely used instrument to assess AS is anxiety sensitivity index (Anxiety Sensitivity Index, ASI, Peterson & Reiss, 1992), which has good psychometric properties. It is an evaluation instrument made up of 16 items which are answered according to a Likert-type scale and which can vary between “Nothing at all” (0) and “Very good” (4).
- Sandin, B., Chorot, P. and McNally, RJ (1996). Validation of the Spanish version of the anxiety sensitivity index in a clinical sample. Behavioral Research and Therapy, 34, 283-290.
- Fullana, MA and Tortella-Feliu, M. (2000). Relationships between sensitivity to anxiety and fear of flying. Behavioral Psychology, 8 (1), 5-25.
- Fullana, MA, Cases, M. and Farré, JM (2001). Anxiety sensitivity in clinical samples: a pilot study. C. Med. Psicosom, 57, 9-17.