The ASP project: do anxiety sensitivity dimensions differ across the stages of psychosis? Preliminary data from cross-sectional investigations across at-risk mental state, first-episode psychosis, chronic psychosis, and anxiety disorders

Background: Anxiety sensitivity is a maintenance cognitive factor for anxiety disorders, consisting of physical concerns (eg, the belief that palpitations lead to a cardiac arrest), social concerns (the belief that observable anxiety reactions will elicit social rejection), and cognitive concerns (cognitive difficulties could lead to mental incapacitation). No study investigated whether specific AS dimensions could be related to stages of psychosis. Objectives: The current study aimed to examine differences on AS dimen- sions across patients with at-risk mental state (ARMS), first-episode psychosis (FEP), chronic psychosis (ChP), anxiety disorders (AD), and non-clinical controls (NCCs). Method: The Anxiety Sensitivity Index-3 was administered to patients with ARMS (n = 20), FEP (n = 25), ChP (n = 20), AD without psychosis (n = 40), and NCCs (n =30). The AD group included patients with a primary panic disorder, social anxiety or generalized anxiety disorder. Results: Similarly to FEP and ChP, the ARMS group reported lower physical concerns scores than AD, and comparable scores to NCCs (F = 7.93, p < 0.01). ARMS group had higher cognitive concerns than NCCs, but lower than AD group (F=4.62, p<0.01). In addition, ARMS group endorsed higher social concerns than NCCs (at a significance level), and than FEP and ChP (only at a trend level), and comparable to AD (F=7.37, p<0.01). Conclusions: Social Concerns seemed to be a cognitive dimension specific to ARMS. Case conceptualizations and therapeutic components specific to social anxiety could be incorporated in modular treatments for ARMS, targeting misinterpretations of social cues and fear of negative evaluation. Replications with larger samples are needed.