‘Fear of fear’:A new concept in the assement of anxiety disorders
Ehlers A., Margraf J.
In the diagnosis of anxiety disorders, internal anxiety triggers such as physical symptoms or catastrophic cognitions have recently created great interest. These internal triggers are important in explaining the etiology of agoraphobic avoidance and ‘spontaneous’ panic attacks Recent research shows that they are also relevant to other anxiety disorders. Patients with anxiety disorders, especially those with panic disorder or agoraphobia, report fear of physical anxiety symptom-and evaluate these symptoms as dangerous. Furthermore, they are afraid of negative social and health-related consequences of anxiety and physical symptoms (‘fear of fear’). Reliable questionnaires foi the assessment of ‘fear of fear’ have been developed: The Body Sensa tions Questionnaire (BSO). the Agoraphobic Cognitions Que stionnaire (ACQ) and the Anxiety Sensitivity Index (ASI). We repori studies on the German versions of these questionnaires. The ‘fear ol fear’ scales explain a proportion of the variance of phobic fear anc avoidance which is independent of trait anxiety. Patients with anxiety disorders score higher on these questionnaires than patients withou anxiety disorders or normal controls. Patients with panic disorder; can be distinguished from patients with other anxiety disorders cspc cially by higher scores in the ACQ factor ‘physical concerns’. Overall our studies support the relevance of the ‘fear of fear’ concept in ex plaining phobic avoidance and in the assessment of anxiety disorders. © 1993 S. Karger AG. Basel.