Emotional reasoning and anxiety sensitivity: associations with social anxiety disorder in childhood

Abstract

Background: Two specific cognitive constructs that have been implicated in the development and maintenance of anxiety symptoms are anxiety sensitivity and emotional reasoning, both of which relate to the experience and meaning of physical symptoms of arousal or anxiety. The interpretation of physical symptoms has been particularly implicated in theories of social anxiety disorder, where internal physical symptoms are hypothesized to influence the individual's appraisals of the self as a social object.

Method: The current study compared 75 children on measures of anxiety sensitivity and emotional reasoning: 25 with social anxiety disorder, 25 with other anxiety disorders, and 25 nonanxious children (aged 7-12 years).

Results: Children with social anxiety disorder reported higher levels of anxiety sensitivity and were more likely than both other groups to view ambiguous situations as anxiety provoking, whether physical information was present or not. There were no group differences in the extent to which physical information altered children's interpretation of hypothetical scenarios.

Limitations: This study is the first to investigate emotional reasoning in clinically anxious children and therefore replication is needed. In addition, those in both anxious groups commonly had comorbid conditions and, consequently, specific conclusions about social anxiety disorder need to be treated with caution.

Conclusion: The findings highlight cognitive characteristics that may be particularly pertinent in the context of social anxiety disorder in childhood and which may be potential targets for treatment. Furthermore, the findings suggest that strategies to modify these particular cognitive constructs may not be necessary in treatments of some other childhood anxiety disorders.

Keywords: Anxiety; Anxiety sensitivity; Child; Cognition; Emotional reasoning; Social anxiety disorder.

Fig. 1

Associations between age, group and Child Anxiety Sensitivity Index (CASI) Illness score.

Fig. 2

Associations between age (months), group and responses to ambiguous stories. (a) Without physical information. Fear threshold. Fear ratings. Negative feelings. (b) With physical information. Fear ratings.

Fig. 3

Associations between age (months), group and difference scores between ambiguous plus physical information stories and ambiguous stories without physical information. Fear threshold difference score. Negative feelings difference score.