Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Nov:155:263-268.
doi: 10.1016/j.jpsychires.2022.09.003. Epub 2022 Sep 12.

Anxiety sensitivity predicts depression severity in individuals with dissociative identity disorder

Xi Pan  1 , Cori A Palermo  1 , Chloe S Kaplan  1 , Nathaniel G Harnett  2 , Sherry R Winternitz  2 , Milissa L Kaufman  2 , Lauren A M Lebois  3
Affiliations

Anxiety sensitivity predicts depression severity in individuals with dissociative identity disorder

Xi Pan et al. J Psychiatr Res. 2022 Nov.

Abstract

Background: Anxiety sensitivity involves the fear of anxiety-related symptoms and can exacerbate both major depressive disorder and posttraumatic stress disorder (PTSD) symptoms. However, it is unclear if anxiety sensitivity plays a similar role in dissociative identity disorder (DID) where symptoms of depression and PTSD commonly co-occur. We examined the association between anxiety sensitivity, depression, PTSD and dissociative symptoms in DID, hypothesizing a positive association between all symptoms and anxiety sensitivity.

Method: Participants were 21 treatment-seeking adult females with histories of childhood trauma, current PTSD, and DID. Participants completed the Anxiety Sensitivity Index (ASI), Beck Depression Inventory-II, Childhood Trauma Questionnaire, Multidimensional Inventory of Dissociation, and PTSD Checklist for DSM-5. The ASI included subscales that assessed anxiety sensitivity in cognitive, physical, and social domains.

Results: Participants reported high levels of anxiety sensitivity. A multiple regression analysis demonstrated that the ASI cognitive subscale was the strongest predictor of depressive symptoms. No direct associations were identified between anxiety sensitivity and PTSD or dissociative symptoms. We conducted a mediation analysis to test an indirect relationship between cognitive anxiety sensitivity and dissociative symptoms, and found a significant indirect effect through depressive symptoms.

Conclusions: Our results suggest that cognitive anxiety sensitivity or the fear of cognitive dyscontrol is linked with symptom severity in DID. These findings emphasize the need to assess for and utilize interventions that target anxiety sensitivity, which may in turn alleviate symptoms of depression and dissociation in DID.

Keywords: Anxiety sensitivity; Depression; Dissociative identity disorder; Posttraumatic stress disorder.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest Dr. Lebois reports unpaid membership on the Scientific Committee for the International Society for the Study of Trauma and Dissociation (ISSTD), grant support from the National Institute of Mental Health, K01 MH118467, and the Julia Kasparian Fund for Neuroscience Research. Dr. Lebois also reports spousal IP payments from Vanderbilt University for technology licensed to Acadia Pharmaceuticals unrelated to the present work. Dr. Kaufman reports unpaid membership on the Scientific Committee for the ISSTD and grant support from the National Institute of Mental Health R01 MH119227 and the Julia Kasparian Fund for Neuroscience Research. ISSTD and NIMH were not involved in the analysis or preparation of the manuscript. All other authors report no conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Mediation model. Note: xAnxiety Sensitivity Index Cognitive Concerns Subscale; mBeck Depression Inventory II; yMultidimensional Inventory of Dissociation severe pathological dissociation subscale.
See this image and copyright information in PMC

References

    1. Armour C, Elklit A, Lauterbach D, Elhai JD, 2014. The DSM-5 dissociative-PTSD subtype: can levels of depression, anxiety, hostility, and sleeping difficulties differentiate between dissociative-PTSD and PTSD in rape and sexual assault victims? J. Anxiety Disord. 28, 418–426. - PubMed
    1. Asmundson GJG, Stapleton JA, 2008. Associations between dimensions of anxiety sensitivity and PTSD symptom clusters in active-duty police officers. Cognit. Behav. Ther. 37, 66–75. - PubMed
    1. Association AP, Association AP, Others, 2013. Diagnostic and Statistical Manual of Mental Disorders. DSM-5, Arlington, VA.
    1. Barnard KE, Broman-Fulks JJ, Michael KD, Webb RM, Zawilinski LL, 2011. The effects of physiological arousal on cognitive and psychomotor performance among individuals with high and low anxiety sensitivity. Hist. Philos. Logic 24, 201–216. - PubMed
    1. Beck AT, 1996. BDI-II, Beck Depression Inventory: Manual. Psychological Corp, San Antonio, Tex. Boston: : Harcourt Brace.

Publication types