Anxiety sensitivity (AS) is essentially the fear of anxiety. A person with anxiety sensitivity is afraid of the feelings and sensations associated with anxiety itself, and this in turn causes the person to feel even more anxiety. The condition is especially prominent in people with panic disorder.

In 1985 psychologists Steven Reiss and Richard McNally were the first to label the “fear of fear” as anxiety sensitivity. Rather than seeing it as simply a fearful anticipation of recurring panic attacks — which was the current point of view — they suggested that anxiety sensitivity might be based on a belief that the experience of anxiety itself is harmful. For example, people with high anxiety sensitivity may believe that the physical sensations they experience — such as a racing heart rate, dizziness, sweating, etc — are harmful and will lead to terrifying outcomes, such as going crazy, losing control, having a heart attack or result in extreme embarrassment.

This theory of anxiety sensitivity implies that the condition is at least partly due to one’s own beliefs or cognition. It also suggests that anxiety sensitivity comes before and may even predict panic attacks.

Anxiety sensitivity is most often measured by the Anxiety Sensitivity Index (ASI), a 16 item questionnaire developed by Reiss. A high score on the ASI often predicts a greater risk of having panic attacks, post-traumatic stress disorder (PTSD) and other types of phobias.

Some experts had a hard time accepting the ASI when it was first introduced. The opposing viewpoint was that since everyone dislikes and avoids anxiety, there was no need to classify and study personal differences. It is now well-known, however, that some people go to great lengths to avoid anxiety, and these are the ones most likely to suffer from panic attacks, phobias and PTSD.

Example: Marlene, who suffers from chronic panic attacks, has high levels of anxiety sensitivity. She worries that she will have a panic attack in front of other people and suffer from extreme rejection and embarrassment.