Construct validity and vulnerability to anxiety: a cognitive interviewing study of the revised Anxiety Sensitivity Index.

The Anxiety Sensitivity Index (ASI; Reiss, S., Peterson, R. A., Gursky, D. M., & McNally, R. J. (1986). Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behaviour Research and Therapy, 24, 1-8) is probably the most widely used measure of cognitive vulnerability to anxiety. However, there have been periodic doubts expressed about whether it measures beliefs about the negative consequences of anxiety symptoms, as it purports to, or actual anxiety experiences. The present study investigated the construct validity of the revised ASI using a cognitive interviewing approach. Sixteen outpatients with anxiety problems responded to ASI-R items and items from another measure of vulnerability to anxiety, the Anxiety Attitude and Belief Scale, while thinking aloud. The resulting verbal protocols were coded according to the apparent cognitive processes respondents engaged in when answering the items. Responses to the revised ASI-R more often entailed retrieval of past episodes of anxiety, and participants more frequently formulated their responses based on judgments of the occurrence or intensity of feelings rather than on the appraisal of anticipated consequences of what was described in the items. These findings potentially have significant implications for interpretation of results from the large body of literature using the different versions of the ASI.