Most people who notice they are anxious--they may notice a pounding heart, sweaty palms, or the "shakes"--expect the anxiety to dissipate when the situation that is worrying them is resolved. A person with low AS would perceive such sensations to be unpleasant, but transient and harmless, consequences of being in an anxious state. But a person with high AS might fear heart palpitations believing they portend a heart attack; fear dizziness believing it to signify imminent mental breakdown; and/or fear trembling in anticipation of public ridicule. Anxiety symptoms drive people into emergency rooms in fear of nonexistent heart attacks or brain tumors, and it results in some people going from doctor to doctor thinking something is physically wrong with them.

Consequently, and all other factors being equal, people with high AS are much more likely to avoid stressful situations than are people with low AS. Consistent with the theory that AS may serve as a risk factor for the development and maintenance of anxiety symptoms and anxiety disorders, numerous studies have demonstrated elevated levels of AS in panic and other anxiety disorder (e.g., PTSD) patients. Longitudinal research has further demonstrated that AS plays a causal role in the development of panic attacks and anxiety disorders. For individuals with high AS, their sensitivity to anxiety-related sensations and their tendency to misinterpret and catastrophize about these sensations predisposes them to various disorders, including hypochondriasis, depression, substance use disorder, and chronic pain.

Hypersensitivity to anxiety can be successfully treated with cognitive-behavioral therapy, which reduces fear by correcting unreasonable ideas about the meaning of body sensations like breathlessness. Cognitive-behavioral treatments for panic disorder aim to reduce anxiety sensitivity in order to prevent recurrence of panic attacks

The overall purposes of this book are:
• to define and explain the concept of AS with lay descriptions of some of the supporting research,
• to provide a self-assessment process for readers to measure their own level of AS,
• to offer empirically-validated cognitive and behavioral techniques designed to help reduce their anxiety vulnerability before facing, and during, trigger situations, and
• to recommend strategies for maintaining gains in managing their AS levels.

Targeting a risk factor for psychopathology, such as AS, offers the promise of prevention, as well as treatment of anxiety and related disorders. Understanding AS allows individuals to intervene early in their own anxiety cycle so as to better manage their anxiety, and reduce their avoidance of anxiety-related situations. The book's approach is very strategic in that it focuses on the cognitions most relevant to high AS. The cognitive and behavioral strategies are empirically-validated techniques. The efficacy of this approach (i.e., brief CBT targeting AS) has been demonstrated in over three years of controlled study, with positive effects found for reducing AS and pain anxiety levels, drinking behavior and problems, and symptoms of depression.