Reference
Guide | Reference

36  Anxiety and Threat Sensitivity

36.1 Summary

  • A dimensional construct describing heightened detection and response to threat signals across contexts.

36.2 Core Construct

  • Tendency to overestimate threat and sustain fear or worry responses.

36.3 Subdimensions

  • Anticipatory worry and vigilance.
  • Acute fear or panic responses.
  • Avoidance and safety behaviors.

36.4 Severity Anchors (0-4)

  • 0: No clinically meaningful threat sensitivity.
  • 1: Mild, situational, manageable.
  • 2: Moderate, recurring, interferes with daily functioning.
  • 3: Severe, frequent, with marked avoidance or panic.
  • 4: Extreme, disabling or unsafe.

36.5 Time-Course Patterns

  • Acute spikes vs chronic baseline elevation.
  • Cue-bound (triggered) vs free-floating.
  • Episodic panic with inter-episode worry.

36.6 Functional Impact

  • Work/school: concentration loss, avoidance, decreased performance.
  • Relationships: withdrawal, reassurance seeking.
  • Self-care: sleep disruption, reduced routine adherence.

36.7 Developmental Expression

  • Childhood: separation fears, somatic complaints.
  • Adolescence: social threat, panic, avoidance.
  • Adulthood: generalized worry, health threat focus.
  • Late life: medical and safety-related fears.

36.8 Cultural / Context Notes

  • Threat appraisal depends on context and lived experience.
  • Somatic framing may predominate in some settings.

36.9 Differential and Rule-Outs

  • Trauma-related hypervigilance.
  • Obsessive intrusive fears.
  • Substance or medication effects.
  • Sleep deprivation or medical contributors.

36.10 Measurement Prompts

  • Brief anxiety measure.
  • Avoidance or trigger tracking.

36.11 Treatment-Relevant Correlates (non-prescriptive)

  • High avoidance often predicts functional restriction.
  • High arousal suggests monitoring of sleep and physiology.

36.13 Documentation Snippet (1-2 lines)

  • “Threat sensitivity elevated with avoidance and panic surges; Threat domain 3, episodic course.”