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Emotion Appraisal and AnxietySymptomatology in a UniversitySampleAngela H. Smitha, Peter J. Nortona & Chad T. Wetterneckb

a Psychology Department, University of Houston, Houston, TX,USAb Rogers Memorial Hospital, Oconomowoc, WI, USAPublished online: 03 Mar 2014.

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Emotion Appraisal and Anxiety Symptomatology in aUniversity Sample

Angela H. Smith1*, Peter J. Norton1 and Chad T. Wetterneck2

1Psychology Department, University of Houston, Houston, TX, USA; 2Rogers MemorialHospital, Oconomowoc, WI, USA

Abstract. Current conceptualizations for anxiety disorders focus heavily on cognitive and behavioralaspects of anxiety and address other emotions to a far lesser extent. Studies have demonstrated thatnegative appraisals of anxiety and fear (e.g., anxiety sensitivity) are elevated in each of the anxietydisorders and depressive disorders. Much less is known about how the appraisal of other emotions isrelated to anxiety disorder symptom presentation. The current study examines the appraisal ofspecific aversive emotions in relation to anxiety symptomatology. Undergraduate university students(N ¼ 530) completed measures of specific anxiety and depressive symptoms, as well as a measure ofemotional appraisal. A maximum likelihood estimated multivariate regression model was used toexamine the unique relationships between emotional appraisal and anxiety and depressive symptoms.Results indicated that anxiety symptoms varied in their relationships with emotional appraisal. Eachsymptom group was highly related to fear of appraisals of anxiety; however, some anxiety symptomswere also related to fear of other emotional states, including guilt, sadness, disgust, lust, andembarrassment. Understanding the full range of appraisals of emotional experiences in anxietyconditions may help inform conceptualizations, and potentially treatments, by guiding the focus tothe feared emotional states of the individual. The present study helps to clarify some of therelationships between emotion appraisal and anxiety symptoms. Key words: anxiety; emotionappraisal.

Received 8 November 2013; Accepted 30 January 2014

Correspondence address: A. H. Smith, M.A., Department of Psychology, University of Houston, 126Heyne Bldg., Houston, TX, USA 77204-5022. Tel: þ1 713 743 8600. E-mail: ahsmith2@uh.edu

IntroductionSimply defined, anxiety is an emotionalresponse to a real or perceived threat whichresults in cognitive, behavioral, and physio-logical responses (Lang, 1968). The ubiquityof anxiety as well as high prevalence rates ofanxiety disorders have led to a large body ofresearch investigating the underlying con-structs related to the anxiety experience. Forseveral decades, the empirical emphasis wason the cognitive and behavioral correlates ofanxiety, and the findings from these investi-gations laid the foundation for the develop-ment of efficacious treatments for anxietydisorders (Barlow & Lehman, 1996; Chamb-less & Gillis, 1993; Craske, 1999; Norton &Price, 2007).

Empirical findings, however, suggest thatindividuals who develop anxiety disorders

have difficulty with emotions in general—including impaired ability to understandemotions, negative responses to emotions(Mennin, Heimberg, Turk, & Fresco, 2005;Turk, Heimberg, Luterek, Mennin, & Fresco,2005), and the use of maladaptive emotionregulation strategies (Campbell-Sills & Bar-low, 2007). This has led to investigations of therole of emotion regulation in anxiety andmood disorders (e.g., Allen & Barlow, 2009),suggesting that individuals with anxietyengage in maladaptive strategies (e.g., sup-pression) to regulate experiences of emotions.There are differences in the ease with whichindividuals elicit, respond to, and recoverfrom emotions, as well as individual differ-ences in acceptance of emotions (i.e., judg-ment as appropriate, tolerable, or logical;Amstadter, 2008). Research on meta-emotionacross disciplines suggests that there are

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individual differences in the way in whichpeople evaluate their emotions. Mayer andGaschke (1988) explain that emotion isexperienced first directly and then reflectively.That is, the emotion is experienced, and one’sreflection on the emotion causes a secondaryexperience of emotion. Bartsch, Vorderer,Mangold, and Viehoff (2008) suggest thatmeta-processes (e.g., appraisal) influence theway in which emotions are expressed andregulated. Ultimately, how emotions areappraised may impact the use of maladaptiveemotion regulation strategies in individualswith anxiety. However, elucidating whetheremotion appraisal is related to anxietysymptomology is a necessary first step.While there is evidence of heightened

negative emotional states in those with anxietydisorders, researchers have only begun toinvestigate how these emotions are perceived.Goldstein and Chambless (1978) and Reiss(1991) introduced concepts of “fear of fear”and anxiety sensitivity, respectively, implicat-ing fear of anxiety in the development andmaintenance of panic disorder. Empiricalevidence has since demonstrated the role ofelevated anxiety sensitivity (i.e., misappraisalof anxiety symptoms as threatening) in each ofthe anxiety disorders (Taylor, Koch, &McNally, 1992) and depressive disorders(Cox, Enns, Freeman, & Walker, 2001; Otto,Pollack, Fava, Uccello, & Rosenbaum, 1995;Rector, Szacun-Shimizu, & Leybman, 2007).Williams, Chambless, and Ahrens (1997)

first examined fear of emotions (i.e., anxiety,anger, depressed mood, and positive emotionsin general) as they relate to panic symptoma-tology and perceived control over emotions inan analogue sample. This research demon-strated a positive relationship between fear ofemotions and panic symptoms, an effect whichremained significant after controlling for fearof anxiety. McCubbin and Sampson (2006)posited that appraising emotions as dangerous(i.e., feeling threat from emotions) is a traitcharacteristic related to heightened awarenessof danger, attempts to avoid emotions, and theuse of maladaptive coping methods. Theyinvestigated threat from emotions in auniversity sample, and their findings indicatedthat threat from specific emotions (i.e., angerand lust) significantly predicted obsessionality.Similarly, appraising a variety of emotions asthreatening was related to symptom severity in

individualswith obsessive-compulsive disorder(OCD; Smith, Wetterneck, Hart, Short, &Bjorgvinsson, 2012). These studies provideprecedence for further investigation into therelationship between negative appraisal ofemotion experiences and anxiety symptoms.The present study expands upon the extant

literature by examining the appraisal of abroad range of emotions (i.e., anxiety, disgust,guilt, anger, sadness, embarrassment, andlust), as well as experiences of anxiety anddepressive symptoms in an undergraduatestudent sample. The aim is to clarify the role ofthreat from specific emotions in relation tosymptoms of anxiety and depression todetermine whether the appraisal of emotionsother than anxiety is predictive of symptoma-tology. As this is one of the first studies toinvestigate the appraisal of a range ofemotions across mood symptomology, thestudy is largely exploratory in nature. How-ever, the following specific hypotheses weremade: (1) appraising anxiety as threateningwill predict symptomatology across anxietyand depressive symptoms; (2) appraisingsadness as threatening will predict symptomsof depression; (3) appraising embarrassmentas threatening will predict symptoms of socialanxiety, and, based on the findings ofMcCubbin and Sampson (2006), appraisinganger and lust as threatening will predictsymptoms of OCD.

MethodParticipantsParticipants (N ¼ 528) were undergraduatepsychology students at the University ofHouston who received extra credit or coursecredit in turn for their participation. Partici-pants ranged in age from 18 to 53 (M ¼ 22.9,SD ¼ 5.3) and were primarily female(n ¼ 471, 89.2%). The sample was raciallydiverse: 29.4% Caucasian, 28.4% Hispanic,18.7%Asian, 15.5% Black/African American,and 8% Other. Of the total sample, 11.7%were Freshman, 21.6% were Sophomores,37.9% were Juniors, and 28.8% were Seniors.

MeasuresMeasures of anxiety symptomatology. ThePanic Disorder Severity Scale-Self Report(PDSS-SR; Houck, Spiegel, Shear, & Rucci,2002) was used as an indicator of the panic

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construct. The PDSS-SR is a seven-itemmeasure that assesses the frequency andseverity of panic attacks as well as avoidancebehavior and impairment from panic attacks.Total scores are an average of the responses tothe seven items and range from 0 to 4. ThePDSS-SR has similar psychometric character-istics as the clinician-administered measure(Houck et al., 2002). The internal consistencyin this sample was excellent (Cronbach’sa ¼ .93).

The Brief Fear of Negative Evaluation Scale(BFNE; Leary, 1983) was used as an estimateof the social anxiety construct. The BFNE isan eight-item measure of the fear of socialevaluation that results from the loss of socialapproval. Scores range from 0 to 40 withhigher scores indicating greater fear of socialevaluation. The BFNE has demonstratedgood psychometric properties (Leary, 1983;Weeks et al., 2005). The internal consistency inthis sample was excellent (Cronbach’sa ¼ .94).

The Yale-Brown Obsessive CompulsiveScale-Self Report (Y-BOCS-SR; Steketee,Frost, & Bogart, 1996) was used as anindicator of the OCD construct. The Y-BOCS-SR is a 10-item measure that containsfive items related to obsessions and five relatedto compulsions. Scores range from 0 to 40,and scores of 16 and above indicate clinicallevels of severity (Shear et al., 2000). The Y-BOCS-SR is highly correlated with theclinician-conducted interview version of theY-BOCS (r ¼ .97; Baer, Brown-Beasley,Sorce, & Henriques, 1993), the gold standardfor assessing OCD severity. The YBOCS-SRhas shown acceptable internal consistency(Cronbach’s a ¼ .78 in an OCD sample) andtest retest reliability (r ¼ .88, p , .001 in anonclinical sample) over a one-week period(Steketee et al., 1996). The internal consistencyin this sample was good (Cronbach’s a ¼ .87).

The Penn State Worry Questionnaire(PSWQ; Meyer, Miller, Metzger, & Borkovec,1990) is a 16-item measure used to assessworry, the core feature of Generalized AnxietyDisorder (GAD). Scores range from 16 to 80,with higher scores indicating a greatertendency to worry. The PSWQ has demon-strated excellent psychometric properties inboth analogue (Meyer et al., 1990) and clinicalsamples (Brown, Antony, & Barlow, 1992).

The internal consistency in this sample wasacceptable (Cronbach’s a ¼ .76).

The Beck Depression Inventory-II (BDI-II;Beck, Steer, & Brown, 1996) was used as anindicator of the depression construct. TheBDI-II consists of 21-items that address thesomatic, cognitive, and affective domains ofdepressions. Scores range from 0 to 63, withhigher scores reflecting more depressivesymptoms. The BDI-II has demonstratedexcellent reliability and validity withboth clinical and nonclinical populations(Beck et al., 1996). The internal consistencyin this sample was excellent (Cronbach’sa ¼ .93).Measure of emotion appraisal. The Perceptionof Threat from Emotion Questionnaire(PTEQ; McCubbin & Sampson, 2006) wasused to assess emotional appraisal for sevenemotions: sadness, anger, fear/anxiety, dis-gust, guilt, lust, and embarrassment. ThePTEQ includes nine questions for eachemotion; the first seven questions assess theappraisal of the emotion, while the last twoquestions ask about clarity and frequency ofthe emotion. The PTEQ was utilized in thestudy, because it seems to measure how oneexperiences their emotions, rather than thefrequency of experiencing certain emotions.For example, questions include “Do you thinkit is dangerous to feel anxiety?,” “Couldanxiety cause you to lose control and do thingsyou would later regret?,” “When you feelanxiety does it seem it will last forever?,” and“Could anxiety overwhelm you so that you areunable to function?” Responses were rated ona five-point scale ranging from not at all (0) todefinitely (5). Subscale scores were generatedby adding the first seven items of each scale,with higher scores indicating greater overallthreat from emotion. The PTEQ has demon-strated strong convergent validity withmeasures of mood, responsibility, andthought–action fusion (i.e., a measure ofbeliefs; McCubbin & Sampson, 2006). Theinternal consistencies in this sample were good(Cronbach’s as ranging from .84 to .89).

ProcedureThe project was reviewed and approved by theCommittee for the Protection of HumanSubjects at the University of Houston.Participants were recruited from undergradu-ate psychology courses to participate in a

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study about “emotions and anxiety symp-toms.” Questionnaires were completed onlinein exchange for course credit.

ResultsMeans and standard deviations for thevariables included in the structural modelsare presented in Table 1. As expected with astudent sample, means were in the nonclinicalrange for each anxiety symptom measure (seeAntony, Orsillo, & Roemer, 2001); however,observed standard deviations and rangesindicated a broad range of scores.

Structural modelingThe data were analyzed in a multivariateregression model (maximum likelihood esti-mator) with the threat from emotion (PTEQsubscales) variables simultaneously regressedonto each of the anxiety symptom measures(PDSS, BFNE, Y-BOCS, PSWQ, BDI) usingMplus (version 4.1; Muthen &Muthen, 2006).To increase confidence in the estimatedparameters, 500 bootstrapping samples weredrawn. All criterion and predictor variableswere allowed to freely covary in order toestimate the unique effects of each emotionalthreat appraisal on each symptom cluster

Table 1. Univariate summaries of observed indicator variables

Measure M SD Range Skew Kurtosis

PDSS 2.94 4.42 0–26 1.94 4.30PSWQ 45.53 9.11 16–67 2 0.05 2 0.33BFNE 20.55 8.11 8–40 0.46 2 0.58Y-BOCS 10.37 6.38 0–35 0.41 2 0.14BDI 13.01 10.26 0–48 0.86 0.12PTEQ: Anxiety 11.08 6.99 0–28 0.29 2 0.74PTEQ: Anger 11.62 6.88 0–28 0.32 2 0.64PTEQ: Disgust 6.67 6.08 0–28 0.98 2 0.49PTEQ: Sadness 8.55 5.84 0–28 0.65 2 0.20PTEQ: Guilt 10.37 6.85 0–28 0.43 2 0.61PTEQ: Embarrassment 8.37 6.31 0–28 0.55 2 0.43PTEQ: Lust 9.24 6.91 0–28 0.58 2 0.37

Note. PDSS, Panic Disorder Severity Scale; BFNE, Brief Fear of Negative Evaluation; PSWQ, Penn StateWorry Questionnaire; Y-BOCS, Yale-Brown Obsessive Compulsive Scale; BDI, Beck Depression Inventory;PTEQ, Perception of Threat from Emotions Questionnaire.

R2= .20 R2= .20 R2= .20 R2= .23R2= .17

AnxietyLust Guilt Disgust Sadness Anger Embarrassment

Panic Social OCD GAD Dep

.42* .27*.22*

.25*.21* .41*.22* .20*

Figure 1. Multivariate regression model with fully standardized path coefficients. Note. Nonsignificantpathways were omitted from the figure to increase clarity.

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(see Figure 1). To control for alpha inflation,critical p-value was set at .01.

As expected, feeling threat from anxietysignificantly predicted symptoms related toeach of the anxiety constructs. Specifically,threat from anxiety seemed to be more salientfor panic symptoms (b ¼ .42, p , .01) thanfor symptoms of social phobia (b ¼ .27, p ,.01), OCD (b ¼ .22, p , .01), and GAD(b ¼ .25, p , .01; see Figure 1). Overall, themodel explained a considerable amount ofvariance for each of the latent constructs(R 2 ¼ 0.17–0.23).

While threat from anxiety seemed to be themost prominent emotion construct measured,feeling threat from other emotions alsocontributed to variability in some anxietysymptoms. For example, together, the PTEQscales accounted for approximately 20% ofthe variability in panic symptoms (R 2 ¼ .20),with only threat from anxiety uniquely andsignificantly contributing to the model. How-ever, 20% of the variability in symptoms ofsocial anxiety were accounted for by PTEQscores (R 2 ¼ .20), with threat from bothanxiety and embarrassment uniquely andsignificantly contributing to the model. Simi-larly, nearly 20% of the variance in worry(GAD) symptoms was accounted for by thePTEQ scales (R 2 ¼ .20). Here, threat fromanxiety and sadness each uniquely andsignificantly contributed to the model. ThePTEQ scales accounted for almost a quarter ofthe variance in BDI-II scores (R 2 ¼ .23), withonly threat from sadness uniquely contribut-ing to the model. Finally, compared to thevariance in the other anxiety and depressiveconstructs, the findings related to OCDsymptoms were somewhat unique and lessintuitive. The PTEQ scales accounted forapproximately 17% of the variance in the Y-BOCS-SR (R 2 ¼ .17), with threat fromanxiety and embarrassment uniquely contri-buting to the model.

DiscussionThe present study adds to the growingliterature on investigations of emotions inrelation to anxiety symptoms. We aimed todetermine whether appraising emotions(including, but not limited to, anxiety) asthreatening predicts anxious symptoms in astudent sample with the ultimate goal of

determining whether emotional appraisal maywarrant further attention in anxiety-disor-dered populations. Overall, the results indi-cated that participants felt threatened by avariety of emotions and that feeling threatfrom some of the emotions (i.e., anxiety,saddens, and embarrassment) predictedanxious and depressive symptoms. Consistentwith our hypotheses, threat from anxietysignificantly contributed to the prediction ofeach anxiety symptom measure, threat fromsadness significantly contributed to the pre-diction of depressive symptoms, and threatfrom embarrassment significantly contributedto the prediction of social anxiety. Notably,the present results did not support ourhypotheses that threat from anxiety wouldpredict symptoms of depression and threatfrom anger would predict symptoms of OCD.These results were inconsistent with the extantliterature, and possible explanations for thepresent findings are discussed in detail below.

Based on fairly well-established relation-ships between disgust sensitivity (Olatunji,Tart, Ciesielski, McGrath, & Smits, 2011) andguilt (Shapiro & Stewart, 2011) with OCDsymptoms in both clinical and nonclinicalsamples, it is somewhat surprising that feelingthreat from guilt and disgust was not relatedto these symptoms. That is, if guilt and disgustare complicating emotions for those withobsessions and compulsions, it is presumablethat when these emotions arise they areregarded as troublesome or threatening.However, the findings here may represent thedifferentiation between the experience ofhaving an emotion and the appraisal of theemotional experience (i.e., emotion appraisal).It is possible that those with OCD experienceguilt and disgust more easily than non-OCDsuffers, but they do not appraise guilt anddisgust as something to be feared. Addition-ally, the diversity of obsessive–compulsiveexpressions (e.g., contamination, harm, unac-ceptable thoughts, and symmetry) may havereduced the likelihood of finding arelationship between these symptoms anddisgust (Smith et al., 2012). The presentfindings also differ from those of McCubbinand Sampson (2006), which indicated thatperceiving anger as threatening predictedOCD symptoms. Apparent anomalies in thepresent study may be explained by the use of auniversity sample in which participants did

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not fully understand the terms “obsession”and “compulsion” as they are used clinically.Nearly 20% of the sample endorsed clinicallysignificant obsessions and/or compulsions,which is well above the prevalence rate ofOCD (approximately 3%, Kessler et al.,2005). Although the terms were defined forparticipants, it is possible that this sample mayhave adopted a more colloquial interpretationof obsessions and compulsions. If the sampleas a whole misunderstood the researchers’intended meaning of obsessions and compul-sions, the findings related to this constructshould be interpreted with caution.Additionally, threat from sadness was the

only unique predictor of depressive symptoms.While previous studies have exemplified therelationship between anxiety sensitivity anddepression, one facet of anxiety sensitivity—cognitive dyscontrol (i.e., fear of mentalincapacitation)—seems to be driving therelationship (Cox et al., 2001). Thus, thehypothesized relationship between anxietyappraisal and depressive symptoms may nothave been realized due to construct differencesbetween anxiety sensitivity and threat fromanxiety. However, the results suggesting thatsadness is appraised as more threatening byindividuals with more depressive symptomssuggest that negative appraisals of sad ordepressive mood states may amplify dysphoricmood in a similar manner as anxietysensitivity/fear of fear amplifies anxious states(Van der Does, 2002; Van der Does &Williams, 2003). More research, however, isclearly warranted.Although anxiety was the only emotion

deemed as threatening across symptom clus-ters, theremay still be room formore specificityin understanding responses to emotional cuesin anxiety and depression. While multiplemeta-analyses support the efficacy of cogni-tive-behavioral therapy and pharmacologicalinterventions for anxiety (e.g., Hofmann &Smits, 2008; Norton & Price, 2007), importantbreakthroughs in behavioral and cognitivetherapy for anxiety occurred several decadesago, and the treatments have remainedrelatively unchanged in recent years. Research-ers continue to investigate underlying con-structs and outcome variables with an ultimategoal of improved treatments, and improve-ments may come from studies that addressemotional experiences.

ConclusionOne broad aim of the study was to determinewhether emotion appraisal may warrantadditional attention in anxiety disorder treat-ment. Overall, it appears that appraisinganxiety as threatening is the only consistentPTEQ factor that adds unique variance to apredictive model of anxiety symptomology.While these findings uphold the role ofnegative appraisal of anxiety in the experienceof anxious and depressive symptoms, thenegative appraisal of other emotions appearsto be less universal. However, these findingsalso provide evidence that the way peopleperceive emotions such as sadness andembarrassment may be related to greaterexperiences of anxiety and depression.Limitations of the study should also be

considered. Most notable is the use of anonclinical sample to help explain variance inclinical constructs. The use of analogue andstudent samples is common in preliminarystudies as this recruitment method providesdata that can be used to determine whether afollow-up study with a harder to recruitclinical sample is necessary. However,attempting to generalize the results with theintention of making clinically relevantinterpretations of the data can be problematic.Also limiting, emotion appraisal was the onlyconstruct included in the model predictingvarious anxiety symptoms. Failing to includeother constructs that have predicted anxietysymptomatology (e.g., anxiety sensitivity,intolerance of uncertainty) prohibited usfrom determining whether the PTEQ factorspredicted variance beyond what has beenreported in previous studies. Similarly, nomeasures of PTSD were administered. Finally,the data were collected via self-reportmeasures. A common issue associated withthis type of research design is shared methodvariance, which has the potential to inflaterelationships between constructs. Despite thevalidity of this limitation, we were moreinterested in the patterns that would emerge inthe data than the magnitude of therelationships.The present study is in line with a trend in

the field to examine emotion constructs inanxiety and anxiety disorders. While wesuggest that the results be interpreted withsome caution due to study limitations, these

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findings support the need to further investi-gate the role of emotion appraisal, includingbut not limited to anxiety, in the anxietydisorder experience.

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