Anxiety sensitivity, catastrophic misinterpretations and panic self-efficacy in the prediction of panic disorder severity: Towards a tripartite cognitive model of panic disorder

• Anxiety sensitivity (AS), catastrophic misinterpretations and panic self-efficacy are uniquely related to PD severity.
• The physical and cognitive domains of AS and catastrophic misinterpretations were also uniquely related to PD severity.
• AS may influence PD severity through direct and indirect effects (mediated by catastrophic misinterpretations).
• The physical and cognitive domains of AS and catastrophic misinterpretations were also uniquely related to PD severity.
• The physical and mental components of catastrophic misinterpretations also mediate the effect of AS on PD severity.
• A tripartite cognitive account of panic attacks and panic disorder is warranted.

The present study examined the contribution of three main cognitive factors (i.e., anxiety sensitivity, catastrophic misinterpretations of bodily symptoms, and panic self-efficacy) in predicting panic disorder (PD) severity in a sample of patients with a principal diagnosis of panic disorder. It was hypothesized that anxiety sensitivity (AS), catastrophic misinterpretation of bodily sensations, and panic self-efficacy are uniquely related to panic disorder severity. One hundred and sixty-eight participants completed measures of AS, catastrophic misinterpretations of panic-like sensations, and panic self-efficacy prior to receiving treatment. Results of multiple linear regression analyses indicated that AS, catastrophic misinterpretations and panic self-efficacy independently predicted panic disorder severity. Results of path analyses indicated that AS was direct and indirectly (mediated by catastrophic misinterpretations) related with panic severity. Results provide evidence for a tripartite cognitive account of panic disorder.