Cognitive processing and acrophobia: validating the Heights Interpretation Questionnaire

In Study 3, the low and medium height fear groups were significantly different from the high height fear group on all height fear measures: AQ-Anxiety, HIQ, average peak state fear on a height, avoidance on the HAT, ACQ, and BSQ.

“Further, as expected, the low and medium height fear groups were significantly different from the high height fear group on all height fear measures: AQ-Anxiety, HIQ, average peak state fear on a height, avoidance on the HAT, ACQ, and BSQ (all p < .01).”

In Study 3, HIQ scores were strongly related to higher average peak fear while on actual heights (r(46) = .81, p < .001).

“more negative height-relevant interpretations on the HIQ are strongly related to higher average peak fear while on actual heights (PANAS-FS: r(46) = .81, p < .001)”

In Study 1, an exploratory principal components analysis of the HIQ yielded a four-factor solution that accounted for 66.91% of total variance.

“Examination of the scree plot yielded a 4-factor solution that accounted for 66.91% of the total variance3.”

In Study 3, HIQ scores were strongly related to more avoidance during stair-climbing (HAT: r(45) = −.60, p < .001).

“more avoidance during stair-climbing (HAT: r(45) = −.60, p < .001)”

In Study 1, the predicted dangerousness-of-heights factor split into two factors: dangerousness of being on a balcony (Factor I, 24.35% of variance) and dangerousness of climbing a ladder (Factor II, 17.91% of variance).

“The predicted dangerousness of heights factor emerged as two separate factors reflecting the two different scenarios in the HIQ: dangerousness of being on a balcony (Factor I, accounting for 24.35% of total variance) and dangerousness of climbing a ladder (Factor II, accounting for 17.91% of total variance).”

In Study 2, correlations among the four factors ranged from r = .39 to .64, all p < .001.

“Correlations among the four factors ranged from r = .39 to .64 (all p < .001).”

In Study 3, HIQ scores were strongly related to more anxiety-related body sensations while on a balcony (BSQ: r(34) = .80, p < .001).

“more anxiety-related body sensations while on a balcony (BSQ; r(34) = .80, p < .001)”

In Study 1, correlations among the four HIQ factors ranged from r = .37 to .56, all p < .001.

“Correlations among the four factors ranged from r = .37 to .56 (all p < .001).”

In Study 3, hierarchical regressions showed that HIQ scores remained a significant predictor of all fear-relevant reactions to heights (avoidance on HAT, average PANAS-FS, ACQ, and BSQ) after AQ-Anxiety scores were entered.

“As expected, when HIQ scores were entered into each regression after AQ-Anxiety scores had been entered, HIQ remained a significant predictor of all fear-relevant reactions to the heights (avoidance on HAT, average PANAS-FS, ACQ, and BSQ; see Table 4).”

In Study 3, follow-up Scheffe tests showed that AQ-Anxiety scores across the three groups were all significantly different from one another in the expected direction.

“Follow-up Scheffe tests showed that AQ-Anxiety scores across the three groups were all significantly different from one another in the expected direction (all p < .05).”

In Study 1, the analysis also produced factors for physical consequences of anxiety (Factor III, 13.9% of variance) and emotional consequences of anxiety (Factor IV, 11.25% of variance).

“As expected, the analysis also resulted in factors reflecting concerns about the physical consequences of anxiety (Factor III; accounting for 13.9% of total variance) and the emotional consequences of anxiety (Factor IV; accounting for 11.25% of the variance).”

In Study 1, a direct comparison of unstandardized regression coefficients showed the AQ coefficient was significantly larger than the DASS coefficient (t(503) = 3.98, p < .001, d = .35).

“Notably, a direct comparison of the AQ-HIQ and DASS-HIQ unstandardized regression coefficients using a dependent means t-test showed that the AQ’s coefficient was significantly larger than the DASS’s coefficient (t(503) = 3.98, p < .001, d = .35).”

In Study 3, the three groups significantly differed in age, with the high height fear group having a higher mean age than the low and medium groups.

“Due to community members participating in the high height fear group (but not in the other two height fear groups) the three groups significantly differed in age (F(2,45) = 11.65, p < .001, ηp2 = .34). Specifically, the high height fear group had a higher mean age compared to the low and medium height fear groups (all p < .001), who did not differ from one another (p > .10).”

In Study 2, the AQ's regression coefficient predicting HIQ scores was significantly larger than the DASS's coefficient (t(304) = 2.72, p < .01, d = .31).

“As in Study 1, the AQ’s coefficient was significantly larger than the DASS’s coefficient (t(304) = 2.72, p < .01, d = .31).”

In Study 3, the three height fear groups had significantly different AQ-Anxiety scores (F(2,45) = 144.57, p < .001, ηp2 = .87).

“As expected given that we recruited participants based on their AQ-Anxiety scores, the three height fear groups had significantly different AQ-Anxiety scores (F(2,45) = 144.57, p < .001,ηp2 = .87).”

In Study 3, HIQ scores were strongly related to more anxious thoughts while on a balcony (ACQ: r(30) = .79, p < .001).

“more anxious thoughts while on a balcony (ACQ: r(30) = .79, p < .001)”

Factor analysis of the HIQ produced four distinct factors.

“Factor analysis resulted in four distinct factors”

• Also stated in: § Discussion · hedged

  “Factor analyses indicate that the HIQ has four replicable factors: dangerousness of being on a balcony, dangerousness of climbing a ladder, physical consequences of anxiety, and emotional consequences of anxiety.”

The HIQ predicted anxiety and avoidance on actual heights after controlling for acrophobia symptoms.

“As expected, the HIQ predicted anxiety and avoidance on actual heights after controlling for acrophobia symptoms.”

In Study 3, there were no significant differences between the height fear groups in baseline state fear or depression symptoms.

“Further, as expected, analysis of variance (ANOVA) tests revealed that there were no significant differences between the height fear groups in baseline state fear as measured by the PANAS-FS (F(2,45) = 2.42, p = .10, ηp2 = .10), or depression symptoms as measured by the DASS21-DS (F(2,45) = .73, p = .49, ηp2 = .03).”

Height-relevant interpretations are multi-faceted.

“This suggests that height-relevant interpretations are multi-faceted.”

When asked to stand on a balcony, height-fearful individuals more strongly endorsed danger-related thoughts and thoughts of being unable to cope with anxiety than low-fear participants.

“Additionally, when asked to stand on a balcony, height-fearful individuals more strongly endorsed experiencing thoughts related to danger (e.g., “The railing will not protect me”) and their inability to cope with anxiety (“I will be paralyzed by fear”), compared to low fear participants (Clerkin et al., 2009; Teachman et al., 2008).”

• cites Clerkin et al., 2009 sourceNot checked yet

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• cites Teachman et al., 2008 sourceNot checked yet

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The HIQ shows promise as a new tool for investigating cognitive processing biases in acrophobia.

“Overall, the HIQ shows promise as a new tool to investigate cognitive processing biases in acrophobia.”

• Also stated in: § Abstract · plain

  “The HIQ shows promise as a new tool to investigate cognitive processing biases in acrophobia.”

• AssumptionRests on an assumption: No standardized published measure of height-relevant interpretation bias existed at the time of the study, to the authors' knowledge.
• AssumptionRests on an assumption: The HIQ scenarios are ambiguous enough that respondents apply their own height-related interpretive styles when answering them.

In Study 1, the HIQ was more closely related to height fear symptoms than to depression symptoms.

“This suggests that the HIQ is more closely related to height fear symptoms than to symptoms in another domain (depression).”

In exposure-based therapy, a desired outcome of interacting with the feared object is disconfirming feared expectations and learning less threatening interpretations of the situation.

“This is important even in exposure-based therapies, in which one of the desired outcomes of interacting with the feared object is the chance to disconfirm feared expectations and learn to make less threatening interpretations of the situation (e.g., Teachman & Smith-Janik, 2005).”

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When anticipating climbing a ladder, acrophobic individuals gave higher estimates of the probability of falling and of resulting injuries than non-fearful controls.

“For instance, when anticipating climbing a ladder, acrophobic individuals gave higher estimates of the probability of falling from the ladder and gave higher estimates of the injuries that would result from falling (compared to non-fearful control participants; Menzies & Clark, 1995).”

• cites Menzies & Clark, 1995Not checked yet

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The dangerousness factors appear more directly tied to the ladder and balcony scenarios used in the HIQ.

“In contrast, the dangerousness factors seem more directly tied to the ladder and balcony scenarios used in the HIQ.”

The HIQ provides clinicians and researchers a way to assess height-relevant interpretations without needing a special environment or equipment.

“The HIQ provides clinicians and researchers a way to assess height-relevant interpretations without the need for a special environment or equipment.”

• AssumptionRests on an assumption: The HIQ scenarios are ambiguous enough that respondents apply their own height-related interpretive styles when answering them.

These results support cognitive models of anxiety by providing evidence that interpretation biases are related to a broad range of clinically meaningful acrophobic responses.

“These results provide support for cognitive models of anxiety (Beck & Clark, 1997; Williams et al., 1997) by offering evidence that biases in interpretation are related to a broad range of clinically meaningful acrophobic responses.”

• cites Beck & Clark, 1997 sourceNot checked yet

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• cites Williams et al., 1997Not checked yet

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• AssumptionRests on an assumption: The HIQ scenarios are ambiguous enough that respondents apply their own height-related interpretive styles when answering them.