Anxiety Sensitivity Index-3
The Anxiety Sensitivity Index-3 (ASI-3) is a validated 18-item self-report measure designed to assess anxiety sensitivity—the specific fear of…
- Questions
- 18
- Duration
- 5 min
- Original title
- ASI-3 — Anxiety Sensitivity Index
- Adaptation
- Anxiety Sensitivity Index-3
- Authors
- Taylor, S., Zvolensky, M. J., Cox, B. J., Deacon, B., Heimberg, R. G., Ledley, D. R., Abramowitz, J. S., Holaway, R. M., Sandin, B., Stewart, S. H., Coles, M., Eng, W., Daly, E. S., Arrindell, W. A., Bouvard, M., & Cardenas, S. J.
- Created
- 2007
The Anxiety Sensitivity Index-3 (ASI-3) is a validated 18-item self-report measure designed to assess anxiety sensitivity—the specific fear of anxiety-related sensations. Often described clinically as the "fear of fear," this construct is a powerful driver of panic attacks and generalized distress. The ASI-3 allows clinicians to quantify how catastrophizing about normal physiological and mental arousal fuels distress and reinforces self-defeating behavioral loops.
By breaking down anxiety sensitivity into distinct physical, cognitive, and social dimensions, the ASI-3 provides actionable data for CBT psychoeducation and treatment planning. Administering this tool repeatedly allows clinicians to monitor a patient's shifting relationship with their internal sensations, making it a valuable addition to a dynamic longitudinal case formulation over the course of therapy.
Example result
Fictitious result, computed from a sample set of answers.
Have your patient take this test
Assign it in one click: your patient answers on their phone, you receive the score and its interpretation.
What the test measures
The ASI-3 measures the extent to which an individual fears their own anxiety symptoms, based on the belief that these sensations will have harmful consequences. This multidimensional tool highlights the exact maintaining processes that keep anxiety alive across three clinical facets:
- Physical concerns: The fear that bodily sensations of arousal (e.g., rapid heartbeat, breathlessness) signal an imminent medical catastrophe.
- Cognitive concerns: The fear that mental phenomena (e.g., brain fog, racing automatic thoughts) indicate severe mental illness or an impending loss of control.
- Social concerns: The fear that observable symptoms of anxiety (e.g., trembling, sweating) will lead to public humiliation or social rejection.
The ASI-3 is designed for adult populations and is especially relevant for patients presenting with panic disorder, health anxiety, or generalized anxiety disorder.
When and why to use it
Clinicians typically administer the ASI-3 to clarify the specific fears driving a patient's distress, moving beyond a general presentation to pinpoint the exact internal sensations they actively dread.
- Intake baseline: To map out the specific physiological or cognitive triggers that a patient misinterprets, clarifying the immediate treatment target.
- Treatment planning: To design precise interoceptive exposure tasks that safely challenge the patient, using frameworks like the comfort, stretch, and panic zones to calibrate the intensity.
- Monitoring change: To track reductions in fear following behavioral experiments or challenging automatic thoughts regarding bodily sensations.
- Differential support: To uncover the hidden fears maintaining experiential avoidance, distinguishing between the fear of external triggers and the fear of internal arousal itself.
Using the ASI-3 provides structured, multidimensional evidence that clinical observation alone might miss, clearly distinguishing whether a patient's primary catastrophic fear is having a heart attack, going crazy, or being harshly judged.
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- Please rate the extent to which each of the following statements applies to you, by selecting the response that best suits you. If a statement concerns an experience you have never had (for example, fainting in public), answer based on how you think you would probably feel if such an experience happened to you. Please answer all items.1. It is important for me not to appear nervous.Probes the fear of displaying outward signs of nervousness.
- Very little
- A little
- Somewhat
- A lot
- Very much
- 2. When I can't focus my thoughts on a task, I worry that I might be going crazy.Evaluates the catastrophic interpretation of poor concentration.
- Very little
- A little
- Somewhat
- A lot
- Very much
- 3. It scares me when my heart beats rapidly.Assesses the fear response to cardiovascular arousal.
- Very little
- A little
- Somewhat
- A lot
- Very much
- 4. When my stomach hurts, I worry that I might be seriously ill.Explores the tendency to interpret gastrointestinal distress as a sign of severe illness.
- Very little
- A little
- Somewhat
- A lot
- Very much
- 5. It scares me when I'm unable to focus my thoughts on a task.Measures the distress caused by experiencing cognitive interference.
- Very little
- A little
- Somewhat
- A lot
- Very much
- 6. When I tremble in front of other people, I worry about what they might think of me.Looks at the social fear associated with visible shaking.
- Very little
- A little
- Somewhat
- A lot
- Very much
- 7. When my chest feels tight, it scares me that I won't be able to breathe properly.Probes the catastrophic fear of suffocation during chest tightness.
- Very little
- A little
- Somewhat
- A lot
- Very much
- 8. When I feel a pain in my chest, I worry that I'm having a heart attack.Evaluates the specific fear that chest pain indicates a cardiac emergency.
- Very little
- A little
- Somewhat
- A lot
- Very much
- 9. I worry that other people will notice my anxiety.Assesses the general fear of others detecting one's internal anxious state.
- Very little
- A little
- Somewhat
- A lot
- Very much
- 10. When I feel 'spacey' or 'out of it,' I worry that I might have a mental illness.Explores the fear that dissociation or derealization signals severe psychopathology.
- Very little
- A little
- Somewhat
- A lot
- Very much
- 11. It scares me when I blush in front of others.Measures the social anxiety specifically linked to visible blushing.
- Very little
- A little
- Somewhat
- A lot
- Very much
- 12. When I notice my heart skips a beat, I worry that I might have a serious problem.Evaluates the catastrophic interpretation of cardiac palpitations.
- Very little
- A little
- Somewhat
- A lot
- Very much
- 13. When I start to sweat in a social situation, I'm afraid others will think badly of me.Looks at the fear of social judgment triggered by visible sweating.
- Very little
- A little
- Somewhat
- A lot
- Very much
- 14. When my thoughts seem to be racing, I worry that I might be going crazy.Probes the fear that racing thoughts indicate an impending loss of sanity.
- Very little
- A little
- Somewhat
- A lot
- Very much
- 15. When my throat feels tight, I worry that I might choke to death.Assesses the extreme fear of choking associated with throat constriction.
- Very little
- A little
- Somewhat
- A lot
- Very much
- 16. When I have difficulty thinking clearly, I worry that there's something wrong with me.Explores the concern that cognitive fogginess reveals a fundamental mental defect.
- Very little
- A little
- Somewhat
- A lot
- Very much
- 17. I think it would be horrible for me to faint in public.Measures the anticipated social catastrophe of losing consciousness around others.
- Very little
- A little
- Somewhat
- A lot
- Very much
- 18. When my mind goes blank, I worry that there's something terribly wrong with me.Evaluates the catastrophic fear of experiencing an empty or blank mind.
- Very little
- A little
- Somewhat
- A lot
- Very much
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