Effects of worry on physiological and subjective reactivity to emotional stimuli in generalized anxiety disorder and nonanxious control participants.

Abstract

The present study examined the effect of worry versus relaxation and neutral thought activity on both physiological and subjective responding to positive and negative emotional stimuli. Thirty-eight participants with generalized anxiety disorder (GAD) and 35 nonanxious control participants were randomly assigned to engage in worry, relaxation, or neutral inductions prior to sequential exposure to each of four emotion-inducing film clips. The clips were designed to elicit fear, sadness, happiness, and calm emotions. Self reported negative and positive affect was assessed following each induction and exposure, and vagal activity was measured throughout. Results indicate that worry (vs. relaxation) led to reduced vagal tone for the GAD group, as well as higher negative affect levels for both groups. Additionally, prior worry resulted in less physiological and subjective responding to the fearful film clip, and reduced negative affect in response to the sad clip. This suggests that worry may facilitate avoidance of processing negative emotions by way of preventing a negative emotional contrast. Implications for the role of worry in emotion avoidance are discussed.

The effect of verbal and imagery-based worry versus distraction on the emotional response to a stressful in-vivo situation

“…Prior worry indeed precluded a further emotional reaction, while distraction led to a strong emotional contrast in response to the stressor. This attenuation effect present in self-report measures dovetails with prior research (Llera & Newman, 2010, 2014Stapinski et al, 2010;Topper et al, submitted). For physiological measures, however, we only found the hypothesized effect for SCL when trait worry was added as a covariate.…”

“…For self-reported emotional response, IBI, or RSA no moderating effect of trait worry was found. These inconsistent results reflect the mixed previous findings on this topic (Fisher & Newman, 2013;Llera & Newman, 2010, 2014Topper et al, submitted).…”

“…Emotion-eliciting film clips can be expected to only lead to moderate levels of negative emotions. In fact, Llera and Newman (2010) results show that in the non-worry conditions anxiety ratings after the fear-inducing film clip did not exceed the maximum anxiety level reached by the worry condition during the worry phase. Therefore, it cannot be ruled out that earlier contrast avoidance effects were merely due to a ceiling effect.…”

“…First, earlier research investigating the attenuating effect of worry on subsequent emotional responding have either used in-sensu exposure to an anxiety-provoking situation (e.g., Borkovec & Hu, 1990;Peasley-Miklus & Vrana, 2000) or emotion-eliciting film clips (e.g., Llera & Newman, 2010, 2014. Both stressors come with crucial limitations: Although asking participants to visualize feared situations is arguably a valid analogue to the natural worry process (see Borkovec et al, 2004), experimental control over this stressor is limited.…”

A Case of Premature Termination in a Treatment for Generalized Anxiety Disorder

“…Among these concerns were skepticism about the usefulness of therapy, occasional lack of compliance with assigned homework, uncertainty about readiness for change, and above all, discomfort with and difficulty tolerating emotional experience. Consistent with findings from experimental and self-report studies on GAD (Llera & Newman, 2010; Mennin, Heimberg, Turk, & Fresco, 2005), reticence to experience emotion was one difficulty that appeared to permeate and fuel several of these other issues. We will briefly detail these concerns and explore their potential contributions to the treatment drop out.…”