Working Memory in Generalized Anxiety Disorder: Effects of Verbal and Image-Based Worry and Relation to Cognitive and Emotional Processes

Tallon, Kathleen; Koerner, Naomi; Yang, Lixia

doi:10.5127/jep.045714

Cited by 13 publications

(12 citation statements)

References 90 publications

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“…For each of the RIG indices, higher scores indicate less random responding and therefore less working memory capacity. Baseline RIG scores on both indices were very similar to scores reported previously for a diagnosed GAD sample (Tallon et al, 2016). One RIG index demonstrated an overall increase in scores among the three conditions, with the WP condition showing a greater rate of increase than the AX-ONLY condition.…”

Section: Cognitive Processes Related To Gadsupporting

confidence: 80%

“…The ACS has good internal reliability (α = .88; Derryberry & Reed, 2002). Scores on the ACS are related to the modulation of attentional response when viewing fear-related images (Mathews, Yiend, Lawrence, 2005) and correlate with a behavioural measure of attentional control, the Random Interval Generation task (r = 0.34; Tallon, Koerner, & Yang, 2016).…”

Section: Symptom Measuresmentioning

confidence: 99%

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Short-Term Efficacy of a Worry Postponement Intervention for Generalized Anxiety Disorder

Tallon¹

2023

Preprint

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Cognitive-Behavioural Therapy (CBT) is an evidence-based treatment for Generalized Anxiety Disorder (GAD). Worry postponement (WP), in which a client is asked to postpone worry until a 30-minute “worry time,” is a common component of CBT for GAD; however, the efficacy of WP has never been tested in people with GAD. Further, the mechanisms of change of WP are not known; nor are its effects on cognitive processes and symptoms related to GAD. A better understanding of the efficacy and mechanisms of change of WP could help to optimize CBT for GAD. The goals of the present study were to examine, in a sample of people with GAD, the effects of WP on worry and GAD symptoms, and cognitive processes and symptoms related to GAD. The study also examined the effects of WP on two proposed mediators: stimulus control and metacognitive beliefs. Sixty-seven adults were randomized to one of three conditions: 2- week worry postponement intervention (WP), 2-week worry monitoring intervention (MON), or an assessment only control. Participants completed outcome measures before and after the 2- week intervention period and at a 2-week follow-up. In the WP and MON conditions, participants completed daily worry monitoring using a phone-based application. All participants showed a significant decrease in past-week worry over the course of the study, with no significant differences between the conditions. There were no significant changes in GAD symptoms across conditions. There was no evidence that WP had superior effects to control groups on cognitive processes or symptoms related to GAD. There was no evidence that stimulus control or metacognitive beliefs mediated the reduction in past week worry in WP. This is the first known study to examine the effects of WP in people with GAD. Whereas worry did decrease on some indices over the course of the study, there were no significant differences between WP and two control conditions. Further this study found no evidence that WP has specific effects on two processes that are thought to be mechanisms of action. The findings of this study demonstrate the need to establish the efficacy of the treatment components used in CBT.

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Section: Cognitive Processes Related To Gadsupporting

confidence: 80%

Section: Symptom Measuresmentioning

confidence: 99%

Short-Term Efficacy of a Worry Postponement Intervention for Generalized Anxiety Disorder

Tallon¹

2023

Preprint

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“…Although informative, these studies also have important limitations. Previous work in this area has tended to suffer from low statistical power, despite complex designs (e.g., N = 32 for a between-subjects design, Tallon et al, 2016; N = 60 for a 2 x 4 x 2 mixed analysis of covariance; Gazzellini et al, 2016). Other methodological limitations include pre-post (uncontrolled) designs that limit inferences about specificity (Gazzellini et al, 2016;Makovac et al, 2016;Ruscio & Borkovec, 2004) and reliance on novel tasks with unclear psychometric properties, or that have not been validated as measures of sustained attention (Makovac et al, 2016;Ottaviani et al, 2013;Ruscio & Borkovec, 2004).…”

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confidence: 99%

Worry alters speed-accuracy tradeoffs but does not impair sustained attention

Hallion

Kusmierski

Caulfield

2020

Behaviour Research and Therapy

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Worry has been experimentally linked to a range of cognitive consequences, including impairments in working memory, inhibition, and cognitive control. However, findings are mixed, and the effects of worry on other phenomenologically-relevant constructs, such as sustained attention, have received less attention. Potential confounds such as speed-accuracy tradeoffs have also received little attention, as have psychometric and related design considerations, and potential moderators beyond trait worry. The present study investigated the effects of experimentally-induced worry versus a neutral control condition on speed-accuracy tradeoffcorrected performance on a validated measure of sustained attention (88 participants; withinsubjects). Moderation by trait worry and trait mindfulness was probed in confirmatory and exploratory analyses, respectively. Worry led to faster and less accurate responding relative to the neutral comparison condition. There was no main effect of condition or trait worry on sustained attention after accounting for speed-accuracy tradeoffs. In exploratory analyses, higher trait mindfulness was robustly related to better post-worry performance, including after controlling for trait worry, general distress, and post-neutral performance, and correction for multiple comparisons. Follow-up analyses exploring dissociable mindfulness facets found a robust relationship between present-moment attention and post-worry performance. Future research should experimentally manipulate mindfulness facets to probe causality and inform treatment development.

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“…However, it is also noteworthy that previous findings are inconsistent regarding the proposed underlying mechanism of the cognitive control model: that verbal worry, in contrast to image‐based worry, helps individuals to reduce AA. While many studies find an association between verbal worry and reduced AA (see Behar & Borkovec, 2020 for review), two recent experimental studies suggest that verbal worry may not lead to reduced AA, relative to image‐based worry (e.g., Skodzik, Zettler, Topper, Blechert, & Ehring, 2016; Tallon, Koerner, & Yang, 2016). Furthermore, previous work has not supported the interaction between EC and worry on imaginal thought (Toh & Vasey, 2017).…”

Section: Discussionmentioning

confidence: 99%

Effortful control moderates relationships between worry and symptoms of depression and anxious arousal

Ranney

Bing-Canar

Behar

2021

British J Clinic Psychol

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Objectives Findings are inconsistent regarding the relationship between worry and anxious arousal (AA). Effortful control (EC) capacity may explain these inconsistent findings, such that only high worriers with higher EC are able to suppress autonomic arousal through worrying. The current study investigated these main and interactive effects of worry and EC on AA as well as depression. Methods Participants (N = 1210, 779 females) were recruited from Amazon’s Mechanical Turk website and completed self‐report measures assessing worry, EC, AA, depression, and negative affect intensity. Results Regression models revealed that EC moderated the relationship between worry and AA, with individuals lower in EC demonstrating a stronger positive relationship between worry and AA. EC also moderated the relationship between worry and depression, with individuals lower in EC demonstrating a stronger positive relationship between worry and depression. Results remained the same when controlling for age, gender, and negative affect intensity. Conclusions Results support the idea that low EC may help to explain a range of comorbid psychiatric symptoms. Practitioner points Individuals low in effortful control demonstrate a stronger association between worry and anxious arousal, as well as between worry and depression Those low in effortful control may be especially vulnerable to comorbid worry and depression High worriers who are high in effortful control may be motivated to continue worrying due to their ability to reduce anxious arousal during worry

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Working Memory in Generalized Anxiety Disorder: Effects of Verbal and Image-Based Worry and Relation to Cognitive and Emotional Processes

Cited by 13 publications

References 90 publications

Short-Term Efficacy of a Worry Postponement Intervention for Generalized Anxiety Disorder

Short-Term Efficacy of a Worry Postponement Intervention for Generalized Anxiety Disorder

Worry alters speed-accuracy tradeoffs but does not impair sustained attention

Effortful control moderates relationships between worry and symptoms of depression and anxious arousal

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