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Changes in Explanatory Flexibility Among Individuals with Generalized Anxiety Disorder in an Emotion Evocation Challenge

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Abstract

Seventy-eight undergraduates, 39 with self-reported generalized anxiety disorder (GAD), completed measures of mood and explanatory flexibility (the capacity to assign causes to negative events with a balance of historical and contextual factors) prior to and directly after a musical priming challenge that consisted of listening to negatively-valenced emotional music and thinking about a personally relevant negative event. After the emotion evocation, participants also completed a measure of state emotion regulation. Despite comparable increases in negative affect, GAD analogues evidenced drops in explanatory flexibility whereas non-GAD Controls did not. Drops in explanatory flexibility among GAD analogues covaried significantly with lack of emotional clarity. Findings suggest that for individuals with GAD, emotionally evocative experiences may result in a constricted perspective when apprehending the causes for negative events. This perspective may serve to dampen arousal, but perhaps at the cost of failing to inform one’s actions with important emotional information.

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Notes

  1. Thirty-eight participants (18 GAD Analogues) who participated in Study 3 of Mennin et al. (2005) were randomly assigned to a Neutral Music condition and listened to Tchaikovsky’s “Waltz of the Flowers” (7 min) from The Nutcracker Suite (1892/1997). We elected not to include these participants in the current study for two reasons. First, only three participants with analogue GAD and dysphoria were randomly assigned to the Neutral Music condition, thus, preventing a credible test of the dysphoria hypothesis. Second, as a follow-up to Fresco et al. (2006a), we wished to retain the ability to evaluate the role of dysphoria among individuals with GAD as it related to changes in explanatory flexibility following a mood priming challenge. Nevertheless, a comparison of the effects of the Neutral Music on explanatory flexibility was evaluated as a function of Analogue GAD status. Findings revealed a significant main effect for time [F(1,37) = 4.22, p < .05; Cohen’s f = .33] but no group by time interaction [F(1,37) = 0.96, ns; f = .15]. Specifics of this analysis are available from the corresponding author.

References

  • Abramson, L. Y., Metalsky, G. I., & Alloy, L. B. (1989). Hopelessness depression: A theory-based subtype of depression. Psychological Review, 96, 358–372.

    Article  Google Scholar 

  • Abramson, L. Y., Seligman, M. E. P., & Teasdale, J. D. (1978). Learned helplessness in humans: Critique and reformulation. Journal of Abnormal Psychology, 87, 49–74.

    Article  CAS  PubMed  Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, D.C.: Author.

    Google Scholar 

  • Ansorge, S., Litz, B. T., & Orsillo, S. M. (1996). Thinking about feelings: The role of meta-mood in post-traumatic stress disorder. National Center for Post-traumatic Stress Disorder Clinical Quarterly, 6, 38–41.

    Google Scholar 

  • Aupperle, R. L., & Paulus, M. P. (2010). Neural systems underlying approach and avoidance in anxiety disorders. Dialogues in Clinical Neuroscience, 12, 517–531.

    PubMed  Google Scholar 

  • Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford.

    Google Scholar 

  • Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck depression inventory manual (2nd ed.). San Antonio: The Psychological Corporation.

    Google Scholar 

  • Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the beck depression inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77–100.

    Article  Google Scholar 

  • Behar, E., Zuellig, A. R., & Borkovec, T. D. (2005). Thought and imaginal activity during worry and trauma recall. Behavior Therapy, 36, 157–168.

    Article  Google Scholar 

  • Blagden, J. C., & Craske, M. G. (1996). Effects of active and passive rumination and distraction: A pilot replication with anxious mood. Journal of Anxiety Disorders, 10, 243–252.

    Article  Google Scholar 

  • Blazer, D. G., Hughes, D., & George, L. K. (1991). Generalized anxiety disorder. In L. N. Robins & D. A. Regier (Eds.), Psychiatric disorders in America: The epidemiological catchment area study (pp. 180–203). New York: The Free Press.

    Google Scholar 

  • Borkovec, T. D., Alcaine, O., & Behar, E. (2004). Avoidance theory of worry and generalized anxiety disorder. In R. G. Heimberg, C. L. Turk, & D. S. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice (pp. 77–108). New York: Guilford.

    Google Scholar 

  • Borkovec, T. D., & Sharpless, B. (2004). Generalized anxiety disorder: Bringing cognitive behavioral therapy into the valued present. In S. Hayes, V. M. Follette, & M. M. Linehan (Eds.), Mindfulness and acceptance: Expanding the cognitive-behavioral tradition (pp. 209–242). New York: Guilford.

    Google Scholar 

  • Brosschot, J. F., & Thayer, J. F. (2004). Worry, preservative thinking, and health. In I. Nyklicek, L. Temoshok, & A. Vingerhoets (Eds.), Emotional expression and health: Advances in theory, assessment, and clinical application (pp. 99–114). New York: Brunner and Rutledge.

    Google Scholar 

  • Brown, T. A., Antony, M. M., & Barlow, D. H. (1992). Psychometric properties of the Penn State Worry Questionnaire in a clinical anxiety disorders sample. Behaviour Research and Therapy, 30, 33–37.

    Article  CAS  PubMed  Google Scholar 

  • Brown, T. A., DiNardo, P. A., & Barlow, D. H. (1994). Anxiety disorders interview schedule for DSM-IV. New York: Oxford University Press.

    Google Scholar 

  • Bruce, S. E., Machan, J. T., Dyck, I., & Keller, M. B. (2001). Infrequency of “pure” GAD: Impact of psychiatric comorbidity on clinical course. Depression and Anxiety, 14, 219–225.

    Article  CAS  PubMed  Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (revised ed.). New York: Academic Press.

    Google Scholar 

  • Ferster, C. B. (1973). A functional analysis of depression. American Psychologist, 28, 857–870.

    Article  CAS  PubMed  Google Scholar 

  • Foa, E. B., & Kozak, M. J. (1986). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99, 20–35.

    Article  CAS  PubMed  Google Scholar 

  • Fresco, D. M., Heimberg, R. G., Abramowitz, A., & Bertram, T. L. (2006a). The effect of a negative mood priming challenge on dysfunctional attitudes, explanatory style, and explanatory flexibility. British Journal of Clinical Psychology, 45, 167–183.

    Article  PubMed  Google Scholar 

  • Fresco, D. M., Mennin, D. S., Heimberg, R. G., & Ritter, M. (2013). Emotion regulation therapy for generalized anxiety disorder. Cognitive and Behavioral Practice, 20, 282–300.

    Article  Google Scholar 

  • Fresco, D. M., Rytwinski, N., & Craighead, L. W. (2007). Explanatory flexibility and negative life events interact to predict depressive symptoms. Journal of Social and Clinical Psychology, 26, 595–608.

    Article  Google Scholar 

  • Fresco, D. M., Williams, N. L., & Nugent, N. R. (2006b). Association of explanatory flexibility and coping flexibility to each other and to depression and anxiety. Cognitive Therapy and Research, 30, 201–210.

    Article  Google Scholar 

  • Greenberg, P. E., Sisitsky, T., Kessler, R. C., Finkelstein, S. N., Berndt, E. R., Davidson, J. R. T., et al. (1999). The economic burden of anxiety disorders in the 1990s. Journal of Clinical Psychiatry, 60, 427–435.

    Article  CAS  PubMed  Google Scholar 

  • Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guilford Press.

    Google Scholar 

  • Hayes-Skelton, S. A., Roemer, L., & Orsillo, S. M. (2011). Acceptance-based behavior therapy for generalized anxiety disorder. Cognitive and Behavioral Practice, 20, 264–281.

    Article  Google Scholar 

  • Herron, E. W. (1969). The multiple affect adjective check list: A critical analysis. Journal of Clinical Psychology, 25, 46–53.

    Article  CAS  PubMed  Google Scholar 

  • Jacobson, N. S., Martell, C. R., & Dimidjian, S. (2001). Behavioral activation treatment for depression: Returning to contextual roots. Clinical Psychology: Science and Practice, 8, 255–270.

    Google Scholar 

  • Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617–627.

    Article  PubMed Central  PubMed  Google Scholar 

  • Kessler, R. C., Walters, E. E., & Wittchen, H.-U. (2004). Epidemiology. In R. G. Heimberg, C. L. Turk, & D. S. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice. New York: Guilford Press.

    Google Scholar 

  • Lang, P. J. (1985). The cognitive psychophysiology of emotion: Fear and anxiety. In A. H. Tuma & J. D. Maser (Eds.), Anxiety and the anxiety disorders (pp. 131–170). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Lewinsohn, P. M. (1974). A behavioral approach to depression. In R. Friedman & M. M. Katz (Eds.), The psychology of depression: Contemporary theory and research (pp. 157–185). Oxford: Wiley.

    Google Scholar 

  • Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.

    Google Scholar 

  • Llera, S. J., & Newman, M. G. (2010a). Effects of worry on physiological and subjective reactivity to emotional stimuli in generalized anxiety disorder and nonanxious control participants. Emotion, 10, 640–650.

    Article  PubMed  Google Scholar 

  • Llera, S. J. & Newman, M. G. (2010b). Revisiting emotional avoidance in GAD. A paper presented at the annual meeting of the Association of Behavioral and Cognitive Therapies, San Francisco, CA.

  • Lubin, B., Whitlock, R. V., & Zuckerman, M. (1998). Affect traits in differential diagnosis of anxiety, depressive, and schizophrenic disorders using the Multiple Affect Adjective Check List-Revised. Assessment, 5, 309–319.

    Article  CAS  PubMed  Google Scholar 

  • Martin, M. (1990). On the induction of mood. Clinical Psychology Review, 10, 669–697.

    Article  Google Scholar 

  • Mathews, A., & MacLeod, C. (2002). Induced processing biases have causal effects on anxiety. Cognition and Emotion, 16, 310–315.

    Article  Google Scholar 

  • Mayer, J. D., & Gaschke, Y. N. (1988). The experience and meta-experience of mood. Journal of Personality and Social Psychology, 55, 102–111.

    Article  CAS  PubMed  Google Scholar 

  • Mayer, J. D., & Stevens, A. A. (1994). An emerging understanding of the reflective (meta-) experience of mood. Journal of Research in Personality, 28, 351–373.

    Article  Google Scholar 

  • Mennin, D. S., & Fresco, D. M. (2013a). Emotion regulation therapy. In J. J. Gross (Ed.), Handbook of emotion regulation (2nd ed.). New York: Guilford Press.

    Google Scholar 

  • Mennin, D. S., & Fresco, D. M. (2013b). What, me worry and ruminate about DSM-5 and RDoC? The importance of targeting negative self-referential processing. Clinical Psychology Science and Practice, 20, 258–267.

    Google Scholar 

  • Mennin, D. S., Heimberg, R. G., Turk, C. L., & Fresco, D. M. (2005). Preliminary evidence for an emotion dysregulation model of generalized anxiety disorder. Behaviour Research and Therapy, 43, 1281–1310.

    Article  PubMed  Google Scholar 

  • Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28, 487–495.

    Article  CAS  PubMed  Google Scholar 

  • Molina, S., Borkovec, T. D., Peasley, C., & Person, D. (1998). Content analysis of worrisome streams of consciousness in anxious and dysphoric participants. Cognitive Therapy and Research, 22, 109–123.

    Article  Google Scholar 

  • Moore, M. T., Anderson, N. L., Barnes, J. M., Haigh, E. A. P., & Fresco, D. M. (2014). Using the GAD-Q-IV to identify generalized anxiety disorder in two clinical samples. Journal of Anxiety Disorders, 28, 25–30.

    Google Scholar 

  • Moore, M. T., & Fresco, D. M. (2007). The relationship of explanatory flexibility to explanatory style. Behavior Therapy, 38, 325–332.

    Article  PubMed  Google Scholar 

  • Newman, M. G., & Llera, S. G. (2011). A novel theory of experiential avoidance in generalized anxiety disorder: A review and synthesis of research supporting a contrast avoidance model of worry. Clinical Psychology Review, 31, 371–382.

    Article  PubMed Central  PubMed  Google Scholar 

  • Newman, M. G., Zuellig, A. R., Kachin, K. E., Constantino, M. J., & Cashman, L. (2001). The reliability and validity of the GAD-Q-IV: A revised self-report diagnostic measure of generalized anxiety disorder. Unpublished manuscript.

  • Newman, M. G., Zuellig, A. R., Kachin, K. E., Constantino, M. J., Przeworski, A., Erickson, T., et al. (2002). Preliminary reliability and validity of the Generalized Anxiety Disorder Questionnaire-IV: A revised self-report diagnostic measure of generalized anxiety disorder. Behavior Therapy, 33, 215–233.

    Article  Google Scholar 

  • Peterson, C., Semmel, A., von Baeyer, C., Abramson, L. Y., Metalsky, G. I., & Seligman, M. E. P. (1982). The attributional style questionnaire. Cognitive Therapy and Research, 6, 287–300.

    Article  Google Scholar 

  • Prokoviev, S. (1934/1987). Russia under the Mongolian yoke [Alexander Nevsky]. Cleveland, OH: Telarc.

  • Rachman, S. (1980). Emotional processing. Behaviour Research and Therapy, 18, 51–60.

    Article  CAS  PubMed  Google Scholar 

  • Rottenberg, J., Gross, J. J., & Gotlib, I. H. (2005). Emotion context insensitivity in major depressive disorder. Journal of Abnormal Psychology, 114, 627–639.

    Article  PubMed  Google Scholar 

  • Scher, C. D., Ingram, R. E., & Segal, Z. V. (2005). Cognitive reactivity and vulnerability: Empirical evaluation of construct activation and cognitive diathesis in unipolar depression. Clinical Psychology Review, 25, 487–510.

    Article  PubMed  Google Scholar 

  • Schoenberg, A. (1909/1996). Ist das noch der weg?, Da kommt ein licht! Er ist auch nicht da [Erwatung [Anticipation], Op. 17]. London, England: London.

  • Segal, Z. V., Gemar, M., & Williams, S. (1999). Differential cognitive response to a mood challenge following successful cognitive therapy or pharmacotherapy for unipolar depression. Journal of Abnormal Psychology, 108, 3–10.

    Article  CAS  PubMed  Google Scholar 

  • Slyker, J. P., & McNally, R. M. (1991). Experimental induction of anxious and depressed mood: Are Velten and musical procedures necessary? Cognitive Therapy and Research, 15, 33–45.

    Article  Google Scholar 

  • Stein, M. B., & Heimberg, R. G. (2004). Well-being and life satisfaction in generalized anxiety disorder: Comparison to major depressive disorder in a community sample. Journal of Affective Disorders, 79, 161–166.

    Article  PubMed  Google Scholar 

  • Stöber, J. (1998). Worry, problem elaboration and suppression of imagery: The role of concreteness. Behaviour Research and Therapy, 36, 751–756.

    Article  PubMed  Google Scholar 

  • Stöber, J., & Borkovec, T. D. (2002). Reduced concreteness of worry in generalized anxiety disorder: Findings from a therapy study. Cognitive Therapy and Research, 26, 89–96.

    Article  Google Scholar 

  • Stöber, J., Tepperwien, S., & Staak, M. (2000). Worrying leads to reduced concreteness of problem elaborations: Evidence for the avoidance theory of worry. Anxiety, Stress, and Coping, 13, 217–227.

    Article  Google Scholar 

  • Tchaikovsky, P. I. (1892/1997). Waltz of the Flowers [The Nutcracker]. New York: Sony Music.

  • Thayer, J. F., Friedman, B. H., & Borkovec, T. D. (1996). Autonomic characteristics of generalized anxiety disorder and worry. Biological Psychiatry, 39, 255–266.

    Article  CAS  PubMed  Google Scholar 

  • Thayer, J. F., & Lane, R. D. (2002). Perseverative thinking and health: Neurovisceral concomitants. Psychology and Health, 17, 685–695.

    Article  Google Scholar 

  • Turk, C. L., & Wolanin, A. (2006). The assessment of generalized anxiety disorder. In G. C. L. Davey & A. Wells (Eds.), Worry and psychological disorders: Theory, assessment and treatment (pp. 137–155). Chichester: Wiley.

    Chapter  Google Scholar 

  • Watson, D., & Clark, L. A. (1991). The mood and anxiety symptom questionnaire. Unpublished manuscript, University of Iowa, Iowa City, IA.

  • Westermann, R., Spies, K., Stahl, G., & Hesse, F. W. (1996). Relative effectiveness and validity of mood induction procedures: A meta-analysis. European Journal of Social Psychology, 26, 557–580.

    Article  Google Scholar 

  • Wilson, K. G., & Murrell, A. R. (2004). Values work in acceptance and commitment therapy: Setting a course for behavioral treatment. In S. C. Hayes, V. M. Follette, & M. M. Linehan (Eds.), Mindfulness and acceptance: Expanding the cognitive-behavioral tradition (pp. 120–151). New York: Guilford.

    Google Scholar 

  • Zuckerman, M., & Lubin, B. (1985). Manual for the multiple affect adjective check list revised. San Diego, CA: EdITS/Educational and Industrial Testing Service.

    Google Scholar 

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Conflict of Interest

David M. Fresco, Douglas S. Mennin, Michael T. Moore, Richard G. Heimberg and James Hambrick declare that they have no conflict of interest.

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This study was approved by the IRB at Temple University.

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Authors and Affiliations

  1. Department of Psychology, Kent State University, 226 Kent Hall Annex, Kent, OH, 44242, USA

    David M. Fresco

  2. Department of Psychology, Hunter College, City University of New York, New York, NY, USA

    Douglas S. Mennin

  3. Department of Psychology, Jackson State University, Jackson, MS, USA

    Michael T. Moore

  4. Department of Psychology, Temple University, Philadelphia, PA, USA

    Richard G. Heimberg & James Hambrick

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  1. David M. Fresco
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Correspondence to David M. Fresco.

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Fresco, D.M., Mennin, D.S., Moore, M.T. et al. Changes in Explanatory Flexibility Among Individuals with Generalized Anxiety Disorder in an Emotion Evocation Challenge. Cogn Ther Res 38, 416–427 (2014). https://doi.org/10.1007/s10608-014-9601-4

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