New Directions in the Psychopathology of Generalized Anxiety Disorder: An Investigation of the Role of Emotion Regulation in the Development and Maintenance of Chronic Worry and Anxiety
AuthorPruitt, Larry Dee
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Generalized anxiety disorder (GAD) is a condition characterized by the experience of chronic and excessive worry and anxiety, which affects nearly seven million people in the United States alone. Research has demonstrated that GAD is the least effectively treated anxiety disorder. Some have argued that this is because treatment development, thus far, may not accurately conceptualize the clinical problem; treating the symptoms rather than the underlying dysfunction that produces them. This paper will argue that GAD pathology stems from problems associated with dysfunctional emotion regulation and that the diagnostic features of GAD, such as chronic worry, are not the cause of the pathology, but rather the product of it. Eighty-four subjects were assigned to one of three groups based on self reported worry levels and GAD symptoms. These groups included a GAD criteria group, a high worry/non-GAD group, and a non-anxious group. Following a battery of trait measures, all participants underwent a negative mood induction. Their emotional reactions to that induction were measured, and they were then asked to actively regulate their emotional experience. This regulation process was tracked over a 24 hour time period. The results of this study suggest specific differences between these three groups with regard to how they experience, and modulate emotional reactions. Further, we provide evidence that emotion regulation affects one's experience of anxiety, independently of their level of worry. Implications for a new model of generalized anxiety disorder are discussed alongside trans-diagnostic implications for emotion regulation across the anxiety disorders.