Prospective Investigation of the Contrast Avoidance Model of Generalized Anxiety and Worry
Prospective Investigation of the Contrast Avoidance Model of Generalized Anxiety and Worry
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DOI：
10.1016/j.beth.2016.10.001
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发表时间：
2017-07-01
期刊：
影响因子：
3.7
通讯作者：
Newman, Michelle G.
中科院分区：
文献类型：
--
作者：
Crouch, Tara A.;Lewis, Jamie A.;Newman, Michelle G.
随着时间的推移，维持广泛性焦虑症（GAD）症状和担忧的因素尚不完全清楚。对比避免模型 (CAM) 假设，存在病理性担忧和广泛性焦虑症症状风险的个体独特地害怕情绪从中性或积极情绪转变为消极情绪状态，因此利用担忧来维持消极情绪，以避免转变或削弱消极对比的影响。该模型已在实验室实验中得到支持，但尚未在日常生活的自然背景下进行前瞻性研究。本研究在纵向经验抽样研究中使用亚临床样本测试了 CAM。选择代表广泛症状的参与者（N = 92）完成了广泛性焦虑症和抑郁症状的基线测量，并每周进行八次担忧评估、一周最糟糕事件期间的负面情绪对比经历以及特定情况的负面情绪。与 CAM 一致，GAD 症状前瞻性地预测负面对比体验作为最坏事件的更高认可度，与抑郁症状无关。毫不奇怪，较高的负面对比预示着较高的负面情绪。然而，较高的基线广泛性焦虑症症状和每周的担忧都独特地调节（减少）了这种关系，为担忧可能会减弱对比的情绪影响的观点提供了一致的支持。抑郁症状没有同样的调节作用。这些发现在生态有效的背景下支持 CAM。
The factors that maintain generalized anxiety disorder (GAD) symptoms and worry over time are not entirely clear. The Contrast Avoidance Model (CAM) postulates that individuals at risk for pathological worry and GAD symptoms uniquely fear emotional shifts from neutral or positive emotions into negative emotional states, and consequently use worry to maintain negative emotion in order to avoid shifts or blunt the effect of negative contrasts. This model has received support in laboratory experiments, but has not been investigated prospectively in the naturalistic context of daily life. The present study tested the CAM in a longitudinal experience sampling study with a subclinical sample. Participants selected to represent a broad range of symptoms (N=92) completed baseline measures of GAD and depression symptoms, and eight weekly assessments of worry, experiences of negative emotional contrasts during their worst event of the week, and situation-specific negative emotion. Consistent with the CAM, GAD symptoms prospectively predicted higher endorsement of negative contrast experiences as worst events, independent of depression symptoms. Unsurprisingly, higher negative contrasts predicted higher negative emotion. However, both higher baseline GAD symptoms and weekly worry uniquely moderated (reduced) this relationship, providing consistent support for the idea that worry may blunt the emotional effects of contrasts. Depression symptoms did not have the same moderating effect. These findings support the CAM in an ecologically valid context.