Preliminary evidence for an emotion dysregulation model of generalized anxiety disorder

Generalized anxiety disorder (GAD) is a chronic illness which impacts significantly on an individual's functioning and quality of life. Pregabalin is a novel structural analogue of the inhibitory neurotransmitter GABA, acting to reduce calcium ion flow through the α2δ subunit of pre-synaptic voltage-dependent calcium channels. Pregabalin has been used in treatment of GAD in a total of eight published controlled trials. In each trial, pregabalin has demonstrated a superiority over placebo, with response rates of over 40% in all studies, including patients on lower doses. One study has provided preliminary evidence for the efficacy of pregabalin in treatment of GAD in older adults. Pregabalin is generally well tolerated, with the most common adverse events being dizziness and somnolence. Adverse effects are generally mild-to-moderate, and transient. Pregabalin has low abuse potential. Limitations of the current literature are discussed, and directions for future research are proposed.

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Does a restriction in working memory capacity mediate the relationship between worry and interpretive biases in generalized anxiety disorder?

10.32920/ryerson.14660979 ◽

2021 ◽

Author(s):

Kathleen Tallon

Keyword(s):

Working Memory ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Emotion Dysregulation ◽

Working Memory Capacity ◽

Generalized Anxiety ◽

Interpretation Biases ◽

Lower Baseline ◽

Negative Problem Orientation ◽

Methodological Considerations

Generalized Anxiety Disorder (GAD) is characterized by excessive, uncontrollable worry and is associated with specific cognitive and emotional difficulties including a threat interpretation bias (IB). Worry, especially in a verbal mode, has been shown to cause a temporary restriction in working memory (WM) capacity. This study examined whether the effects of worry on WM account for threat interpretation biases in GAD. Participants (N = 36) with GAD completed questionnaires assessing worry and related processes. Lower baseline WM was related to higher state anxiety, emotion dysregulation, intolerance of uncertainty, thought suppression, negative problem orientation, and lower attentional control, and was not associated with trait worry. Participants were trained to worry in verbal or imagery form, per Leigh and Hirsch (2011), and then completed a WM task and an IB task a second time. Induced worry, regardless of its form, did not significantly affect WM or IB. Theoretical implications and methodological considerations are discussed.

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Mindfulness and Emotion Regulation Difficulties in Generalized Anxiety Disorder: Preliminary Evidence for Independent and Overlapping Contributions

Behavior Therapy ◽

10.1016/j.beth.2008.04.001 ◽

2009 ◽

Vol 40 (2) ◽

pp. 142-154 ◽

Cited By ~ 201

Author(s):

Lizabeth Roemer ◽

Jonathan K. Lee ◽

Kristalyn Salters-Pedneault ◽

Shannon M. Erisman ◽

Susan M. Orsillo ◽

...

Keyword(s):

Emotion Regulation ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Preliminary Evidence ◽

Generalized Anxiety

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An experimental and experience sampling study of emotion in people with generalized anxiety disorder

10.32920/ryerson.14661000.v1 ◽

2021 ◽

Author(s):

Elizabeth J. Pawluk

Keyword(s):

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Emotion Dysregulation ◽

Positive Emotions ◽

Emotional Reactivity ◽

Negative Emotions ◽

Experience Sampling ◽

Generalized Anxiety ◽

Emotional Intensity ◽

Mean Intensity

Difficulties with emotion and emotion regulation have a significant role in generalized anxiety disorder (GAD), however, much remains unknown about the emotional profile of people with GAD. The emotion dysregulation model (Mennin et al., 2005) suggests that people with GAD experience emotions at a heightened intensity and use maladaptive strategies, including worry, to regulate their distress. This dissertation comprises two independent studies to test tenets of the model. Study 1 was a laboratory-based experiment to clarify if the heightened emotional intensity experienced by people with GAD is due to baseline arousal or emotional reactivity. The subjective emotional and physiological responses of people with GAD (n = 22) were compared to those of people with social anxiety disorder (SAD; n = 23) and nonclinical controls (NCC; n = 20) at baseline and following an emotion induction. The GAD group reported greater subjective intensity of negative emotions and lower intensity of positive emotions relative to the control groups. No differences were found across the three groups in their level of emotional reactivity. The findings highlight that baseline intensity, not emotional reactivity, accounts for the heightened emotional intensity reported by people with GAD. Study 2 was an experience sampling study to identify the emotional profile of people with GAD and examine direct effect of worry and of external events on negative and positive emotions in daily life. Relative to the NCC group (n = 41), the GAD group (n = 39) exhibited an emotional profile characterized by elevated mean intensity, greater instability and greater inertia of negative emotions and lower mean intensity, greater instability and lower inertia of positive emotions. Worry had a greater negative effect on the emotions reported by the GAD group relative to those of the NCC group. Finally, the groups did not differ in degree of emotional reactivity to negative events, but the GAD group reported a greater increase in positive emotion and a greater decrease in negative emotion following a positive event compared to the NCC group. Overall, the findings inform the emotion dysregulation model and provide unique insights into the dynamic emotional experiences of those with GAD.

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Aripiprazole as Augmentation Treatment of Refractory Generalized Anxiety Disorder and Panic Disorder

CNS Spectrums ◽

10.1017/s109285290001676x ◽

2008 ◽

Vol 13 (6) ◽

pp. 522-525 ◽

Cited By ~ 31

Author(s):

Elizabeth A. Hoge ◽

John J. Worthington ◽

Rebecca E. Kaufman ◽

Hannah R. Delong ◽

Mark H. Pollack ◽

...

Keyword(s):

Anxiety Disorder ◽

Panic Disorder ◽

Generalized Anxiety Disorder ◽

Antipsychotic Agent ◽

Preliminary Evidence ◽

Generalized Anxiety ◽

Open Label ◽

Pharmacologic Agent ◽

Severity Scores ◽

Augmentation Strategy

ABSTRACTIntroduction:Individuals with anxiety disorders often remain symptomatic despite treatment with a first-line pharmacologic agent. More research examining pharmacotherapy augmentation strategies to improve outcomes is needed.Methods:In an 8-week, open-label, prospective augmentation study, we examined the efficacy and tolerability of the novel antipsychotic agent aripiprazole for adult outpatients with generalized anxiety disorder (n=13) or panic disorder (n=10) who remained symptomatic despite treatment for at least 8 weeks with an adequate (or maximally tolerated) dose of typical pharmacotherapy.Results:Aripiprazole augmentation was associated with a significant reduction in Clinical Global Impressions-Severity scores (paired t=4.41, df=22, P<.001) in the intent-to-treat sample of 23 individuals. Three subjects (13%) discontinued due to sedation, chest discomfort, and restlessness, respectively.Conclusion:These data provide preliminary evidence that aripiprazole may be a useful augmentation strategy for individuals with generalized anxiety disorder or panic disorder who show a limited response to initial pharmacotherapy.

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Does a restriction in working memory capacity mediate the relationship between worry and interpretive biases in generalized anxiety disorder?

10.32920/ryerson.14660979.v1 ◽

2021 ◽

Author(s):

Kathleen Tallon

Keyword(s):

Working Memory ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Emotion Dysregulation ◽

Working Memory Capacity ◽

Generalized Anxiety ◽

Interpretation Biases ◽

Lower Baseline ◽

Negative Problem Orientation ◽

Methodological Considerations

Generalized Anxiety Disorder (GAD) is characterized by excessive, uncontrollable worry and is associated with specific cognitive and emotional difficulties including a threat interpretation bias (IB). Worry, especially in a verbal mode, has been shown to cause a temporary restriction in working memory (WM) capacity. This study examined whether the effects of worry on WM account for threat interpretation biases in GAD. Participants (N = 36) with GAD completed questionnaires assessing worry and related processes. Lower baseline WM was related to higher state anxiety, emotion dysregulation, intolerance of uncertainty, thought suppression, negative problem orientation, and lower attentional control, and was not associated with trait worry. Participants were trained to worry in verbal or imagery form, per Leigh and Hirsch (2011), and then completed a WM task and an IB task a second time. Induced worry, regardless of its form, did not significantly affect WM or IB. Theoretical implications and methodological considerations are discussed.

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Inhibitory Control in Individuals with Clinical Levels of Depression and Anxiety Symptoms

The Spanish Journal of Psychology ◽

10.1017/sjp.2021.18 ◽

2021 ◽

Vol 24 ◽

Author(s):

María B. García-Martín ◽

Francisco J. Ruiz ◽

Luna Bedoya-Valderrama ◽

Miguel A. Segura-Vargas ◽

Andrés Peña-Vargas ◽

...

Keyword(s):

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Inhibitory Control ◽

Processing Speed ◽

Total Sample ◽

Preliminary Evidence ◽

Control Group ◽

Generalized Anxiety ◽

Healthy Controls ◽

Ex Post

Abstract Previous research has shown that individuals suffering from depression and generalized anxiety disorder (GAD) seem to have inhibitory control deficits compared with healthy controls. However, few studies have been conducted in Spanish-speaking countries. Thus, this study aims to analyze the performance on the Stroop Color and Word Test (SCWT) between groups of Colombian participants with clinical levels of depression and GAD symptoms and a nonclinical control group. According to previous research, we expected to find significant differences in inhibitory control among groups. An ex post facto design was implemented. The SCWT was administered to a total sample of 105 individuals (64.8% women, M = 22.94 years, SD = 4.62), including 27 depressed and 15 anxious participants according to their scores on the Personal Health Questionnaire–9 and the Generalized Anxiety Disorder–7, respectively. Bayesian t-tests showed that depressed participants showed the same processing speed but lower scores on inhibitory control than healthy controls, BF = 13.70, δ = 0.50, 95% CI [0.08, 0.94]. Conversely, anxious participants showed deficits in processing speed, SCWT-Word: BF = 16.19, δ = 0.68, 95% CI [0.15, 1.24]; SCWT-Color: BF = 5.98, δ = 0.50, 95% CI [–0.01, 1.04], but not in inhibitory control compared with the nonanxious counterparts. This study provides preliminary evidence concerning the inhibitory control deficits in Colombian depressed individuals and processing speed deficits in those experiencing clinical levels of GAD symptoms.

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