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15-04-2021 | Original Article

Attentional Control Moderates the Relations between Intolerance of Uncertainty and Generalized Anxiety Disorder and Symptoms

Auteurs: Kevin G. Saulnier, Nicholas P. Allan, Matt R. Judah, Brandon Koscinski, Nathan M. Hager, Brian Albanese, Ashley A. Knapp, Norman B. Schmidt

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 6/2021

Abstract

Background

Intolerance of uncertainty (IU), perceived attentional control (AC), and poor cognitive control abilities are risk factors for anxiety; however, few studies have examined their interactive effects in relation to anxiety. A more complete understanding of interplay between IU, perceived AC, and cognitive control could inform intervention efforts.

Methods

The current study examined the direct and interactive effects of IU and AC on anxiety in a sample of 280 community outpatients (M age = 36.01 years, SD = 16.17). Perceived AC was measured using self-report and cognitive control abilities were measured using a Go/No-Go task.

Results

Findings indicated a significant IU by perceived AC interaction predicting worry and GAD diagnoses. There was a positive relation between IU and worry/GAD diagnoses that was strongest among those with high perceived AC. Perceived AC was unrelated to cognitive control abilities, and cognitive control abilities did not interact significantly with IU. Cognitive control abilities were related to worry symptoms but not to GAD diagnoses.

Conclusions

These results indicate that at high levels of perceived AC, individuals with elevated IU report higher levels of worry, potentially due to the conscious use of worry as an emotion regulation strategy. Clinical implications and future directions are discussed.

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Albanese, B. J., Macatee, R. J., Allan, N. P., Short, N. A., Norr, A. M., & Schmidt, N. B. (2018). Interactive effects of anxiety sensitivity and attentional control on posttraumatic stress in community and clinical populations. Psychiatry (New York), 81(1), 71–84. https://doi.org/10.1080/00332747.2017.1309867CrossRef

Albanese, B. J., Macatee, R. J., Gallyer, A. J., Stanley, I. H., Joiner, T. E., & Schmidt, N. B. (2019). Impaired conflict detection differentiates suicide attempters from ideating nonattempters: Evidence from event-related potentials. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 4(10), 902–912. https://doi.org/10.1016/j.bpsc.2019.05.015CrossRef

Allan, N. P., Norr, A. M., Macatee, R. J., Gajewska, A., & Schmidt, N. B. (2015). Interactive effects of anxiety sensitivity and emotion regulation on anxiety symptoms. Journal of Psychopathology and Behavioral Assessment, 37(4), 663–672. https://doi.org/10.1007/s10862-015-9484-zCrossRef

Alonso, J., Mortier, P., Auerbach, R. P., Bruffaerts, R., Vilagut, G., Cuijpers, P., & WHO WMH-ICS Collaborators, on behalf of the W. W.I. (2018). Severe role impairment associated with mental disorders: Results of the WHO world mental health surveys international college student project. Depression and Anxiety, 35(9), 802–814. https://doi.org/10.1002/da.22778CrossRefPubMedPubMedCentral

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. (5th ed.). American Psychiatric Publishing.CrossRef

Ansari, T. L., & Derakshan, N. (2011). The neural correlates of impaired inhibitory control in anxiety. Neuropsychologia, 49(5), 1146–1153. https://doi.org/10.1016/j.neuropsychologia.2011.01.019CrossRefPubMed

Armstrong, T., Zald, D. H., & Olatunji, B. O. (2011). Attentional control in OCD and GAD: Specificity and associations with core cognitive symptoms. Behaviour Research and Therapy, 49(11), 756–762. https://doi.org/10.1016/j.brat.2011.08.003CrossRefPubMedPubMedCentral

Bardeen, J. R., & Fergus, T. A. (2016). Emotional distress intolerance, experiential avoidance, and anxiety sensitivity: The buffering effect of attentional control on associations with posttraumatic stress symptoms. Journal of Psychopathology and Behavioral Assessment, 38, 320–329. https://doi.org/10.1007/s10862-015-9522-xCrossRef

Behar, E., DiMarco, I. D., Hekler, E. B., Mohlman, J., & Staples, A. M. (2009). Current theoretical models of generalized anxiety disorder (GAD): Conceptual review and treatment implications. Journal of Anxiety Disorders. https://doi.org/10.1016/j.janxdis.2009.07.006CrossRefPubMed

Braver, T. S. (2012). The variable nature of cognitive control: A dual mechanisms framework. Trends in Cognitive Sciences. https://doi.org/10.1016/j.tics.2011.12.010CrossRefPubMedPubMedCentral

Carleton, N. R., Sharpe, D., & Asmundson, G. J. G. G. (2007). Anxiety sensitivity and intolerance of uncertainty: Requisites of the fundamental fears? Behaviour Research and Therapy, 45, 2307–2316. https://doi.org/10.1016/j.brat.2007.04.006CrossRefPubMed

Carleton, R. N. (2016a). Into the unknown: A review and synthesis of contemporary models involving uncertainty. Journal of Anxiety Disorders, 39, 30–43. https://doi.org/10.1016/j.janxdis.2016.02.007CrossRefPubMed

Carleton, R. N. (2016b). Fear of the unknown: One fear to rule them all? Journal of Anxiety Disorders, 41, 5–21. https://doi.org/10.1016/j.janxdis.2016.03.011CrossRefPubMed

Carleton, R. N., Norton, M. A. P. J., & Asmundson, G. J. G. (2007). Fearing the unknown: A short version of the intolerance of uncertainty scale. Journal of Anxiety Disorders, 21, 105–117. https://doi.org/10.1016/j.janxdis.2006.03.014CrossRefPubMed

Chen, N. T. M., Clarke, P. J. F., Watson, T. L., MacLeod, C., & Guastella, A. J. (2015). Attentional bias modification facilitates attentional control mechanisms: Evidence from eye tracking. Biological Psychology, 104, 139–146. https://doi.org/10.1016/J.BIOPSYCHO.2014.12.002CrossRefPubMed

Cieslik, E. C., Mueller, V. I., Eickhoff, C. R., Langner, R., & Eickhoff, S. B. (2015). Three key regions for supervisory attentional control: Evidence from neuroimaging meta-analyses. Neuroscience and Biobehavioral Reviews. https://doi.org/10.1016/j.neubiorev.2014.11.003CrossRefPubMed

Curran, P. J., West, S. G., & Finch, J. F. (1996). The robustness of test statistics to nonnormality and specification error in confirmatory factor analysis. Psychological Methods, 1, 16–29. https://doi.org/10.1037/1082-989X.1.1.16CrossRef

Derryberry, D., & Reed, M. A. (2002). Anxiety-related attentional biases and their regulation by attentional control. Journal of Abnormal Psychology, 111, 225–236. https://doi.org/10.1037//0021-843X.111.2.225CrossRefPubMed

Dugas, M. J., Gagnon, F., Ladouceur, R., & Freeston, M. H. (1998). Generalized anxiety disorder: A preliminary test of a conceptual model. Behaviour Research and Therapy, 36, 215–226. https://doi.org/10.1016/S0005-7967(97)00070-3CrossRefPubMed

Dugas, M. J., Gosselin, P., & Ladouceur, R. (2001). Intolerance of uncertainty and worry: Investigating specificity in a nonclinical sample. Cognitive Therapy and Research, 25, 551–558. https://doi.org/10.1023/A:1005553414688CrossRef

Enders, C. K. (2001a). A primer on maximum likelihood algorithms available for use with missing data. Structural Equation Modeling, 8(1), 128–141. https://doi.org/10.1207/S15328007SEM0801_7CrossRef

Enders, C. K. (2001b). The impact of nonnormality on full information maximum-likelihood estimation for structural equation models with missing data. Psychological Methods, 6(3), 352–370. https://doi.org/10.1037/1082-989x.6.4.352CrossRefPubMed

Enders, C. K. (2001c). The performance of the full information maximum likelihood estimator in multiple regression models with missing data. Educational and Psychological Measurement, 61(5), 713–740. https://doi.org/10.1177/0013164401615001CrossRef

Enders, C. K. (2008). A note on the use of missing auxiliary variables in full information maximum likelihood-based structural equation models. Structural Equation Modeling, 15(3), 434–448. https://doi.org/10.1080/10705510802154307CrossRef

Eysenck, M. W., Derakshan, N., Santos, R., & Calvo, M. G. (2007). Anxiety and cognitive performance: Attentional control theory. Emotion, 7(2), 336–353. https://doi.org/10.1037/1528-3542.7.2.336CrossRefPubMed

First, M. B., Williams, J. B. W., Karg, R. S., & Spitzer, R. L. (2015). Structured clinical interview for DSM-5—Research version (SCID-5 for DSM-5, research version; SCID-5-RV). American Psychiatric Association.

Fox, E., Dutton, K., Yates, A., Georgiou, G. A., & Mouchlianitis, E. (2015). Attentional control and suppressing negative thought intrusions in pathological worry. Clinical Psychological Science, 3(4), 593–606. https://doi.org/10.1177/2167702615575878CrossRefPubMedPubMedCentral

Freeston, M. H., Rhéaume, J., Letarte, H., Dugas, M. J., & Ladouceur, R. (1994). Why do people worry? Personality and Individual Differences, 17, 791–802. https://doi.org/10.1016/0191-8869(94)90048-5CrossRef

Garavan, H., Ross, T., Kaufman, J., & Stein, E. (2003). A midline dissociation between error-processing and response-conflict monitoring. NeuroImage, 20(2), 1132–1139. https://doi.org/10.1016/S1053-8119(03)00334-3CrossRefPubMed

Gentes, E. L., & Ruscio, A. M. (2011). A meta-analysis of the relation of intolerance of uncertainty to symptoms of generalized anxiety disorder, major depressive disorder, and obsessive–compulsive disorder. Clinical Psychology Review, 31, 923–933. https://doi.org/10.1016/j.cpr.2011.05.001CrossRefPubMed

Gyurak, A., Gross, J. J., & Etkin, A. (2011). Explicit and implicit emotion regulation: A dual-process framework. Cognition and Emotion, 25(3), 400–412. https://doi.org/10.1080/02699931.2010.544160CrossRefPubMed

Hallion, L. S., Tolin, D. F., Assaf, M., Goethe, J., & Diefenbach, G. J. (2017). Cognitive control in generalized anxiety disorder: Relation of inhibition impairments to worry and anxiety severity. Cognitive Therapy and Research, 41(4), 610–618. https://doi.org/10.1007/s10608-017-9832-2CrossRef

Hallion, L. S., Tolin, D. F., Billingsley, A. L., Kusmierski, S. N., & Diefenbach, G. J. (2019). “Cold” cognitive control and attentional symptoms in anxiety: Perceptions versus performance. Behavior Therapy. https://doi.org/10.1016/j.beth.2019.04.002CrossRefPubMed

Hampshire, A., Chamberlain, S. R., Monti, M. M., Duncan, J., & Owen, A. M. (2010). The role of the right inferior frontal gyrus: Inhibition and attentional control. NeuroImage, 50(3), 1313–1319. https://doi.org/10.1016/J.NEUROIMAGE.2009.12.109CrossRefPubMed

Hester, R., Fassbender, C., & Garavan, H. (2004). Individual differences in error processing: A review and reanalysis of three event-related fMRI studies using the Go/NoGo task. Cerebral Cortex, 14(9), 986–994. https://doi.org/10.1093/cercor/bhh059CrossRefPubMed

Judah, M. R., Grant, D. M., Mills, A. C., & Lechner, W. V. (2014). Factor structure and validation of the attentional control scale. Cognition and Emotion, 28, 433–451. https://doi.org/10.1080/02699931.2013.835254CrossRefPubMed

Judah, M. R., Saulnier, K. G., Hager, N. M., & Allan, N. P. (2020). A bifactor model of the straightforward attentional control scale. Journal of Psychopathology and Behavioral Assessment, 42(1), 127–136. https://doi.org/10.1007/s10862-019-09737-yCrossRef

Kelly, A. M. C., Hester, R., Murphy, K., Javitt, D. C., Foxe, J. J., & Garavan, H. (2004). Prefrontal-subcortical dissociations underlying inhibitory control revealed by event-related fMRI. European Journal of Neuroscience, 19(11), 3105–3112. https://doi.org/10.1111/j.0953-816X.2004.03429.xCrossRefPubMed

Kessler, R. C., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Wittchen, H.-U. (2012). Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. International Journal of Methods in Psychiatric Research, 21, 169–184. https://doi.org/10.1002/mpr.1359CrossRefPubMedPubMedCentral

Ladouceur, R., Gosselin, P., & Dugas, M. J. (2000). Experimental manipulation of intolerance of uncertainty: A study of a theoretical model of worry. Behaviour Research and Therapy, 38, 933–941. https://doi.org/10.1016/S0005-7967(99)00133-3CrossRefPubMed

Macatee, R. J., Albanese, B. J., Allan, N. P., Schmidt, N. B., & Cougle, J. R. (2016). Distress intolerance as a moderator of the relationship between daily stressors and affective symptoms: Tests of incremental and prospective relationships. Journal of Affective Disorders, 206, 125–132. https://doi.org/10.1016/j.jad.2016.07.035CrossRefPubMedPubMedCentral

Macatee, R. J., Albanese, B. J., Clancy, K., Allan, N. P., Bernat, E. M., Cougle, J. R., & Schmidt, N. B. (2018). Distress intolerance modulation of neurophysiological markers of cognitive control during a complex Go/No-Go task. Journal of Abnormal Psychology, 127(1), 12–29. https://doi.org/10.1037/abn0000323CrossRefPubMedPubMedCentral

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. https://doi.org/10.1016/0005-7967(90)90135-6CrossRefPubMed

Mills, A. C., Grant, D. M. M., Judah, M. R., White, E. J., Taylor, D. L., & Frosio, K. E. (2016). Trait attentional control influences the relationship between repetitive negative thinking and psychopathology symptoms. Psychiatry Research, 238, 277–283. https://doi.org/10.1016/j.psychres.2016.02.055

Miskin, C., Carvalho, K. S., Valencia, I., Legido, A., & Khurana, D. S. (2015). EEG duration: The long and the short of it. Journal of Child Neurology, 30(13), 1767–1769. https://doi.org/10.1177/0883073815579969CrossRefPubMed

Moradi, M., Fata, L., Abhari, A. A., & Abbasi, I. (2014). Comparing attentional control and intrusive thoughts in obsessive-compulsive disorder, generalized anxiety disorder and nonclinical population. Iranian Journal of Psychiatry, 9(2), 69–75PubMedPubMedCentral

Muthén, L. K., & Muthén, B. O. (1998). Mplus user’s guide (Seventh). Muthén & Muthén.

Naragon-Gainey, K., & Watson, D. (2018). What lies beyond neuroticism? An examination of the unique contributions of social-cognitive vulnerabilities to internalizing disorders. Assessment, 25, 143–158. https://doi.org/10.1177/1073191116659741CrossRefPubMed

Newman, M. G., & Llera, S. J. (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(3), 371–382. https://doi.org/10.1016/J.CPR.2011.01.008CrossRefPubMedPubMedCentral

Norr, A. M., Oglesby, M. E., Capron, D. W., Raines, A. M., Korte, K. J., & Schmidt, N. B. (2013). Evaluating the unique contribution of intolerance of uncertainty relative to other cognitive vulnerability factors in anxiety psychopathology. Journal of Affective Disorders, 151, 136–142. https://doi.org/10.1016/j.jad.2013.05.063CrossRefPubMed

Norton, P. J., & Mehta, P. D. (2007). Hierarchical model of vulnerabilities for emotional disorders. Cognitive Behaviour Therapy, 36, 240–254. https://doi.org/10.1080/16506070701628065CrossRefPubMed

Ouimet, A. J., Gawronski, B., & Dozois, D. J. A. (2009). Cognitive vulnerability to anxiety: A review and an integrative model. Clinical Psychology Review, 29, 459–470. https://doi.org/10.1016/j.cpr.2009.05.004CrossRefPubMed

Paulus, M. P. (2015). Cognitive control in depression and anxiety: Out of control? Current Opinion in Behavioral Sciences. https://doi.org/10.1016/j.cobeha.2014.12.003CrossRef

Peers, P. V., & Lawrence, A. D. (2009). Attentional control of emotional distraction in rapid serial visual presentation. Emotion, 9(1), 140–145. https://doi.org/10.1037/a0014507CrossRefPubMed

Podsakoff, P. M., MacKenzie, S. B., & Podsakoff, N. P. (2012). Sources of method bias in social science research and recommendations on how to control it. Annual Review of Psychology, 63, 539–569. https://doi.org/10.1146/annurev-psych-120710-100452CrossRefPubMed

Posner, M. I., & Petersen, S. E. (1990). The attention system of the human brain. Annual Review of Neuroscience, 13(1), 25–42. https://doi.org/10.1146/annurev.ne.13.030190.000325

Posner, M. I., & Snyder, C. R. R. (2004). Attention and cognitive control. In: D. A. Balota & E. J. Marsh (Eds.), Cognitive psychology: Key readings in cognition (pp. 205–223). New York, NY: Taylor & Francis Books, Inc. Retrieved March 26, 2021 from https://books.google.com/books?hl=en&lr=&id=DcJAqyCK6T8C&oi=fnd&pg=PA205&dq=cognitive+control&ots=q5vh-2i6DO&sig=HEqIEEYY8oEK6bGt7VZpoo2Qi7A#v=onepage&q=cognitivecontrol&f=false

Schmidt, N. B., Capron, D. W., Raines, A. M., & Allan, N. P. (2014). Randomized clinical trial evaluating the efficacy of a brief intervention targeting anxiety sensitivity cognitive concerns. Journal of Consulting and Clinical Psychology, 82, 1023–1033. https://doi.org/10.1037/a0036651CrossRefPubMed

Scholz, U., La Marca, R., Nater, U. M., Aberle, I., Ehlert, U., Hornung, R., & Kliegel, M. (2009). Go no-go performance under psychosocial stress: Beneficial effects of implementation intentions. Neurobiology of Learning and Memory, 91(1), 89–92. https://doi.org/10.1016/j.nlm.2008.09.002CrossRefPubMed

Sexton, K. A., Norton, P. J., Walker, J. R., & Ron Norton, G. (2005). Hierarchical model of vulnerabilities for anxiety: Replication and extension with a clinical sample. Cognitive Behaviour Therapy, 34, 50–63. https://doi.org/10.1080/16506070410005401CrossRefPubMed

Shihata, S., McEvoy, P. M., Mullan, B. A., & Carleton, R. N. (2016). Intolerance of uncertainty in emotional disorders: What uncertainties remain? Journal of Anxiety Disorders, 41, 115–124. https://doi.org/10.1016/j.janxdis.2016.05.001CrossRefPubMed

Simmonds, D. J., Pekar, J. J., & Mostofsky, S. H. (2008). Meta-analysis of Go/No-go tasks demonstrating that fMRI activation associated with response inhibition is task-dependent. Neuropsychologia, 46(1), 224–232. https://doi.org/10.1016/J.NEUROPSYCHOLOGIA.2007.07.015CrossRefPubMed

Stefanopoulou, E., Hirsch, C. R., Hayes, S., Adlam, A., & Coker, S. (2014). Are attentional control resources reduced by worry in generalized anxiety disorder? Journal of Abnormal Psychology, 123(2), 330–335. https://doi.org/10.1037/a0036343CrossRefPubMedPubMedCentral

Susa, G., Pitică, I., Benga, O., & Miclea, M. (2012). The self regulatory effect of attentional control in modulating the relationship between attentional biases toward threat and anxiety symptoms in children. Cognition and Emotion, 26(6), 1069–1083. https://doi.org/10.1080/02699931.2011.638910CrossRefPubMed

Taylor, C. T., Cross, K., & Amir, N. (2016). Attentional control moderates the relationship between social anxiety symptoms and attentional disengagement from threatening information. Journal of Behavior Therapy and Experimental Psychiatry, 50, 68–76. https://doi.org/10.1016/J.JBTEP.2015.05.008CrossRefPubMed

Wells, A. (1995). Meta-cognition and worry: A cognitive model of generalized anxiety disorder. Behavioural and Cognitive Psychotherapy, 23(3), 301–320. https://doi.org/10.1017/S1352465800015897CrossRef

Wells, A., & Matthews, G. (1996). Modelling cognition in emotional disorder: The S-REF model. Behaviour Research and Therapy, 34(11–12), 881–888. https://doi.org/10.1016/S0005-7967(96)00050-2CrossRefPubMed

Williams, P. G., Rau, H. K., Suchy, Y., Thorgusen, S. R., & Smith, T. W. (2017). On the validity of self-report assessment of cognitive abilities: Attentional control scale associations with cognitive performance, emotional adjustment, and personality. Psychological Assessment, 29(5), 519–530. https://doi.org/10.1037/pas0000361CrossRefPubMed

Wright, L., Lipszyc, J., Dupuis, A., Thayapararajah, S. W., & Schachar, R. (2014). Response inhibition and psychopathology: A meta-analysis of Go/No-Go task performance. Journal of Abnormal Psychology, 123(2), 429–439. https://doi.org/10.1037/a0036295CrossRefPubMed

Yancey, J. R., Venables, N. C., & Patrick, C. J. (2016). Psychoneurometric operationalization of threat sensitivity: Relations with clinical symptom and physiological response criteria. Psychophysiology, 53(3), 393–405. https://doi.org/10.1111/psyp.12512CrossRefPubMedPubMedCentral

Yook, K., Kim, K.-H., Suh, S. Y., & Lee, K. S. (2010). Intolerance of uncertainty, worry, and rumination in major depressive disorder and generalized anxiety disorder. Journal of Anxiety Disorders, 24, 623–628. https://doi.org/10.1016/j.janxdis.2010.04.003CrossRefPubMed

Zainal, N. H., & Newman, M. G. (2018). Executive function and other cognitive deficits are distal risk factors of generalized anxiety disorder 9 years later. Psychological Medicine, 48(12), 2045–2053. https://doi.org/10.1017/S0033291717003579CrossRefPubMed

Titel: Attentional Control Moderates the Relations between Intolerance of Uncertainty and Generalized Anxiety Disorder and Symptoms
Auteurs: Kevin G. Saulnier
Nicholas P. Allan
Matt R. Judah
Brandon Koscinski
Nathan M. Hager
Brian Albanese
Ashley A. Knapp
Norman B. Schmidt
Publicatiedatum: 15-04-2021
Uitgeverij: Springer US
Gepubliceerd in: Cognitive Therapy and Research / Uitgave 6/2021
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-021-10223-7

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Abstract

Background

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Conclusions

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