Paradoxical cardiovascular effects of implementing adaptive emotion regulation strategies in generalized anxiety disorder
Highlights
► Acceptance (and No Regulation Instruction) led to higher subjective negative affect than Reappraisal in both groups. ► In the GAD group, Acceptance and Reappraisal led to lower HRV than No Regulation (opposite than in controls). ► Findings are interpreted in light of emotion regulation framework and recent findings on physiological feedback loops.
Section snippets
Background
Generalized anxiety disorder (GAD) is characterized by excessive and uncontrollable worry (APA, 2000). According to Borkovec’s avoidance theory, worry is a verbal/linguistic process that, although associated with heightened subjective distress, is negatively reinforced through the facilitated avoidance of unpleasant somatic activation and imagery (Borkovec, Alcaine, & Behar, 2004). Recent theories have expanded upon the avoidance perspective by detailing the role of emotional components that
Participants
Participants were recruited from an urban community surrounding a large private university in the northeast United States. In order to qualify for the study, they had to be between the ages of 21 and 65, not be college students, be fluent in English, and have no history of heart conditions or diabetes. In addition, participants were excluded if they reported current substance use or abuse (with the exception of nicotine), pertinent medical conditions (e.g., heart condition, epilepsy) and use of
Group characteristics
The following demographic variables did not differ across diagnostic group or regulation condition: age, gender, ethnicity, alcohol quantity, caffeine quantity, exercise status, smoking status, and antidepressant status (p’s > .05). In addition, there were no differences in terms of comorbid depression across regulation conditions within the GAD group, χ2 (2) = 1.08, ns. Lastly, given documented gender difference in HRV (e.g., Kosinken et al., 2009, Snieder et al., 2007, Sztajzel et al., 2008),
Discussion
Despite recent advances in the delineation of emotion regulation deficits in GAD, our understanding of the process of implementation of strategies beyond worry is still in its infancy. Specifically, very little is known about the actual sources of difficulties that individuals with this disorder encounter when seeking to deploy adaptive regulation strategies, such as cognitive reappraisal or acceptance. Given that adaptive regulation strategies are seldom compared to one another in experimental
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2020, Personality and Individual DifferencesCitation Excerpt :Although we found differences at the subjective level and in terms of greater PFC left side activation for the FR group, we did not find any differences at the level of autonomic reactions and flexibility. The lack of differences in autonomic effects obtained in this study for between groups can be related to various paradoxical effects documented in the literature (see Aldao & Mennin, 2012) in terms of the lower cardiac flexibility for individuals with generalized anxiety disorder while using adaptive ER strategies, compared to healthy participants. In terms of the potential mechanisms explaining our results, we obtained a marginally significant moderating effect of the severity of social anxiety only for the lateral prefrontal asymmetries after the ER statement in the FR group compared to the control condition.
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