Level of emotional awareness as a differentiating variable between individuals with and without generalized anxiety disorder

https://doi.org/10.1016/j.janxdis.2004.06.001Get rights and content

Abstract

Using Mennin, Heimberg, Turk, and Fresco’s [Emotion regulation deficits as a key feature of generalized anxiety disorder: Testing a theoretical model, submitted for publication] conceptualization of generalized anxiety disorder (GAD) as a syndrome involving emotion dysregulation and an overuse of cognitive control strategies, this study sought to differentiate individuals with GAD from controls by offering differences in emotional awareness as one of the central distinctions between these groups. This study employs the Levels of Emotional Awareness Scale (LEAS) [Lane et al., 1990Lane, R. D., Quinlan, D. M., Schwartz, G. E., Walker, P. A., & Zeitlin, S. B. (1990). The Levels of Emotional Awareness Scale: a cognitive-developmental measure of emotion. Journal of Personality Assessment, 55, 124–134] a rater-coded measure, to assess level of emotional awareness, a methodological improvement over previous tests of the model, which relied upon self-report. Individuals with GAD scored significantly higher than controls on emotional awareness. These findings are discussed in light of the theoretical implications for GAD.

Section snippets

Participants

Participants were 293 unselected undergraduate students (219 women) who took part in the study for course extra credit. Using the study criteria described below, 73 participants were classified as having GAD and 220 participants were classified as normal controls. The ethnic composition of the sample was 76.5% Caucasian, 13% African American, 3% Asian American, 2.7% Latino/a, 1.4% mixed ethnic heritage, and 3.4% individuals who endorsed “other.” The marital status of the sample was 94.2%

Preliminary analyses

As expected, the GAD group had significantly higher scores on the PSWQ than the control group, t(291) = −12.4, P < .001 (see Table 1). The mean of the GAD group was similar to that observed in treatment-seeking samples (e.g., Borkovec & Costello, 1993). This GAD group also had significantly higher scores on the dimensional score for the GAD-Q-IV than the control group, t(290) = −16.1, P < .001 (see Table 1).

The groups did not differ significantly in age [t(291) = 1.53, ns], ethnicity [χ2(2, N =

Discussion

Contrary to hypotheses, individuals with GAD performed at a significantly higher level of emotional awareness on the LEAS total score than controls. Even when more fine grained analyses of different aspects of the LEAS were examined (i.e., self vs. others; discrete emotion category; level of complexity), the GAD group was consistently rated as higher in emotional awareness than the control group (although these differences were not always statistically significant, the effect sizes were

Acknowledgements

The data reported herein are from the first author’s doctoral dissertation, completed under the supervision of the second author. The authors wish to thank Dr. Frank Gardner for his helpful input and support as a dissertation committee member.

References (48)

  • Borkovec, T.D., & Costello. E. (1993). Efficacy of applied relaxation and cognitive-behavioral therapy in the treatment...
  • T.A. Brown et al.

    Anxiety Disorders Interview Schedule for DSM-IV (ADIS-IV)

    (1994)
  • D. Cicchetti et al.

    Emotions and emotion regulation in developmental psychopathology

    Development and Psychopathology

    (1995)
  • J. Cohen

    Statistical power analysis for the behavioral sciences (revised edition)

    (1988)
  • M. Conway

    On sex roles and representations of emotional experience: masculinity, femininity, and emotional awareness

    Sex Roles

    (2000)
  • K.L. Croyle et al.

    Emotional awareness and couples’ relationship satisfaction

    Journal of Marital and Family Therapy

    (2002)
  • P.A. DiNardo et al.

    Anxiety Disorders Interview Schedule for DSM-IV: Lifetime Version (ADIS-IV-L)

    (1994)
  • L. Feldman-Barrett et al.

    Knowing what you’re feeling and knowing what to do about it: mapping the relation between emotion differentiation and emotion regulation

    Cognition and Emotion

    (2001)
  • L.S. Greenberg

    Integrating an emotion-focused approach to treatment into psychotherapy integration

    Journal of Psychotherapy Integration

    (2002)
  • J.J. Gross

    The emerging field of emotion regulation: an integrative review

    Review of General Psychology

    (1998)
  • J.J. Gross

    Antecedent-and response-focused emotion regulation: divergent consequences for experience, expression, and physiology

    Journal of Personality and Social Psychology

    (1998)
  • C.E. Izard

    Patterns of emotions

    (1972)
  • Lane, R.D. (1991). LEAS scoring manual & glossary. Tuscon, AZ:...
  • R.D. Lane et al.

    Levels of emotional awareness: a cognitive-developmental theory and its application to psychopathology

    American Journal of Psychiatry

    (1987)
  • Cited by (52)

    • Social problem-solving attitudes and performance as a function of differences in trait and state worry

      2023, Journal of Behavior Therapy and Experimental Psychiatry
      Citation Excerpt :

      While results indicated that pathological worry was associated with endorsing higher emotion dysregulation, emotion regulation abilities were not predictive of problem-solving performance. Considering the discrepancy between self-reports of ability (Mennin et al., 2005) and observed performance regarding emotional awareness (Decker et al., 2008; Novick-Kline et al., 2005), it is possible that individuals who engage in excessive worry may employ more emotion regulation strategies during problem-solving than they believe. A potential limitation regards the lack of measurement of personal relevance of the problem-solving task situations, to determine if results are as applicable to real-life, personal problem-solving as they are of hypothetical problem-solving.

    • Affective agnosia: Expansion of the alexithymia construct and a new opportunity to integrate and extend Freud's legacy

      2015, Neuroscience and Biobehavioral Reviews
      Citation Excerpt :

      Patients with schizophrenia had lower scores on the LEAS than matched controls on those LEAS items depicting more complex social scenarios, suggesting that emotional awareness declines in these patients when resources are taxed (Baslet et al., 2009). Individuals with generalized anxiety disorder have higher LEAS scores than matched controls (Novick-Kline et al., 2005), indicating emotional awareness can be a double-edged sword. In contrast, patients with depression were found to have decreased awareness of the emotions of others (Berthoz et al., 2000; Donges et al., 2005), consistent with the pathological introspective focus that can occur with depression.

    View all citing articles on Scopus

    Portions of this paper were presented at the annual meeting of the Association for the Advancement of Behavior Therapy, Boston, MA, November, 2003.

    View full text