Recent models of generalized anxiety disorder (GAD) have expanded on Borkovec’s avoidance theory by delineating emotion regulation deficits associated with the excessive worry characteristic of this disorder (see Behar, DiMarco, Hekler, Mohlman, & Staples, 2009). However, it has been difficult to determine whether emotion regulation is simply a useful heuristic for the avoidant properties of worry or an important extension to conceptualizations of GAD. Some of this difficulty may arise from a focus on purported maladaptive regulation strategies, which may be confounded with symptomatic distress components of the disorder (such as worry). We examined the implementation of adaptive regulation strategies by participants with and without a diagnosis of GAD while watching emotion-eliciting film clips. In a between-subjects design, participants were randomly assigned to accept, reappraise, or were not given specific regulation instructions. Implementation of adaptive regulation strategies produced differential effects in the physiological (but not subjective) domain across diagnostic groups. Whereas participants with GAD demonstrated lower cardiac flexibility when implementing adaptive regulation strategies than when not given specific instructions on how to regulate, healthy controls showed the opposite pattern, suggesting they benefited from the use of adaptive regulation strategies. We discuss the implications of these findings for the delineation of emotion regulation deficits in psychopathology.
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 reinforce the worry process. These conceptualizations commonly view worry as a dysfunctional regulatory response to various aspects of emotional experience (e.g., Mennin and Fresco, 2010, Mennin et al., 2005, Mennin et al., 2007, Newman and Llera, 2011 and Roemer et al., 2008; for a recent review see Behar et al., 2009). Moreover, worry has shown strong associations with other maladaptive emotion regulation strategies that are positively correlated with psychopathology ( Aldao, Nolen-Hoeksema, & Schweizer, 2010), such as suppression (e.g., Robichaud, Dugas, & Conway, 2003) and rumination (e.g., Nolen-Hoeksema, Wisco, & Lyubomirsky, 2008).
