Category: Adult Anxiety - GAD
Generalized anxiety disorder (GAD) is characterized, in part, by excessive and uncontrollable worry (APA, 2013). Additionally, higher rates of rumination are often reported among these individuals (McEvoy, Watson, Watkins, & Nathan, 2013). Given that people with GAD are more likely than their healthy counterparts to experience negative emotions and associated affect, in addition to higher rates of perseveration, it is therefore important to understand the role that sustained daily negative affect may play in the maintenance or exacerbation of perseverative processes among individuals with GAD. This study utilized ecological momentary assessment (ESM) methods to examine if greater daily negative affect reported predicted greater end of day worry and rumination. We hypothesized that greater momentary negative affect would predict end of day worry and rumination and that this relationship would be moderated by group (i.e., people with GAD or healthy controls). It was also hypothesized that greater momentary negative affect would predict greater social disability. Participants diagnosed with GAD (n = 38) and healthy controls (n = 46) completed 14 days of data collection where they were pinged randomly twice per day to report momentary levels of negative affect, worry, and rumination. They then completed end of day measures of worry (measured through the PSWQ), rumination (measured through the RS), and social disability (measured through the SDS) on each of the 14 days. Data points were aggregated across days to create overall mean ratings for negative affect, worry, and rumination. Analyses revealed that, overall, higher levels of aggregate negative affect significantly predicted end of day worry (F[1,84] = 76.74, p < .001), rumination (F[1,84] = 101.12, p < .001), and social disability (F[1,84] = 84.12, p < .001). These results were moderated by group for rumination (β = -.91, p = .009), but not for worry (β = -.60, p = .10) indicating that greater negative affect predicted higher end of day rumination for those in the GAD, but not control, group. Group also did not moderate momentary negative affect predicting end of day social disability (β = .05, p = .66). These analyses controlled for momentary ratings of worry and rumination. These results suggest that negative affect plays an important role in promoting increased rates of perseverative processes and social disability broadly, and that this relationship may be particularly strong when examining rumination in GAD. Negative affect may therefore indicate a particularly important intervention target, as a reduction in negative affect may subsequently promote reductions in perseverative processes and social disability both among healthy populations and individuals with GAD.