Category: Adult Anxiety - GAD
Introduction: Stress is a transdiagnostic risk factor for many disorders and negative health outcomes that affects emotional as well as physiological response systems. In particular, the autonomic nervous system (ANS) has been linked with the stress response, and quick recovery following the cessation of the stressor is associated with salubrious outcomes. Generalized Anxiety Disorder (GAD) is characterized by worry about potential stressors, and is associated with a dampened autonomic reactivity, although the literature is mixed as to whether these blunted reactions are a function of reduced parasympathetic and heighted sympathetic activity at baseline that constrains the magnitude of the ANS response. Relatively little is known about the relationship between worry and ANS activity following the termination of stressful events. Given that a prolonged stress response is associated with adverse health outcomes, the present study examined the relationship between worry and ANS reactivity before, during, and following an interpersonal stressor.
Method: Forty (n=40) students who completed measures of worry (Penn State Worry Questionnaire), a free 3 minute breathing baseline, the Trier Social Stress Test (TSST), and two one-minute rest periods following the TSST. TSST involved participants preparing and presenting a speech, as well as counting backwards from a large number while they were ostensibly video and audio recorded in front of confederates. This was then followed by a 2 minute recovery period. ANS indices in the form of respiratory sinus arrhythmia (RSA) and left ventricular pre-ejection period (PEP) were derived from electrocardiogram and impedance cardiogram data, and reflected parasympathetic and sympathetic nervous system activity, respectively.
Results: One-way repeated measures ANOVA was used to analyze the data. While the TSST evoked significant parasympathetic nervous system withdrawal and sympathetic activation, the effects of worry were only observed during the recovery phase that followed the TSST. Specifically, while RSA returned to near baseline levels after the TSST was terminated, elevated worry was associated with reduced parasympathetic activity during the second 60 second phase of the recovery period (F(1,35)=4.46, p < .05).
Conclusion: Our results suggest that the worry impedes the ability for the ANS to recover from stress. Such failures are consistent with the sustained physiological arousal associated with GAD, and may place worriers at risk to experience associated adverse health effects in the long term.