Category: Comorbidity - Anxiety and Other

PS15- #B58 - Are You Looking at Me? Understanding Fear of Negative Evaluation in the Link Between PTSD and GAD

Sunday, Nov 19
9:00 AM – 10:00 AM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: PTSD (Posttraumatic Stress Disorder) | GAD (Generalized Anxiety Disorder) | Fear

Objective: Posttraumatic stress disorder (PTSD) is a complex psychiatric disorder that is frequently diagnosed in conjunction with Generalized Anxiety Disorder (GAD). Common underlying factors, such as anxiety sensitivity and intolerance of uncertainty, have been identified as potential explanations for the high comorbidity.  Another potential underlying factor that has received less attention in the literature is fear of negative evaluation. Despite it being characterized as the cornerstone of social anxiety disorder, fear of negative evaluation has been linked to the avoidance and emotional numbing symptoms in PTSD and interpersonal worry common in GAD. Thus, the underlying social impairment common in these disorders suggests that fear of negative evaluation may help explain their relationship. Therefore, the current study examined 1) the relationship between fear of negative evaluation and PTSD, after accounting for GAD, and 2) the mediating role of fear of negative evaluation in the relationship between PTSD and GAD. Methods: Participants included 133 veterans (Mage = 49.38, 82% male) presenting to a Veterans Administration (VA) General Mental Health clinic for an initial intake evaluation. Veterans completed a brief assessment packet, including a demographic form and self-report measures of PTSD, GAD, and fear of negative evaluation. In particular, veterans completed the PTSD Symptom Checklist-5, Penn State Worry Questionnaire, and Brief Fear of Negative Evaluation. All measures demonstrated adequate internal consistency with the current sample. Results: Hierarchical multiple regression analysis revealed that more fear of negative evaluation was related to more PTSD symptoms (β = .22, p < .01), after accounting for GAD. Mediation analyses revealed that fear of negative evaluation partially explained the direct link between GAD and PTSD (β = .21, p < .001) and accounted for 43 percent of the variance. Specifically, more GAD symptoms were related to increased FNE (β = .43, p < .001), which in turn, was related to more PTSD symptoms (β = .73, p < .01). Conclusions: The social evaluative fears may be an important underlying factor contributing to the high comorbidity of PTSD and GAD.   

Margo Villarosa-Hurlocker

Psychology Intern
Southeast Louisiana Veterans Health Care System

Amanda MEDLEY.. Raines

Post-Doctoral Fellow
Southeast Louisiana Veterans HealthCare System (SLVHCS)

Thomas Hallinan

AMH Psychologist
Southeast Louisiana Veterans Health Care System

Shannon Hartley

AMH Psychologist
Southeast Louisiana Veterans Health Care System

Holly Mackenna

Psychiatrist
Southeast Louisiana Veterans Health Care System

C. Laurel Franklin

MIRECC Site Lead
Southeast Louisiana Veterans Health Care System (SLVHCS)