Cognitive Control and Anxious Arousal in Worry and Generalized Anxiety: An Initial Test of an Integrative Model

Abstract

Pathological worry is thought to persist, in part, because it fosters avoidance of unpleasant internal experience. However, current models disagree as to whether worry serves that function because: (1) it suppresses high levels of autonomic arousal (AA) symptoms or (2) it leads to persistent heightened AA symptoms. In fact, pathological worry and generalized anxiety disorder (GAD) are linked to both high and low levels of AA symptoms. To account for this heterogeneity, we propose an integrative model, which predicts that AA symptoms vary as a function of the worrier’s capacity to perform the subtle cognitive maneuver necessary to avoid such arousal. We review evidence supporting this model and report an initial test in a large college sample. Our results provide clear support for the major premise of our model: AA symptoms in worry and GAD vary as a function of individual differences in cognitive control capacity.