Abstract
Paradoxically, some individuals who experience pathological worry also have good capacity for top-down control over their thoughts. Why such individuals would nevertheless worry excessively remains unclear. One explanation is suggested by research showing that those experiencing pathological worry are set apart from healthy controls by their beliefs that worry has utility and that effective worrying requires them to consider all possibilities before terminating a worry bout. This suggests that worriers with good capacity for cognitive control may engage in prolonged worry because they believe it is adaptive to do so. In a sample of 109 college students, among whom individuals reporting pathological worry were overrepresented, we tested this hypothesis using an objective index of top-down control capacity (i.e., resting vagally mediated heart rate variability [vmHRV]) and self-report measures of beliefs about worry and generalized anxiety disorder (GAD) symptom severity/status. As predicted, GAD symptom severity and vmHRV interacted to predict beliefs about worry. Specifically, high GAD symptoms were most strongly associated with beliefs that worry has utility at higher levels of vmHRV. Furthermore, this pattern was mostly a function of the belief that worry serves to distract the worrier from more emotional things. Similarly, high GAD symptoms were most strongly associated with endorsement of an ‘as many as can’ (AMAC) problem-solving rule when vmHRV was high. From the opposite perspective, both worry utility beliefs and AMAC rule endorsement were associated with the highest GAD symptom severity at higher levels of vmHRV. This was also true for the belief that worry distracts from more emotional things predicting analog GAD status. These results suggest that worriers who have higher levels of top-down control capacity may initiate and persist in worry, at least initially, because they value it. However, why they nevertheless rate their worry as excessive and uncontrollable is an important question for future research.
Highlights
Generalized anxiety disorder (GAD), is characterized by uncontrollable and excessive worry
GAD symptom severity was uncorrelated with resting vagally mediated heart rate variability (vmHRV) (r = −0.01, p = 0.948)
Item #7 of the Problem Solving Inventory (PSI) did not correlate significantly with GAD symptom severity. It was significantly positively correlated with the “worry distracts from more emotional things” item (#5) on the Reasons to Worry Questionnaire (RWQ) (r = 0.22, p < 0.05)
Summary
Generalized anxiety disorder (GAD), is characterized by uncontrollable and excessive worry (i.e., pathological worry; American Psychiatric Association [APA], 2013). A review by Hebert et al (2014) showed that worry utility beliefs characterize individuals diagnosed with GAD (e.g., Borkovec and Roemer, 1995; Ladouceur et al, 1998; Newman and Llera, 2011), GAD-analogs (e.g., Freeston et al, 1994), and high worriers (e.g., Davey et al, 1996; Laugesen et al, 2003) Such beliefs are associated with higher levels of worry in response to stressful events (Iijima and Tanno, 2013). We predicted that (1) GAD symptom severity should be most strongly, positively correlated with worry utility beliefs among individuals with high levels of resting vmHRV because they are able to use their capacity for cognitive control in the service of worrying. Too did we predict (6) that endorsement of an AMAC rule would be most strongly, positively correlated with GAD severity/status among those with higher levels of vmHRV
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