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广泛性焦虑和担忧的对比回避模型的前瞻性研究。

Prospective Investigation of the Contrast Avoidance Model of Generalized Anxiety and Worry.

作者信息

Crouch Tara A, Lewis Jamie A, Erickson Thane M, Newman Michelle G

机构信息

Seattle Pacific University.

Seattle Pacific University.

出版信息

Behav Ther. 2017 Jul;48(4):544-556. doi: 10.1016/j.beth.2016.10.001. Epub 2016 Oct 29.

Abstract

The factors that maintain generalized anxiety disorder (GAD) symptoms and worry over time are not entirely clear. The Contrast Avoidance Model (CAM) postulates that individuals at risk for pathological worry and GAD symptoms uniquely fear emotional shifts from neutral or positive emotions into negative emotional states, and consequently use worry to maintain negative emotion in order to avoid shifts or blunt the effect of negative contrasts. This model has received support in laboratory experiments, but has not been investigated prospectively in the naturalistic context of daily life. The present study tested the CAM in a longitudinal experience sampling study with a subclinical sample. Participants selected to represent a broad range of symptoms (N = 92) completed baseline measures of GAD and depression symptoms, and eight weekly assessments of worry, experiences of negative emotional contrasts during their worst event of the week, and situation-specific negative emotion. Consistent with the CAM, GAD symptoms prospectively predicted higher endorsement of negative contrast experiences as worst events, independent of depression symptoms. Unsurprisingly, higher negative contrasts predicted higher negative emotion. However, both higher baseline GAD symptoms and weekly worry uniquely moderated (reduced) this relationship, providing consistent support for the idea that worry may blunt the emotional effects of contrasts. Depression symptoms did not have the same moderating effect. These findings support the CAM in an ecologically valid context.

摘要

长期维持广泛性焦虑障碍(GAD)症状和担忧的因素尚不完全清楚。对比回避模型(CAM)假设,有病理性担忧和GAD症状风险的个体特别害怕情绪从中性或积极情绪转变为消极情绪状态,因此会利用担忧来维持消极情绪,以避免情绪转变或减弱消极对比的影响。该模型在实验室实验中得到了支持,但尚未在日常生活的自然情境中进行前瞻性研究。本研究在一项针对亚临床样本的纵向经验抽样研究中对CAM进行了测试。被选中代表广泛症状范围的参与者(N = 92)完成了GAD和抑郁症状的基线测量,以及对担忧、一周中最糟糕事件期间的消极情绪对比经历和特定情境下消极情绪的八次每周评估。与CAM一致,GAD症状前瞻性地预测了将消极对比经历视为最糟糕事件的更高认可度,且与抑郁症状无关。不出所料,更高的消极对比预测了更高的消极情绪。然而,更高的基线GAD症状和每周的担忧都独特地调节(减弱)了这种关系,为担忧可能减弱对比的情绪影响这一观点提供了一致的支持。抑郁症状没有同样的调节作用。这些发现在生态有效情境中支持了CAM。

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