Department of Psychology, University of Pittsburgh, 210 S. Bouquet St., Pittsburgh, PA 15260, United States; Anxiety Disorders Center, Institute of Living, Hartford Hospital, 200 Retreat Ave, Hartford, CT 06106, United States.
Anxiety Disorders Center, Institute of Living, Hartford Hospital, 200 Retreat Ave, Hartford, CT 06106, United States; Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, United States.
J Anxiety Disord. 2019 May;64:71-78. doi: 10.1016/j.janxdis.2019.02.004. Epub 2019 Feb 28.
Generalized anxiety disorder (GAD) is defined in part by excessive and uncontrollable worry. However, little is known about cognitive control abilities in adults with GAD. The present study examined cognitive control over negative and neutral material in a mixed clinical sample of adults with GAD and/or obsessive-compulsive disorder and a comparison healthy control sample. Participants completed a novel emotional variant of the AX-CPT (eAX-CPT) to index proactive and reactive cognitive control in the presence of negative and neutral distractor stimuli. Participants with GAD demonstrated enhanced cognitive control specifically over negative emotional distractors, relative to neutral distractors (within-subjects) and relative to OCD and controls (between-subjects). Findings were specific to GAD versus trait worry; however, higher trait worry predicted better cognitive control in GAD only. These findings are inconsistent with deficit-based cognitive models of GAD and may be better accounted for by models that conceptualize worry as an intentional (albeit maladaptive) cognitive control or emotion regulation strategy that is actively maintained by individuals with GAD in order to avoid engaging with more distressing emotional information.
广泛性焦虑障碍（GAD）的部分定义是过度且无法控制的担忧。然而，对于 GAD 成年人的认知控制能力知之甚少。本研究在 GAD 和/或强迫症的混合临床样本以及健康对照组中，检查了对负面和中性材料的认知控制。参与者完成了一种新颖的情绪性 AX-CPT（eAX-CPT），以在存在负面和中性干扰刺激的情况下对前摄性和反应性认知控制进行索引。与中性干扰物（在个体内）和强迫症及对照组（在个体间）相比，GAD 患者在负性情绪干扰物上表现出增强的认知控制。研究结果仅与 GAD 与特质性担忧有关；然而，较高的特质性担忧仅预示着 GAD 中的认知控制更好。这些发现与 GAD 的基于缺陷的认知模型不一致，而可以通过将担忧视为个体为避免处理更令人痛苦的情绪信息而主动维持的有意（尽管适应不良）认知控制或情绪调节策略的模型更好地解释。
