Fishback Grace M, Chriki Lyvia, Thayer Julian F, Vasey Michael W
Department of Neurology, University of Colorado School of Medicine, Denver, CO, United States.
Private Practice, Newton, MA, United States.
Front Neurosci. 2020 Oct 7;14:569359. doi: 10.3389/fnins.2020.569359. eCollection 2020.
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 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 . 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.
矛盾的是，一些经历病理性担忧的个体对其思维也具有良好的自上而下的控制能力。然而，为什么这些个体仍然会过度担忧尚不清楚。一项研究提出了一种解释，该研究表明，经历病理性担忧的个体与健康对照组的区别在于，他们认为担忧有用，且有效的担忧要求他们在结束一轮担忧之前考虑所有可能性。这表明，具有良好认知控制能力的担忧者可能会持续长时间担忧，因为他们认为这样做是适应性的。在一个包含109名大学生的样本中（其中报告病理性担忧的个体比例过高），我们使用自上而下控制能力的客观指标（即静息时迷走神经介导的心率变异性[vmHRV]）以及关于担忧和广泛性焦虑障碍（GAD）症状严重程度/状态的自我报告测量方法来检验这一假设。正如预测的那样，GAD症状严重程度和vmHRV相互作用以预测对担忧的信念。具体而言，在vmHRV水平下，高GAD症状与认为担忧有用的信念最密切相关。此外，这种模式主要是因为相信担忧能使担忧者从更情绪化的事情上分心。同样，当vmHRV为 时，高GAD症状与对“尽可能多”（AMAC）解决问题规则的认可最密切相关。从相反的角度来看，在较高的vmHRV水平下，担忧有用性信念和AMAC规则认可都与最高的GAD症状严重程度相关。对于认为担忧能从更情绪化的事情上分心从而预测类似GAD状态的信念也是如此。这些结果表明，具有较高自上而下控制能力水平的担忧者可能会发起并持续担忧，至少在最初是因为他们重视担忧。然而，为什么他们仍然将自己 的担忧评为过度且无法控制，这是未来研究的一个重要问题。
