|About the Book|
General anxiety disorder (GAD) is the least understood and most treatment refractory of all the anxiety disorders. Contemporary models of GAD posit that worry functions as an avoidance strategy of strong emotions, including threat-related mentalMoreGeneral anxiety disorder (GAD) is the least understood and most treatment refractory of all the anxiety disorders. Contemporary models of GAD posit that worry functions as an avoidance strategy of strong emotions, including threat-related mental imagery and associated autonomic reactivity, indicating underlying emotion regulation deficits. The current study examined the relationship between emotion regulation deficits, self-reported worry, and other GAD symptoms in a sample of older adults diagnosed with GAD and a nonanxious control group matched on age. Consistent with predictions, the GAD sample reported more difficulties with emotion regulation than non-anxious older adults. Effects were found on total measure scores, and on specific emotion dysregulation subscales including: lack of awareness of emotions, non-acceptance of emotional experience, difficulties engaging in goal-directed behavior when experiencing negative emotions, and lack of access to emotion regulation strategies perceived as effective. These general and specific emotion regulation deficits, except for non-acceptance of emotional experience, significantly predicted worry even after variance accounted for by anxiety and depression was controlled. Also consistent with predictions, after being treated with a standard CBT protocol for GAD, responders (i.e. those no longer meeting DSM-IV-TR criteria for a diagnosis of GAD) reported a significant improvement in general emotion regulation skills and improvement in access to emotion regulation strategies perceived as effective, as compared to the group of older adults with GAD who did not respond to treatment or were in the wait-list condition. Responders also reported significant improvements in difficulties engaging in goal-directed behavior when experiencing negative emotions and lack of awareness of emotions. These findings provide additional preliminary evidence for an emotion regulation deficit model of GAD, and the first such evidence from an older adult clinical sample. Continued integration of treatments and techniques focused on improving emotion regulation and emotionality are needed to improve outcomes.