Expanding our conceptualization of excessive worry and GAD : the role of fear and avoidance of emotional experiences

Fear of emotional responding and experiential avoidance may play an important role in excessive worry and generalized anxiety disorder (GAD). The goal of the first study was to replicate previous research findings by investigating the role of fear and avoidance of emotional experiences in problematic worry and GAD. Moreover, the study served as an extension of previous research by contrasting the relationship between fear and avoidance of emotional responding and excessive worry with constructs already linked to worry and GAD, such as intolerance of uncertainty. Findings from a nonclinical sample indicated that fear of emotions, in particular fear of anxiety, and experiential avoidance were significantly related to excessive worry, which is the defining feature of GAD. Worry was also highly associated with intolerance of uncertainty. Additional analyses revealed that fear of anxiety, experiential avoidance, and intolerance of uncertainty, all made significant and unique contributions to the prediction of worry. Finally, the results suggested that the tendency to fear and avoid emotional experiences was related to GAD diagnostic criteria. The goal of the second study was to clarify the role of fear of anxiety in worry by assessing whether the experimental manipulation of fear of anxiety affected worry level. The study also assessed the combined effects of fear of anxious responding and intolerance of uncertainty on level of worry by grouping participants according to their tolerance for uncertainty. The results indicated that participants whose fear of anxiety was increased showed higher levels of worry compared to participants whose fear of anxiety was decreased. This finding provides preliminary support for the causal role of fear of anxiety in worry. Moreover, the results showed that increased fear of anxiety in combination with an intolerance for uncertainty led to the highest levels of worry, which suggests that these constructs have an additive effect on worry. The findings from the present research lend support to the integration of new conceptualizations of psychopathology with existing models of excessive worry, which could ultimately increase treatment efficacy for GAD