(PS8-C65) Using a Behavioral Paradigm of Uncertainty to Investigate Emotion Regulation Among Individuals with and Without Generalized Anxiety Disorder Symptoms

Background: Research on the established theoretical models of generalized anxiety disorder (GAD; e.g., Behar et al., 2009) indicate two transdiagnostic processes prominent in the development and maintenance of GAD. The intolerance of uncertainty (IU) theory proposes that those with GAD find uncertainty and uncertain situations to be anxiety provoking and distressing (Dugas et al., 1998). In addition,  individuals with GAD experience deficits in emotion regulation (ER) abilities, with worry as a primary ER strategy (Mennin et al., 2005). Only four studies to date have specifically examined the association between IU and ER (e.g., Bottesi et al., 2018), and none of these studies have looked at the interconnection of these processes in GAD. The current study used an experimental design to investigate the association between ER deficits and the behavioral and emotional responses to an induced state of uncertainty in those with and without GAD symptoms. In particular, we predicted that GAD group status would predict emotional and behavioral outcomes after an uncertain task, after controlling for baseline negative affect and IU. Further, it was expected that GAD status would be associated with the outcomes via ER deficits.

Methods: Participants (N = 137; M_age = 18.74; 79.6% female; 84.7% White) completed an online survey and behavioral task. The battery included measures of anxiety (GAD-Q-IV; Newman et al., 2002), IU (IUS; Buhr & Dugas, 2002), ER (DERS; Gratz & Roemer, 2004), and emotional and behavioral responses to an uncertainty task (Beads Task; Jacoby et al., 2016). The GAD group (n = 68) screened positive for clinical levels of GAD based on the GAD-Q-IV (M = 8.87, SD = 1.63), whereas the control group (n = 69) endorsed low or no GAD symptoms (M = 2.11, SD = 1.78). A series of hierarchical multiple linear regression and mediation analyses were conducted to examine the the study hypotheses.

Results: Bivariate correlations yielded significant associations between the study variables (rs = .32 - .92; p < .001). After controlling for baseline variables, GAD status was significantly associated with distress (R² = .28, p = .003) and anxiety (R² = .34, p = .001), contributing an additional 5.0% and 5.3% of variance in negative affect, respectively. Supporting the hypothesis, an indirect effect was observed for distress (B = 8.14, [95% CI: 0.67, 16.29]) and anxiety (B = 7.62, [95% CI: 0.52, 15.13]). Specifically, GAD status contributed to increased emotion dysregulation, which in turn, was associated with higher negative affect. Additional analyses evaluating the behavioral outcomes will be conducted and presented. These data are collected, but were not available at the time of submission. 

Discussion: This study provides preliminary support for the simultaneous roles ER and uncertainty in those with and without GAD symptoms. Further work is needed to evaluate the connections between ER and IU to inform treatment improvements for those with GAD. Understanding the intersection of ER and GAD symptoms in uncertainty is important for further understanding how people with mental health issues, particularly GAD, function in highly uncertain situations, such as crises, emergencies, and pandemics (e.g., COVID-19).