title: Worry as an adaptive avoidance strategy in healthy controls but not in pathological worriers.
abstract: The cognitive avoidance model of worry assumes that worry has the adaptive function to keep under control the physiological arousal associated with anxiety. This study aimed to test this model by the use of a fear induction paradigm in both pathological and healthy individuals. Thirty-one pathological worriers and 36 healthy controls accepted to be exposed to a fear induction paradigm (white noise) during three experimental conditions: worry, distraction, and reappraisal. Skin conductance (SCR) and heart rate variability (HRV) were measured as indices of sympathetic and parasympathetic nervous system functioning. Worriers showed increased sympathetic and decreased parasympathetic activation during the worry condition compared to non-worriers. There were no differences between groups for the distraction and reappraisal conditions. SCRs to the white noises during worry were higher in worriers versus controls throughout the entire worry period. Intolerance of uncertainty - but not metacognitive beliefs about worry - was a significant moderator of the relationship between worry and LF/HF-HRV in pathological worriers. Results support the cognitive avoidance model in healthy controls, suggesting that worry is no longer a functional attitude when it becomes the default/automatic and pathological response.
authors.affiliation: IRCCS Santa Lucia Foundation, Rome, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Ottaviani
authors.affiliation: Department of Psychology, University of Bologna, Bologna, Italy.
authors.forename: Rosita
authors.initials: R
authors.lastname: Borlimi
authors.affiliation: Department of Psychology, University of Bologna, Bologna, Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Brighetti
authors.affiliation: Studi Cognitivi, Post Graduate Cognitive Psychotherapy School, Milano, Modena and San Benedetto del Tronto, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Caselli
authors.affiliation: Studi Cognitivi, Post Graduate Cognitive Psychotherapy School, Milano, Modena and San Benedetto del Tronto, Italy; Azienda Sanitaria di Bolzano, Italy.
authors.forename: Ettore
authors.initials: E
authors.lastname: Favaretto
authors.affiliation: Studi Cognitivi, Post Graduate Cognitive Psychotherapy School, Milano, Modena and San Benedetto del Tronto, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Giardini
authors.affiliation: Studi Cognitivi, Post Graduate Cognitive Psychotherapy School, Milano, Modena and San Benedetto del Tronto, Italy.
authors.forename: Camilla
authors.initials: C
authors.lastname: Marzocchi
authors.affiliation: Department of Psychology, University of Bologna, Bologna, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Nucifora
authors.affiliation: Studi Cognitivi, Post Graduate Cognitive Psychotherapy School, Milano, Modena and San Benedetto del Tronto, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Rebecchi
authors.affiliation: Psicoterapia Cognitiva e Ricerca, Post Graduate Cognitive Psychotherapy School, Milano and Bolzano, Italy. Electronic address: grupporicerca@studicognitivi.net.
authors.forename: Giovanni M
authors.initials: GM
authors.lastname: Ruggiero
authors.affiliation: Studi Cognitivi, Post Graduate Cognitive Psychotherapy School, Milano, Modena and San Benedetto del Tronto, Italy.
authors.forename: Sandra
authors.initials: S
authors.lastname: Sassaroli
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D000328:Adult; D001007:Anxiety / Q000523:psychology*; D001008:Anxiety Disorders / Q000503:physiopathology* / Q000523:psychology*; D001362:Avoidance Learning / Q000502:physiology*; D005260:Female; D005712:Galvanic Skin Response / Q000502:physiology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D012727:Sex Characteristics; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Cognitive avoidance model; Heart rate variability; Skin conductance response; White noise; Worry