Honors Theses
Date of Award
Spring 5-8-2022
Document Type
Undergraduate Thesis
Department
Psychology
First Advisor
Laura Dixon
Relational Format
Dissertation/Thesis
Abstract
Generalized Anxiety Disorder (GAD) features excessive worry, with additional symptoms including sleep disturbances, muscle tension, concentration issues, fatigue, and irritability (APA, 2013). The Contrast Avoidance Model (CAM) posits that those with GAD maintain worry to avoid emotional shifts by engaging in contrast avoidance (CA) tendencies (Newman & Llera, 2011). Additionally, chronic worry is associated with dysfunctional outcomes of GAD such as sleep difficulties and quality of life (QoL; Henning et al., 2007; Smith et al., 2000). Although both CA tendencies and these dysfunctional outcomes of GAD have shown to be related to worry, CA tendencies have yet to be explored in relation to sleep difficulties and QoL among those with GAD. However, an association between these variables may further explain the perpetuation of adverse outcomes in GAD. The current study assessed associations between GAD severity, CA tendencies, sleep difficulties, and QoL among adults who endorsed anxiety. It was hypothesized that CA tendencies would be significantly correlated with sleep difficulties and poor QoL, and that CA tendencies would mediate the association between GAD severity and both sleep difficulties and QoL. This study was conducted through CloudResearch (Litman et al., 2017), where participants were recruited from a panel of individuals who endorsed anxiety symptoms. The sample included 255 individuals (Mage = 38.33; SD = 10.86), who were predominately White (88.2%) and female (70.6%). Participants completed self-report measures of GAD severity (GAD-Q-IV; Newman et al., 2002), CA tendencies (CA Questionnaire General Emotion [CAQ-GE]; Llera & Newman, 2017), sleep difficulties (Insomnia Severity Index [ISI]; Bastien et al., 2001), and QoL (Q-LES-Q-SF; Mendlowicz & Stein, 2000). Within the sample, 72.5% of participants reported GAD symptoms at or above the clinical cutoff on the GAD-Q-IV. As predicted, significant correlations were observed between CA tendencies and sleep difficulties (r = .43) and QoL (r = -.34). Two mediation analyses were conducted using PROCESS Macro to estimate the indirect effect of CA tendencies (Hayes, 2022). The overall models were significant for both sleep difficulties (F = 53.81, p < .001) and QoL (F = 138.72, p < .001), accounting for 30% and 20% of the variance, respectively. As predicted, CA significantly mediated the link between GAD severity and sleep difficulties, (B = 0.16, 95% CI[0.023, 0.291]), but not QoL, (B = -0.11, 95% CI[-.254, 0.029]); however, CA tendencies was significantly negatively correlated with QoL (r = -.34, p < .001). The results replicate prior work by demonstrating the role of CA tendencies on GAD severity and the effect of GAD severity on dysfunctional outcomes. These results expand our understanding of how CA tendencies relate to the development of dysfunctional outcomes of GAD, indicating that CA may be important to consider when examining sleep difficulties among those with GAD symptoms. Additionally, these findings suggest the potential benefit of screening for CA tendencies in populations struggling with severe sleep difficulties, particularly insomnia.
Recommended Citation
Shepherd, Whitney S., "The Relationship Between the Contrast Avoidance Model and Dysfunctions of Generalized Anxiety Disorder" (2022). Honors Theses. 2565.
https://egrove.olemiss.edu/hon_thesis/2565
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