Reducing contrast avoidance in GAD by savoring positive emotions: Outcome and mediation in a randomized controlled trial. (January 2023)

• Record Type: Journal Article
• Authors: LaFreniere, Lucas S.; Newman, Michelle G.
• Is Part Of: Journal of anxiety disorders. Volume 93(2023)
• Publication Date: 2023-01
• Subjects: Contrast avoidance -- Generalized anxiety disorder -- Savoring -- Positive emotion -- Worry; Anxiety -- Periodicals; Anxiety Disorders -- Periodicals; Angoisse -- Périodiques; Electronic journals; 616.8522
• DOI: 10.1016/j.janxdis.2022.102659
• Languages: English
• ISSNs: 0887-6185

Abstract

Abstract: This secondary analysis of a randomized controlled trial (RCT) examined whether contrast avoidance (CA) in Generalized Anxiety Disorder (GAD) could be reduced through savoring—purposeful engagement with positive emotions. 85 participants were diagnosed with GAD by both questionnaire and clinical interview. They were then randomly assigned to one of two seven-day smartphone-delivered ecological momentary interventions (EMIs). The SkillJoy EMI facilitated in-the-moment practice of savoring positive emotions in participants' daily lives. The active self-monitoring control (ASM) was nearly identical to SkillJoy in ratings, activities, and language, yet omitted specific attention to positive emotion and savoring. CA was assessed by questionnaire at pre-trial and post-trial. Savoring was assessed by questionnaire at pre-trial and fifth-day mid-trial. Longitudinal linear mixed models and simple slope analyses examined CA change between and within conditions. Bias-corrected boot strapping path analysis examined mediation by savoring using individuals' CA slopes extracted from a multilevel model as outcome. Results showed that SkillJoy led to significant reductions in CA, whereas the ASM control did not. The relation between treatment condition and reduction in CA was mediated by increases in savoring from pre- to mid-trial. It may be possible for treatment to meaningfully reduce CA in GAD, specifically through savoring practices. Highlights: An RCT compared savoring practices to a control on changes in contrast avoidance. Savoring practices significantly reduced contrast avoidance. The control did not. Reductions in contrast avoidance were mediated by increases in savoring.