Avoidance of negative emotional contrast from worry and rumination: An application of the Contrast Avoidance Model

According to the Contrast Avoidance model (CAM), worry causes increased and sustained negative affect and such negative affect enables avoidance of a future sharp increase in negative emotion. However, only pathological worriers (vs. controls) view worry as a positive coping strategy to avoid a negative emotional contrast (NEC). We examined if rumination, which is another type of repetitive negative thought, would function similarly. Individuals with self-reported symptoms of pure generalized anxiety disorder (GAD; n=90), pure depression (MDD; n=85), and non-anxious/non-depressed controls (HC; n=93) were randomly assigned to conditions where they were asked to worry, ruminate, or relax. Emotional and physiological changes were measured during worry and subsequent exposure to fearful and sad videos. We also assessed participant group differences in preference for worry or rumination as a strategy to cope with negative affect during the negative emotional video exposures. Consistent with CAM, regardless of the group, both worry and rumination enabled avoidance of NEC. Whereas worry led to greater avoidance of a fear contrast, rumination led to greater avoidance of a sadness contrast. On the other hand, relaxation enhanced NEC. Skin conductance also indicated patterns in line with CAM. In the subjectively perceived preference, the GAD group reported a greater preference for worry in coping with a fear contrast than HC. However, such a salient pattern was not found for the MDD group. Treatment implications of these findings are discussed.