Impulsivity and Emotional Regulation in Generalized Anxiety Disorder

Le 30 novembre 2020
De 10h00 à 12h00

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Introduction: Although anxiety and impulsivity are intuitively thought to be inversely correlated, increased impulsivity has been associated both with generalized anxiety disorder (GAD) diagnosis and GAD symptoms in non clinical samples. The emotional dysregulation model of GAD posits that patients experience more frequent and intense negative emotions while having poor regulatory control over emotional states and greater negative reactivity to their emotions. We hypothesized that poor regulatory control in the presence of negative emotions might explain the increased impulsivity found in GAD patients.

Methods : Thirty four GAD patients and thirty five healthy controls were included, and evaluated with measurements of impulsivity, negative and positive emotions, the severity of worrying and GAD symptoms, depression and 5-factor personality traits. General GAD symptoms were measured using the GAD-7. Worrying severity, the cardinal symptom of GAD, was accessed by the Penn-State Worry Questionnaire (PSWQ). Impulsivity was measured by Barratt Impulsiviness Scale (BIS-11) which accesses 3 facets of impulsivity: motor, cognitive and non-planning. Negative and positive affectivity were measured using the Positive and Negative Affect Schedule (PANAS) and personality factors were measured using a list of trait-describing adjectives developed in Brazilian Portuguese by Hutz et al which replicates the Big-5 factor structure.

Results: Global impulsivity scores and the attentional facet of impulsivity were higher in the patient group when compared to the controls. Negative affect was correlated with global impulsivity in the patient group only and explained impulsivity in our regression model while worrying and depressive symptoms did not. To evaluate patient status effects on impulsivity using only second-order factors, we performed a one-way between-subjects multivariate analysis of variance (MANOVA)  using the 3 second order subscales ( attention, motor, and non-planning) as dependent variables. Negative affect (NA) scores were strongly correlated with BIS in the patient group ( r = 0.473, p = 0.005) but not in the control group ( r = 0.053, p = 0.767)

Conclusion: Our results confirm our hypothesis that individuals with GAD report increased impulsivity in general when compared to healthy controls, which is specially related to the attentional facet of the BIS. We also confirmed the hypothesis that NA correlated with impulsivity score only in the patient subgroup and that NA mediates the effect of GAD diagnosis in self-reported impulsivity. Thus, increased impulsivity in GAD seems to be mediated by the increased presence of negative emotions, as it is common in mood and impulse control disorders, indicating an unspecific shared vulnerability factor to psychopathology.