The Contrast Avoidance Model in Generalized Anxiety and Depression: A Longitudinal Panel Study

Abstract

Generalized anxiety disorder (GAD) and major depressive disorder (MDD) are two of the most commonly comorbid diagnoses (American Psychiatric Association, 2013), suggesting they may share etiological and maintenance processes, such as repetitive negative though (worry and rumination). The negative emotional contrast avoidance model (NECAM; Newman & Llera, 2011) provides a new framework for understanding the role of worry in GAD, but few investigations have explored the parallel role of rumination in MDD. This is problematic, as research illuminating transdiagnostic factors in GAD and MDD would prove highly influential in future conceptualizations and treatment of these disorders. This investigation sought to close this gap in this literature and hypothesized that emotional contrast avoidance would be positively associated with worry, rumination, generalized anxiety symptoms, and depressive symptoms cross-sectionally and that the relationships between emotional contrast avoidance and symptoms of generalized anxiety and depression would be longitudinally mediated by worry and rumination, respectively. Using a large adult sample, three waves of data collection over eight months, and structural equation modeling, the current study found that emotional contrast avoidance was positively associated with worry, rumination, generalized anxiety symptoms, and depressive symptoms cross-sectionally, but all hypothesized longitudinal paths were non-significant. Findings, as well as theoretical implications for the NECAM and other methodological and analytical considerations, are discussed.