Positive emotion regulation strategies as mediators in depression and generalized anxiety disorder symptoms: A Transdiagnostic framework investigation

Savoring changes novel positive mindset targets of GAD treatment: Optimism, prioritizing positivity, kill-joy thinking, and worry mediation

This study analyzed effects of savoring on unstudied positive mindset targets of generalized anxiety disorder (GAD) treatment (ClinicalTrials.gov: NCT05040061). 85 students with GAD were randomly assigned to one of two ecological momentary interventions (EMIs) on smartphone for seven days. The SkillJoy EMI promoted practices for savoring positive emotions. An active control EMI mirrored SkillJoy, yet did not include savoring or positive emotion. Optimism, worry, kill-joy thinking (lessening positive emotion with cognition), and prioritization of positive emotion activities and goals were assessed at pre-trial, eighth-day, post-trial, and 30th-day follow-up. Savoring was assessed pre-trial and fifth-day mid-trial. Longitudinal linear mixed models and simple slope analyses examined change between and within conditions. Bias-corrected bootstrapping path analysis examined mediation of worry change by increased savoring. SkillJoy led to significantly greater increases in both optimism and prioritizing positivity than the control from pre-trial to post-trial and pre-trial to follow-up. Both interventions significantly reduced kill-joy thinking at both timepoints with Skilljoy leading to marginally greater change at post-trial. Pre- to mid-trial increases in savoring mediated the relationships between treatment condition and reductions in worry at both post-trial and follow-up.

Correlates of Dampening and Savoring in Generalized Anxiety Disorder

Chronic worry and generalized anxiety disorder (GAD) symptoms are associated with infrequent savoring, and high dampening, of positive emotions. The goal of the present study was to investigate the indirect role of GAD-relevant processes, including intolerance of uncertainty (IU), fear of negative emotional contrasts, and negative beliefs about positive emotion and its regulation, in the relationship between GAD symptom severity and the tendency to engage in dampening and not savor positive emotions. Community participants (N = 233) completed questionnaires online.

In separate models, IU, fear of negative emotional contrasts, and negative beliefs about positive emotion and its regulation fully mediated the relationships between GAD symptom severity and greater dampening and lower savoring. However, controlling for depression, only IU remained a significant mediator. A post hoc latent analysis of the mediators provided support for an underlying construct that may reflect intolerance of uncomfortable states. Intolerance of uncomfortable states was found to significantly mediate the relationship between GAD symptoms and greater dampening and lower savoring. Difficulty withstanding uncertainty may be particularly relevant in understanding why people with elevated GAD symptoms engage in efforts to avoid experiencing positive emotions. Further, the findings suggest that there may be a common factor underlying a variety of GAD-associated constructs reflecting a broad intolerance of uncomfortable inner states. Theoretical and clinical implications are discussed.