The relations among worry, meta-worry, intolerance of uncertainty and attentional bias for threat in men at high risk for generalized anxiety disorder: a network analysis

Abstract

Background: Improving the psychotherapies for generalized anxiety disorder (GAD) is dependent on a deeper understanding of the relations between GAD and its associated cognitive factors. In the present study, we investigate how the core feature of GAD (i.e., worry) and its associated cognitive factors, such as meta-worry, intolerance of uncertainty, and attention bias towards threat, relate to each other in men at high risk for GAD.

Methods: We used network analysis to explore the relations among these variables in a cross-sectional sample of 122 men at high risk for generalized anxiety disorder. Specifically, we computed the expected influence and predictability of each variable.

Results: In the final network, we found that worry and meta-worry had the highest expected influence and predictability. In contrast, attention bias towards threat showed the lowest expected influence and predictability. The estimates of the expected influence of the nodes were stable (correlation stability coefficient = 0.52).

Conclusions: The present study is the first to investigate the relations among worry, meta-worry, intolerance of uncertainty, and attention bias towards threat in men at high risk for generalized anxiety disorder. These findings indicate that worry and meta-worry may play important roles in the present network. The implications for clinical interventions and future studies are discussed.

Keywords: Attention bias; Generalized anxiety disorder; High risk; Intolerance of uncertainty; Meta-worry; Network analysis; Worry.

Fig. 1

Regularized partial correlation network. Blue edges represent positive correlation, red edges represent negative correlation. The rings around nodes depict its predictability. AB = attention bias towards threat; MW = meta-worry; IU = intolerance of uncertainty; WO = worry

Fig. 2

Z-scored expected influence of each variable. AB = attention bias towards threat; MW = meta-worry; IU = intolerance of uncertainty; WO = worry

Fig. 3

Accuracy of edge weights. The sample edge-weight is depicted by red line and the bootstrap mean edge-weight is depicted by black line. The bootstrapped confidence interval is depicted by gray area

Fig. 4

Stability of node expected influences. The red line depicts the average correlation between expected influence in the whole sample and subsample with the red area depicting the 2.5th quantile to the 97.5th quantile