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. 2020 Oct 7:14:569359.
doi: 10.3389/fnins.2020.569359. eCollection 2020.

Heart Rate Variability Moderates the Association Between Beliefs About Worry and Generalized Anxiety Disorder Symptoms

Grace M Fishback  1 , Lyvia Chriki  2 , Julian F Thayer  3 , Michael W Vasey  4
Affiliations

Heart Rate Variability Moderates the Association Between Beliefs About Worry and Generalized Anxiety Disorder Symptoms

Grace M Fishback et al. Front Neurosci. .

Abstract

Paradoxically, some individuals who experience pathological worry also have good capacity for top-down control over their thoughts. Why such individuals would nevertheless worry excessively remains unclear. One explanation is suggested by research showing that those experiencing pathological worry are set apart from healthy controls by their beliefs that worry has utility and that effective worrying requires them to consider all possibilities before terminating a worry bout. This suggests that worriers with good capacity for cognitive control may engage in prolonged worry because they believe it is adaptive to do so. In a sample of 109 college students, among whom individuals reporting pathological worry were overrepresented, we tested this hypothesis using an objective index of top-down control capacity (i.e., resting vagally mediated heart rate variability [vmHRV]) and self-report measures of beliefs about worry and generalized anxiety disorder (GAD) symptom severity/status. As predicted, GAD symptom severity and vmHRV interacted to predict beliefs about worry. Specifically, high GAD symptoms were most strongly associated with beliefs that worry has utility at higher levels of vmHRV. Furthermore, this pattern was mostly a function of the belief that worry serves to distract the worrier from more emotional things. Similarly, high GAD symptoms were most strongly associated with endorsement of an 'as many as can' (AMAC) problem-solving rule when vmHRV was high. From the opposite perspective, both worry utility beliefs and AMAC rule endorsement were associated with the highest GAD symptom severity at higher levels of vmHRV. This was also true for the belief that worry distracts from more emotional things predicting analog GAD status. These results suggest that worriers who have higher levels of top-down control capacity may initiate and persist in worry, at least initially, because they value it. However, why they nevertheless rate their worry as excessive and uncontrollable is an important question for future research.

Keywords: cognitive control capacity; generalized anxiety disorder; heart rate variability; worry; worry beliefs.

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Figures

FIGURE 1
FIGURE 1
GAD symptom severity predicting worry utility beliefs score at high (+ 1 SD) and low (−1 SD) vmHRV.
FIGURE 2
FIGURE 2
GAD symptom severity predicting worry distracts score at high (+ 1 SD) and low (−1 SD) vmHRV.
FIGURE 3
FIGURE 3
GAD symptom severity predicting ‘As Many As Can’ rule endorsement at high (+ 1 SD) and low (−1 SD) vmHRV.
FIGURE 4
FIGURE 4
Worry utility beliefs score predicting GAD symptom severity at high (+ 1 SD) and low (−1 SD) vmHRV.
FIGURE 5
FIGURE 5
Worry distracts score predicting GAD symptom severity at high (+ 1 SD) and low (−1 SD) vmHRV.
FIGURE 6
FIGURE 6
‘As Many As Can’ rule endorsement predicting GAD symptom severity at high (+ 1 SD) and low (−1 SD) vmHRV.
FIGURE 7
FIGURE 7
Worry distracts score predicting probability of analog GAD diagnosis at high (+ 1 SD) and low (−1 SD) vmHRV.
FIGURE 8
FIGURE 8
‘As Many As Can’ rule endorsement predicting analog GAD at high (+ 1 SD) and low (−1 SD) vmHRV.
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