A transdiagnostic evaluation of contrast avoidance across generalized anxiety disorder, major depressive disorder, and social anxiety disorder
Open accessAbstract
Background The contrast avoidance model (CAM) proposes that persons with generalized anxiety disorder (GAD) are sensitive to sharp increases in negative emotion or decreases in positive emotion (i.e., negative emotional contrasts; NEC) and use worry to avoid NEC. Sensitivity to and avoidance of NEC could also be a shared feature of major depressive disorder (MDD) and social anxiety disorder (SAD).Methods In a large college sample (N = 1409), we used receiver operating characteristics analysis to examine the accuracy of a measure of emotional contrast avoidance in detecting probable GAD, MDD, and SAD.Results Participants with probable GAD, MDD, and SAD all reported higher levels of contrast avoidance than participants without the disorder (Cohen's d = 1.32, 1.62 and 1.53, respectively). Area under the curve, a measure of predictive accuracy, was 0.81, 0.87, and 0.83 for predicting probable GAD, MDD, and SAD, respectively. A cutoff score of 48.5 optimized predictive accuracy for probable GAD and SAD, and 50.5 optimized accuracy for probable MDD.Conclusion A measure of emotional contrast avoidance demonstrated excellent ability to predict probable GAD, MDD, and SAD. Sensitivity to and avoidance of NEC appears to be a transdiagnostic feature of these disorders.
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Three single-arm trials showed that increased global trait mindfulness mediated the impact of mindfulness-based interventions on reduction in generalized anxiety disorder severity and perceived stress.
“Three single-arm trials showed that increased global trait mindfulness mediated the impact of MBIs on reduction in GAD severity [8] and perceived stress [9-11]”
From Treatment condition as a moderator and change in trait mindfulness as a mediator of a brief mindfulness ecological momentary intervention for generalized anxiety disorder (2024) · cites this paper as [10]
The Method > Procedures passage describes an online screening survey and analyses of contrast avoidance as a predictor of probable GAD, MDD, and SAD. Searches for global trait mindfulness, mindfulness-based interventions, single-arm trials, and perceived stress found no passage reporting the claimed mediation finding. No page numbers are available in our copy. (LLM, conf=0.76)
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- Authors
- Newman, M. G., Rackoff, G. N., Zhu, Y., & Kim, H.
- Affiliations
- Pennsylvania State University (US)
- University of Pennsylvania (US)
- University of Michigan (US)
- Corresponding author
- Newman, Michelle G.
- Venue
- Journal of Anxiety Disorders
- Publisher
- Elsevier BV
- Published
- 2023-01
- Volume
- 93
- Pages
- 102662
- ISSN
- 0887-6185 (ISSN-L)
- PMC
- PMC10080671
- OpenAlex
- W4312141060
- Cited by
- 42
- References
- 51
- Citations by year
- 2026: 10 · 2025: 8 · 2024: 13 · 2023: 9 · 2022: 2
- FWCI
- 7.35
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Journal of Anxiety Disorders (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- ScholarSphere (Penn State Libraries) (submittedVersion, cc-by-nc-nd)
- Funders
- National Institute of Mental Health (MH-39172)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- generalized anxiety disorder, major depressive disorder, social anxiety disorder, transdiagnostic features, worry, diagnostic prediction, university students
- MeSH terms
- Phobia, Social, Anxiety, Anxiety Disorders, Major Depressive Disorder, Emotions, Humans
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