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Regulatory focus and anxiety: A self-regulatory model of GAD-depression comorbidity
Open accessAbstract
The etiology of generalized anxiety disorder (GAD), including its high degree of comorbidity with major depressive disorder (MDD), remains a conceptual and clinical challenge. In this article, we discuss the relevance of regulatory focus theory, an influential theory of self-regulation, for understanding vulnerability to GAD as well as GAD/MDD comorbidity. The theory postulates two systems for pursuing desired end states: the promotion and prevention systems. Drawing upon studies documenting the affective and motivational consequences of failing to attain promotion versus prevention goals, as well as the literature linking promotion failure with depression, we propose how dysfunction within the prevention system could lead to GAD - with, as well as without, MDD.
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“GAD, especially when comorbid with MDD, can be seen as characterized by subjective emotional intensity/distress20, reflecting greater temperamental negative affect25–26 and activation of motivational systems that prize obtaining safety (from perceived threat) over seeking reward27–29 [motivational mechanisms].”
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In the citing paper
“The comorbidity between GAD and depression is more the rule than the exception (Klenk et al., 2011), with studies estimating it at up to 80% of the cases (Judd et al., 1998; Lamers et al., 2011).”
From A Multiple-Baseline Evaluation of Acceptance and Commitment Therapy Focused on Repetitive Negative Thinking for Comorbid Generalized Anxiety Disorder and Depression (2020) · cites this paper as Klenk et al., 2011
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“emerging evidence that promotion/prevention goals may be supported by differential neural patterns (Eddington et al., 2009; Klenk, Strauman, & Higgins, 2011).”
From Extension of the Transdiagnostic Model to Focus on Intolerance of Uncertainty: A Review of the Literature and Implications for Treatment (2014) · cites this paper as Klenk, Strauman, & Higgins, 2011
In the citing paper
“In accounting for GAD, especially when it co-occurs with MDD, Klenk et al. (2011) postulate primary failure in the prevention system (i.e., hyperactivation) that in turn can lead to failure (e.g., hypoactivation) in the promotion system.”
From Emotion Regulation Therapy: A Mechanism-Targeted Treatment for Disorders of Distress (2017) · cites this paper as Klenk et al., 2011
In the citing paper
“Individuals with distress disorders frequently experience conflicting pulls from reward/loss and safety/threat systems and lack the means to effectively resolve these motivation conflicts.”
From Emotion Regulation Therapy: A Mechanism-Targeted Treatment for Disorders of Distress (2017) · cites this paper as Klenk et al., 2011
In the citing paper
“patients with distress disorders, especially GAD and MDD are characterized by intense emotional experiences resulting in an inordinately cautious manner that favors protection over promotion (Woody and Rachman, 1994; Chorpita et al., 1998; Klenk et al., 2011).”
From Emotion Regulation Therapy: A Mechanism-Targeted Treatment for Disorders of Distress (2017) · cites this paper as Klenk et al., 2011
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Cites
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Promotion and Prevention: Regulatory Focus as A Motivational Principle
Higgins, E. T. (1998) · Advances in Experimental Social Psychology · doi:10.1016/s0065-2601(08)60381-0 · Cited by 3,511
Self-citationOrigins and functions of positive and negative affect: A control-process view.
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Petrou, P., Demerouti, E., & Schaufeli, W. B. (2016) · Journal of Management · doi:10.1177/0149206315624961 · Cited by 533
Shanahan, L., Copeland, W., Angold, A. C., Bondy, C. L., & Costello, E. J. (2014) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2013.12.029 · Cited by 306
Zbozinek, T. D., Rose, R. D., Wolitzky-Taylor, K. B., Sherbourne, C. D., Sullivan, G., Stein, M. B., Roy‐Byrne, P., & Craske, M. G. (2012) · Depression and Anxiety · doi:10.1002/da.22026 · Cited by 246
Einstein, D. A. (2014) · Clinical Psychology: Science and Practice · doi:10.1111/cpsp.12077 · Cited by 223
Motivational Mechanisms Underlying Second Language Achievement: A Regulatory Focus Perspective
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Metadata
- Authors
- Klenk, M. M., Strauman, T. J., & Higgins, E. T.
- Affiliations
- Duke University (US)
- Columbia University (US)
- Corresponding author
- Strauman, Timothy J.
- Venue
- Personality and Individual Differences
- Publisher
- Elsevier BV
- Published
- 2011-05
- Volume
- 50
- Issue
- 7
- Pages
- 935-943
- ISSN
- 0191-8869 (ISSN-L)
- PMC
- PMC3079259
- OpenAlex
- W2036025989
- Cited by
- 105
- References
- 75
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 10 · 2023: 3 · 2022: 6 · 2021: 10 · 2020: 10 · 2019: 7 · 2018: 3 · 2017: 7 · 2016: 6 · 2015: 7 · 2014: 11 · 2013: 5 · 2012: 5
- FWCI
- 9.47
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Personality and Individual Differences (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- DukeSpace (Duke University) (submittedVersion, cc-by-nc-nd)
- Funders
- National Institute of Mental Health (R24MH067447, R21MH052281)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- regulatory focus, generalized anxiety disorder, major depressive disorder, self-regulation, promotion focus, prevention focus, anxiety, depression, motivation
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