Exploring the relationship between contrast avoidance and generalized anxiety disorder symptoms: the mediating roles of fear of emotion and intolerance of uncertainty

The contrast avoidance model (CAM) proposes that individuals suffering from generalized anxiety disorder (GAD) fear abrupt shifts from a positive to a negative emotional state (negative emotional contrast). We posited that greater fear of uncontrollable emotional experiences and intolerance of uncertainty could have an indirect effect on the relationship between avoidance of negative emotional contrasts and GAD. As an exploratory objective, we investigated whether fear of a specific emotion (anger, anxiety, depression and positive emotion) is implicated in the mediation. A sample of 233 adults completed measures of the study variables. Avoidance of negative emotional contrast was significantly related to GAD symptom severity. General fear of emotions and intolerance of uncertainty each mediated the relationship between the tendency to avoid emotional contrast and GAD symptoms. However, when the mediation analysis was repeated with fear of specific emotions, none of the feared emotions was a significant mediator, and neither was intolerance of uncertainty. The results suggest that the relation between avoidance of emotional contrasts and GAD symptoms is explained by a greater fear of emotional reactions and intolerance of uncertainty. However, when fear of a specific emotion was taken into account, none of these emotional experiences seems to drive this relationship, which is consistent with the CAM that does not posit a fear of a specific emotion, but rather the fear of an unexpected negative emotional contrasts.