Neural correlates of emotion acceptance vs worry or suppression in generalized anxiety disorder
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nsx025.pdf
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Author(s)
Ellard, Kristen K.
Barlow, David H.
Deckersbach, Thilo
Whitfield-Gabrieli, Susan
Gabrieli, John D. E.
Date Issued
April 2017
Journal
Social Cognitive and Affective Neuroscience
Publisher
Oxford University Press (OUP)
Citation
Ellard, Kristen K. et al. “Neural Correlates of Emotion Acceptance Vs Worry or Suppression in Generalized Anxiety Disorder.” Social Cognitive and Affective Neuroscience 12, 6 (April 2017): 1009–1021 © The Author
Version
Final published version
Abstract
Recent emotion dysregulationmodels of generalized anxiety disorder (GAD) propose chronic worry in GAD functions as a maladaptive attempt to regulate anxiety related to uncertain or unpredictable outcomes. Emotion acceptance is an adaptive emotion regulation strategy increasingly incorporated into newer cognitive behavioral therapy (CBT) approaches to GAD to counter chronic worry. The current study explores themechanisms of emotion acceptance as an alternate emotion regulation strategy to worry or emotion suppression using functionalmagnetic resonance imaging. Twenty-one female participants diagnosed with GAD followed counterbalanced instructions to regulate responses to personally relevant worry statements by engaging in either emotion acceptance, worry or emotion suppression. Emotion acceptance resulted in lower ratings of distress than worry and was associated with increased dorsal anterior cingulate cortex (dACC) activation and increased ventrolateral prefrontal cortex (VLPFC)-amygdala functional connectivity. In contrast, worry showed significantly greater distress ratings than acceptance or suppression and was associated with increased precuneus, VLPFC, amygdala and hippocampal activation. Suppression did not significantly differ fromacceptance in distress ratings or amygdala recruitment, but resulted in significantly greater insula and VLPFC activation and decreased VLPFC-amygdala functional connectivity. Emotion acceptance closely aligned with activation and connectivity patterns reported in studies of contextual extinction learning and mindful awareness.
MIT Department
Massachusetts Institute of Technology. Department of Brain and Cognitive Sciences
McGovern Institute for Brain Research at MIT
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Creative Commons Attribution-NonCommercial 4.0 International
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DOI of Published Version
https://doi.org/10.1093/SCAN/NSX025
