Emotional reactivity in anxiety disorder subtypes: an examination of Social and Generalized Anxiety Disorder

Authors

• B Foote
• L Cui
• Y Xiao
• K Witonsky
• A Riddle
• K Merikangas

Abstract

There is increasing recognition that major subtypes of anxiety disorders have different underlying biological and experiential mechanisms. Two prominent subtypes are Social anxiety disorder (SAD), characterized by excessive reactivity to social context, and Generalized Anxiety Disorder (GAD), characterized by high levels of arousal without specific environmental exposures. Laboratory-controlled task studies have shown that people with SAD have impairment in fear response extinction and emotion regulation. Ecological momentary assessment (EMA), a tool to track patterns and reactivity of emotional states in daily life, rarely has been used to distinguish between subtypes of anxiety. These studies miss an important opportunity to elucidate the differences in anxiety subtypes that could be crucial for informing treatment. Our aim was to use EMA to investigate differences in patterns and emotional reactivity to social context and to positive and negative life events between people with a history of SAD compared to those with GAD; and to examine if reactivity differs by comorbid mood disorder diagnosis. Our study sample consists of 75 participants with SAD and 145 with GAD. Participants responded to prompts asking about mood, anxiety, life events, and situational context 4x a day over a 2-week period. We found that emotional reactivity to daily events differs in mood and anxiety disorders. Participants with GAD were found to have more variability in both sad mood and anxiousness as well as higher mean anxiety level than controls. From these analyses we will present findings on context and variability for anxiety and depression in different anxiety subtypes.

Scientific Focus Area: Epidemiology

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