Examining the Contrast Avoidance Model to Understand the Association between Generalized Anxiety Disorder and Sleep
Whitney S Shepherd1, Mary J Schadegg2, Laura J Dixon3
1Department of Clinical Child Psychology, University of Kansas, Lawrence, KS, USA.
The Psychiatric Quarterly
|June 5, 2025
Summary
Generalized anxiety disorder (GAD) involves excessive worry and sleep problems. This study found that avoiding emotional contrast is linked to sleep difficulties in people with GAD symptoms.
Area of Science:
- Psychology
- Clinical Psychology
- Anxiety Disorders
Background:
- Generalized anxiety disorder (GAD) is characterized by excessive worry and physiological arousal, often leading to significant distress and functional impairment.
- Sleep disturbances are common in GAD and can exacerbate clinical outcomes.
- The Contrast Avoidance Model (CAM) suggests worry in GAD serves to prevent emotional shifts by maintaining a negative emotional state.
Purpose of the Study:
- To investigate the role of contrast avoidance in the relationship between Generalized Anxiety Disorder (GAD) severity and sleep difficulties.
- To examine whether contrast avoidance mediates the association between GAD severity and sleep problems.
Main Methods:
- A sample of 255 adults with anxiety symptoms completed online self-report measures.
- Measures included assessments of GAD severity, contrast avoidance, and sleep difficulties.
- Statistical analyses, including mediation modeling, were used to examine the relationships between variables.
Main Results:
- Significant positive correlations were found between contrast avoidance and sleep difficulties.
- GAD severity was indirectly associated with sleep difficulties through greater engagement in contrast avoidance.
- The mediation model explained 28% of the variance in sleep difficulties.
Conclusions:
- Contrast avoidance plays a significant role in the relationship between Generalized Anxiety Disorder (GAD) severity and sleep difficulties.
- Findings suggest that interventions targeting contrast avoidance may be beneficial for improving sleep in individuals with GAD symptoms.
- The Contrast Avoidance Model (CAM) provides a useful framework for understanding sleep problems in the context of GAD.
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