Indirect effects of threat processing on worry: The roles of emotion dysregulation and contrast avoidance

Automatic attention to threat, known as attentional bias, is theorized to give rise to worry (Hirsch and Mathews, 2012). However, results have been equivocal regarding the link between worry and attentional bias as indicated by the late positive potential (LPP), a neural marker of attention. Additionally, theories suggest that emotion dysregulation and contrast avoidance may explain why attention to threat is related to worry. However, no studies have examined this or even determined whether there is an association between contrast avoidance and the LPP evoked by threat. To address these inconsistencies and gaps in the current research, the present study examined the associations between the early portion (400-700 ms) of the threat-evoked LPP, emotion dysregulation, contrast avoidance, and worry in a sample of 106 undergraduate students, 54.7% of whom endorsed clinically significant worry. Results indicated that the LPP was positively associated with both emotion dysregulation and contrast avoidance. Higher emotion dysregulation and higher contrast avoidance scores were associated with greater self-reported worry. There was an indirect effect of the LPP on worry through both emotion dysregulation and contrast avoidance. These results support a link between early attentional bias to threat and worry and suggest that clinicians should consider multiple mechanisms of pathological worry.