Does repetitive negative thinking affect attention? Differential effects of worry and rumination on attention to emotional stimuli.

Worry and rumination, two cardinal responses to emotional events, are key for maintaining negative emotion and have been implicated in the etiology and maintenance of anxiety and depressive disorders. Though worry and rumination are highly correlated with one another and people who engage in one often engage in both, they may differentially affect emotion. Specifically, previous work suggests that worry helps people avoid (intense) emotion, while rumination provokes it. Examining the ways in which these two forms of repetitive negative thinking (RNT) influence cognitive processing of emotional material may help us better understand the emotional sequelae of worry and rumination. This study examines visual attention to emotional information, since attending to certain types of information opens the door for further processing of it. The current study induced worry and rumination and then used eye tracking to compare how each form of RNT influenced the allocation of attention to emotional scenes. Participants induced to worry, compared with those induced to ruminate, spent less time viewing positive (vs. neutral) scenes and were the only group to preferentially maintain their attention on negative images when they were paired with positive images. These findings suggest that worry, compared with rumination, leads to the relative avoidance of positive information. Implications of these findings for research on mood and anxiety disorders are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Emotion regulation and biological stress responding: associations with worry, rumination, and reappraisal.

Individual differences in the habitual use of emotion regulation strategies may play a critical role in understanding psychological and biological stress reactivity and recovery in depression and anxiety. This study investigated the relation between the habitual use of different emotion regulation strategies and cortisol reactivity and recovery in healthy control individuals (CTL; n = 33) and in individuals diagnosed with social anxiety disorder (SAD; n = 41). The tendency to worry was associated with increased cortisol reactivity to a stressor across the full sample. Rumination was not associated with cortisol reactivity, despite its oft-reported similarities to worry. Worry and rumination, however, were associated with increased cortisol during recovery from the stressor. The only difference between CTL and SAD participants was observed for reappraisal. In the CTL but not in the SAD group, reappraisal predicted recovery, such that an increased tendency to reappraise was associated with greater cortisol recovery. These results suggest an important role of the habitual use of emotion regulation strategies in understanding biological stress reactivity and recovery.

Exploring the use of computer games and virtual reality in exposure therapy for fear of driving following a motor vehicle accident.

Specific phobia, situational type-driving, induced by accident (accident phobia) occurs in 18-38% of those involved in a vehicular accident of sufficient severity to warrant referral to the emergency departments of a general hospital. The objective is to investigate, in an open study, the effectiveness of the combined use of computer generated environments involving driving games (game reality [GR]) and a virtual reality (VR) driving environment in exposure therapy for the treatment of driving phobia following a motor vehicle accident (MVA) program. Fourteen subjects who met DSM-IV criteria for Simple Phobia/Accident Phobia and were referred from the emergency department of a general hospital were exposed to a Virtual Driving Environment (Hanyang University Driving Phobia Environment) and computer driving games (London Racer/Midtown Madness/Rally Championship). Patients who experienced "immersion" (i.e., a sense of presence with heightened anxiety) in one of the driving simulations (defined as an increase in SUD ratings of 3 and/or an increase of heart rate > 15 BPM in a 1-h trial session of computer simulation driving) were exposed to a cognitive behavioral program of up to 12 1-h sessions involving graded driving simulation tasks with self-monitoring, physiological feedback, diaphragmatic breathing and cognitive reappraisal. Subjects were assessed at the beginning and end of therapy with measurements of: physiological responsivity (heart rate), subjective ratings of distress (SUD), rating scales for severity of fear of driving (FDI), Posttraumatic Stress Disorder (CAPS) and depression (HAM-D) and achievement of target behaviors. Of all patients 7/14 (50%) became immersed in the driving environments. This immersed group (n = 7) completed the exposure program. Pre- and post-treatment comparisons showed significant post treatment reductions on all measures SUDS (p = 0.008), FDI (p = 0.008), CAPS (p = 0.008), HR (p = 0.008), CAPS (p = 0.008), HAM-D (p = 0.031). Further analysis of the FDI showed significant reductions in all three subscales: travel distress (p = 0.008), travel avoidance (p = 0.008), and maladaptive driving strategies (p = 0.016). The findings of this study suggest that VR and GR may have a useful role in the treatment of driving phobia post-accident even when co-morbid conditions such as post-traumatic stress disorder and depression are present.