The Effects of Worry in Daily Life: An Ecological Momentary Assessment Study Supporting the Tenets of the Contrast Avoidance Model

The contrast avoidance model (CAM) suggests that worry increases and sustains negative emotion to prevent a negative emotional contrast (sharp upward shift in negative emotion) and increase the probability of a positive contrast (shift toward positive emotion). In Study 1, we experimentally validated momentary assessment items (N = 25). In Study 2, participants with generalized anxiety disorder (N = 31) and controls (N = 37) were prompted once per hour regarding their worry, thought valence, and arousal 10 times a day for 8 days. Higher worry duration, negative thought valence, and uncontrollable train of thoughts predicted feeling more keyed up concurrently and sustained anxious activation 1 hr later. More worry, feeling keyed up, and uncontrollable train of thoughts predicted lower likelihood of a negative emotional contrast in thought valence and higher likelihood of a positive emotional contrast in thought valence 1 hr later. Findings support the prospective ecological validity of CAM. Our findings suggest that naturalistic worry reduces the likelihood of a sharp increase in negative affect and does so by increasing and sustaining anxious activation.