Grant: Operating Grant

Generalized anxiety disorder (GAD) is characterized by excessive and uncontrollable worry and anxiety. GAD increases risk for heart disease and depression. Although cognitive-behavioural therapy is recommended; not everyone benefits. People who do not benefit are those who continue to think about problems and worries in a vague, "fuzzy" way after treatment. People with GAD think in this way to avoid triggering uncomfortable emotions. But research shows the opposite happens: thinking in a vague way about threatening situations makes people feel overwhelmed. We have developed a promising intervention called written exposure, which involves writing a "story" about one's worst fear coming true. The goal of written exposure is for people to "confront" their fears by writing them out in vivid, concrete detail. We found that when people with GAD wrote about the same worst fear coming true for just 20 minutes on each of 3 days, this led to a large improvement in worry one week later. Now, we are looking to improve our procedure. Adults with GAD will be recruited from the community and will be assigned at random (like flipping a coin) to our standard written exposure procedure, to a written exposure procedure that emphasizes affect labeling or to a neutral writing condition that will help determine whether it is the act of writing, or writing about fears, that leads to benefits. Research shows that labeling affect reduces activity in the part of the brain that produces fear and anxiety, which is why we are interested in seeing whether adding affect labeling to our written exposure procedure improves outcomes. All participants will write at our lab at Ryerson for 30 min. on each of 5 days. They will also track their thoughts and worry levels on a smartphone 6 times per day, which will help us look at what is changing in "real-time." Symptoms, concentration, problem-solving quality, and mood will be assessed before and after the intervention, and at 3 follow-ups.