(PS2-A3) Differences in Fear of Emotion in Anxiety Disorders

Background: People with anxiety disorders may exhibit more fear of experiencing or losing control over their emotions, known as "affective control,” than those without psychiatric diagnoses. How specific anxiety disorders, such as generalized anxiety disorder (GAD) and social anxiety disorder (SAD), differ in affective control remains unclear. Only one prior study examined affective control in GAD and SAD; they found greater fear of depression for GAD than SAD. The current study explored differences in global and subtypes of affective control in adults with GAD, SAD, and controls. We hypothesized that those with anxiety disorders (GAD or SAD) would report more global fear of experiencing emotions than controls. Further, we hypothesized that greater fear of depression, anger, and positive emotions would be present for GAD versus SAD.

Methods: 357 adults with primary GAD (n=150; Mage=29.04(10.1), 75% female) or SAD (n=125; Mage = 27.77(9.8), 54% female) based on structured diagnostic interview as well as non-clinical controls (n=82; M age= 29.18 (11.9), 65% female) completed the Affective Control Scale (ACS), a 42-item scale assessing fear of losing control over emotions or of one’s reactions to emotions. ACS has four subscales: fear of anger, depression, anxiety, and positive emotions. Higher scores indicate greater distress related to emotional response. An ANOVA with Tukey post-hoc test was conducted to compare ACS scores for GAD, SAD, and controls. Three independent samples T-tests compared ACS subscales for GAD versus SAD.

Results: As hypothesized, people with a primary diagnosis of GAD (M(SD)=3.4(0.7)) or SAD (M(SD)=3.5(0.7)) reported higher ACS scores than controls (M(SD)=2.2(.67), F(354)= 102.9, p< .001). However, those with SAD vs. GAD did not significantly differ in ACS total scores (p=.10). Contrary to expectations in ACS subscale analyses, those with SAD (M(SD)=3.05(0.99)) vs. GAD (M(SD)=2.72(0.78)) demonstrated significantly more fear of positive emotions (t(273)=3.08, p=.003, d=0.36). Those with SAD vs. GAD did not show significant differences in ACS depression (t(273)=1.01, p=.31) or anger (t(273)=1.75, p=.08).

Conclusion: ACS scores were higher in adults with GAD and with SAD compared to controls suggesting that understanding how to best reduce affective control is an important future direction. SAD and GAD did not differ significantly in global ACS scores; however, there were notable subscale differences. Those with SAD reported significantly more fear of positive emotions than those with GAD. This aligns with previous research that those with SAD may restrict positive emotions compared to GAD to protect themselves from feared consequences of evaluation and supports it as an intervention target.