(PS3-C59) Effects of Daily Negative Expectancy Bias and Daily Worry on Anxiety Symptoms in Adolescent Females

Adolescence is a developmental period when anxiety disorders first onset, particularly for females, (Rapee et al., 2019, Rabner et al., 2017). Worry about future events is thought to be a predictor of anxiety, but specific cognitive and behavioral mechanisms underlying the association between worry and anxiety symptoms remain understudied. Previous research examining the associations between these constructs has relied on cross-sectional designs and retrospective reporting, which limits our understanding of how these factors impact prospective anxiety symptoms among adolescents in their daily lives. This study expands upon previous work by examining the associations between worry, negative expectancy bias, behavioral avoidance, and prospective anxiety symptoms using an ecological momentary assessment (EMA) design among adolescent girls. We hypothesized that girls who exhibit greater worry in daily life will report greater prospective anxiety symptoms. We also hypothesized that the association between worry and anxiety symptoms will be accounted for by the indirect effects of negative expectancy bias and avoidance. The sample was 107 females (Mage = 12.26; Age Range = 11,13, 13.98; 68% Caucasian) at temperamental risk for internalizing disorders. A two-week EMA protocol was used to assess the primary independent variables of interest of this study. Indices for the primary independent variables were created by averaging or summing across all completed EMA calls for continuous (worry, negative expectancy) and dichotomous variables (avoidance), respectively. Anxiety symptoms were assessed at the time of EMA (Baseline) and each year for up to three years (3YR follow-up) via the Screen for Childhood Anxiety Disorders (Birmaher et al., 1999). Two mediation models within a linear regression framework were conducted to determine if negative expectancy bias and avoidance mediated the association between daily worry and anxiety symptoms at 3YR follow-up. Daily worry (b=0.149, p=.030) and negative expectancy bias (b=.147, p=.025) were significantly positively associated with prospective anxiety symptoms, controlling for baseline anxiety symptoms. Additionally, the direct effect of daily worry on negative expectancy bias was significant controlling for baseline anxiety symptoms (b=.878, p=0.00), such that on average girls who worried more frequently day-to-day expected more negative outcomes in potentially threatening situations throughout their day. However, the effect of daily avoidance on prospective anxiety and the indirect effects of negative expectancy and avoidance were not significant (ps > .05). This is the first study to show that worry in real-time contributes to the development of anxiety over time, extending previous cross-sectional and questionnaire-based data. Greater moment to moment reports of worry in real life were associated with more negative expectancies and predicted anxiety symptoms three years later. Teaching youth tools to disrupt and/or manage their real-time worry and negative expectancy bias may be an important prevention strategy for anxiety symptoms during adolescence.