(PS10-B49) Specific Emotion Regulation Difficulties Mediate the Effect of Worry on Subsequent Stress: A Prospective Study

Introduction: Stress-related mental health complaints such as anxiety, depressive symptoms, sleeping difficulties, and somatic symptoms are common and debilitating. Worry, a form of future-oriented repetitive negative thinking, is a well-established risk and maintenance factor for stress-related symptoms (Newman et al., 2013). Worry is theorized to function as a form of cognitive avoidance, as worriers search for ways to avoid potential threats and eschew affectively laden imagery by engaging in future-oriented, verbal-linguistic perseverative thought (Borkovec et al., 2004). Accordingly, worry may interfere with adaptive processing and regulation of emotions, which in turn contributes to the maintenance of stress-related symptoms. Indeed, prior research has demonstrated links between worry, difficulties with emotion regulation, and stress responding (Lewis et al., 2018). However, the specific mechanisms of emotion regulation that are perturbed by excessive worry to confer risk for stress-related symptoms are unclear. The present analyses aimed to clarify the role of worry in the maintenance of stress-related symptoms via emotion dysregulation by (1) identifying which difficulties in emotion regulation were most strongly associated with worry, and (2) examining which difficulties in emotion regulation mediated the link between worry and subsequent stress.

Methods: 637 adult participants aged 18-66 (M = 44.14, SD = 13.81) completed measures of worry (Penn State Worry Questionnaire; PSWQ; Meyer et al., 1990), emotion regulation difficulties (Difficulties in Emotion Regulation Scale-Brief; DERS; Bjureberg et al., 2016), and stress (Depression, Anxiety, and Stress Scales- Short Form Stress Subscale; DASS-S; Lovibond & Lovibond, 1995) every month for three months (time 1 – time 3).

Results: Worry was significantly, positively associated with all DERS subscales at time 1, with the largest correlations being between worry and limited access to effective emotion regulation strategies (r(628) = .57, p < .001) and difficulties engaging in goal-directed behavior (r(631) = .54,  p < .001). A multiple mediation model revealed that the effect of worry at time 1 on stress at time 3 was partially mediated by difficulties with emotional clarity (indirect effect = .01, SE = .00, p < .001), difficulty engaging in goal-directed behavior (indirect effect = .01, SE = .01, p < .05), and emotional nonacceptance (indirect effect = .01, SE = .00, p < .05) at time 2 after controlling for age, gender, and time 1 DASS-S.

Conclusion: Results suggest that excessive worry results in specific forms of emotion dysregulation (lack of emotional clarity, difficulty engaging in goal-directed behavior, and emotional nonacceptance) that confer risk for subsequent stress. Findings will be considered in the context of the development and maintenance of stress-related mental health complaints.