A Preliminary Investigation of Stimulus Control Training for Worry

Abstract

For individuals with generalized anxiety disorder, worry becomes associated with numerous aspects of life (e.g., time of day, specific stimuli, environmental cues) and is thus under poor discriminative stimulus control (SC). In addition, excessive worry is associated with anxiety, depressed mood, and sleep difficulties. This investigation sought to provide preliminary evidence for the efficacy of SC procedures in reducing anxiety-, mood-, and sleep-related symptoms. A total of 53 participants with high trait worry were randomly assigned to receive 2 weeks of either SC training (consisting of a 30-min time- and place-restricted worry period each day) or a control condition called focused worry (FW; consisting of instructions to not avoid naturally occurring worry so that worry and anxiety would not paradoxically increase). At post-training, SC was superior to FW in producing reductions on measures of worry, anxiety, negative affect, and insomnia, but not on measures of depression or positive affect. Moreover, SC was superior to FW in producing clinically significant change on measures of worry and anxiety. Results provide preliminary support for the use of SC training techniques in larger treatment packages for individuals who experience high levels of worry.

A BRIEF ECOLOGICAL MOMENTARY INTERVENTION FOR GENERALIZED ANXIETY DISORDER: A RANDOMIZED CONTROLLED TRIAL OF THEWORRY OUTCOME JOURNAL

“…These are promising results for worry outcome monitoring, especially when the brevity of the trial is considered. In clinical practice and RCTs, worry outcome monitoring is typically used continuously for approximately [8][9][10][11][12][13][14][15][16] weeks. Yet the current study shows significant, maintained improvement in worry after 10 days.…”

“…Cognitive therapy, progressive muscle relaxation, and applied relaxation components have received research attention, [8][9][10][11][12] with self-control desensitization and stimulus control to a lesser degree. [6,13,14] Other techniques have gone virtually unexamined-though frequently used.…”

Self-Monitoring by College Students With ADHD: The Impact on Academic Performance

“…In addition to statistical effects, we analyzed clinically significant change by evaluating the percent of participants who improved on each variable by at least two standard deviations of the pretest scores (e.g., McGowan & Behar, 2012). In the SM+ group, 40.91% (ASRS), 22.73% (SSC), and 13.64% (GPA) of participants made clinically significant improvements.…”

Short-Term Efficacy of a Worry Postponement Intervention for Generalized Anxiety Disorder

“…Compared to the focused worry control condition, after 2 weeks of the intervention, the worry postponement condition showed significantly lower worry (between-group effect size: It is notable that the focused worry condition, intended as a control, lead to a large reduction in worry. The authors speculate that the instructions for the focused worry condition may reduce experiential avoidance by asking participants to actively engage in their worry, and that this mechanism may explain the improvement in worry seen in their control condition (McGowan & Behar, 2013). A mixed analysis of variance (ANOVA) found no Condition x Time effect on depressive symptoms measured using the Beck Depression Inventory (BDI-II).…”

“…The reason for this is not known. Most recently, worry postponement was studied in a sample of individuals with high levels of trait worry (McGowan & Behar, 2013). A 2-week intervention of daily worry postponement as per was compared to an active control condition.…”