Episodic future thinking in generalized anxiety disorder

Abstract

Research on future-oriented cognition in generalized anxiety disorder (GAD) has primarily focused on worry, while less is known about the role of episodic future thinking (EFT), an imagery-based cognitive process. To characterize EFT in this disorder, we used the experimental recombination procedure, in which 21 GAD and 19 healthy participants simulated positive, neutral and negative novel future events either once or repeatedly, and rated their phenomenological experience of EFT. Results showed that healthy controls spontaneously generated more detailed EFT over repeated simulations. Both groups found EFT easier to generate after repeated simulations, except when GAD participants simulated positive events. They also perceived higher plausibility of negative—not positive or neutral—future events than did controls. These results demonstrate a negativity bias in GAD individuals’ episodic future cognition, and suggest their relative deficit in generating vivid EFT. We discuss implications for the theory and treatment of GAD.

Reducing future fears by suppressing the brain mechanisms underlying episodic simulation

“…Such a representation, in turn, would facilitate future simulations of the scenario, thereby enhancing accessibility of the event (10,15) and increasing its perceived plausibility (14)(15)(16). It thus may be why the mPFC is particularly engaged when people worry more strongly about possible future events (66).…”

“…Highly anxious individuals think of more negative future experiences than healthy people (10,12), their imagination of those episodes is more vivid (12), and anticipatory processing of distressing situations aggravates symptoms (13). Recurrent simulations of feared situations may moreover help to maintain anxiety, because imagined episodes are deemed as more likely to occur (14)(15)(16). Thus, sometimes it may be beneficial to stop persistent simulations of feared prospective episodes.…”

Episodic future thinking: mechanisms and functions

“…Episodic future thinking has also been linked to emotional regulation, partly on the basis of evidence of reduced specificity and vividness of episodic future thinking in anxious individuals with emotion regulation problems (82–84). Recent evidence indicates that administering the ESI procedure described earlier just before individuals simulate possible solutions to personally worrisome future events has beneficial effects on emotion regulation: following ESI versus a control induction, participants generated more constructive steps to address a future worrisome event, were better able to reappraise the event, and showed improvements on several measures of subjective well-being (85).…”

Preparing for what might happen: An episodic specificity induction impacts the generation of alternative future events

“…For example, in emotional disorders such as anxiety or depression, individuals may show greater anticipation of negative future experiences (e.g., MacLeod & Byrne, 1996) and harbor excessive worry about the future (e.g., Borkovec, Ray, & Stöber, 1998; see also Bulley, Henry, & Suddendorf, 2017; Miloyan, Pachana, & Suddendorf, 2014). Negative thoughts towards the future can be maladaptive if one repeatedly engages in those thoughts, particularly given that repetitive future thinking has been linked to increased estimates in the perceived plausibility of an event’s occurrence (Szpunar & Schacter, 2013; Wu, Szpunar, Godovich, Schacter, & Hofmann, 2015) and increased accessibility of negative event outcomes (Byrne & MacLeod, 1997; MacLeod, Tata, Kentish, Carroll, & Hunter, 1997). Thus, it is critical to interrupt the cycle of repetitive thinking and reevaluate the perceived plausibility of anticipated negative future experiences, and one way to do so may be to consider alternative outcomes to negative future events.…”