The verbal nature of worry in generalized anxiety: Insights from the brain

Abstract

BackgroundThe Cognitive Avoidance Theory of Worry argues that worry is a cognitive strategy adopted to control the physiological arousal associated with anxiety. According to this theory, pathological worry, as in Generalized Anxiety Disorder (GAD), is verbal in nature, negative and abstract, rather than concrete. Neuroimaging studies link the expression of worry to characteristic modes of brain functional connectivity, especially in relation to the amygdala. However, the distinctive features of worry (verbal, abstract, negative), and their relationship to physiological arousal, have not so far been mapped to brain function.MethodsWe addressed this omission by undertaking a resting-state functional magnetic resonance neuroimaging study of 19 patients with GAD and 21 controls, before and after induction of perseverative cognitions, while measuring emotional bodily arousal from heart rate (HR). Seed-based analyses quantified brain changes in whole brain functional connectivity from the amygdala.ResultsIn GAD, the induction increased negative thoughts and their verbal content. In line with predictions, the verbal expression of worry in GAD was associated with higher HR at baseline and attenuated HR increases after induction of perseverative cognitions. Within brain, the increased use of words during worry, and the associated dampening of HR after induction were mediated by the strength of functional connectivity between the amygdala and default mode network ‘hubs’ and the opercular cortex. The negative content of worry was further related to functional communication between amygdala and cingulo-opercular and temporal cortices.ConclusionsFindings provide a neurobiological basis for the impact of verbal worry on HR in GAD.

The disentanglement of the neural and experiential complexity of self-generated thoughts: A users guide to combining experience sampling with neuroimaging data

“…generalised anxiety disorder) and healthy participants. (Makovac et al, 2018;Sanders, Wang, Schooler, & Smallwood, 2017; Amsterdam Resting state questionnaire (Diaz et al, 2013) 50-items from which 5 factors can be extracted: Discontinuity of Mind, Theory of Mind, Self, Planning, Sleepiness, Comfort, and Somatic Awareness Assess thoughts and feelings experienced during rest. Sensitive to brain disorder.…”

Network abnormalities in generalized anxiety pervade beyond the amygdala-pre-frontal cortex circuit: Insights from graph theory

“…For example, other studies have reported a crucial role of the communication between amygdala and temporal pole in GAD (Li et al, 2016). Similarly, recent data have pointed to an involvement of the communication between amygdala and temporal areas in the mediation of the negative affectivity that accompanies worry in GAD (Makovac et al, 2018).…”

Interactions between the neural correlates of dispositional internally directed thought and visual imagery

“…Extending this work to clinical conditions, especially those which are partly identifiable through their patterns of cognition, will be important. For example, studies have found that patterns of repetitive verbal thoughts can be a characteristic of anxiety [90]. Moving forward, it will be important to develop better self-report measures, more generalisable populations and to use alternative techniques for mapping neural activity to completely understand the neural correlates of different aspects of ongoing thought.…”