Anxiety Sensitivity and Intolerance of Uncertainty Uniquely Explain the Association of the Late Positive Potential With Generalized Anxiety Disorder Symptoms

Abstract

Studies suggest that generalized anxiety disorder (GAD) symptoms are related to late positive potential (LPP) responses to negative images, suggesting greater attention. Anxiety sensitivity (AS) and intolerance of uncertainty (IU) are cognitive factors in GAD vulnerability that may be activated by negative stimuli, thereby explaining why the LPP and GAD symptoms are related. We examined whether AS and IU explain the association of the LPP with GAD symptoms. Eighty-seven (77% women) young adults viewed 60 negative and 60 neutral images. The LPP was examined using both frequentist and Bayesian approaches. This revealed unique indirect effects of the LPP on GAD symptoms through AS and IU. Neither indirect effect was stronger, and the indirect effects were present regardless of using frequentist or Bayesian analyses or quantifying the LPP using residual-based scores or difference scores. The indirect effects predicted not only GAD symptoms but social anxiety and depression as well, consistent with the role of AS and IU in transdiagnostic vulnerability. The findings support AS and IU as links that explain how attention to negative stimuli is related not only to GAD symptoms but to other internalizing symptoms as well.

Keywords: anxiety sensitivity; generalized anxiety disorder; intolerance of uncertainty; late positive potential.