Specific emotion regulation difficulties and executive function explain the link between worry and subsequent stress: A prospective moderated mediation study

Worry is a transdiagnostic risk factor for stress-related mental health complaints such as anxiety, depression, and insomnia. Although worry may function as a form of avoidance of unwanted emotions and accordingly interfere with adaptive emotion regulation, the specific domains of emotion regulation that are perturbed by excessive worry to confer risk for stress-related symptoms are unclear. Further, it is unknown if cognitive control mechanisms that underlie successful emotion regulation influence the effect of worry on stress. The present study addressed these gaps in the literature by examining specific emotion regulation difficulties as mediators of the relationship between worry and subsequent stress, as well as executive function as a moderator of the mediated effects.656 community adults were assessed for trait worry, emotion dysregulation, stress, and executive dysfunction once per month for three months (time 1 - time 3).The effect of worry (time 1) on subsequent stress (time 3) was partially mediated by difficulties with emotional clarity and difficulty engaging in goal-directed behavior when upset (time 2) after controlling for age, gender, and baseline stress. Moderated mediation models revealed that the indirect effect of worry on stress via difficulty with goal-directed behavior was significantly moderated by executive dysfunction, such that fewer executive function difficulties acted as a buffer against the harmful effects of worry.Limitations include reliance on self-report measures, lack of experimental manipulation, and a nonclinical sample.Findings point to specific domains of emotion regulation as treatment targets for individuals with high worry proneness.