There were no significant interactions for the planned analyses of the present study. That is, worry (Induction 1) and regulation strategy (Induction 2) did not interact in their effects on negative affect or emotion dysregulation, contrary to study hypotheses. However, visual
inspection indicated trends toward possible interactions inconsistent with study hypotheses (see Figures 3 and 4). Consideration of these unexpected trends should be discussed and interpreted cautiously as these interactions were not statistically significant. However, the following discussion is warranted for future investigations.
First, as Figure 3 shows, there was a possible small trend toward an interaction effect on emotion dysregulation (p = .12) with a small effect size (partialη2 = .022). Visually, Induction 2
appeared to operate as expected for those in the no-worry group, such that they reported the lowest dysregulation in the mindfulness condition, followed by the experimental control
condition. The thought suppression condition demonstrated the highest dysregulation within the no-worry group. However, those in the worry group showed a different pattern of results. In the worry group, the no-strategy condition demonstrated the highest emotion dysregulation, followed by mindfulness. Contrary to hypotheses, the thought suppression group showed the lowest
Thought suppression is consistently linked to ironic effects in the literature, such that people who suppress their thoughts tend to experience paradoxical increases in the target thoughts (Wegner et al., 1987), as well as lower mood (Purdon & Clark, 2001) and higher anxiety (Koster et al., 2003), following a period of suppression of affect-related thoughts. Whereas the pattern of results for the no-worry group is consistent with this prior literature, the pattern for the worry group is not. Although the interacting effects of worry and subsequent thought suppression have yet to be examined in the literature, it is possible that thought suppression operates differently under different circumstances (e.g., following worry).
One possibility is that worry enhanced the effect of thought suppression as a successful emotion regulation strategy, at least temporarily. Extant literature shows that participants who worry before encountering an anxiety-provoking stimulus experience lower physiological arousal and report lower initial distress in response to that stimulus (Borkovec & Hu, 1990; Wells & Papageorgiou, 1995). However, this effect is short-lived; worry is associated with lower habituation to those stimuli and higher intrusive thoughts about the stimulus in the following week (Borkovec & Hu, 1990; Wells & Papageorgiou, 1995). That is, worry appears to have a “rebound effect” on emotional experience. A similar “rebound effect” has also been documented in the thought suppression literature. A 2001 meta-analysis on the effects of thought suppression showed that the strongest effect of thought suppression was a subsequent “rebound” in the frequency of target thoughts (Abramowitz, Tolin, & Street, 2001). Their meta-analysis found that, on average, thought suppression did not immediately enhance unwanted thoughts, and that
participants are able to successfully suppress thoughts over the short term. However, thought
suppression was related to increased frequency of those thoughts over a delay. As such, it is possible that thought suppression is briefly effective under distress, but ineffective over time. It
is also possible that the 3-minute sad video was an insufficient delay to detect the rebound effect of thought suppression. From this perspective, the present findings may be consistent with the literature indicating that thought suppression is effective in the short term.
With regard to the effects of conditions on negative affect, the interaction was also not significant, with little to no trend toward an interaction effect (p = .26). Patterns of overall
response to the three conditions were similar across groups, with both worry and no-worry groups (i.e., Induction 1) reporting the highest negative affect in the thought suppression condition, somewhat lower negative affect in the no-strategy condition, and the lowest negative affect in the mindfulness condition. These patterns are consistent with the statistically significant main effect difference between the mindfulness and thought suppression conditions on negative affect. However, visual inspection indicates that mindfulness may have been somewhat less effective for those in the worry group than those in the no-worry group. That is, visually, the effect of mindfulness appeared to be driven by its effect on those who were in the no-worry control group (see Figure 4).
The effects of mindfulness have never previously been examined immediately following a worry induction. These results indicate that following worry, mindfulness might not be as effective as it is following a period of neutral thinking. It is possible that the effects of the worry period contaminated the mindfulness period, because it may have been difficult for participants to switch from worrying to a mindfulness exercise. GAD is marked by uncontrollable worry; when clinically diagnosed, worry must be experienced as uncontrollable in order for a person to meet clinical criteria for GAD (APA, 2013). The very instruction in the mindfulness script that participants “switch from a mode of doing to a mode of nondoing” (see Appendix C) may be
exceptionally challenging for people with GAD immediately after they are instructed to actively worry.
Although little research has documented that mindfulness is challenging during distress, this has been discussed theoretically. Hayes and Feldman (2004) discuss that mindfulness may have distressing, destabilizing effects because meditation may lead participants to become more aware of their own difficult emotions. In fact, mindfulness has been conceptualized as a form of exposure to internal experience (Roemer & Orsillo, 2002), and exposure-based treatments sometimes lead to a temporary worsening of symptoms (e.g., Gilboa-Schechtman & Foa, 2001; Nishith, Resick, & Griffin, 2002). Mindfulness may not actually operate to reduce short-term distress or increase regulation of emotions under distress. It is unknown if there are specific emotion regulation strategies can influence these processes under distress; a comparison of different strategies following worry could be a direction for future research. Additionally, if mindfulness operates similarly to exposure treatment, it may be most effective with practice. As discussed in the previous section, it is possible that mindfulness is most helpful with more experience; in this vein, future research could also examine optimal dosing of mindfulness.