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Contrast Avoidance

Everybody knows about the COVID-19 pandemic. What has gone under-reported, however, is a secondary pandemic–one that is just as prominent and problematic. It is one of fear, worry, anxiety, and stress. Early on during the public health emergency, frantic people stockpiled rolls of toilet paper and emptied supermarket shelves, while looters took advantage of frayed social contracts. The panic evinced by this behavior represented the anxious behavior that has come to define the pandemic period. Indeed, the Centers for Disease Control and Prevention (CDC) reported an increase in symptoms of anxiety and depression in the US between August 2020 and February 2021 (Jia et al, 2021).

This means that even if we ourselves aren’t experiencing anxiety or even an anxiety disorder, we likely know someone who is. One of the most common anxiety disorders is generalized anxiety disorder (GAD), which can develop at any age (Comer, 2015). People with GAD experience excessive worry and anxiety and struggle to control it. They experience restlessness, sleep disturbances, and difficulty concentrating, among other symptoms (APA, 2013). Taking into account that worry is key to GAD, multiple studies have investigated the role of worry as a mechanism of emotional avoidance that maintains the disorder (Borkovec, 1994; Borkovec, Alcaine, & Behar, 2004 as cited in Newman & Llera, 2011).

In particular, Newman and Llera (2011) proposed the Contrast Avoidance Model of Worry, which explains how worry enables emotional avoidance in GAD. In 2010, they conducted a study in which participants were engaged in one of three tasks. One task induced worry (instructions read: “think about your most worrisome topic and worry about it as intensely as you can”) and another relaxation (through instructions of slowed diaphragmatic breathing). The remaining one was a neutral task (instructions read: “think about what you did over the last weekend”). After the task, the participants from all three groups watched a scary clip. As expected, the participants who watched the clip after the relaxing task or neutral tasks, reported heightened negative emotions and showed a heightened physical response. However, the interesting findings showed something different in the third group: the worriers. those who were engaged in the worry-induced task before watching the clip did not exhibit an increase in negative emotions.

It might be surprising considering that when a person encounters a stressor he is likely to experience heightened negative emotions such as fear. Also, he is likely to have a physiological response, such as an increase in blood pressure and breathing rate. To explain that, Newman and Llera (2010) proposed the following assumptions:

(1) individuals with GAD (who are worried chronically) find sharp shifts in emotions (particularly shifts from the positive to the negative) especially distressing. Therefore, they prefer to experience negative emotions chronically instead of experiencing a shift from positive feelings to negative feelings.

(2) worrying itself induces negative emotions.

(3) worry serves in preventing the increase of negative feelings and a physiological response that usually people experience when confronting a stressful event.

In other words, the contrast-avoidance model holds that worry serves as a coping mechanism for individuals with GAD, as they use worry to avoid the sharp increase of negative feelings when facing frightening experiences.

Unfortunately, some might believe that worry can be beneficial. They might tell themselves something similar to the following: “we should worry because we need to prepare for the worst,” “worry will motivate me,” or “worry will prevent bad things from happening”. However, worrying constantly is maladaptive and might have significant consequences. For example, worriers report higher discomfort during worry than non-worriers (Davey & Levy, 1998; Vasey & Borkovec, 1992 as cited in Newman & Llera, 2011). Furthermore, people with GAD tend to have a biased tendency to interpret ambiguous cues as threats, and difficulty learning from experiences (Albu, 2008).

It is beneficial to think about the nature of worry. Worry makes our body react as if the worst has already happened. Yet the majority of what we worry about will never happen. Since worry creates an unnecessary and sustained negative impact on one's body, it is important to intervene on worry cycles.

If you or your loved ones are experiencing symptoms of GAD, there are options:

Crisis TextLine: Text to 741741

National Suicide Prevention Lifeline: 800-273-8255


American Psychological Association. (2013). Publication manual of the American Psychological Association (5th ed.). https:l/

Adhanom Ghebreyesus, T. (2020). Addressing mental health needs: an integral part of COVID‐19 response. World Psychiatry, 19(2), 129–130.

Comer, R. (2015). Abnormal psychology (Ninth edition). Worth.

Jia, H., Guerin, R. J., Barile, J. P., Okun, A. H., McKnight-Eily, L., Blumberg, S. J., Njai, R., & Thompson, W. W. (2021). National and state trends in anxiety and depression severity scores among adults during the COVID-19 pandemic — United States, 2020–2021. MMWR. Morbidity and Mortality Weekly Report, 70(40), 1427–1432.

Labad, J., González-Rodríguez, A., Cobo, J., Puntí, J., & Farré, J. M. (2021). A systematic review and realist synthesis on toilet paper hoarding: COVID or not COVID, that is the question. PeerJ (San Francisco, CA), 9, e10771–e10771.

Llera, S. J., & Newman, M. G. (2010). Effects of worry on physiological and subjective reactivity to emotional stimuli in generalized anxiety disorder and nonanxious control participants. Emotion, 10(5), 640–650.

Newman, M. G. (2011). A novel theory of experiential avoidance in generalized anxiety disorder: A review and synthesis of research supporting a contrast avoidance model of worry. Clinical Psychology Review., 31(3), 371–382.

National institution of health, Generalized Anxiety Disorder: When Worry Gets Out of Control (2019).

WHO. (2020e) WHO Timeline – COVID-19. Available at:

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