Trial reportJournal of anxiety disorders2023
Reducing contrast avoidance in GAD by savoring positive emotions: Outcome and mediation in a randomized controlled trial.
Trial report in Journal of anxiety disorders, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effectiveness of savoring interventions: A systematic review and meta-analysis of randomized controlled trials.Applied psychology. Health and well-being · 2026Pooled it
- Dampening of positive affect as an emotional contrast avoidance strategy: An experimental test of the contrast avoidance model.Behaviour research and therapy · 2026Trial
- A brief ecological momentary intervention for generalized anxiety disorder: A randomized controlled trial of the worry outcome monitoring app.Journal of anxiety disorders · 2026Trial
- Positive Affect Treatment for Depression, Anxiety, and Low Positive Affect: A Randomized Clinical Trial.JAMA network open · 2026Trial
- Savoring changes novel positive mindset targets of GAD treatment: Optimism, prioritizing positivity, kill-joy thinking, and worry mediation.Behaviour research and therapy · 2024Trial
- Worry undermines savoring's ability to reduce negative picture processing.Cognitive, affective & behavioral neuroscience · 2026Article
- Dampening of Positive Affect Serves an Emotional Contrast Avoidance Function: Preliminary Evidence From an Adult Community Sample.Journal of clinical psychology · 2026Article
- Development and validation of the eight item contrast avoidance questionnaire-general emotion scale (CAQ-GE-8): An item-response theory analysis.Journal of anxiety disorders · 2026Article
- Examining the Contrast Avoidance Model to Understand the Association between Generalized Anxiety Disorder and Sleep Difficulties.The Psychiatric quarterly · 2026Article
- Why do individuals with generalized anxiety disorder and depression engage in worry and rumination? A momentary assessment study of positive contrast enhancement.Journal of anxiety disorders · 2025Article
- Contrast avoidance as a diagnostic feature of OCD: A receiver-operator characteristic curve analysis of the contrast avoidance questionnaires.Journal of affective disorders · 2025Article
- Introduction to a special issue on the contrast avoidance model.Journal of anxiety disorders · 2024Article
- The Contrast Avoidance Model: Conclusion and synthesis of new research in the special issue.Journal of anxiety disorders · 2024Article
- Incremental validity of the contrast avoidance model: A comparison with intolerance of uncertainty and negative problem orientation.Journal of anxiety disorders · 2023Article
- The transdiagnostic use of worry and rumination to avoid negative emotional contrasts following negative events: A momentary assessment study.Journal of anxiety disorders · 2023Article
- Worry and rumination enhance a positive emotional contrast based on the framework of the Contrast Avoidance Model.Journal of anxiety disorders · 2023Article
- A transdiagnostic evaluation of contrast avoidance across generalized anxiety disorder, major depressive disorder, and social anxiety disorder.Journal of anxiety disorders · 2023Article
- The naturalistic reinforcement of worry from positive and negative emotional contrasts: Results from a momentary assessment study within social interactions.Journal of anxiety disorders · 2022Article
Corrections and comments
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Authors and funding
2 authors.
Funding
Abstract
This secondary analysis of a randomized controlled trial (RCT) examined whether contrast avoidance (CA) in Generalized Anxiety Disorder (GAD) could be reduced through savoring-purposeful engagement with positive emotions. 85 participants were diagnosed with GAD by both questionnaire and clinical interview. They were then randomly assigned to one of two seven-day smartphone-delivered ecological momentary interventions (EMIs). The SkillJoy EMI facilitated in-the-moment practice of savoring positive emotions in participants' daily lives. The active self-monitoring control (ASM) was nearly identical to SkillJoy in ratings, activities, and language, yet omitted specific attention to positive emotion and savoring. CA was assessed by questionnaire at pre-trial and post-trial. Savoring was assessed by questionnaire at pre-trial and fifth-day mid-trial. Longitudinal linear mixed models and simple slope analyses examined CA change between and within conditions. Bias-corrected boot strapping path analysis examined mediation by savoring using individuals' CA slopes extracted from a multilevel model as outcome. Results showed that SkillJoy led to significant reductions in CA, whereas the ASM control did not. The relation between treatment condition and reduction in CA was mediated by increases in savoring from pre- to mid-trial. It may be possible for treatment to meaningfully reduce CA in GAD, specifically through savoring practices.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.