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. Author manuscript; available in PMC: 2025 Mar 1.
Published in final edited form as: J Anxiety Disord. 2024 Jan 10;102:102831. doi: 10.1016/j.janxdis.2024.102831

Introduction to a Special Issue on the Contrast Avoidance Model

Michelle G Newman a, Amy Przeworski b
PMCID: PMC10923019  NIHMSID: NIHMS1960205  PMID: 38219396

Abstract

The current paper introduces the special issue on the contrast avoidance model. The contrast avoidance model theorizes that chronic worriers are afraid of a sharp increase in negative emotion and/or sharp reduction in positive emotion (labeled negative emotional contrasts; NECs). They thus use perseverative thought as means to create and sustain negative emotion to prevent NECs if they were to experience negative events. Further, these individuals are uncomfortable with sustained positive emotion because it leaves them vulnerable to NECs. At the same time, worry increases the probability of positive emotional contrasts (PECs) or sharp increases in positive emotion or decreases in negative emotion when things turn out better than expected or positive events are experienced. Therefore, these individuals generate negative emotion via perseverative thought as a way to avoid NECs and increase the likelihood of PECs. The current special issue provides novel research on the model.

Keywords: contrast avoidance, worry, perseverative thought, positive emotional contrasts, negative emotional contrasts

The Contrast Avoidance Model (CAM) is a well-supported theoretical approach to understanding the function that worry may play in regulating affect (Newman & Llera, 2011). CAM suggests that those who worry are sensitive to sharp emotional shifts from neutral or positive moods to negative moods, called negative emotional contrasts (NECs). This theory also suggests that individuals may engage in worrying to increase and maintain a heightened negative mood to prevent NECs. In other words, they would rather be anxious for a sustained period of time than experience NECs. CAM expands upon the affective contrast theory, which states that negative affect is less unpleasant after an earlier negative emotion and positive emotion feels more pleasant when it follows a negative emotion (Bacon et al., 1914; Harris, 1929).

CAM has several tenets. The first and second tenet are that worry increases and sustains negative emotion. Thus, worry does not enable either concurrent or future suppression, escape, or avoidance of negative emotion. This has been demonstrated in multiple experimental studies showing increased physiological activation and subjective negative emotion during worry (Andrews & Borkovec, 1988; Borkovec & Hu, 1990; Borkovec et al., 1983; Dickson et al., 2012; Llera & Newman, 2010, 2014; Ottaviani et al., 2016; Skodzik et al., 2016; Stapinski et al., 2010), as well as subsequent to worry (Brosschot et al., 2007; Llera & Newman, 2010; Newman et al., 2019; Ottaviani et al., 2011; Pieper et al., 2010; Stapinski et al., 2010; Weise et al., 2013). Furthermore, experimental studies showed that prior worry led to similar absolute levels of negative emotion when exposed to fear videos relative to prior relaxation (Llera & Newman, 2010, 2014). Thus, the mechanism of CAM is theorized to be different than avoidance of feared or distressing situations wherein the goal is to avoid, escape from, or suppress the discomfort of fear or negative emotion.

Instead, by increasing and sustaining negative emotion worry is theorized to prevent the subjective experience of NECs or sharp increases in negative emotion or sharp reduction in positive emotion (third tenet). In other words, because during or subsequent to worry, individuals are already in a heightened state of negative emotion (as well as low positive emotion), it prevents the experience of a sharp increase in negative emotion or reduction of positive emotion in response to a negative emotion inducing situation. The function that worry serves to increase and sustain anxiety and thus prevent NECs has been demonstrated in experimental studies (Jamil & Llera, 2021; Llera & Newman, 2010, 2014; Peasley-Miklus & Vrana, 2000; Skodzik et al., 2016) as well as diary studies (Crouch et al., 2017; Newman et al., 2019; Vîslă et al., 2021) and self-report questionnaire studies (Llera & Newman, 2017).

The fourth tenet is that worriers are uncomfortable with NECs. Empirical studies support CAM demonstrating that individuals with generalized anxiety disorder (GAD) find NECs especially unpleasant (Jamil & Llera, 2021; Kim & Newman, 2019; Llera & Newman, 2014, 2017). Further, compared to individuals without GAD, those with GAD indicated that they would prefer to maintain a negative emotional state than to experience NECs (Llera & Newman, 2017). Individuals with GAD also indicated that it was easier to cope with stressors if they were already anxious (Jamil & Llera, 2021; Kim & Newman, 2019, 2022; Llera & Newman, 2014); whereas non-anxious controls did not report this. Relatedly, contrast avoidance mediated the relationship between GAD and relaxation-induced anxiety (Kim & Newman, 2019). The heightened discomfort of sustained positive emotion due to vulnerability to NECs has also been reported by those with GAD (vs. those without GAD; Llera & Newman, 2017).Thus, contrast avoidance was also related to discomfort with sustained levels of euthymic or positive states, because this increases the probability of experiencing NECs.

CAM also suggests that individuals who worry will experience enhanced positive emotional contrasts (PECs; fifth tenet) in response to a positive event. PECs are increases in positive emotion or reductions in negative affect when a positive event occurs or the feared outcome turns out better than expected (Newman et al., 2019; Newman et al., 2013). Furthermore, the theory suggests that one motivation of worrying is because some individuals would rather feel bad now and relief or a surge in positive emotion later if their fear doesn’t happen or turns out better than expected. For example, those who worry may experience both a decrease in negative emotion (relief) and an increase in positive emotion when their feared outcomes do not occur and instead a positive event occurs. This is a common experience because studies have found that most (91.4%) worries in those with GAD did not come true (LaFreniere & Newman, 2020). This may serve to reinforce worry (Newman & Llera, 2011).

Studies support that worry leads to PECs when exposed to a positive event. For example, those who worried prior to watching an entertaining video experienced a sharper decrease in negative emotion after watching the entertaining video (Llera & Newman, 2014) relative to those who engaged in relaxation prior to watching the video. Additionally, worry prior to a positive event led to greater reduction in negative emotion than did a positive experience occurring before the positive event (Vîslă et al., 2021). Also, individuals with GAD reported that it was better to “expect the worst and be pleasantly surprised” rather than to have positive expectations and be disappointed if something negative occurs (Llera & Newman, 2017). Thus, although people with GAD enjoy short bursts of positive or euthymic emotion, as already noted, they report being uncomfortable with sustaining such emotion because it leaves them vulnerable to NECs (Llera & Newman, 2017).

Contrast avoidance is an easily assessed construct, with studies including self-report of affect before and after experimental manipulations (Llera & Newman, 2014) and in ecological momentary assessment, physiological measures of affect and affect regulation, and through a well validated self-report questionnaire that was specifically designed to assess contrast avoidance (Llera & Newman, 2017). As such, the role of contrast avoidance in psychopathology is an accessible and important construct in those who worry.

In the current special issue, researchers examined whether worry was negatively and positively reinforced through PECs, and or low worry was punished via NECs, important mechanisms by which GAD and chronic worry may be maintained (Newman et al., 2022). Additionally, the role of contrast avoidance in issues associated with worry, such as problem-solving difficulties (Llera & Newman, 2023a), fear of emotional responding, negative problem orientation, and negative beliefs about control (Boi & Llera, 2023) were also explored. Furthermore, the use of interpersonal behaviors to avoid NECs was examined (Erickson et al., 2023). One study (Llera & Newman, 2023b) examined the degree to which contrast avoidance predicted GAD symptoms above and beyond other constructs consistently associated with worry, such as intolerance of uncertainty and negative problem orientation. Further, several studies in this series explored whether contrast avoidance was transdiagnostic and/or was associated with repetitive cognitive processes other than worry, such as rumination (Baik & Newman, 2023; Kim & Newman, 2023; Newman et al., 2023). Finally, one study (LaFreniere & Newman, 2023) examined the effect of a novel intervention, savoring enjoyable experiences, on CAM. Thus, the studies in this series examined several novel variables related to contrast avoidance.

Highlights.

  • This paper introduces a special issue on the contrast avoidance model

  • Negative emotional contrast is a sharp increase in negative emotion or decrease in positive emotion

  • Positive emotional contrast is a sharp increase in positive emotion or decrease in negative emotion

  • Contrast avoidance is the fear or avoidance of sharp increases in negative emotion or decrease in positive emotion

Acknowledgments

This paper was supported in part by the National Institute of Mental Health R01 MH115128.

Footnotes

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Declaration of Competing Interest

none.

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