Perceived Control and Vulnerability to Anxiety Disorders: A Meta-analytic Review

Abstract Contemporary theories of psychopathology suggest a lack of perceived control as central to the experience of negative emotion and to be particularly relevant to the development of anxiety disorders. The present study meta-analytically reviewed the relationship between perceived control and both trait and disorder-specific measures of anxiety in order to determine whether current evidence is consistent with perceived control functioning as a transdiagnostic vulnerability factor. A comprehensive literature review identified 51 studies with a total of 11,218 participants that were determined to meet eligibility criteria. The mean effect sizes between perceived control and trait measures of anxiety (k = 29) and disorder specific measures of anxiety (k = 37) were calculated using random-effects methods. Results indicated a large, negative association between perceived control and both trait measures of anxiety and disorder-specific measures of anxiety, with the largest associations being between perceived control and generalized anxiety disorder. Moderator analyses indicated that the associations between perceived control and trait anxiety were greater in adults than children, and varied across different measures of perceived control. These results underscore the importance of perceived control as a transdiagnostic vulnerability factor across the anxiety disorders.

[1]  B. J. Zebb,et al.  The catastrophic misinterpretation of physiological distress. , 1999, Behaviour research and therapy.

[2]  P. Muris,et al.  The Relationships Among Parental Anxiety, Parenting, and Children’s Anxiety: The Mediating Effects of Children’s Cognitive Vulnerabilities , 2014 .

[3]  A. Field.  Meta-analysis of correlation coefficients: a Monte Carlo comparison of fixed- and random-effects methods. , 2001, Psychological methods.

[4]  S. Shankman,et al.  Does intolerance of uncertainty predict anticipatory startle responses to uncertain threat? , 2011, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[5]  James F. Boswell,et al.  The Interactive Contributions of Perceived Control and Anxiety Sensitivity in Panic Disorder: A Triple Vulnerabilities Perspective , 2013 .

[6]  Michael Kyrios,et al.  Desire for Control, Sense of Control and Obsessive-Compulsive Symptoms , 2007, Cognitive Therapy and Research.

[7]  M. Zvolensky,et al.  Anxiety sensitivity and perceived control over anxiety-related events: evaluating the singular and interactive effects in the prediction of anxious and fearful responding to bodily sensations. , 2008, Behaviour research and therapy.

[8]  W. Silverman,et al.  An integrative model of control: implications for understanding emotion regulation and dysregulation in childhood anxiety. , 2006, Journal of affective disorders.

[9]  P. Baltes,et al.  Life Span Development and Behavior , 1978 .

[10]  A. Lang,et al.  Use of the anxiety control questionnaire in psychiatric inpatients , 2006, Depression and anxiety.

[11]  C. Weems,et al.  Cognitive biases in childhood anxiety disorders: do interpretive and judgment biases distinguish anxious youth from their non-anxious peers? , 2010, Journal of anxiety disorders.

[12]  W. Usui,et al.  Family functioning, perceived control, and anxiety: a mediational model. , 2006, Journal of anxiety disorders.

[13]  David H. Barlow,et al.  Anxiety and its disorders : the nature and treatment of anxiety and panic , 1988 .

[14]  R. Rapee,et al.  Fear and perceived uncontrollability of emotion: Evaluating the unique contribution of emotion appraisal variables to prediction of worry and generalised anxiety disorder. , 2010, Behaviour research and therapy.

[15]  S. Watts,et al.  Cognitive Errors, Anxiety Sensitivity, and Anxiety Control Beliefs , 2007, Behavior modification.

[16]  D H Barlow,et al.  The influence of an illusion of control on panic attacks induced via inhalation of 5.5% carbon dioxide-enriched air. , 1989, Archives of general psychiatry.

[17]  F. Boer,et al.  An indirect and direct measure of anxiety-related perceived control in children: the Implicit Association Procedure (IAP) and Anxiety Control Questionnaire for Children (ACQ-C). , 2008, Journal of behavior therapy and experimental psychiatry.

[18]  R. Rapee,et al.  The Role of Control in Childhood Anxiety Disorders , 2003, Cognitive Therapy and Research.

[19]  D. Barlow,et al.  The Nature, Diagnosis, and Treatment of Neuroticism , 2014 .

[20]  R. Rapee,et al.  Chronic anxiety : generalized anxiety disorder and mixed anxiety-depression , 1991 .

[21]  D H Barlow,et al.  The development of anxiety: the role of control in the early environment. , 1998, Psychological bulletin.

[22]  Richard A. Brown,et al.  Incremental Validity of Perceived Control Dimensions in the Differential Prediction of Interpretive Biases for Threat , 2001 .

[23]  B. Olatunji,et al.  A comparative evaluation of panicogenic processes and quality of life in a sample of non-clinical panickers and age and sex matched non-panicking controls. , 2008, Journal of anxiety disorders.

[24]  A. Viana.  ANXIETY SENSITIVITY, BEHAVIORAL INHIBITION, AND COGNITIVE BIASES AS RISK FACTORS FOR ANXIETY: CUMULATIVE, INCREMENTAL, AND MEDIATED INFLUENCES , 2011 .

[25]  S. Mineka,et al.  Conditioning and ethological models of anxiety disorders: stress-in-dynamic-context anxiety models. , 1996, Nebraska Symposium on Motivation. Nebraska Symposium on Motivation.

[26]  J. Rodin,et al.  Control By Any Other Name: Definitions, Concepts, and Processes , 2013 .

[27]  C. Weems,et al.  Patterns of actual and perceived control: are control profiles differentially related to internalizing and externalizing problems in youth? , 2010, Anxiety, stress, and coping.

[28]  B. J. Zebb,et al.  Superstitiousness and perceived anxiety control as predictors of psychological distress. , 2003, Journal of anxiety disorders.

[29]  J. Averill.  Personal control over aversive stimuli and its relationship to stress. , 1973 .

[30]  W. Silverman,et al.  The Relations between Anxiety Sensitivity and Anxiety Control in the Prediction of Anxiety Symptoms among Children and Adolescents , 2008, Behavioural and Cognitive Psychotherapy.

[31]  B. Edelstein,et al.  Predictors of health anxiety among older and young adults , 2012, International Psychogeriatrics.

[32]  R. Dantzer.  The Psychology of Fear and Stress, J.A. Gray (Ed.). Cambridge University Press, Cambridge (1987), viii and 422 pp, ISBN 0-521-27098-7 , 1989 .

[33]  David H. Barlow,et al.  Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual , 2001 .

[34]  Karen L. Sokolowski,et al.  Perceived anxiety control as a mediator of the relationship between family stability and adjustment. , 2008, Journal of anxiety disorders.

[35]  M. Kelly,et al.  Emotional avoidance and panicogenic responding to a biological challenge procedure , 2004 .

[36]  C. R. Snyder.  TARGET ARTICLE: Hope Theory: Rainbows in the Mind , 2002 .

[37]  M. Kyrios,et al.  Mediated and direct effects of general control beliefs on obsessive compulsive symptoms , 2009 .

[38]  M. Zvolensky,et al.  Cognitive-affective characteristics of smokers with and without posttraumatic stress disorder and panic psychopathology. , 2010, Addictive behaviors.

[39]  M. Carter.  Diagnostic and Statistical Manual of Mental Disorders, 5th ed. , 2014 .

[40]  S. Nowicki,et al.  A locus of control scale for children. , 1973 .

[41]  S. Kertz,et al.  A structural equation model analysis of perceived control and psychological distress on worry among African American and European American young adults. , 2009, Journal of anxiety disorders.

[42]  S. Hofmann.  Perception of control over anxiety mediates the relation between catastrophic thinking and social anxiety in social phobia. , 2005, Behaviour research and therapy.

[43]  J. Burger.  Negative reactions to increases in perceived personal control. , 1989 .

[44]  P. Corr.  Perceived control, motivation, and coping: E. A. Skinner: London: Sage Publications (1995). Paperback: £15.50. ISBN 0-8039-5561-8; hardback: £34.95, ISBN 0-8039-5560-X, 214 pp , 1996 .

[45]  B. Edelstein,et al.  Worry, emotion control, and anxiety control in older and young adults. , 2010, Journal of anxiety disorders.

[46]  P. Muris,et al.  Predictors of Change Following Cognitive-Behavioral Treatment of Children with Anxiety Problems: A Preliminary Investigation on Negative Automatic Thoughts and Anxiety Control , 2008, Child psychiatry and human development.

[47]  E. Skinner.  A guide to constructs of control. , 1996, Journal of personality and social psychology.

[48]  P. Baltes,et al.  Can I control it? The pursuit of veridical answers across the life-span , 1983 .

[49]  J. Graham.  Racism and Anxiety in a Black American Sample: The Role of Mediators and a Brief Mindfulness Manipulation , 2013 .

[50]  M. Feldner,et al.  Perceived control over anxiety-related events as a predictor of pain behaviors in a cold pressor task. , 2001, Journal of behavior therapy and experimental psychiatry.

[51]  T. Kashdan,et al.  Experiential avoidance as a generalized psychological vulnerability: comparisons with coping and emotion regulation strategies. , 2006, Behaviour research and therapy.

[52]  Jay Brand,et al.  File Drawer Problem , 2022, The SAGE Encyclopedia of Research Design.

[53]  Anke Seidel,et al.  Respiratory and cognitive mediators of treatment change in panic disorder: evidence for intervention specificity. , 2010, Journal of consulting and clinical psychology.

[54]  K. Nooner,et al.  Family Functioning and Anxiety in School Age Children: The Mediating Role of Control Cognitions , 2010 .

[55]  J. Rodin,et al.  Control and Efficacy as Interdisciplinary Bridges , 1999 .

[56]  D. Barlow.  The nature of anxiety: Anxiety, depression, and emotional disorders. , 1991 .

[57]  S. Mineka,et al.  Unpredictable and uncontrollable events: a new perspective on experimental neurosis. , 1978, Journal of abnormal psychology.

[58]  M. Gallagher.  Agency, Optimism, and the Longitudinal Course of Anxiety and Well-Being , 2010 .

[59]  M. Tull,et al.  Childhood Exposure to Parental Threatening Behaviors and Anxiety Symptoms in a Community Sample of Young Adults: The Mediating Role of Cognitive Biases , 2012, Cognitive Therapy and Research.

[60]  M. Zvolensky,et al.  Incremental Associations Between Facets of Anxiety Sensitivity and Posttraumatic Stress and Panic Symptoms Among Trauma‐Exposed Adults , 2008, Cognitive behaviour therapy.

[61]  T. Brown,et al.  Avoidance behavior in panic disorder: the moderating influence of perceived control. , 2006, Behaviour research and therapy.

[62]  R. Dienstbier,et al.  Perspectives on anxiety, panic, and fear , 1996 .

[63]  M. Gallagher,et al.  Perceived Control is a Transdiagnostic Predictor of Cognitive–Behavior Therapy Outcome for Anxiety Disorders , 2014, Cognitive Therapy and Research.

[64]  R. Rapee,et al.  Measurement of perceived control over anxiety-related events. , 1996 .

[65]  Mark W. Lipsey,et al.  Practical Meta-Analysis , 2000 .

[66]  J. Harris,et al.  Preferred Prayer Styles and Anxiety Control , 2005, Journal of Religion and Health.

[67]  C. Weems,et al.  Resting vagal tone and vagal response to stress: associations with anxiety, aggression, and perceived anxiety control among youths. , 2014, Psychophysiology.

[68]  Luísa Barros,et al.  Perceived Control and Anxiety in Portuguese Children , 2012, The Spanish journal of psychology.

[69]  M. Liebowitz,et al.  The empirical basis of generalized anxiety disorder. , 1994, The American journal of psychiatry.

[70]  D. Cartwright.  Social Learning and Clinical Psychology. , 1955 .

[71]  Laura B. Allen,et al.  Emotional disorders: A unified protocol. , 2008 .

[72]  T. Brown,et al.  Evaluation of the unique and specific contributions of dimensions of the triple vulnerability model to the prediction of DSM-IV anxiety and mood disorder constructs. , 2013, Behavior therapy.

[73]  M. Seligman,et al.  Learned helplessness in humans: critique and reformulation. , 1978, Journal of abnormal psychology.

[74]  H. Blumenthal,et al.  Relations Among Perceived Control Over Anxiety-Related Events, Worry, and Generalized Anxiety Disorder in a Sample of Adolescents , 2010, Journal of abnormal child psychology.

[75]  J. Rotter.  Generalized expectancies for internal versus external control of reinforcement. , 1966, Psychological monographs.

[76]  R. Rapee,et al.  Beliefs over control and meta-worry interact with the effect of intolerance of uncertainty on worry , 2012 .

[77]  A. Bandura.  Self-efficacy mechanism in human agency , 2024, Psihologìâ ì suspìlʹstvo.

[78]  L. Hedges,et al.  Fixed- and random-effects models in meta-analysis. , 1998 .

[79]  Advancing an Understanding of the Anxiety Control Questionnaire for Children (ACQ-C) in Clinically Anxious and Non-Anxious Youth: Psychometric Properties, Incremental Prediction and Developmental Differences , 2013 .

[80]  A. Bandura.  Self-efficacy: toward a unifying theory of behavioral change. , 1977, Psychology Review.

[81]  D. Barlow,et al.  Unraveling the mysteries of anxiety and its disorders from the perspective of emotion theory. , 2000, The American psychologist.

[82]  Larry Dossey,et al.  Optimism , 1908, Explore.

[83]  T. Brown,et al.  The structure of perceived emotional control: Psychometric properties of a revised anxiety control questionnaire , 2004 .

[84]  L. Hedges,et al.  Statistical Methods for Meta-Analysis , 1987 .

[85]  R. Rosenthal.  The file drawer problem and tolerance for null results , 1979 .

[86]  Janet B W Williams,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[87]  Dc Washington.  Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. , 1994 .