“…The S-REF model (Wells & Matthews, 1996) is a transdiagnostic model describing the contribution of metacognitions to engagement in the Cognitive Attentional Syndrome (CAS), which consists of RNT along with heightened self-focus, maladaptive coping behavior, and threat monitoring. The S-REF model argues that the CAS causally contributes to emotional disorder, and there is evidence that metacognitions are associated with a range of symptoms and disorders including depression (Papageorgiou & Wells, 2003;Roelofs et al, 2007), anxiety (Yilmaz, Gencoz, & Wells, 2011), GAD (Wells & Carter, 2001), social anxiety disorder (McEvoy et al, 2009), obsessive compulsive disorder and panic disorder (Cucchi et al, 2012). van der Heiden et al (2010) used worry as the primary outcome variable given that their focus was on the core feature of GAD.…”