The Effects of Worry and Relaxation on Flexibility During Cognitive Restructuring

Abstract

Worry is associated with inflexibility in cognitive, emotional, and physiological functioning. In addition, worry's negative valence and abstract level of construal are rigid characteristics that contribute to its nonadaptive consequences. Relaxation and cognitive therapy aim to increase flexibility in chronic worriers, and may have greater efficacy when administered in combination. We examined the extent to which relaxation enhances and/or worry inhibits cognitive flexibility during a cognitive restructuring exercise in which participants generated alternative predictions for their worries. Participants ( n = 189) were randomly assigned to engage in relaxation, worry, or neutral thinking prior to cognitive restructuring. We measured the number and perceived likelihood of alternative predictions generated by participants, and coded those alternative predictions for their degree of positive valence, negative valence, and level of construal (abstractness to concreteness). Worry and relaxation did not lead to different numbers or perceived likelihood of alternative predictions. However, compared with participants with minimal symptoms of generalized anxiety disorder (GAD), those with elevated symptoms of GAD who engaged in prior worry generated alternative predictions characterized by greater negative valence and more abstractness (i.e., less concreteness). We also found that greater negative valence of alternative predictions was associated with more abstractness, whereas greater positive valence of alternative predictions was associated with more concreteness. These findings suggest that after engaging in worry, individuals with GAD may be less able to flexibly shift from the use of nonadaptive characteristics (negative valence, abstractness) associated with feared outcomes to the use of more adaptive characteristics (positive valence, concreteness) when considering alternative predictions.

Investigating the Relationship Between Worry and Social Problem-Solving Attitudes and Performance

“…A repeated measures, between factors ANOVA was selected as the statistical test with the following inputs: a medium effect size of Cohen's f = .25, power of .85, and an estimated r = 0.7 repeated measures correlation. Medium effect to high effect sizes were found on relatively comparable studies comparing rumination to distraction in social problem-solving, as well as worry to neutral thought activity in concreteness and emotional reactivity (Watkins & Baracaia, 2002;Llera & Newman, 2010;Stevens et al, 2017). There is no published MEPS test-retest data so a high correlation was assumed.…”

“…They then underwent a neutral mentation induction which involved instructions to engage in neutral thinking as per previously successful neutral thought inductions (i.e., Stevens et al, 2017). Specifically, they were asked to close their eyes and count backward by 3s beginning at 900 at their own pace while being as accurate as possible.…”

“…Additionally, to ensure that the quality of mentation was verbal, as to be comparable with the verbal quality of worry (Borkovec & Inz, 1990), they were asked to count in words as if speaking to oneself. Following 5 minutes (Stevens et al, 2017) of neutral verbal mentation, participants completed a VAS manipulation check on their current mood and anxiety levels in order to discern if the induction was successful.…”

Impaired disengagement from worry: Dissociating the impacts of valence and internally-directed attention

“…A relevant limitation shared across most experimental designs in this area is a primary emphasis on only a few major characteristics of worry, most commonly negative valence, with less attention to other dimensions that may play a role in impaired disengagement and accompanying subjective experiences of uncontrollability. In keeping with the cognitive model's emphasis on negative processing biases, the major experimental comparison conditions for worry include positive thought (Hayes et al, 2008;Sari et al, 2017;Stefanopoulou et al, 2014), neutral thought (Hallion et al, 2014), and induced relaxation (Salters-Pedneault et al, 2008;Stevens et al, 2018). Although different in valence, these non-negative comparators share an important feature with worry: they all involve the internal orientation of attention.…”

Introduction to the Special Issue on Cognitive and Behavioral Flexibility in Fear and Anxiety Disorders

“…Overall, this study provides a new perspective on the link between trauma-focused rumination and PTSD and highlights the importance of considering inflexible patterns of cognition as potential avoidance strategies in future work in this area. In the second contribution in this series, Stevens and colleagues (2018) use an experimental paradigm to examine whether worry and relaxation affect flexibility during cognitive restructuring. Here, the authors conceptualize cognitive inflexibility in worry as stemming from both biased information processing and a weakening of attentional control.…”