The Mediating Relationship Between Maladaptive Behaviours, Cognitive Factors, and Generalised Anxiety Disorder Symptoms

Abstract

Cognitive theories of generalised anxiety disorder (GAD) posit that cognitive and behavioural factors maintain the disorder. This study examined whether avoidance and safety behaviours mediated the relationship between cognitive factors and GAD symptoms. We also examined the reverse mediation model; that is, whether cognitive factors mediated the relationship between maladaptive behaviours and GAD symptoms. Undergraduate psychology students (N = 125 and N = 292) completed the Worry Behaviours Inventory (a recently developed measure of maladaptive behaviours associated with GAD), in addition to measures of intolerance of uncertainty, cognitive avoidance, metacognitive beliefs, and symptoms of GAD and depression. Analyses supported the reliability and validity of the WBI. We consistently found that engagement in maladaptive behaviours significantly mediated the relationship between cognitive factors and symptoms of GAD. The reverse mediation model was also supported. Our results are consistent with the contention that cognitive and behavioural factors contribute to GAD symptom severity.

Problematic behaviours associated with generalized anxiety disorder during pregnancy and the postpartum period: A thematic analysis

“…As such, it appears that temporally unique worries are met with worry‐specific behaviours in perinatal women with GAD. This finding is consistent with research demonstrating a bidirectional relation between worry and behaviour in those with GAD in the general population (Mahoney, Hobbs, Williams, Andrews, & Newby, 2018a) and during the perinatal period (Green et al, 2021). Interestingly, in the general population, information seeking has been found to poorly discriminate between those with and without GAD (Beesdo‐Baum et al, 2012; Mahoney et al, 2016).…”

“…Similarly, most postpartum women reported repeatedly checking their sleeping babies for signs of health and well‐being. While confirming the health of the baby is a normal and adaptive behaviour, excessive checking and other problematic behaviours, have been shown to maintain GAD symptoms (Green et al, 2021; Mahoney, Hobbs, Williams, Andrews, & Newby, 2018a), as the non‐occurrence of a catastrophic outcome is attributed to the behavioural response (i.e. checking prevented harm to baby), which increases the likelihood of engaging in that behaviour again.…”

“…calling a loved repeatedly to ensure their safety), rather than preventing and controlling their meta‐worries, more specifically. These problematic behaviours have, in turn, been found to contribute to the maintenance and severity of GAD symptoms (Mahoney, Hobbs, Newby, Williams, Sunderland, & Andrews, 2018b; Mahoney, Hobbs, Williams, Andrews, & Newby, 2018a).…”

Evaluation of an Augmented Cognitive Behavioural Group Therapy for Perinatal Generalized Anxiety Disorder (GAD) during the COVID-19 Pandemic

“…Again, gains on all secondary outcomes were maintained at 3-months follow-up for pregnant and postpartum women and were not influenced by psychotropic medication use. Given that worry is a defining feature of GAD [ 11 ], and has been linked to maintenance of GAD symptoms [ 20 , 59 , 60 ], reduction of worry symptoms in our sample is promising.…”

What if we have too many models of worry and GAD?

“…There have been various studies on different behaviours in GAD over the years (e.g. Beesdo-Baum et al, 2012;Clark et al, 2020;Mahoney et al, 2018;Tallis and de Silva, 1992) but, perhaps due to the dominating presence of worry, the data do not seem to have led as yet to specific models or interventions with a concerted focus on overt behaviours.…”