Worry and Generalized Anxiety Disorder

Borkovec, Thomas D.; Newman, Michelle G.

doi:10.1016/b0080-4270(73)00201-7

Cited by 320 publications

(481 citation statements)

References 64 publications

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“…In line with the notion that worry in GAD is likely to be more quantitatively than qualitatively different from normal worry (Borkovec, Alcaine, & Behar, 2004;Ruscio & Borkovec, 2004), the induction increased the amount of perseverative negative thoughts in controls up to an equivalent level reported by GAD patients, making the two groups more similar.…”

Section: Discussionsupporting

confidence: 64%

Neurobiological substrates of cognitive rigidity and autonomic inflexibility in generalized anxiety disorder

Ottaviani

Watson

Meeten

et al. 2016

Biological Psychology

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Neurobiological substrates of cognitive rigidity and autonomic inflexibility in generalized anxiety disorder.Biological Psychology http://dx.doi.org/10. 1016/j.biopsycho.2016.06.009 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.  Trait worry was inversely related with prefrontal deactivation to target detection. HRV predicted neural activation changes produced by attentional focus switching. A worry induction increased pre-to post-target deactivation of default mode areas. The induction reduced behavioural and neurobiological differences between groups. AbstractGeneralized anxiety disorder (GAD) is characterized by difficulties in inhibiting both perseverative thoughts (worry and rumination) and autonomic arousal. We investigated the neurobiological substrates of such abnormal inhibitory processes, hypothesizing aberrant functional coupling within 'default mode' (DMN) and autonomic brain networks. Functional imaging and heart rate variability (HRV) data were acquired from GAD patients and controls during performance of three tracking tasks interspersed with a perseverative cognition (PC) induction. After detection of infrequent target stimuli, activity within putative DMN hubs was suppressed, consistent with a redirection of attentional resources from internal to external focus. This magnitude of activity change was attenuated in patients and individuals with higher trait PC, but was predicted by individual differences in HRV. Following the induction of PC in controls, this pattern of neural reactivity became closer to that of GAD patients. Results support, at a neural level, the association between cognitive inflexibility and autonomic rigidity.

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Section: Discussionsupporting

confidence: 64%

Neurobiological substrates of cognitive rigidity and autonomic inflexibility in generalized anxiety disorder

Ottaviani

Watson

Meeten

et al. 2016

Biological Psychology

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“…Watkins et al (2005) found that worry, which is typically studied within the context of GAD, and rumination, which is commonly studied within the context of depression, were more similar than different. These forms of RNT have been found to be associated with various emotional disorders cross-sectionally, experimentally, and longitudinally (Nolen-Hoeksema, 2000;NolenHoeksema & Morrow, 1993;Nolen-Hoekseema, Wisco, & Lyubomirsky, 2008;Borkovec, Alcaine, & Behar, 2004;McEvoy et al, 2009), and there is evidence that they are associated with symptoms of multiple emotional disorders (McEvoy & Brans, 2013;Segerstrom, Tsao, Alden, & Craske, 2000). McEvoy et al (2010) found that after diagnosis-specific confounds were removed from the instructions and items in various well-validated measures of RNT (i.e., worry, rumination, and post-event processing) items loaded on a single RNT factor in a clinical sample with anxiety and depressive disorders.…”

Section: Introductionmentioning

confidence: 99%

Intolerance of uncertainty and negative metacognitive beliefs as transdiagnostic mediators of repetitive negative thinking in a clinical sample with anxiety disorders

McEvoy

Mahoney

2013

Journal of Anxiety Disorders

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This study aimed to replicate and extend a hierarchical model of vulnerability to worry, with neuroticism and extraversion as higher-order factors and negative metacognitions and intolerance of uncertainty as second-order factors. The model also included a transdiagnostic measure of repetitive negative thinking (RNT) and depression symptoms as outcome variables to determine whether relationships would extend beyond worry, which has traditionally been studied within the context of generalized anxiety disorder (GAD). Participants (N = 99) were referrals to a specialist anxiety disorders clinic with a principal anxiety disorder who completed a battery of self-report questionnaires assessing neuroticism, extraversion, metacognitions, intolerance of uncertainty, worry, RNT, and depression symptoms.Mediational analyses using bootstrapping provided support for transdiagnostic and diagnosis-specific mediation effects. Negative metacognitions fully mediated the relationship between neuroticism and RNT for the whole sample and for subsamples with and without generalized anxiety disorder (GAD). Intolerance of uncertainty mediated the relationship between neuroticism and worry (for the whole sample and for those with GAD) and between neuroticism and RNT (for those with GAD).Implications for theory, treatment, and nosology are discussed.

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“…The role of processing underlying emotion has recently emerged as important to cognitive behavioral formulations of problems like generalized anxiety (see Borkovec, Alcaine, & Behar, 2004) and in cognitive therapy in general (Samoilov & Goldfried, 2000). Moreover, Elliott, Watson, Goldman, and Greenberg (2004) provided a broad framework for how emotional change occurs through the intrapersonal tasks described in emotion-focused therapy (EFT).…”

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confidence: 99%

Emotional processing in experiential therapy: Why "the only way out is through."

Pascual‐Leone¹,

Greenberg²

2007

Journal of Consulting and Clinical Psychology

275

326

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The purpose of this study was to examine observable moment-by-moment steps in emotional processing as they occurred within productive sessions of experiential therapy. Global distress was identified as an unprocessed emotion with high arousal and low meaningfulness. The investigation consisted of 2 studies as part of a task analysis that examined clients processing distress in live video-recorded therapy sessions. Clients in both studies were adults in experiential therapy for depression and ongoing interpersonal problems. Study 1 was the discovery-oriented phase of task analysis, which intensively examined 6 examples of global distress. The qualitative findings produced a model showing: global distress, fear, shame, and aggressive anger as undifferentiated and insufficiently processed emotions; the articulation of needs and negative self-evaluations as a pivotal step in change; and assertive anger, self-soothing, hurt, and grief as states of advanced processing. Study 2 tested the model using a sample of 34 clients in global distress. A multivariate analysis of variance showed that the model of emotional processing predicted positive in-session effects, and bootstrapping analyses were used to demonstrate that distinct emotions emerged moment by moment in predicted sequential patterns.

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Worry and Generalized Anxiety Disorder

Cited by 320 publications

References 64 publications

Neurobiological substrates of cognitive rigidity and autonomic inflexibility in generalized anxiety disorder

Neurobiological substrates of cognitive rigidity and autonomic inflexibility in generalized anxiety disorder

Intolerance of uncertainty and negative metacognitive beliefs as transdiagnostic mediators of repetitive negative thinking in a clinical sample with anxiety disorders

Emotional processing in experiential therapy: Why "the only way out is through."

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