Further tests of a cognitive model of generalized anxiety disorder: Metacognitions and worry in GAD, panic disorder, social phobia, depression, and nonpatients (original) (raw)
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Journal of psychopathology and behavioral assessment, 2024
high levels of comorbidity (Kessler et al., 2005) and psychosocial impairment (Hunt et al., 2004). As a result, much research over the past 20 years has explored the cognitive mechanisms contributing to the development and maintenance of GAD, with the aim of identifying targets for intervention and treatment. The metacognitive model of GAD (Wells, 1995) is based on the Self-Regulatory Executive Function (S-REF) model (Wells & Matthews, 1994, 1996), a transdiagnostic theory that incorporates the cognitive and attentional processes and biases implicated in emotional disorders. In relation to GAD, the metacognitive model postulates that holding both positive and negative beliefs about worry results in heightened levels of perseverative thinking and distress. When perceived threats trigger intrusive negative thoughts (e.g., "What if it's cancer?"), positive beliefs are activated (e.g., "Worrying helps me solve problems"), leading to the selection of worry as a coping strategy. This form of worry,
Preliminary tests of a cognitive model of generalized anxiety disorder
Behaviour Research and Therapy, 1999
Although worry is the central feature of Generalised Anxiety Disorder (GAD), little is known about the factors that contribute to pathological or problematic worry. In a recent cognitive model of GAD, Wells, A. (1995) proposed that negative appraisal of worrying itself (meta-worry or type 2 worry) should be distinguished from other types of worrying (type 1 worry). A central feature of this model is the idea that individuals with GAD hold rigid positive beliefs about the usefulness of worrying as a coping strategy. However, these individuals also hold negative beliefs and appraise worrying as uncontrollable and dangerous. This combination of cognitions and associated responses leads to an increased frequency and generality of worrying, and thus to the pathological worry characteristic of GAD. This paper reports a preliminary test of the hypothesis that meta-worry contributes to problematic and pathological worrying, and this relationship is independent of the frequency of other types of worry. In testing for associations between worry dimensions we controlled for overlaps with Trait anxiety, and the controllability of worrying. Results of a series of regression analyses support the hypothesis that pathological worry is associated with meta-worry and this association is independent of Trait-anxiety and type 1 worry. The clinical implications of these data are brie¯y discussed. #
Meta-cognition and worry: A cognitive model of generalized anxiety disorder
Behavioural and Cognitive Psychotherapy, 1995
A meta-cognitive classification and analysis of factors contributing to the development of problematic worry is presented. Dimensions of meta-beliefs, meta-worry, cognitive consciousness, and strategies can be distinguished. A cognitive model of Generalized Anxiety Disorder is advanced ...
Intolerance of uncertainty and meta-worry: Relative importance in discriminating GAD
This study explored whether intolerance of uncertainty and/or meta-worry discriminate between non-clinical individuals and those diagnosed with generalised anxiety disorder (GAD group). The participants were 107 GAD clients and 91 university students. The students were divided into two groups (high and low GAD symptom groups). A multivariate analysis of covariance (MANCOVA) adjusting for age indicated that intolerance of uncertainty distinguished between the low GAD symptom group and the high GAD symptom group, and between the low GAD symptom group and the GAD group. Meta-worry distinguished all three groups. A discriminant function including intolerance of uncertainty and meta-worry classified 94.4% of the GAD group and 97.9% of the low GAD symptom group. Only 6.8% of the high GAD symptom group was classified correctly, 77.3% of the high GAD symptom group was classified as GAD.
2019
Objective: The present study aimed at examining worry, cognitive avoidance, intolerance of uncertainty, and metacognitive beliefs, as transdiagnostic factors, in clinical samples with Generalized Anxiety Disorder (GAD) and Obsessive-Compulsive Disorder (OCD). Methods: In total, 200 patients (66 with GAD, 74 with OCD, and 60 with comorbid GAD and OCD) were selected to participate in this study using the purposeful sampling method. The participants completed the Penn State worry questionnaire, cognitive avoidance questionnaire, intolerance of uncertainty scale, and metacognitive beliefs questionnaire. Results: The findings showed no significant difference between patients with GAD and OCD in total scores of these constructs; however, the patients with comorbidity of GAD and OCD showed significantly higher scores in these measures (P<0.01) compared with the patients with GAD or OCD. Conclusion: These cognitive factors are possible transdiagnostic factors shared between GAD and OCD. Moreover, they considerably increase when GAD and OCD co-occur.
Metacognitive therapy for generalized anxiety disorder: An open trial
Journal of behavior therapy and experimental …, 2006
Generalized anxiety disorder (GAD) responds only modestly to existing cognitive-behavioural treatments. This study investigated a new treatment based on an empirically supported metacognitive model [Wells, (1995). Metacognition and worry: A cognitive model of generalized anxiety ...
Nordic Journal of Psychiatry, 2019
Background: The impairments in metacognitive functions and emotion recognition are considered as liable factors in anxiety disorders. Aims: The better understanding of these cognitive abilities might lead to develop more accurate treatment methods for patients who suffer from anxiety. Methods: Forty-four patients with panic disorder (PD), 37 individuals with generalized anxiety disorder (GAD) and 44 healthy control (HC) were participated in our study. Metacognition questionnaire-30 (MCQ-30), Reading The Mind From The Eyes Test and symptom severity tests were administered. Results: Statistical analyses estimated the dysfunctional metacognitive beliefs and disrupted emotion recognition in patients relative to HC. The 'need to control thoughts' aspect of metacognitive beliefs was accounted for symptom severity in GAD. Improper metacognitive beliefs were significantly predicted the PD and GAD. In addition, impoverished emotion recognition predicted the GAD. Conclusions: Our study revealed the role of inconvenient metacognitive beliefs and distorted emotion recognition in PD and GAD. These findings might facilitate the treatment management in cognitive therapies of anxiety disorders via pointing out more reasonable targets across improper cognitive fields.
Objective:This study aimed to differentiate illness anxiety and generalized anxiety by the role of metacognition and intolerance of uncertainty. Methods: This research was a descriptive-correlational study with an ex post facto design. The study population included all students of Yazd University, and the study sample comprised 400 healthy adult university students (Mean age=23.3 years, SD=4.9) who were selected using the convenience sampling method. Participants were asked to fill out 4 self-report measures: short health anxiety inventory, intolerance of uncertainty scale, metacognitions questionnaire, and Penn State Worry questionnaire. Finally, 338 questionnaires were statistically analyzed by SPSS 20, using ANOVA and discriminant function analysis. Results: The results showed that there were significant differences between different groups with respect to most studied variables and that intolerance of uncertainty cannot discriminate between 2 disorders. We can argue that this factor is a significant risk factor in both illness anxiety and generalized anxiety disorders. Conclusion: In general, transdiagnostic factors such as intolerance of uncertainty and cognitive beliefs have significant roles in emotional disorders, and can be considered as therapeutic targets.