Characteristics of worry in Generalized Anxiety Disorder

Abstract

Background & objectivesGroups of clients and community volunteers with Generalized Anxiety Disorder (GAD) and clients with Panic Disorder were compared to a group with elevated worry but without GAD on a range of measures, to identify individual differences beyond a high propensity to worry.MethodParticipants completed standardised questionnaires and a behavioural worry task that assesses frequency and severity of negative thought intrusions.ResultsRelative to high worriers, clients with GAD had higher scores on trait anxiety, depression, more negative beliefs about worry, a greater range of worry topics, and more frequent and severe negative thought intrusions. Relative to community volunteers with GAD, clients in treatment reported poorer attentional control. Compared to clients with Panic Disorder, clients with GAD had higher trait anxiety, propensity to worry, negative beliefs and a wider range of worry content.ConclusionsResults confirmed expectations of group differences based on GAD diagnostic criteria, but also revealed other differences in mood, characteristics of worry, and perceived attentional control that may play a role in the decision to seek treatment.

Shared and Distinct Cognitive/Affective Mechanisms in Intrusive Cognition: An Examination of Worry and Obsessions

“…In a large community sample, poorer self-reported AC and greater NU were associated with more severe worry symptoms, even after controlling for trait negative affect, replicating prior findings in clinical and student samples (Armstrong et al, 2011; Gay et al, 2011; Hirsh et al, 2013; Pawluk & Koerner, 2013). Similarly, poorer self-reported AC was also related to greater repugnant obsessions independent of trait negative affect.…”

“…Indeed, GAD patients have reported poorer self-reported AC compared to healthy controls in multiple studies (Armstrong, Zald, & Olatunji, 2011; Moradi, Fata, Abhari, & Abbasi, 2014). Poorer self-reported AC was also associated with greater worry symptoms in a clinical GAD sample (Armstrong et al, 2011) and distinguished GAD patients who sought treatment from those in the community (Hirsch, Mathews, Lequertier, & Perman, 2013); this suggests perceived AC may vary with GAD severity. Additionally, poor self-reported AC was found to mediate the relationship between GAD diagnosis and impaired target detection following distractors, with the effect driven by neutral, not affective, distractors (Olatunji, Ciesielski, Armstrong, Zhao, & Zald, 2011).…”

“…Based on prior studies demonstrating symptom level associations between obsessions and NU (Cougle et al, 2012), but not AC (Armstrong et al, 2011), and data suggesting the importance of affective context to response suppression in OCD, especially for repugnant obsessions (Najmi et al, 2010; Morein-Zamir et al, 2010), we hypothesized an interaction between AC and NU such that perceived AC would only be related to repugnant obsessions for individuals with low NU, controlling for negative affect. Conversely, given self-report data revealing associations between AC and worry/GAD severity (Armstrong et al, 2011; Hirsch et al, 2013) and neural/behavioral data suggesting that AC deficits in GAD are not dependent on affective context (Bishop, 2008; Olatunji et al, 2011), we hypothesized that NU would only be associated with worry in individuals with good self-reported AC.…”

Metacognitive, Emotional, and Avoidance Predictors of Generalized Anxiety Disorder

“…Negative metacognitive beliefs represent a view of worrying as uncontrollable and dangerous that can eventually lead to worrying about worrying. There has been strong empirical support for the relationship between negative metacognitive beliefs and GAD, whereas the predictive power of positive beliefs on GAD symptoms is relatively weak (e.g., Hirsch, Mathews, Lequertier, Perman, & Hayes, 2013;Penney, Mazmanian, & Rudanycz, 2013).…”

Cognitive bias modification for interpretation with and without prior repetitive negative thinking to reduce worry and rumination in generalised anxiety disorder and depression: protocol for a multisession experimental study with an active control condition

“…Based on the original breathing focus task/worry task,17 18 53 participants focus on their breathing for 5 min and indicate at randomly cued intervals whether they are indeed focusing on their breathing or are experiencing a thought intrusion. Participants categorise thought intrusions as negative or otherwise and provide brief summaries of content.…”