The Effects of Worry and Relaxation on Flexibility During Cognitive Restructuring

2017 ◽  
Vol 42 (6) ◽  
pp. 838-863 ◽  
Author(s):  
Elizabeth S. Stevens ◽  
Alexander A. Jendrusina ◽  
Alison C. Legrand ◽  
Erica R. Nahin ◽  
Michelle Goldwin Kaufman ◽  
...  

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.

2008 ◽  
Vol 22 (4) ◽  
pp. 716-721 ◽  
Author(s):  
Susan Evans ◽  
Stephen Ferrando ◽  
Marianne Findler ◽  
Charles Stowell ◽  
Colette Smart ◽  
...  

1999 ◽  
Vol 27 (1) ◽  
pp. 19-35 ◽  
Author(s):  
Robert C. Durham ◽  
Peter L. Fisher ◽  
Linda R. Trevling ◽  
Cathryn M. Hau ◽  
Karen Richard ◽  
...  

A one year follow-up is reported of a randomized clinical trial with generalized anxiety disorder (GAD) in which the main comparison was between analytic psychotherapy (AP) and cognitive therapy (CT), each delivered at weekly or fortnightly intervals over a six month period. CT was found to be significantly more effective than AP. However, GAD is a chronic and relapsing condition and follow-up data are needed to assess the durability of improvement and the possibility that the benefits of analytic psychotherapy may be more apparent over the longer term. Data were collected in three areas: (1) symptomatology and overall improvement; (2) medication usage and contact with GPs; and (3) attitudes to therapy. CT was clearly superior to AP on the main outcome measures and only a minority of AP patients made significant improvements. CT but not AP was associated with significant reductions in medication usage, and patients receiving CT were generally more positive about treatment received. Differences between treatments were less evident in the less intensive treatment condition where overall results were relatively poor. The most positive outcomes were achieved in the more intensive CT condition in which approximately two-thirds of patients achieved clinically significant improvements.


1995 ◽  
Vol 23 (3) ◽  
pp. 301-320 ◽  
Author(s):  
Adrian Wells

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 based on this framework in which GAD results from an interaction between the motivated use of worry as a coping strategy, negative appraisal of worry, and worry control attempts. These factors result from combinations of dysfunctional meta-beliefs and contribute to subjectively diminished cognitive control. The model presents new implications for a cognitive therapy of GAD, and these are illustrated with a single case treatment study.


2011 ◽  
Vol 25 (8) ◽  
pp. 1087-1094 ◽  
Author(s):  
Paul Crits-Christoph ◽  
Michelle G. Newman ◽  
Karl Rickels ◽  
Robert Gallop ◽  
Mary Beth Connolly Gibbons ◽  
...  

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