The effects of verbal and imaginal worry on panic symptoms during an interoceptive exposure task.

Previous research has documented the inhibitory effects of worry on cardiovascular reactivity to subsequently presented fear-relevant stimuli. Although theoretical assertions point to the verbal-linguistic (as opposed to imagery-based) nature of worry as the cause of these inhibitory effects, extant research investigating the effects of worrisome thinking on subsequent anxiety-eliciting tasks has not isolated the verbal-linguistic nature of worry as the active ingredient in its suppressive effects on arousal. Furthermore, prior research has not examined the potential effects of worry on maintenance of panic symptoms.

Metacognitive therapy versus cognitive-behavioural therapy in adults with generalised anxiety disorder.

Background: Cognitive-behavioural therapy (CBT) is the treatment of choice for generalised anxiety disorder (GAD), yielding significant improvements in approximately 50% of patients. There is significant room for improvement in the outcomes of treatment, especially in recovery.

Aims: We aimed to compare metacognitive therapy (MCT) with the gold standard treatment, CBT, in patients with GAD (clinicaltrials.

The Effects of Worry and Relaxation on Flexibility During Cognitive Restructuring.

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.

A contemporary view of applied relaxation for generalized anxiety disorder.

Applied relaxation (AR), originally developed by Lars-Göran Öst, is a long-standing, efficacious treatment for generalized anxiety disorder (GAD). While newer treatments are continuing to be developed, AR remains one of the most efficacious treatments for GAD. However, AR has received less in-depth attention more recently, particularly in terms of potential mechanisms of action.

The PTSD Checklist-Civilian Version: reliability, validity, and factor structure in a nonclinical sample.

Objectives: We examined the reliability, validity, and factor structure of the posttraumatic stress diorder (PTSD) Checklist-Civilian Version (PCL-C; Blanchard, Jones-Alexander, Buckley, & Forneris, 1996) among unselected undergraduate students.

Participants: Participants were 471 undergraduate students at a large university in the Eastern United States and were not preselected based on trauma history or symptom severity.

Results: The PCL-C demonstrated good internal consistency and retest reliability.

Concreteness of positive, negative, and neutral repetitive thinking about the future.

Consistent with assertions that the adaptiveness of repetitive thinking is influenced by both its valence and style, Stöber (e.g., Stöber & Borkovec, 2002) has argued that worry is characterized by a reduced concreteness of thought content and that the resulting abstractness contributes to its inhibition of some aspects of anxious responding.

The extent and nature of imagery during worry and positive thinking in generalized anxiety disorder.

Clients in treatment for Generalized Anxiety Disorder (GAD) were compared to a control group to assess the extent and nature of imagery during worry or while thinking about a personally relevant positive future event. Two methods were used to assess mentation and were completed in counter balanced order within the worry and positive conditions. One method assessed the occurrence of imagery by requiring participants to categorize their mentation as verbal thoughts or images every 10 s.

A randomized controlled trial of cognitive-behavioral therapy for generalized anxiety disorder with integrated techniques from emotion-focused and interpersonal therapies.

Objective: Recent models suggest that generalized anxiety disorder (GAD) symptoms may be maintained by emotional processing avoidance and interpersonal problems.

Method: This is the first randomized controlled trial to test directly whether cognitive-behavioral therapy (CBT) could be augmented with the addition of a module targeting interpersonal problems and emotional processing. Eighty-three primarily White participants (mean age = 37) with a principle diagnosis of GAD were recruited from the community.

Psychotherapists, researchers, or both? A qualitative analysis of psychotherapists' experiences in a practice research network.

This paper describes the experiences of psychotherapists who, as part of a practice research network (PRN), collaborated with researchers in designing and conducting a psychotherapy study within their own clinical practices. A qualitative analysis of interviews conducted with these psychotherapists led to the delineation of several benefits (e.g.

Helpful and hindering events in psychotherapy: a practice research network study.

This paper presents the findings of a psychotherapy process study conducted within the Pennsylvania Psychological Association Practice Research Network (PPA-PRN). The investigation was the product of a long-term collaborative effort, both in terms of the study design and implementation, between experienced clinicians of various theoretical orientations and full-time psychotherapy researchers. Based on a relatively large sample of clients seen in independent practice settings, close to 1,500 therapeutic events (described by clients and therapists as being particularly helpful or hindering) were collected.

Diagnostic comorbidity in adults with generalized anxiety disorder: impact of comorbidity on psychotherapy outcome and impact of psychotherapy on comorbid diagnoses.

The current study examined the impact of comorbidity on cognitive and behavioral therapies for generalized anxiety disorder (GAD) as well as the impact of these therapies on diagnoses comorbid to GAD. Seventy-six treatment-seeking adults with principal diagnoses of GAD received 14 sessions of therapy. Most (n=46; 60.

Future-oriented decision-making in Generalized Anxiety Disorder is evident across different versions of the Iowa Gambling Task.

Generalized Anxiety Disorder (GAD) and excessive worrying are characterized by a preoccupation with the future. Thus, enhanced identification of potential future punishments or omissions of reward may be related to the disorder. To test this hypothesis, n=47 students meeting GAD criteria according to the GADQ-IV (GAD analogues) or not (control participants) performed the Iowa Gambling Task, which has been related to sensitivity to future consequences.

Generalized worry disorder: a review of DSM-IV generalized anxiety disorder and options for DSM-V.

Background: Generalized anxiety disorder (GAD) has undergone a series of substantial classificatory changes since its first inclusion in DSM-III. The majority of these revisions have been in response to its poor inter-rater reliability and concerns that it may lack diagnostic validity. This article provides options for the revision of the DSM-IV GAD criteria for DSM-V.

Generalized anxiety disorder: connections with self-reported attachment.

Even though generalized anxiety disorder (GAD) is one of the most common of the anxiety disorders, relatively little is known about its precursors. Bowlby's attachment theory provides a framework within which these precursors can be considered. According to Bowlby, adult anxiety may be rooted in childhood experiences that leave a child uncertain of the availability of a protective figure in times of trouble.

Startle response in generalized anxiety disorder.

Background: The main purpose of the present study was to examine the startle reflex in individuals diagnosed with Generalized Anxiety Disorder (GAD) and control participants in terms of three questions. First, is the basic startle reflex modulated by autonomic nervous system (ANS) activation and/or attentional focus? Second, are induced and self-reported emotional states related to the magnitude of the startle response? And third, do individuals with GAD and their controls show differential startle responses?

Methods: Experimental tasks designed to elicit sympathetic and parasympathetic activation and requiring internal and external attention foci were administered to nine individuals with GAP and nine controls.

Results: Individuals with GAD showed a greater startle reflex than controls during involvement in tasks that either induced worry or relaxation but not during a baseline period.

AN OPEN TRIAL OF INTEGRATIVE THERAPY FOR GENERALIZED ANXIETY DISORDER.

Cognitive- behavioral therapy (CBT), although effective, has the lowest average effect size for generalized anxiety disorder (GAD), when compared to effect sizes of CBT for other anxiety disorders. Additional basic and applied research suggests that although interpersonal processes and emotional avoidance may be maintaining GAD symptomatology, CBT has not sufficiently addressed interpersonal issues or emotion avoidance. This study aimed to test the feasibility and preliminary efficacy of an integrative psychotherapy, combining CBT with techniques to address interpersonal problems and emotional avoidance.

Family history of psychological problems in generalized anxiety disorder.

The current investigation examined self-reported family history of psychological problems in a large sample of individuals diagnosed with generalized anxiety disorder (GAD) and nonanxious controls. The GAD participants were all individuals receiving cognitive-behavioral therapy as part of two large randomized clinical trials. Family history information was obtained from the Anxiety Disorders Interview Schedule-Revised (ADIS-R; DiNardo & Barlow, 1988).

Worry, generalized anxiety disorder, and emotion: evidence from the EEG gamma band.

The present study examined EEG gamma (35-70 Hz) spectral power distributions during worry inductions in participants suffering from generalized anxiety disorder (GAD) and in control participants without a history of psychiatric illness. As hypothesized, the EEG gamma band was useful for differentiating worry from baseline and relaxation. During worry induction, GAD patients showed higher levels of gamma activity than control participants in posterior electrode sites that have been previously associated with negative emotion.

The effects of worry and rumination on affect states and cognitive activity.

The effects of worry and rumination on affective states and mentation type were examined in an unselected undergraduate sample in Study 1 and in a sample of individuals with high trait worry and rumination, high rumination, and low worry/rumination in Study 2. Participants engaged in worry and rumination inductions, counterbalanced in order across participants to assess main and interactive effects of these types of negative thinking. During mentation periods, the thought vs.

Interpersonal process and outcome in variants of cognitive-behavioral psychotherapy.

Early sessions from three variants of cognitive-behavioral therapy (CBT) were examined to replicate work done in psychodynamic-interpersonal treatments linking interpersonal process to outcome (W. P. Henry, T.

Problems with the use of placebo conditions in psychotherapy research, suggested alternatives, and some strategies for the pursuit of the placebo phenomenon.

Due to the numerous conceptual, methodological, and ethical problems that are associated with placebo conditions in psychotherapy research, their use should be abandoned, and more powerful therapy outcome designs (dismantling, additive, parametric, and catalytic) that can contribute to basic knowledge through their ability to isolate specific cause-and-effect relationships are recommended. On the other hand, if indeed the placebo effect is a reliable phenomenon, it would be wise to pursue its causal mechanisms, and some research strategies for initiating such pursuit are briefly described.

Validity of the inventory of interpersonal problems for predicting treatment outcome: an investigation with the Pennsylvania Practice Research Network.

In this study, we examined the relationship between treatment outcome and variables from the Inventory of Interpersonal Problems Circumplex scales (IIP-C; Horowitz, Alden, Wiggins, & Pincus, 2000) in the Pennsylvania Psychological Association's Practice Research Network (PRN; Borkovec, Echemendia, Ragusea, & Ruiz, 2001). The PRN was a naturalistic observation treatment outcome study conducted with clinicians who were providing outpatient therapy. Assessment instruments, including the Compass Assessment System (Howard, Brill, Lueger, O'Mahoney, & Grissom, 1993; Sperry, Brill, Howard, & Grissom, 1996) and the IIP-C, were used to assess outcome at the 7th session (N=73) and at termination (N=42).

Experience and appraisal of worry among high worriers with and without generalized anxiety disorder.

Recent research has revealed that a large number of highly worried individuals do not qualify for a diagnosis of generalized anxiety disorder (GAD). This raises the intriguing question of why some high worriers are more impaired and distressed by their worrying than others, particularly when the severity of their worry is the same. The present investigation sought to address this question by examining whether GAD and non-GAD high worriers differ in their actual worry experiences, their subjective appraisals of worry experiences, or both experiences and appraisals of worry.

A test of the role of metaworry in the prediction of worry severity in an elderly sample.

Wells (Behav. Cogn. Psychother.

Interpretive cues and ambiguity in generalized anxiety disorder.

The current study investigated whether generalized anxiety disorder (GAD) individuals rely on antecedent information to interpret ambiguity and whether reliance on such preceding cues persists in the absence of potential threat. Twenty-six GAD and 23 nonanxious control college students performed a lexical decision task, using homographs (i.e.