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Szabo J, Koerner N, Carney CE. Social problem-solving attitudes and performance as a function of differences in trait and state worry. J Behav Ther Exp Psychiatry 2023; 78:101792. [PMID: 36435552 DOI: 10.1016/j.jbtep.2022.101792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 07/29/2022] [Accepted: 09/30/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES This study investigated problem-solving attitudes and state-dependent, performance-based problem-solving abilities of individuals with high trait worry as compared to those low in trait worry. Secondary objectives involved investigating the relationship between problem-solving effectiveness and processes hypothesized to influence worry and problem-solving (i.e., working memory, attentional control, emotional dysregulation, and concreteness of thought). METHODS A 2 (group: high worry, n = 68, vs. low worry, n = 66) X 2 (induction type: worry vs. neutral mentation) factorial design was employed to investigate the differential effects of state worry, and neutral mentation for comparison, on performance-based problem-solving effectiveness. Independent samples t-tests tested for group differences in self-reported problem-solving attitudes. Multiple regression analyses were used to investigate if aforementioned processes predict problem-solving effectiveness. RESULTS Previous findings that individuals with high trait worry endorse greater tendencies to self-report unconstructive problem-solving attitudes were replicated. Contrary to predictions, there were no significant within or between group differences on problem-solving performance. Concreteness of problem solutions was the only consistent predictor of problem-solving effectiveness. LIMITATIONS Study did not directly assess problem-solving for personal problems. CONCLUSIONS Disparities in self-appraisal may account for lack of worry-related performance differences. Findings suggest that when employing problem-solving interventions with a high worry population, emphasis should be placed on changing maladaptive problem attitudes. Nonclinical and clinical populations alike may benefit from incorporating training in concreteness in problem-solving therapy.
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Affiliation(s)
- Judit Szabo
- Department of Psychology, Toronto Metropolitan University, Canada
| | - Naomi Koerner
- Department of Psychology, Toronto Metropolitan University, Canada.
| | - Colleen E Carney
- Department of Psychology, Toronto Metropolitan University, Canada
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Zabelina DL, Jennings PE, Veilleux JC. EXPRESS: Cognition and Affect in Imagined and Recalled Scenarios as a Function of a Specificity Manipulation: An Experience Sampling Study. Q J Exp Psychol (Hove) 2022; 75:1763-1772. [PMID: 35073805 DOI: 10.1177/17470218221078869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Previous work has examined the effect of specificity and temporal focus (i.e., memory vs. imagina-tion) on people's cognition and associated affect. Here, using experience sampling methods, we take these previously addressed questions out of the laboratory into daily-life settings. Participants (N = 228) were randomly assigned to a specificity or control condition, and recorded imagined or recalled scenarios twice a day for one week. Results revealed a main effect of specificity where specificity prompts resulted in written scenarios that were rated by independent judges as more cre-ative, more positive, less negative, more coherent, and incorporated more sensory content. Specific-ity had few direct influences on affect, though an interaction showed that imagined scenarios with specificity prompts resulted in reduced self-reported anxiety. Implications and future directions are discussed.
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A randomized experimental analysis of the attention training technique: Effects on worry and relevant processes in individuals with probable generalized anxiety disorder. Behav Res Ther 2021; 141:103863. [PMID: 33872957 DOI: 10.1016/j.brat.2021.103863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/31/2021] [Accepted: 04/06/2021] [Indexed: 11/23/2022]
Abstract
CONTEXT The Attention Training Technique (ATT, Wells, 1990) is an intervention guiding individuals to focus, shift, and divide their attention in response to sounds presented in an audiorecording. The ATT has long been recommended for generalized anxiety disorder (GAD); however, there is insufficient research on its effects on excessive worry and related processes. OBJECTIVES This experiment examined whether the ATT is more efficacious than a control intervention at reducing worry and modifying worry-related processes (e.g., attention control, negative metacognitive beliefs, attention bias, mindfulness). PARTICIPANTS 78 adults with probable GAD. DESIGN Participants completed measures of worry and worry-related processes at the lab. They then monitored worry and attention daily for a week. Following this baseline, participants recompleted the lab measures and were randomly assigned to ATT or control. Participants listened to their assigned recording once/day for a week while again monitoring worry and attention daily. Participants then recompleted the lab measures. RESULTS The ATT did not perform better than the control condition on any measure. A variety of improvements were seen over the intervention period in both conditions. CONCLUSIONS ATT may not have meaningful effects on excessive worry and worry-related processes. Explanations for null findings are offered. CLINICALTRIALS. GOV REGISTRATION NCT03216382.
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Jendrusina AA, Stevens ES, Nahin ER, Legrand AC, Behar E. Concreteness of thoughts and images during suppression and expression of worry. Behav Res Ther 2020; 135:103754. [PMID: 33091681 DOI: 10.1016/j.brat.2020.103754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 06/21/2020] [Accepted: 10/07/2020] [Indexed: 11/26/2022]
Abstract
The avoidance theory of worry (Borkovec, Alcaine, & Behar, 2004) posits that the verbal-linguistic (versus imagery-based) nature of worry elicits abstract (versus concrete) processing, which inhibits affective responding and generates a host of negative consequences. Although suppression of worrisome thinking is maladaptive (Purdon, 1999), expression of worry using vivid imagery may increase concreteness of worrisome thinking and facilitate more adaptive emotional responding. The present study examined whether the valence, content, and expression of mentation impacts concreteness of thought. Participants (N = 62) were randomly assigned to verbalize their thoughts while engaging in either verbal-linguistic- or imagery-based mentation about both worrisome and neutral topics. Participants were also randomly assigned to engage in a 5-min period of suppressing or expressing the target stimuli before engaging in 5-min of freely expressing the targets. Verbalizations of mental content were coded for level of abstractness/concreteness. For neutral stimuli, imagery-based mentation led to greater concreteness than did verbal-linguistic mentation; however, for worrisome stimuli, imagery-based mentation did not enhance concreteness. In addition, for neutral (but not worrisome) stimuli, an initial period of suppression was associated with increased concreteness during subsequent expression. Imagery-based mentation about worrisome stimuli may not enhance concreteness; moreover, unlike suppression of neutral stimuli, suppression of worrisome stimuli may maintain, rather than ameliorate, abstractness of thought.
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Affiliation(s)
| | | | | | | | - Evelyn Behar
- City University of New York - Hunter College, USA
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Behar E, Borkovec TD. The effects of verbal and imaginal worry on panic symptoms during an interoceptive exposure task. Behav Res Ther 2020; 135:103748. [PMID: 33035740 DOI: 10.1016/j.brat.2020.103748] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 09/23/2020] [Accepted: 09/28/2020] [Indexed: 11/18/2022]
Abstract
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. In this study, participants high in anxiety sensitivity were asked to engage in verbal worry, imaginal worry, or relaxation prior to each of three repeated presentations of an interoceptive exposure task. Relaxation was associated with lower initial subjective fear that remained low across repeated exposures, and related stable sympathetic arousal (and decreased heart rate) over time. Imagery-based worry was associated with moderate initial subjective fear that was sustained across repeated exposures, and sympathetic arousal (and heart rate) that was likewise stable over time. However, verbal worry was associated with high initial subjective fear that was sustained over time, but sympathetic arousal (and heart rate) that decreased across repeated exposures. Thus, verbal worry was uniquely associated with a lack of synchronous response systems and maintenance of anxious meaning over time. Theoretical and clinical implications are discussed.
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Affiliation(s)
- Evelyn Behar
- Hunter College - City University of New York, USA.
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Yeo GC, Hong RY, Riskind JH. Looming Cognitive Style and Its Associations with Anxiety and Depression: A Meta-analysis. COGNITIVE THERAPY AND RESEARCH 2020. [DOI: 10.1007/s10608-020-10089-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Wahl K, Ehring T, Kley H, Lieb R, Meyer A, Kordon A, Heinzel CV, Mazanec M, Schönfeld S. Is repetitive negative thinking a transdiagnostic process? A comparison of key processes of RNT in depression, generalized anxiety disorder, obsessive-compulsive disorder, and community controls. J Behav Ther Exp Psychiatry 2019; 64:45-53. [PMID: 30851652 DOI: 10.1016/j.jbtep.2019.02.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 02/06/2019] [Accepted: 02/17/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND OBJECTIVES The transdiagnostic view of repetitive negative thinking (RNT) claims that different forms of RNT are characterized by identical processes that are applied to disorder-specific content. The purpose of the study was to test whether the processes of RNT differ across major depression disorder (MDD), generalized anxiety disorder (GAD), and obsessive-compulsive disorder (OCD). METHODS Forty-two individuals diagnosed with MDD, 35 individuals with GAD, 41 individuals with OCD, and 35 community controls were asked to think of a typical RNT episode and to rate its processes (core processes; use of mental capacity, unproductivity, abstractness, verbal quality, duration). Ratings were compared across groups using planned contrasts and analysis of variance. RESULTS All individuals with a clinical diagnosis rated the key processes of RNT and avoidance function of RNT as higher than healthy controls. There were no differences between individuals diagnosed with MDD, GAD or OCD on key processes and avoidance function of RNT. LIMITATIONS Results are based on retrospective self-reports, which might restrict validity of the measurements. CONCLUSIONS Data support the transdiagnostic hypothesis of RNT. Transdiagnostic prevention and intervention techniques seem highly recommendable given these findings.
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Affiliation(s)
- Karina Wahl
- University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Missionsstr. 62a, 4055, Basel, Switzerland.
| | - Thomas Ehring
- LMU Munich, Department of Psychology, Division of Clinical Psychology and Psychotherapy, Leopoldstr. 13, 80802, Munich, Germany
| | - Hanna Kley
- Bielefeld University, Department of Psychology, Division of Clinical Psychology and Psychotherapy, Psychotherapy Clinic of the University Bielefeld, Morgenbreede 2-4, 33615, Bielefeld, Germany
| | - Roselind Lieb
- University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Missionsstr. 62a, 4055, Basel, Switzerland
| | - Andrea Meyer
- University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Missionsstr. 62a, 4055, Basel, Switzerland
| | - Andreas Kordon
- Oberbergklinik Hornberg, Oberberg 1, 79132, Hornberg, Germany
| | - Carlotta V Heinzel
- University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Missionsstr. 62a, 4055, Basel, Switzerland
| | - Martin Mazanec
- University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Missionsstr. 62a, 4055, Basel, Switzerland
| | - Sabine Schönfeld
- Institut für Allgemeine Psychologie, Biopsychologie und Methoden der Psychologie; Professur Differentielle und Persönlichkeitspsychologie; TU Dresden, 01062, Dresden, Germany
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Jing HG, Madore KP, Schacter DL. Not to worry: Episodic retrieval impacts emotion regulation in older adults. Emotion 2019; 20:590-604. [PMID: 30816741 DOI: 10.1037/emo0000581] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Interventions that increase the specificity of episodic memory and future-oriented problem solving have been shown to help both young adults and clinical populations regulate their emotions toward potential stressors. However, little is known about how episodic specificity impacts anxiety levels in older adults, who show reduced specificity of episodic memory, future simulation, and problem-solving performance. Although emotion regulation generally improves with age, older adults still experience worries pertaining to their health and interpersonal relationships. The current studies test how episodic specificity affects emotion regulation in older adults. In Experiment 1, participants received an episodic specificity induction (ESI)-brief training in recollecting details of past experiences-prior to generating steps to solve worrisome problems. Older adults provided more relevant steps and episodic details after the specificity induction relative to a control induction, but we found no difference in emotion regulation ratings between induction conditions. In Experiment 2, we contrasted performance on a personal problem-solving task (i.e., generating steps to solve one's own problems) intended to draw on episodic retrieval with an advice task focused on semantic processing (i.e., listing general advice for an acquaintance worried about similar problems). Participants provided more relevant steps and episodic details in the personal problem-solving task relative to the advice task, and boosts in detail were related to larger reductions in anxiety toward the target worrisome events. These results indicate that solving worrisome problems with greater levels of episodic detail can positively influence emotion regulation in older adults. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Stevens ES, Behar E, Jendrusina AA. Enhancing the Efficacy of Cognitive Bias Modification for Social Anxiety. Behav Ther 2018; 49:995-1007. [PMID: 30316496 DOI: 10.1016/j.beth.2018.02.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 01/24/2018] [Accepted: 02/13/2018] [Indexed: 10/18/2022]
Abstract
Cognitive bias modification for interpretation (CBM-I) is a promising treatment modality for social anxiety disorder, but effect sizes are relatively small across investigations (Hallion & Ruscio, 2011). Additionally, the extent to which CBM-I impacts other cognitive, emotional, and behavioral outcomes is unclear. This study investigated whether two empirically supported treatment components for anxiety disorders, imaginal exposure (IE) and relaxation, augment the effects of CBM-I and increase the extent to which the effects of CBM-I generalize to behavioral and affective outcomes. We randomly assigned 111 undergraduate students with social anxiety to undergo IE, relaxation, or neutral thinking prior to CBM-I, then measured their interpretation biases, as well as their speaking time, anxiety, and subjective evaluations of performance during a speech task. Results indicated that individuals who received IE prior to CBM-I evidenced more adaptive interpretation biases and less behavioral avoidance during the speech task than did individuals who engaged in relaxation or neutral thinking. However, they did not report differential anxiety, habituation, or evaluations of their performance on the speech task. These findings suggest that the combination of CBM-I with adjunct components that target behavioral, rather than cognitive, mechanisms can facilitate transfer of the effects of CBM-I to reducing behavioral avoidance.
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Skodzik T, Adelt MH, Nossek VA, Kuck ST, Ehring T. Does a novel training in mental imagery reduce pathological worry? Behav Res Ther 2018; 109:56-67. [DOI: 10.1016/j.brat.2018.07.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 07/17/2018] [Accepted: 07/23/2018] [Indexed: 11/30/2022]
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Stevens ES, Jendrusina AA, Legrand AC, Nahin ER, Kaufman MG, Borkovec TD, Behar E. The Effects of Worry and Relaxation on Flexibility During Cognitive Restructuring. Behav Modif 2017; 42:838-863. [DOI: 10.1177/0145445517732272] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
| | | | | | | | | | | | - Evelyn Behar
- University of Illinois at Chicago, Chicago, IL, USA
- Hunter College, City University of New York, NY, USA
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Preparing for what might happen: An episodic specificity induction impacts the generation of alternative future events. Cognition 2017; 169:118-128. [PMID: 28886407 DOI: 10.1016/j.cognition.2017.08.010] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 08/24/2017] [Accepted: 08/28/2017] [Indexed: 12/17/2022]
Abstract
A critical adaptive feature of future thinking involves the ability to generate alternative versions of possible future events. However, little is known about the nature of the processes that support this ability. Here we examined whether an episodic specificity induction - brief training in recollecting details of a recent experience that selectively impacts tasks that draw on episodic retrieval - (1) boosts alternative event generation and (2) changes one's initial perceptions of negative future events. In Experiment 1, an episodic specificity induction significantly increased the number of alternative positive outcomes that participants generated to a series of standardized negative events, compared with a control induction not focused on episodic specificity. We also observed larger decreases in the perceived plausibility and negativity of the original events in the specificity condition, where participants generated more alternative outcomes, relative to the control condition. In Experiment 2, we replicated and extended these findings using a series of personalized negative events. Our findings support the idea that episodic memory processes are involved in generating alternative outcomes to anticipated future events, and that boosting the number of alternative outcomes is related to subsequent changes in the perceived plausibility and valence of the original events, which may have implications for psychological well-being.
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Bulley A, Henry JD, Suddendorf T. Thinking about threats: Memory and prospection in human threat management. Conscious Cogn 2017; 49:53-69. [DOI: 10.1016/j.concog.2017.01.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 09/10/2016] [Accepted: 01/22/2017] [Indexed: 12/15/2022]
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