Theoretical approaches to worry

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Borkovec's theory

The three theoreticians, Borkovec, Metzger, and Pruzinsky (1986), combined to propose a tripartite theory of worry and anxiety. The three tiers reflect their three predominant areas of interest: learning theory, cognitive psychology, and self-theory. However, the foundation of the model is Borkovec's work on learning theory and we shall concentrate on that in our brief review of this approach. Borkovec et al. (1986; Borkovec & Miranda, 1999), inspired by Mowrer's (1947) two-stage theory of fear, suggested that worry "can be viewed as a cognitive attempt to anticipate and avoid a myriad of possible, future outcomes" (p. 240). Thus, the individual anticipates a series of desired goals; however, due to a learning history of frustrated non-reward, the individual, when presented with cues associated with these goals, begins to feel increasingly anxious and thus attempts to avoid such cues. Worry, then, is viewed as an attempt to avoid negative outcomes by anticipating and contemplating all possibilities; Borkovec transfers Mowrer's concepts of frustrated non-reward and avoidance into the cognitive domain.

This initial theoretical formulation of Borkovec et al. has been developed (e.g., Borkovec, 1994; Borkovec & Miranda, 1999; Borkovec, Shadick, & Hopkins, 1990). The reformulation emphasises that worry primarily involves a verbal-linguistic activity; however, they go further, and suggest that such verbal-linguistic worry processes have a function of reducing the generation of threat-related imagery and subsequent physiological activity: "We are positing an actual suppression of physiological/ affective process as a direct consequence of worrisome conceptual activity" (Borkovec et al., 1990, p. 453). It is this negatively reinforcing function that, Borkovec suggests, maintains the worry process. Borkovec and Roemer (1995) and Borkovec et al. (1999) have reported evidence to show that individuals with GAD have a number of positive beliefs about the function of worry in their lives; for example, that worry reduces the likelihood of bad outcomes, that worry is motivating, and that it is often a method of distraction from current problems. Worry can therefore serve as a mechanism for cognitive avoidance of major current problems by re-focusing on either relatively minor or extremely unlikely events in the future, which leaves the worrier with an increased perception of control.

Barlow's theory

Barlow (1988, 2002) conceptualises worry as the end process in a series of causally linked events. These events are schematically illustrated in Figure 6.6.

Barlow's theory is impressive in that it incorporates psychological processes that are clearly important in worry, such as memory, attention, and self-evaluation. Furthermore, there are a number of studies that seem to support some of Barlow's proposals; for example, there is a body of research emphasising the importance of uncontrollability and unpredictability in the maintenance and onset of anxiety states (e.g., see Dugas, Buhr, & Ladouceur, 2004, for a review). Barlow goes some way towards explaining why intense worrying is so pervasive and difficult to bring to a halt, in that an internal focus of attention and a narrowing of attentional focus make it difficult for attentional resources to be directed to non-worry-relevant stimuli. However, as Eysenck (1992) points out, there are a number of problems with Barlow's approach: first, he is focusing almost exclusively on intense worrying as experienced by anxious patients; second, he argues that high arousal is a necessary antecedent of worry; and, finally, that worry is always a dysfunctional state. As Eysenck notes, "These contentions may be largely correct when applied to clinical worries, but seem implausible with respect to the everyday worries of normal individuals" (1992, p. 114).

Tallis and Eysenck's theory

Tallis and Eysenck (cited in Eysenck, 1992), building on the theoretical work of both Borkovec and Barlow, have proposed a theoretical approach to worry in which worry fulfils several major functions: first, worry serves an alarm function in that it introduces information concerning threat-related material into consciousness; second, worry serves a "prompt function" in that threat-related information in memory is continually re-presented to awareness so that the cognitive system might resolve it in some way; and finally, worry serves a preparation function, in that it allows the worrier to anticipate future situations and conceptualise possible solutions and dangers involved in them. Eysenck (1992) and his colleagues incorporate the functions of worry, as they see them, into the theoretical framework illustrated in Figure 6.7.

As is clear from the figure, external stimuli are appraised in terms of their threat value, and threat is seen by Eysenck et al. (Tallis & Eysenck, 1994) as a function of the putative cost, imminent likelihood, and self-efficacy associated with the event. Events that are appraised in this way as highly threatening initiate the process of worry, which serves to prompt the individual, ring alarm bells that something threatening is in the internal or external environment, and help to prepare the individual for possible future situations. Such worrying increases hypervigilant scanning of the environment and emotional sensitivity to worry-congruent material.

EVOCATION OF ANXIOUS PROPOSITIONS (Situational contexts, unexplained arousal or other cues)

(POSSIBLE) AVOIDANCE

DYSFUNCTIONAL PERFORMANCE and/or lack of concentration on task at hand

EVOCATION OF ANXIOUS PROPOSITIONS (Situational contexts, unexplained arousal or other cues)

C^intensification^^

ATTENTIONAL SHIFT to self-evaluative focus (on physiological or other aspects of responding)

ADDITIONAL INCREASES IN AROUSAL

(^^tensificatiorT^

ATTENTION NARROWING on negative affective content APPREHENSIVE HYPERVALENT COGNITIVE SCHEMA

Figure 6.6 Barlow's theory of worry (based on Barlow, 1988).

Borkovec Model Gad
Figure 6.7 Schematic diagram of the theory of worry (based on Tallis & Eysenck, 1994).

This process in turn increases arousal and self-focused attention, which operate in a vicious circle. Becoming lost in the vicious circle of worrying, increased arousal, and increased self-focused attention leads the individual to construct negative, catastrophic models of future events. The individual can then appropriately problem-solve the issue surrounding these events, in which case either the initial threat is diminished and the worry process recedes, or the individual can enter into inappropriate problemsolving strategies in which case the threat is preserved and the worry processes maintained.

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Do Not Panic

Do Not Panic

This guide Don't Panic has tips and additional information on what you should do when you are experiencing an anxiety or panic attack. With so much going on in the world today with taking care of your family, working full time, dealing with office politics and other things, you could experience a serious meltdown. All of these things could at one point cause you to stress out and snap.

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