Understanding the cognitive processes that maintain uncontrollable worry in Generalised Anxiety Disorder Seminar

Generalised anxiety disorder (GAD) is characterised by the repeated experience of excessive and uncontrollable worry about a range of ever changing topics. Although anticipation of probable danger may be adaptive in ensuring an individual’s safety, it is less clear why excessive worry persists when it causes mental distress without producing apparent benefits.

Worry in GAD tends to be as if talking to oneself about multiple negative future outcomes, will little mental imagery. Furthermore, worry itself takes up cognitive resources that are needed to shift attention to more benign thoughts. GAD is characterised by increased attention to threat and generation of threatening interpretations of ambiguous events.

Whilst it is important to establish whether or not cognitive processes are biased towards threat in GAD, it may be the case that these biases are incidental or even a secondary consequence of the emotional problem. Given this research examining causality is essential. Research will be presented which demonstrates the causal role of cognitive processes in maintaining worry and GAD. These cognitive processes make it more difficult for individuals with GAD to redirect their thoughts away from worry and onto more benign topics, causing their worry to persist. Findings from this research programme have been used to guide the development of a clinical approach to CBT that is guided by our understanding of how cognitive processes are at the heart of worry in GAD.