94 COGNITIVE THEORY AND RESEARCH ON ANXIETY
NEgATIvE EFFECTS oF PATHoLogICAL WoRRY
Anxious individuals worry in order to avoid unpleasant somatic anxiety or other nega-
tive emotions, as well as a problem- solving strategy that seeks to avoid or at least pre-
pare for anticipated future negative events (Borkovec et al., 2004; Wells, 2004). In his
cognitive model of GAD, Wells (1999, 2004) emphasized that positive beliefs about the
perceived benefits of worry are an important factor in the persistence of worry and the
anxious state. However, worry is a problematic coping strategy that ultimately contrib-
utes to an escalation in anxiety by intensifying perceived threat. For clinically anxious
individuals, excessive worry will contribute to a reappraisal of the threat as even more
dangerous and imminent, and their coping resources as less than adequate for the antici-
pated event. Worry, then, causes an intensification of anxiety through its negative effect
on emotional responding, cognition, and ineffective problem solving.
Wells (1999) argued that the worry process is problematic because (1) it involves
the generation of numerous negative scenarios that cause a greater sense of threat and
personal vulnerability, (2) it heightens sensitivity to threat- related information, (3) it
increases the occurrence of unwanted intrusive thoughts, and (4) it leads to a misattribu-
tion of the cause for the nonoccurrence of a catastrophe, thereby strengthening positive
beliefs about worry (e.g., “I won’t do well on an exam unless I worry”).
There is considerable evidence that worry leads to an increase in subjective anxiety.
Both cross- sectional and longitudinal studies indicate that increased worry is associ-
ated with elevations in both anxiety and depression (Constans, 2001; Segerstrom, Tsao,
Alden, & Craske, 2000). The close association between repeated anxious thoughts or
worry and subjective negative emotion has been found in daily dairy studies (Papageor-
giou & Wells, 1999) as well as in laboratory-based research in which nonclinical indi-
viduals are assigned to an instructed worry condition (e.g., Andrews & Borkovec, 1988;
Borkovec & Hu, 1990; York, Borkovec, Vasey, & Stern, 1987).
Another negative consequence of worry is an increase in unwanted negative intru-
sive thoughts. In a number of studies worry-prone individuals who engaged in a worry
induction condition later reported an increase in unwanted anxious and depressive
intrusive thoughts (Borkovec, Robinson, et al., 1983; York et al., 1987). Pruzinsky and
Borkovec (1990) found that self- labeled worriers had significantly more negative thought
intrusions than nonworriers even without a worry induction manipulation, and Ruscio
and Borkovec (2004) reported that GAD worriers had greater difficulty controlling neg-
ative thought intrusions after a worry induction than did non-GAD worriers, although
the negative intrusions caused by worry were short-lived. A causal relation between
worry and unwanted intrusive thoughts has also been demonstrated after exposure to
a stressful stimulus in which instructions to worry after viewing a film resulted in a
greater number of unwanted film intrusions (see Butler, Wells, & Dewick, 1995; Wells
& Papageorgiou, 1995).
PATHoLogICAL WoRRY, AvoIDANCE, AND PRobLEM SoLvIN g
The persistence of worry is a paradox. On the one hand, it is an aversive state associated
with elevated anxiety and distress, and yet we are drawn to it in times of anxiousness.
One explanation is that worry persists because of the nonoccurrence of that which
we dread (Borkovec, 1994; Borkovec et al., 2004). Moreover, it is maintained by the