Generalized Anxiety Disorder 417
nates GAD from other anxiety disorders (Wells & Carter, 1999, 2001). Thus AnTi
Meta-Worry is the only subscale that is likely to provide clinically useful information
since it focuses on negative appraisals of worry. More recently Wells (2005b) published
a short seven-item measure of metaworry, the Meta-Worry Questionnaire, that holds
considerable promise.
Meta- Cognitions Questionnaire
The Meta- Cognitions Questionnaire (MCQ; Cartwright- Hatton & Wells, 1997) is a
65-item self- report measure that assesses positive and negative beliefs and appraisals
about worry and unwanted intrusive thoughts. The questionnaire has five subscales:
positive beliefs about worry, negative beliefs about the danger and uncontrollabil-
ity of worry, cognitive confidence, control of intrusive thoughts, and cognitive self-
consciousness. The MCQ Danger and Uncontrollability subscale has the most relevance
for pathological worry (Cartwright- Hatton & Wells, 1997; Wells & Carter, 2001; see
discussion in Chapter 3, Hypothesis 2) and so can be useful when developing a case
formulation. Wells and Cartwright- Hatton (2004) published a brief 30-item version of
the MCQ that appears to be psychometrically sound.
Intolerance of Uncertainty Scale
The Intolerance of Uncertainty Scale (IUS; Freeston, Rhéaume, et al., 1994) is a 27-item
questionnaire that assesses maladaptive beliefs that uncertainty is unacceptable, that it
reflects badly on a person, will lead to frustration and stress, and causes inaction (Dugas
et al., 2004). Although the measure is multidimensional, the total score has proven most
useful in research studies (Freeston, Rhéaume, Letarte, Dugas, & Ladouceur, 1994;
Dugas et al., 2004). Numerous studies have shown that the IUS has a specific associa-
tion with pathological worry and discriminates GAD (e.g., Dugas, Gagnon, et al., 1998;
Dugas et al., 2001; Dugas et al., 2005). Given its strong discriminant validity, the IUS is
useful for assessing key pathologic beliefs in GAD.
Thought Control Questionnaire
The Thought Control Questionnaire (TCQ; Wells & Davies, 1994) is a 30-item ques-
tionnaire that assesses the extent that individuals use five different thought control strat-
egies: distraction, punishment, reappraisal, social control, and worry. Research suggests
that individuals with GAD score significantly higher than nonanxious controls only on
the TCQ Punishment and Worry subscales (Coles & Heimberg, 2005; Fehm & Hoyer,
2004) and only these two subscales correlate with the PSWQ (Wells & Davies, 1994).
Clinician Guideline 10.15
Cognitive assessment for GAD should include the ADIS-IV, the PSWQ, and possibly a mea-
sure of worry content such as the Worry Domains Questionnaire. In addition the IUS and
certain subscales of the MCQ may be helpful when assessing maladaptive beliefs that char-
acterize GAD.