Cognitive Therapy of Anxiety Disorders

52 COGNITIVE THEORY AND RESEARCH ON ANXIETY

normal anD abnormal anxiety: a Cognitive perspeCtive

In our description of the cognitive model, we focused primarily on pathological anxiety.
As noted earlier, fear can be adaptive and anxiety is a common experience in every-
day life. So, how does the cognitive model explain the difference between normal and
abnormal anxiety? This is an important consideration for clinical practitioners as well
as researchers. After all, our goal as therapists is to normalize the experience of anxiety.
Thus what is the nature of normal cognitive processing of anxiety? Table 2.5 sum-
marizes a few key differences at the automatic and elaborative phases of information
processing that characterize nonclinical and clinical anxiety.

Automatic Cognitive Processes in Normal Anxiety

Given the automatic and involuntary nature of the immediate fear response, it is obvious
that individuals who do not suffer an anxiety disorder have a distinct advantage over
clinical samples. In normal anxiety, the orienting mode is not as primed for the detec-
tion of negative self- referent stimuli as in the anxiety disorders. In nonclinical states,
the detection of negative stimuli will still be given attentional priority, but the range of
stimuli that would be identified as negative and potentially self- relevant would be nar-
rower. In fact, Mogg and Bradley (1999a) reviewed evidence that less anxious individu-
als show attentional avoidance of low threat stimuli whereas highly anxious individuals
show enhanced attention to low, and especially moderately, threatening stimuli (see also

table 2.5. Cognitive Differences between normal and abnormal anxiety predicted by the
Cognitive model
Phase of processing Abnormal anxiety Normal anxiety

Orienting mode ••Heightened sensitivity to negative
stimuli

••More balanced sensitivity to the

detection of positive and negative

stimuli

Primal threat activation ••Exaggerated primary appraisal of
threat
••Negative evaluation of autonomic
arousal
••Presence of threat-related
processing biases and errors
••Frequent and salient automatic
thoughts and images of threat
••Initiation of automatic, inhibitory
self-protective behaviors

••More appropriate, reality-based

appraisal of threat

••Views arousal as an uncomfortable

but not a threatening state

••Attention not as narrowly focused

on threat; fewer cognitive errors

••Fewer and less salient anxious

thoughts and images

••Delay in inhibitory self-protective

behaviors as more elaborative

coping responses are considered

Secondary elaborative
reappraisal

••Focus on weakness; low self-

efficacy and negative outcome

expectancy

••Poor processing of safety cues

••Inaccessibility of constructive mode

thinking

••Uncontrollable, threat-oriented

worry

••Initial threat estimation is enhanced

••Focus on strength; high self-efficacy

and positive outcome expectancy

••Better processing of safety cues

••Ability to access and utilize

constructive mode thinking

••More controlled and reflective,

problem-oriented worry

••Initial threat estimation is

diminished