Cognitive Therapy of Anxiety Disorders

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Chapter 3

Empirical Status

of the Cognitive Model of Anxiety

Since the emergence of the cognitive model in the early 1960s (Beck, 1963, 1964,

1967), an emphasis on empirical verification has been important to its development and
elaboration. The scientific basis of the model rests on constructs and hypotheses that are
sufficiently precise to enable their support or disconfirmation in the laboratory (D. A.
Clark et al., 1999). In this chapter and the next, we present a review of the empirical sta-
tus of the cognitive model of anxiety based on the 12 hypotheses presented in Table 2.6.
We begin in this chapter with the initial three hypotheses that refer to core cognitive
attributes of primal threat mode activation. The next section discusses empirical sup-
port for the cognitive, physiological, and behavioral products involved in the immediate
fear response (i.e., Hypotheses 4 to 7). The final section of this chapter reviews empirical
findings that are relevant to the persistence of anxiety (i.e., Hypotheses 8 to 10), that is,
the secondary elaboration and reappraisal phase of the model. Hypotheses 11 and 12
will be discussed in the next chapter on cognitive vulnerability to anxiety because they
deal with the etiology of anxiety.

immeDiate fear response: threat moDe aCtivation

Hypothesis 1. Attentional Threat Bias

Highly anxious individuals will exhibit an automatic selective attentional bias for negative
stimuli that are relevant to threats of particular vital concerns. This automatic selective
attentional threat bias will not be present in nonanxious states.

After 20 years of experimental research it is now clear that anxiety disorders are
characterized by a preconscious, automatic selective attentional bias for emotionally
threatening information (for reviews, see D. M. Clark, 1999; Macleod, 1999; Mogg &