Cognitive Therapy of Anxiety Disorders

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414 TREATMENT OF SPECIFIC ANXIETY DISORDERS


Hypothesis 6


In GAD worry is associated with a greater loss of perceived safety and poorer problem solving
compared to non-GAD worry.


Rachman (2004) made a compelling argument that GAD is the unsuccessful search
for safety (see also Lohr et al., 2007; Woody & Rachman, 1994). Individuals with GAD
perceive a wide range of threats involving uncertain future possibilities. They search for
safety cues that will delimit the range and duration of the threat. Safety strategies such
as seeking reassurance from others, repeated checking, avoiding risks, and generally
engaging in overprotective behaviors could potentially reduce immediate general anxi-
ety and avoidance if the sense of safety is achieved (Rachman, 2004). But safety signals
may be more difficult to detect than danger signals, even at the best of times, and given
the abstract future- oriented threat in worry, they may be particularly ill- suited for this
type of threat (Lohr et al., 2007; Woody & Rachman, 1994). If safety remains elusive,
general anxiety and worry will increase. Thus unsuccessful attempts to attain a sense
of safety must be considered a factor that could contribute to the persistence of worry.
Unfortunately, very little research has examined safety seeking in worry or GAD. An
exception is an experimental study involving a simple detection of threat and safe stim-
uli, in which high trait- anxious students with good attentional control were better able
to disengage from the threat stimulus and shift attention to the safe cue at the later,
more strategic stage of information processing (Derryberry & Reed, 2002).
Problem solving could be construed as a type of safety- seeking strategy as worried
individuals search for some way to resolve or at least prepare themselves for the possibil-
ity of a future negative threat. It is not surprising that researchers have been particularly
interested in the relation between problem solving ability and worry given that failed
problem- solving is embedded in the very notion of worry (e.g., Borkovec, Robinson, et
al., 1983). Two aspects of problem solving have been investigated. The first is whether
pathological worry reflects deficiencies in problem- solving abilities such as problem for-
mulation, generating alternative solutions, decision making, solution implementation,
and evaluation. The second possibility is that chronic worriers adopt a negative prob-
lem orientation which, coupled with intolerance of uncertainty, impedes their ability
to solve problems and maintains the worry process (Koerner & Dugas, 2006). Davey
and colleagues suggested that pathological worry might result from high-trait anxious
individuals not accepting any solutions generated by their constructive, task- oriented
worrying because of low problem- solving confidence, lack of perceived control over the
problem- solving process, and a tendency to seek further information due to catastrophic
thinking (Davey, 1994; Davey et al., 1992). Although Davey (1994) focused mainly on
problem- solving confidence, Koerner and Dugas (2006) argued for the broader con-
struct of negative problem orientation that includes (1) a tendency to view problems as
threats, (2) a lack of self- confidence in one’s problem- solving ability, (3) a tendency to
become easily frustrated with problem solving, and (4) negative expectation about the
problem- solving outcome.
Numerous studies have failed to find any evidence of problem- solving deficiencies in
GAD or that poor problem solving is associated with worry (e.g., Davey, 1994; Dugas et
al., 1995; Ladouceur et al., 1999). However, there is considerable evidence that negative
problem orientation and low problem- solving confidence in particular may be specific

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