Cognitive Therapy of Anxiety Disorders

36 COGNITIVE THEORY AND RESEARCH ON ANXIETY

Clinician Guideline 2.2

Cognitive therapy teaches individuals to be more aware of their immediate threat appraisals

and to correct maladaptive secondary cognitive processes.

Central tenets of the Cognitive moDel of anxiety

A number of propositions derived from the cognitive perspective guided the develop-
ment of the cognitive model (see Figure 2.1). These propositions were first articulated in
the original cognitive model of anxiety (Beck et al., 1985, 2005) and are elaborated in
the sections below (see Table 2.2 for a definition of the basic tenets).

table 2.2. Central tenets of the Cognitive model of anxiety

Exaggerated threat appraisals

Anxiety is characterized by an enhanced and highly selective attention to personal risk,

threat, or danger that is perceived as having a serious negative impact on vital interests

and well-being.

Heightened helplessness

Anxiety involves an inaccurate evaluation of personal coping resources, resulting in an

underestimation of one’s ability to cope with a perceived threat.

Inhibitory processing of safety information

Anxiety states are characterized by inhibited or highly restricted processing of safety

cues and information that convey diminished likelihood and severity of a perceived

threat or danger.

Impaired constructive or reflective thinking

During anxiety more constructive, logical, and realistic elaborative thinking and

reasoning are difficult to access and so are ineffectively utilized for anxiety reduction.

Automatic and strategic processing

Anxiety involves a mixture of automatic and strategic cognitive processes that are

responsible for the involuntary and uncontrollable quality of anxiety.

Self-perpetuating process

Anxiety involves a vicious cycle in which heightened self-focused attention on the signs

and symptoms of anxiety will itself contribute to an intensification of subjective distress.

Cognitive primacy

The primary cognitive appraisal of threat and the secondary appraisal of personal

vulnerability can generalize such that a broader array of situations or stimuli are

misperceived as threatening and various physiological and behavioral defensive

responses are inappropriately mobilized to deal with the threat.

Cognitive vulnerability to anxiety

Increased susceptibility to anxiety is a result of enduring core beliefs (schemas) about

personal vulnerability or helplessness and the salience of threat.