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gungor

Member
Hello,

I want to ask a question about GAD. It is written in the book named Cognitive Therapy of Anxiety Disorders of Adrian Wells that the main problem in GAD is believing "uncontrollability of worries" (meta-worry) . Elicitation of these beliefs and modification must be aimed during therapy. However, as a patient suffering from GAD, i cannot find anything in my mind about my worries are uncontrollable.

Can different problems except "uncontrollability of worries" be key point of GAD?

Is it my failure about thought elicitation?
 

Daniel E.

daniel@psychlinks.ca
Administrator
Can different problems except "uncontrollability of worries" be keypoint of GAD?
Sure, like problems living with uncertainty:

[Intolerance of uncertainty] and meta-worry were strongly related but made a unique and independent contribution to trait worry.

The Role of Intolerance of Uncertainty, Meta-Worry, and Neuroticism
Typical beliefs and assumptions that fuel worry: (Shearer & Gordon, 2006)

Intolerance for uncertainty: "If I think about this enough, I should feel a sense of certainty."

Intolerance for discomfort: "If I can just think this through, I won't have to feel this way."

Inflated sense of responsibility and culpability: "If bad things happen, it's my fault."

Distorted risk assessment/emotional reasoning: "If it feels likely, it is likely. If it feels dangerous, it is dangerous."

Perfectionism--mistakes are unacceptable: "Mistakes mean I wasn't in control and screwed up."

Pessimism/presumed incapability: "Bad things will happen to me and I won't be able to deal with it."

Misconstrued virtue: "Worry shows how deeply I care about my children."

Overvaluation of the thought process: "Because I have a thought, it is, therefore, an important thought, and I must give it my full attention and get it settled. I can anticipate and avoid discomfort by worrying."

"Meta-worry" or worry about worrying: "I'm making myself sick. I'm going to bring on an early heart attack. I'm out of control. I'm weak. If my faith was stronger, I wouldn't worry."

Implicit magical beliefs: "Worry prevents bad things from happening. It keeps loved ones safer."

Dealing with Worry
 

Daniel E.

daniel@psychlinks.ca
Administrator
http://eprints.qut.edu.au/46271/2/46271.pdf

This study explored how meta-worry and intolerance of uncertainty relate to pathological
worry, generalised anxiety, obsessive compulsive disorder, social phobia, and depression.
University students (n = 253) completed a questionnaire battery. A series of regression
analyses were conducted. The results indicated that meta-worry was associated with
GAD, social phobia, obsessive compulsive, and depressive symptoms. Intolerance of
uncertainty was related to GAD, social phobia, and obsessive compulsive symptoms, but
not depressive symptoms. The importance of meta-worry and intolerance of uncertainty
as predictors of pathological worry, GAD, social phobia, obsessive compulsive and
depressive symptoms was also examined. Even though both factors significantly
predicted the aforementioned symptoms, meta-worry emerged as a stronger predictor of
GAD and obsessive compulsive symptoms than did intolerance of uncertainty.

Intolerance of uncertainty, compared with meta-worry, appeared as a stronger predictor
of social phobia symptoms. Findings emphasise the importance of addressing meta-worry
and/or intolerance of uncertainty not only for the assessment and treatment of generalised
anxiety disorder (GAD), but also obsessive compulsive disorder, social phobia, and
depression.
 

Daniel E.

daniel@psychlinks.ca
Administrator
Conceptual Models of Generalized Anxiety Disorder :acrobat:
Psychiatric Annals
February 2011

...For example, the person with GAD is concerned about the consequences of worrying and will therefore use avoidance to try to limit worry. Specifically, attempts are made to avoid triggers for worry episodes, but this denies opportunities to acquire knowledge that worry is both controllable and not dangerous. The model also specifies that metacognitive control strategies, such as suppression or mental distraction are frequently employed. Unfortunately, these strategies are only occasionally effective, thereby fuelling negative metacognitive beliefs about the danger and uncontrollability of worry.
 
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