Colette R. Hirsch

Interpretative inferences when reading about emotional events

In three experiments we investigated the extent to which individuals with high or low levels of anxiety about interviews made emotionally-congruent interpretative inferences while reading descriptions of a relevant ambiguously-threatening event (being interviewed for a job). Evidence was found to support the hypothesis that groups varying in self-reported concern about the described event differed in the interpretations that they made while reading. Taken together, the results of the three experiments are consistent with the conclusion that non-anxious individuals infer positive outcomes to an ambiguous event, while highly anxious individuals do not. We suggest that these results have implications for cognitive processes that could maintain anxiety in real life.

Restriction of working memory capacity during worry

The authors report the first direct assessment of working memory capacity when people engage in worry. High and low worriers performed a random key-press task while thinking about a current worry or a positive personally relevant topic. High (but not low) worriers showed more evidence of restricted capacity during worry than when thinking about a positive topic. These findings suggest that high worriers have less residual working memory capacity when worrying than when thinking about other topics and, thus, have fewer attentional resources available to redirect their thoughts away from worry.

Looking on the Bright Side: Accessing Benign Meanings Reduces Worry

This research investigated whether increasing access to benign outcomes of ambiguous events decreases excessive worry. Participants reporting high levels of worry were assigned either to practice in accessing benign meanings of threat-related homographs and emotionally ambiguous scenarios or to a control condition in which threatening or benign meanings were accessed with equal frequency. Results were assessed by use of a breathing focus task that involved categorizing the valence of thought intrusions before and after an instructed worry period and a test of working memory capacity available to participants while worrying. In comparison with the control group, the benign group reported fewer negative thought intrusions (as rated by both participants and an assessor) and less anxiety during the breathing focus task and showed greater residual working memory capacity while worrying. These findings suggest that enhancing access to benign outcomes is an effective method of reducing both the persistence of worry and its detrimental consequences.

The effects of modifying interpretation bias on worry in generalized anxiety disorder

This study investigated whether facilitating a benign interpretive bias decreases negative thought intrusions in generalized anxiety disorder (GAD). Clients were randomly allocated to an interpretation modification condition in which they repeatedly accessed benign meanings of emotionally ambiguous homographs and scenarios, or to a control condition in which they accessed threat and benign meanings with equal frequency. Worry frequency was assessed using a breathing focus task that involved categorising the valence of thought intrusions before and after an instructed worry period. Interpretation bias was assessed during the modification tasks, and on a different measure of interpretation bias (sentence completion) following a period of worry. The experimental procedure modified interpretations made during training, and in the later sentence completion task. Furthermore, compared to the control group, the benign group showed fewer negative thought intrusions during breathing focus (as rated by both participants and an assessor). These findings show that it is possible to induce a more benign interpretive bias in GAD clients and that this reduces negative thought intrusions.

A cognitive model of pathological worry

We present an evidence-based model of pathological worry in which worry arises from an interaction between involuntary (bottom-up) processes, such as habitual biases in attention and interpretation favouring threat content, and voluntary (top-down) processes, such as attentional control. At a pre-conscious level, these processes influence the competition between mental representations when some correspond to the intended focus of attention and others to threat distracters. Processing biases influence the probability of threat representations initially intruding into awareness as negative thoughts. Worry in predominantly verbal form then develops, influenced by conscious processes such as attempts to resolve the perceived threat and the redirection of attentional control resources to worry content, as well as the continuing influence of habitual processing biases. After describing this model, we present evidence for each component process and for their causal role in pathological worry, together with implications for new directions in the treatment of pathological worry.

The effect of attention modification with explicit vs. minimal instructions on worry.

In this experiment we investigated the effect of different instructions on the modification of attentional biases, and subsequently on worry persistence. Participants without excessive worry completed a modified dot-probe task, designed to train attention either to threat or neutral words. Half of each group was given explicit instructions regarding the relationship between word valence and target location, and half were given the more usual minimal instructions. Impact on worry persistence was assessed by categorizing the valence of thought intrusions before and after a period of instructed worry. Response latencies to test items on the dot-probe task showed that attention had been successfully manipulated in the expected direction, and explicit instructions led to more effective attention modification. Moreover, participants in the attend-threat group who received explicit instructions reported significantly more negative thought intrusions following instructed worry, as rated by an assessor, whereas participants in the attend-neutral group did not. These findings suggest that an attentional bias towards threatening information plays a role in worry persistence, and that explicit instructions may be helpful in modifying this bias.

Facilitating a Benign Attentional Bias Reduces Negative Thought Intrusions

The causal role of biased attention in worry was investigated in an experiment in which high worriers were assigned either to a condition requiring attention to nonthreatening words and text while ignoring worry-related material or to a mixed-attention control condition. The former procedure led to fewer negative thought intrusions in a worry test (as rated by both participants and an assessor) than did the control condition. These findings suggest that attentional bias plays a causal role in worry and that its modification can reduce excessive worry.

Worry in imagery and verbal form: effect on residual working memory capacity.

Worry-prone individuals have less residual working memory capacity during worry compared to low-worriers (Hayes, Hirsch, & Mathews, 2008). People typically worry in verbal form, and the present study investigated whether verbal worry depletes working memory capacity more than worry in imagery-based form. High and low-worriers performed a working memory task, random interval generation, whilst thinking about a worry in verbal or imagery form. High (but not low) worriers had less available working memory capacity when worrying in verbal compared to imagery-based form. The findings could not be accounted for by general attentional control, amount of negatively-valenced thought, or appraisals participants made about worry topics. The findings indicate that the verbal nature of worry is implicated in the depletion of working memory resources during worry among high-worriers, and point to the potential value of imagery-based techniques in cognitive-behavioural treatments for problematic worry.

Interview anxiety: Taking the perspective of a confident other changes inferential processing

Previous research with an on-line processing task found that individuals without social anxiety generate benign inferences when ambiguous social information is encountered, but people with high social anxiety or social phobia do not (Hirsch and Mathews, 1997, 2000). In the present study, we tested if it is possible to induce a benign (or less negative) inferential bias in people who report anxiety about interviews by requiring them to take the perspective of an interview confident person, rather than their own. High interview anxious volunteers were allocated to read descriptions of job interviews, either taking their own perspective in the described situation or that of a confident interviewee. At certain points during the text, a target letter string appeared and participants were asked to indicate whether it formed a word or a non-word (lexical decision). Some of the lexical decisions occurred in the context of ambiguous text that could be interpreted in both a threatening and a benign manner. In a baseline condition, decisions were made following text for which there was only one possible inference (either threat or benign). The results indicated that, compared to the self referent condition, participants who adopted the perspective of a confident other person showed enhanced inhibition of threat inferences.

The contribution of attentional bias to worry: Distinguishing the roles of selective engagement and disengagement

Research highlights ▶ Two variants of a novel attention modification paradigm were developed. ▶ Attention to threat meaning was modified rather than just its location. ▶ One variant modified attentional engagement and the other disengagement from threat. ▶ Only attentional engagement training significantly influenced worry. ▶ Attentional engagement with threat meanings may causally contribute to worry.