Sarra Hayes

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.

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.

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.

Are attentional control resources reduced by worry in generalized anxiety disorder

This is the first study to examine attentional control capacities in generalized anxiety disorder (GAD). GAD is characterized by uncontrollable worry. Individuals diagnosed with GAD and healthy participants (HPs) performed a random key-pressing task while thinking about a worrisome or a positive future event, to assess the extent to which attentional control resources are used by worry. Attentional control was also assessed when participants were not instructed to think about a specific topic using the N-back task, which varies in task difficulty, and therefore is sensitive to subtle differences in ability to handle increasing demands on attentional control within the same paradigm. GAD participants (but not HPs) were less random while worrying than thinking about a positive event during the key-pressing task, suggesting that worry consumed more attentional control resources in this population. During the N-Back task, GAD participants performed worse than HPs during the high load conditions only, indicating greater difficulty in sustaining focus on conditions requiring a higher degree of attentional control, even without concurrent task activity. Poor attentional control might underpin the difficulty of GAD individuals to stop worrying and switch to thinking more benign information. Further research could investigate whether worry consumes attentional control resources in other psychological disorders with high rates of worry (e.g., panic disorder, psychosis), as well as the extent to which attentional control is used by other forms of repetitive thinking, such as depressive rumination.

The Extent and Nature of Imagery During Worry and Positive Thinking in Generalized Anxiety Disorder

Clients in treatment for Generalized Anxiety Disorder (GAD) were compared to a control group to assess the extent and nature of imagery during worry or while thinking about a personally relevant positive future event. Two methods were used to assess mentation and were completed in counter balanced order within the worry and positive conditions. One method assessed the occurrence of imagery by requiring participants to categorize their mentation as verbal thoughts or images every 10 s. The other method involved participants estimating the duration of any imagery that occurred in the previous 10 s. Imagery during worry occurred less often than while thinking about a positive event for both groups, but GAD clients had a more pronounced deficit of imagery during worry than the control group. Images that occurred were briefer during worry than while thinking about a positive future event and were briefer in the GAD than the control group for both worry and positive conditions. The results thus confirmed that imagery is less common during worry in clients with GAD but also demonstrated that the imagery that does occur in GAD is briefer.

Anxiety-linked task performance: Dissociating the influence of restricted working memory capacity and increased investment of effort

The present set of studies evaluated two specific predictions generated by Eysenck et al.s (2007) attentional control theory of anxiety-linked task performance. First, to the extent that a task increases the need for working memory capacity, an anxiety-linked performance decrement should become more evident. Second, to the extent that a task increases the likelihood of effort, this anxiety-linked performance decrement should attenuate. Experiments 1 and 2 examined the learning performance of low and high trait anxious participants in capacity-dependent and capacity-independent tasks, under incidental and intentional learning conditions. Experiments 3 and 4 then examined the learning preference of such participants under incidental and intentional learning conditions. The pattern of findings provides direct support for the models predictions.

Characteristics of worry in Generalized Anxiety Disorder

Background & objectives Groups of clients and community volunteers with Generalized Anxiety Disorder (GAD) and clients with Panic Disorder were compared to a group with elevated worry but without GAD on a range of measures, to identify individual differences beyond a high propensity to worry. Method Participants completed standardised questionnaires and a behavioural worry task that assesses frequency and severity of negative thought intrusions. Results Relative to high worriers, clients with GAD had higher scores on trait anxiety, depression, more negative beliefs about worry, a greater range of worry topics, and more frequent and severe negative thought intrusions. Relative to community volunteers with GAD, clients in treatment reported poorer attentional control. Compared to clients with Panic Disorder, clients with GAD had higher trait anxiety, propensity to worry, negative beliefs and a wider range of worry content. Conclusions Results confirmed expectations of group differences based on GAD diagnostic criteria, but also revealed other differences in mood, characteristics of worry, and perceived attentional control that may play a role in the decision to seek treatment.

The power of positive thinking: Pathological worry is reduced by thought replacement in Generalized Anxiety Disorder

Worry in Generalized Anxiety Disorder (GAD), takes a predominantly verbal form, as if talking to oneself about possible negative outcomes. The current study examined alternative approaches to reducing worry by allocating volunteers with GAD to conditions in which they either practiced replacing the usual form of worry with images of possible positive outcomes, or with the same positive outcomes represented verbally. A comparison control condition involved generating positive images not related to worries. Participants received training in the designated method and then practiced it for one week, before attending for reassessment, and completing follow-up questionnaires four weeks later. All groups benefited from training, with decreases in anxiety and worry, and no significant differences between groups. The replacement of worry with different forms of positive ideation, even when unrelated to the content of worry itself, seems to have similar beneficial effects, suggesting that any form of positive ideation can be used to effectively counter worry.