Worry Flashcards

1
Q

What are the 3 models in GAD

A

Wells - metacognitive model - worry about worry
Borkovek - avoidance model of imagery
Dugas - intolerance of uncertainty model

Worry is problem solving gone wrong. Concern turns into preoccupation - common with uncertainty and imagining the worst

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2
Q

Wells - metacognitive model concept

A

Type 1 worry creates anxiety , then type 2 worries about how bad or uncontrollable the worry is < leads to more worry > suppression or avoidance > disconfirmation of beliefs about worry.

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3
Q

Wells - metacognitive model tx

A
  1. Case formulation
  2. Psychoeducation
  3. Challenge type2 worries of positive and neg beliefs
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4
Q

Borkovek - avoidance model concept

A

Worry is a form of coping by somatic and emotional avoidance caused by images so worry in words which is a form of avoidance > increases worry and cycle continues because fear is not disconfirmed

Worry is negatively reinforced because it removes the aversive imagery and by the positive beliefs that problem solving and is further reinforced when negative event does not happen

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5
Q

Borkovec - avoidance model tx

A

EXPOSURE!!! to Imagery

Self- Monitoring​
Relaxation strategies​ (PMR breathing)
Desensitization – to visual imagery 
Gradual stimulus control ​ - worry time
Cognitive restructuring​
Present moment focus​
Expectancy free living
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6
Q

Dugas - intolerance of uncertainty model Concept

A

Difficulty in accepting uncertainties that cannot be resolved​. Focus is on the feared outcome rather than solving the problem. Worry may feel like problem-solving, but worry makes it harder to concentrate and make decisions so increases rather than decreases uncertainty​.

Coping by avoidance and thought control

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7
Q

Dugas - intolerance of uncertainty Tx

A

Increasing tolerance to uncertainty by:

Self Monitoring​
Education about IoU​
Evaluating worry beliefs​
Problem orientation – positive orientation (opportunities rather than threats)​
Process core fears – exposure to threatening mental imagery​

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8
Q

Worry control strategies

A

Cognitive restructure about worry beliefs
Behavioral experiments to challenge beliefs​
Acceptance of uncertainty
Problem-solving

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9
Q

how to challenge neg worry beliefs

A

That worry is uncontrollable ask - has worry ever been interrupted or stopped by external events? Does the worry ever stop? engage in worry time to control how often and when

dangerous - how can be good but bad for health? what harm done so far, what about people in stressful jobs?

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10
Q

how to BE for worry

A

Lack of control eg I have no control over my worry and need to keep trying to suppress it​

Prediction: My worry will be out of control if I don’t try and not think about it​

Demonstration of the paradoxical effect of thought suppression​

Establishing a worry time – notebook of things (single word) to worry about later in the day​

Outcome: recognized difficulties (futility) in trying to control worry by trying to not think about them​

Had some difficulties recalling specific worries in her ‘worry time’

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11
Q

Behaviour exp - worry make me go crazy

A

In session focus on the worry – (exposure + suds ratings) – allow yourself to go crazy
Anxiety increased followed by significant decreases
Not convincing but helpful in challenging the dangerousness of worry

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12
Q

Challenge positive benefits of woryr

A

Cons of worrying?

How many situations have turned out OK and you haven’t worried?

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13
Q

Testing the Belief

A

Situation that caused concern – what did the person think would happen (all the disastrous scenarios) ​

What actually happened (factual account)​

What actually happened versus what the worry predicted would happen​

What can the individual learn from this exercise​

Same process for when she had worried and things went wrong anyway – how did the worry assist in dealing with the problem?​

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14
Q

Behavioural Exp example

A

Challenging the utility of worry – alternate days with increased worry, days with postponed worry (or minimal worry)​
Predictions of what will happen days when worries and days when doesn’t

monitoring of what happened
Compare predictions
What learnt?

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15
Q

Acceptance

A

Do the opposite and awareness of worry thoughts, no suppression - be observer
Allow thoughts and feelings - stay in the present , refocus on environment

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16
Q

Uncertainty

A

Advantages and disadvantages of seeking certainty
Predictions of unpleasant outcomes when uncertain – are good outcomes just as likely
Behavioural exp to test assumptions about need for certainty

17
Q

Decision tree process

A

Worry- is there any action to be taken (ie solvable vs unsolvable) ?​

Is it a real and likely problem that requires action?​

If so, what?​

When should it be taken? (ie now or when and if it happens?)​

If now, SPS….​