Dr Suzanne Dash [email protected] MARS Mood and Anxiety Research in Sussex.

The role of systematic processing in worry

Dr Suzanne [email protected]

MARSMood and Anxiety Research in Sussex

Outline

Worry

Heuristic Systematic Model What is systematic processing? When does it happen?

Why might worriers systematically process?

Clinical Implications

Conclusions

Worry

“ a chain of thoughts and images, negatively affect-laden and relatively uncontrollable” (Borkovec et al., 1983, p.10)

Catastrophising (Davey & Levy, 1998a)

Themes of personal inadequacy (Davey & Levy, 1998b)

Why worry about worry?

Generalized Anxiety Disorder (APA, DSM-IV-TR, 4th ed, 2000)

Social anxiety (Purdon & Harrington, 2006)

Panic disorder (Purdon & Harrington, 2006)

Hypochondriasis (Purdon & Harrington, 2006)

OCD checking and doubting (Tallis & DeSilva, 1992)

Psychosis (Startup, Freeman & Garety, 2007)

Mechanisms of worry

Negative mood Intolerance of uncertainty Problem-solving confidence

Q. How do these variables increase worry?A.(???) Alter the way we process information

Increase worry perseveration

Dual process models of information processing

17 × 24

Dual process models of information processing

17 × 24

Why might worriers be using systematic processing (SP)?

1. SP: detailed, analytical processingWorry: persistent, detailed processing

2. Worry and SP arise through unconscious/non-deliberative means

3. SP deployed when confidence is unsatisfactoryWorriers strive to feel prepared, consider all possible negative outcomes, feel confident that they can cope

4. Influenced by similar cognitive appraisals and cognitive states

5. Similar functional neuroanatomy

Heuristic Systematic Model

Systematic processing

“An analytic orientation in which perceivers access

and scrutinize all informational input for its

relevance and importance... and integrate all useful

information in forming their judgements”

(Chaiken et al., 1989, p. 212)

The sufficiency threshold

Q. How much processing do I need to do to be confident in my judgement?

Lots, I need to be very confident

Not much, I don’t need to be that confident

Systematic processing

Heuristic processing

The sufficiency threshold

Systematic processing

Heuristic processing

Trivial task

Maheswaran & Chaiken (1991)

The sufficiency threshold

Systematic processing

Heuristic processing

Important task

Maheswaran & Chaiken (1991)

The sufficiency threshold

Q. How much processing do I need to do to be confident in my judgement?

DesiredActual

Raised sufficiency thresholds

Construct/Appraisal

Definition Systematic processing

worry

Accountability Pressure to justify one’s opinions (Erb et al., 2007; Livingston & Sinclair, 2008)

Livingston & Sinclair (2008); Tetlock (1983)

Brain et al. (2008); Sweet & Pelton-Sweet (2008)

Responsibility “one has power which is pivotal to bring about or prevent subjectively crucial negative outcomes” (Salkovskis et al., 1992)

Bohner et al.. (1995); Uleman (1989)

Startup & Davey (2003)

Need for cognition

“a need to structure relevant situations in meaningful, integrated ways” (Cohen et al., 1955, p. 21)

Batra & Stayman (1990); Cacioppo et al. (1983)

Davey, Tallis et al. (1996); Startup & Davey (2001)

Desire for Control

Motive to control events in one’s life

Swann et al. (1981) Borkovec (1994)

Negative Mood

Construct/Appraisal

Definition Systematic processing

worry

Negative Mood

“a dimension of subjective distress and unpleasurable engagement” (Watson et al., 1988, p.1063)

Ambady & Gray (2002); Bodenhausen et al. (1994); Bohner et al. (1998); Tiedens & Linton (2001)

Johnston & Davey (1997); Startup & Davey (2001)

Worriers experience greater endemic negative affect(Davey, Hampton, Farrell, & Davidson, 1992; Meyer, Miller, Metzger, & Borkovec, 1990; Tallis, Eysenck,

& Mathews, 1991; Metzger, Miller, Cohen, Sofka, & Borkovec, 1990; Wisocki, Handen & Morse,

1986)

Dash & Davey (2012)

Negative mood

Sufficiency

threshold

Worry (PSWQ)

Unmediated: b = 8.21, p = .01Mediated: b = 4.13, p = .12

High intolerance of uncertainty Correlates with trait worry (Buhr & Dugas, 2006)

Causes worry (Meeten et al. 2012)

Drives ‘what if...?’ thinking

Seek more information before decision-making (Carleton et al., 2007)

Is associated with desire for control OCD (Moulding & Kyrios, 2007)

Anorexia nervosa (Sternheim et al., 2011)Desired

IU increases desired confidence

Low problem-solving confidence Correlates with worry (Belzer et al., 2002; Davey, 1994; Davey & Levy, 1998a)

Causes worry (Davey, Jubb & Cameron, 1996)

Deplete confidence that goals are met for worry Low PSC increases uncertainty (Tormala et al., 2008)

detailed processing (e.g. Weary & Jacobson, 1997)

Actual

Low PSC decreases actual confidence

Summary

Raised sufficiency thresholds Experience negative mood Intolerant of uncertainty Discrepancy between desired confidence and actual

confidence Feel accountable and responsible Desire control of, and have a high need for cognition about,

worry-related cognitions

Clinical Implications

Socialisation to two processing modes allows dialogue of when it is useful to deploy effortful processing, and when it is unnecessary

Attention should be paid to appraisals that raise sufficiency thresholds Responsibility, accountability, desire for control

Hirsch & Mathews – top-down and bottom-up processes – most effective treatments may tackle both. Combine with cognitive bias modification?

Treat comorbid low mood

Conclusions

Worry occurs across a range of psychopathologies, as well as in the general population

Key dispositional factors exhibited by worriers – low PSC, IU and negative mood – are all likely to widen the gap between actual and desired confidence – raising the sufficiency threshold

Worriers will deploy systematic processing in an attempt to meet their sufficiency threshold

Clinical implications include challenging appraisals that raise sufficiency thresholds in conjunction with targeting heuristic processes

Collaborators and funding

Professor Graham Davey

Dr Frances Meeten

Graduate Teaching Assistantship

Thank you for listening

Any questions?

[email protected]