Stop Rules for Worrying & Checking: A Metacognitive Factor in Perseverative Psychopathologies

Stop Rules for Worrying & Checking: A Metacognitive Factor in Perseverative PsychopathologiesGraham DaveyUniversity of Sussex, UK

CollaboratorsBenie MacDonaldHelen StartupGary BrittonSuzanne DashFrances MeetenFergal Jones

Introduction Perseveration is a defining element of many

psychopathologies Examples include worrying (GAD), checking (OCD),

rumination (in major depression) Perseverative activities are usually ‘neutralizing’ activities Linked to meta-cognitive and global beliefs about how to deal

with distressing emotions

What are ‘stop rules’?• Relate to Task Motivation• Performance Focused OR

Task Focused• ‘Enough’ OR ‘Enjoy’• ‘As Many as Can’ (AMA) OR

‘Feel Like Continuing’ (FL)

What do we know about stop rules? Often not easily verbalizable Can often be derived from dispositional characteristics or

meta-beliefs about emotional control strategies Stop rule type is linked to mood Stop rules interact with mood to determine perseveration at a

task (the ‘Mood-as-Input Hypothesis’, Davey, 2006, Startup & Davey, 2001).

Stop Rule x Mood Interaction Effects Hawksley & Davey (2010) Depressive Rumination Task Participants asked to iterate what had made them feel

depressed during a recent episode of depression Both mood (positive v negative) and stop rule (AMA v FL)

were manipulated

Hawksley & Davey (2010)

Perseverative Worrying• Manipulating Stop Rule (Startup

& Davey, 2001)• Stop Rules & Responsibility

(Startup & Davey, 2003)• Stop Rule deployment in High &

Low Worriers (Davey et al., 2005)

• Do stop rules change during a worry bout? (Davey et al., 2007)

The Catastrophizing Interview1. I’m worried about not being able to move2. That I would be attacked in some way3. That I would not be able to fight back4. That I would not be able to control what other people did to me5. That I would feel inadequate6. That other people would begin to think I was inadequate7. That in my relationship with those people I would not be respected8. That I would not have any influence over others9. That other people would not listen to me10. That it would cause a loss of self-esteem11. That this loss of self-esteem would have a negative effect on my relationships with others12. That I would lose friends13. That I would be alone14. That I would have no-one to talk to15. Because it would mean that I would not be able to share any thoughts/problems with other people16. That I would not get advice from others17. That none of my problems would be adequately sorted out18. That they would remain and get worse19. That eventually I would not be able to cope with them20. That eventually my problems would have more control over me than I had over them21. That they would prevent me from doing other things22. That I would be unable to meet new people and make friends23. That I would be lonely

Manipulating Stop Rules in High & Low Worriers

Characteristics leading to the deployment of AMA stop rules

AMA – ‘Enough’ FL – ‘Enjoy’

Worry Stop Rule Check List

I must find a solution to this problem, so keep thinking about it.

I must try and think about the worst possible outcome, just in case it happens

I must think everything through properly

What’s done is done, so what’s the point in worrying?

I don’t have time to think about this now

Stop worrying, things always work out for the best.

Davey, Startup, MacDonald, Jenkins & Patterson (2005)QUESTIONNAIRE VARIABLE AMA FL

PSWQ Trait Worry .54*** -.15

PFQ Shame .39*** -.08

PFQ Guilt .27** .08

COWS Negative Cons .35*** -.08

COWS Positive Cons .49*** -.10

CAT INTERVIEW

Steps .43* .04

What ends a worry bout? - Mood changes during worrying

AMA FL No Stop Rule

-4-202468

101214

Low WorrierHigh Worrier

Changes in Stop Rule Endorsement

AMA FL0

20

40

60

80

100

120

140

Prior to TaskEnd of Task

Perseverative Checking• Compulsive checkers deploy AMA

stop rules (Meyer, Fisher & Wells, 2009)

• Termination of rituals often based on subjective stop criteria

• Explanatory constructs such as ‘Inflated Responsibility’ interact with mood (MacDonald & Davey, 2005)

• It is the goal-directed nature of checking that causes perseveration, not its complexity

MacDonald & Davey (2005)

Er r or Bar s show 95. 0% Cl of M ean

Bar s show M eans

1 .0 0 2 .0 0 3 .0 0 4 .0 0

posi t i ve mood negati ve mood

0 .0 0

5 0 .0 0

1 0 0 .0 0

1 5 0 .0 0

2 0 0 .0 0

Black = High ResponsibilityWhite = Low Responsibility

Stop Rule is not Independent of Mood• Negative mood facilitates

endorsement of AMA checking stop rules (Gary Britton)

• Negative mood facilitates endorsement of AMA worry stop rules (Suzanne Dash)

Britton & Davey (2011)Mood & Checking Stop Rules

AMA FL0

10

20

30

40

50

60

70

Negative MoodPositive Mood

Dash & Davey (2011)Mood & Worrying Stop Rules

AMA0

10

20

30

40

50

Negative Mood Neutral Mood Cognitive Priming

Dash & Davey (2011)Systematic Processing & AMA deployment mediate effect of Negative Mood on Worry Scores

Summary AMA Stop Rules + Negative Mood = Perseveration Perseveration is not a Dispositional Style Perseveration is a Performance Factor caused by a

configuration of stop rule and mood Deployment of AMA stop rules is facilitated by Negative

Mood

Future Directions More Research on Stop Rules in Clinical Populations Characteristics of Clinical Populations Facilitate Mood-as-

Input Processes Mood-as-Input as a Mechanism for Acquisition of

Perseverative Activities Mood-as-Input as a Transdiagnostic Process Mood & Stop Rule Awareness Interventions