Cognitive process in excessive worry : a cross cultural investigation of three theories

[摘要] English: Research interest in worry has increased over the past three decades. Theory development, laboratory studies and clinical experience have resulted in the formulation of a number of theories and models related to the development and maintenance of excessive worry and generalized anxiety disorder (GAD). The available cognitive behavioural literature on worry seems to place particular emphasis on three models of worry. The avoidance model of worry (AMW) and GAD (Borkovec, Ray & Stöber, 1998), the metacognitive model (MCM) of GAD (Wells, 1995) and the intolerance of uncertainty model (IUM) (Dugas, Gagnon, Ladouceur & Freeston, 1998) have all enjoyed significant empirical attention and have all formed the basis for specific cognitive-behavioural interventions for worry and GAD. However, to date, no attempt appears to have been made to compare these models to one another or to determine the applicability of these particular models of worry to a multi-ethnic context. Therefore, the current study aimed to determine the applicability of these three cognitive models of worry to the understanding of worry in a non-clinical multi-ethnic sample. To this end, a convenience sample of 1224 university students (87.7% undergraduate) was drawn. Ethnicity was equally distributed in the sample (49.9% black and 50.1% Caucasian). However, the majority (709) of the participants were female. Participants were also assigned to one of three groups (low worry: n = 1105; high-worry non-GAD: n = 49; high-worry GAD: n = 70) based on their worry intensity and GAD self-report diagnoses. Moderated hierarchical regression analyses revealed that gender and worry/GAD status moderated the relationship between the cognitive processes hypothesised to underpin the development and maintenance of worry and worry intensity across all three models of worry, as well as in a model comprised of the cognitive processes relevant to all three individual cognitive models. However, ethnicity was found not to moderate these relationships. Furthermore, hierarchical regression analyses indicated that the three cognitive models of worry, individually and in combination, accounted for a significant proportion of the variance in the worry intensity of the current sample. This finding was evident across gender and worry/GAD status. Thus, the AMW, MCM and IUM, as well as a combination of the three models, appear to be applicable to the understanding of non-clinical worry in the multi-ethnic South African context. Furthermore, when the AWM, MCM and IUM were compared to the combined model of worry, only the AWM was found to account for a significantly lower proportion of the variance in the worry intensity of the sample than the combined model did. Consequently, although all three models appear to be applicable to the understanding of nonclinical worry in the multi-ethnic context, using a combined model to explain worry intensity appears superior only to the AWM. With regard to the interaction between specific cognitive processes and worry intensity, only positive beliefs about worry were found to account consistently for a significant proportion of the worry intensity reported by the low-worry, female and male participants. Furthermore, positive beliefs about worry were not found to account for a significant proportion of the variance in the worry intensity of the high-worry participants. Gender-specific trends were evident with respect to positive beliefs about worry in relation to the non-clinical worry reported by the participants, with females generally viewing worry as a source of motivation and men perceiving worry to be a positive personality trait. The current findings also suggest a significant relationship between negative problem orientation and worry intensity among high-worry GAD individuals. Contrary to most of the existing literature, the current study suggests that negative beliefs about worry, intolerance of uncertainty, negative problem orientation and cognitive avoidance do not significantly contribute to the worry experienced by non-clinical individuals. In addition, negative beliefs about worry, intolerance of uncertainty and cognitive avoidance were not found to contribute significantly to the worry experienced by excessive worriers, irrespective of their self-report GAD diagnostic status. The current study raises a number of questions regarding the applicability of the three cognitive models of worry and their specific components to the understanding of worry, particularly excessive worry, in the multiethnic South African context. Nonetheless, this study has succeeded in exploring the contribution of cognitive processes to the experience of worry in a specific multi-ethnic context by investigating the applicability of theoretical cognitive models of worry in this context. Furthermore, this study has provided a starting point from which a clearer understanding of the role of cognitive processes in worry can be achieved in the South African context.

[发布机构] University of the Free State