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Dr Suzanne Dash MARS Mood and Anxiety Research in Sussex.

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1 Dr Suzanne Dash MARS Mood and Anxiety Research in Sussex

2  Worry  Heuristic Systematic Model  What is systematic processing?  When does it happen?  Why might worriers systematically process?  Clinical Implications  Conclusions

3  “ 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)

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

5  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

6 17 × 24


8 1. SP: detailed, analytical processing Worry: persistent, detailed processing 2. Worry and SP arise through unconscious/non- deliberative means 3. SP deployed when confidence is unsatisfactory Worriers 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

9  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)

10 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

11 Systematic processing Heuristic processing Trivial task Maheswaran & Chaiken (1991)

12 Systematic processing Heuristic processing Important task Maheswaran & Chaiken (1991)

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

14 Construct/ Appraisal Definition  Systematic processing  worry AccountabilityPressure 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)

15 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)

16 Negative mood Sufficiency threshold Worry (PSWQ) Unmediated: b = 8.21, p =.01 Mediated: b = 4.13, p =.12

17  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

18  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

19  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

20  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

21  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

22 Professor Graham Davey Dr Frances Meeten Graduate Teaching Assistantship

23  Any questions? 

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