Skip to main content
Log in

Unique Correlates of Problem Solving Effectiveness in Individuals with Generalized Anxiety Disorder

  • Original Article
  • Published:
Cognitive Therapy and Research Aims and scope Submit manuscript

Abstract

Over the last decade, research on the problem-solving characteristics of individuals high in chronic worry has waned. It is proposed that there remains a lot to be learned about the way in which excessive and uncontrollable worrying affects the way in which people approach problems. The present study examined the relations of negative problem orientation, problem solving styles, intolerance of uncertainty, and worry to in vivo problem-solving performance in people with generalized anxiety disorder (GAD; N = 43). Problem-solving performance was assessed by rating participants’ ability to develop effective problem solutions. Impulsive/careless problem-solving style was uniquely predictive of lower effectiveness of problem solutions; whereas negative problem orientation, habitual avoidant problem solving style, intolerance of uncertainty and chronic worrying were not. After controlling for state anxiety, none of the variables were unique correlates of problem-solving effectiveness. The study represents an initial examination of the potential impact of negative problem orientation, dysfunctional problem-solving style, intolerance of uncertainty, and worry on problem-solving quality. The findings are discussed in relation to theoretical models and therapeutic approaches for GAD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Aldao, A., Mennin, D. S., Linardatos, E., & Fresco, D. M. (2010). Differential patterns of physical symptoms and subjective processes in generalized anxiety disorder and unipolar depression. Journal of Anxiety Disorders, 24, 250–259.

    Article  CAS  PubMed  Google Scholar 

  • American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Arlington, VA: American Psychiatric Press.

    Google Scholar 

  • American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders: Fifth Edition (DSM-5). Arlington, VA: American Psychiatric Press.

    Book  Google Scholar 

  • Anderson, K. G., Dugas, M. J., Koerner, N., Radomsky, A. S., Savard, P., & Turcotte, J. (2012). Interpretive style and intolerance of uncertainty in individuals with anxiety disorders: A focus on generalized anxiety disorder. Journal of Anxiety Disorders, 26, 823–832.

    Article  PubMed  Google Scholar 

  • Anderson, R. J., Goddard, L., & Powell, J. H. (2009). Social problem-solving processes and mood in college students: An examination of self-report and performance based approaches. Cognitive Therapy and Research, 33, 175–186.

    Article  Google Scholar 

  • Belzer, K. D., D’Zurilla, T. J., & Maydeu-Olivares, A. (2002). Social problem-solving and trait anxiety as predictors of worry in a college student population. Personality and Individual Differences, 33, 573–585.

    Article  Google Scholar 

  • Borkovec, T. D., Newman, M. G., Pincus, A. L., & Lytle, R. (2002). A component analysis of cognitive-behavioral therapy for generalized anxiety disorder and the role of interpersonal problems. Journal of Consulting and Clinical Psychology, 70, 288–298.

    Article  CAS  PubMed  Google Scholar 

  • Borkovec, T. D., Ray, W. J., & Stöber, J. (1998). Worry: A cognitive phenomenon intimately linked to affective, physiological, and interpersonal behavioral processes. Cognitive Therapy and Research, 22, 561–576.

    Article  Google Scholar 

  • Borkovec, T. D., Robinson, E., Pruzinsky, T., & DePree, J. A. (1983). Preliminary exploration of worry: Some characteristics and processes. Behaviour Research and Therapy, 21, 9–16.

    Article  CAS  PubMed  Google Scholar 

  • Bray, S., Barrowclough, C., & Lobban, F. (2007). The social problem-solving abilities of people with borderline personality disorder. Behaviour Research and Therapy, 45, 1409–1417.

    Article  PubMed  Google Scholar 

  • Brown, T. A., Antony, M. M., & Barlow, D. H. (1992). Psychometric properties of the Penn State worry questionnaire in a clinical anxiety disorders sample. Behaviour Research and Therapy, 30, 33–37.

    Article  CAS  PubMed  Google Scholar 

  • Buhr, K., & Dugas, M. J. (2002). The intolerance of uncertainty scale: Psychometric properties of the English version. Behaviour Research and Therapy, 40, 931–945.

    Article  CAS  PubMed  Google Scholar 

  • Buhr, K., & Dugas, M. J. (2006). Investigating the construct validity of intolerance of uncertainty and its unique relationship with worry. Journal of Anxiety Disorders, 20(2), 222–236.

    Article  PubMed  Google Scholar 

  • Calvo, M. G., & Castillo, M. D. (2001). Selective interpretation in anxiety: Uncertainty for threatening events. Cognition and Emotion, 15, 299–320.

    Article  Google Scholar 

  • Cartwright-Hatton, S., & Wells, A. (1997). Beliefs about worry and intrusions: The meta-cognitions questionnaire and its correlates. Journal of Anxiety Disorders, 11, 279–296.

    Article  CAS  PubMed  Google Scholar 

  • Cassady, J. C., & Johnson, R. E. (2002). Cognitive test anxiety and academic performance. Contemporary Educational Psychology, 27, 270–295.

    Article  Google Scholar 

  • D’Zurilla, T. J., & Goldfried, M. R. (1971). Problem-solving and behavior modification. Journal of Abnormal Psychology, 78, 107–126.

    Article  PubMed  Google Scholar 

  • D’Zurilla, T. J., Nezu, A. M., & Maydeu-Olivares, A. (2002). Social problem-solving inventory - revised (spsi-r): manual. North Tonawanda, NY: Multi-Health Systems.

    Google Scholar 

  • D’Zurilla, T. J., & Nezu, A. M. (1990). Development and preliminary evaluation of the social problem-solving inventory. Psychological Assessment, 2, 156–163.

    Article  Google Scholar 

  • D’Zurilla, T. J., & Nezu, A. M. (2010). Problem-solving therapy. In K. S. Dobson (Ed.), Handbook of cognitive behavioral therapies (3rd edn., pp. 197–225). New York, NY: Guilford Press.

    Google Scholar 

  • Davey, G.C.L. (1994). Worrying, social problem-solving abilities, and social problem-solving confidence. Behaviour Research and Therapy, 32, 327–330.

    Article  CAS  PubMed  Google Scholar 

  • Davey, G.C.L., Jubb, M., & Cameron, C. (1996). Catastrophic worrying as a function of changes in problem-solving confidence. Cognitive Therapy and Research, 20, 333–344.

    Article  Google Scholar 

  • Derakshan, N., Smyth, S., & Eysenck, M. W. (2009). Effects of state anxiety on performance using a task switching paradigm: An investigation of attentional control theory. Psychonomic Bulletin and Review, 16, 1112–1117.

    Article  PubMed  Google Scholar 

  • Dixon-Gordon, K. L., Chapman, A. L., Lovasz, N., & Walters, K. (2011). Too upset to think: The interplay of borderline personality features, negative emotions, and social problem-solving in the laboratory. Personality Disorders: Theory, Research and Treatment, 2, 243–260.

    Article  Google Scholar 

  • Dugas, M. J., Freeston, M. H., & Ladouceur, R. (1997). Intolerance of uncertainty and problem orientation in worry. Cognitive Therapy and Research, 21, 593–606.

    Article  Google Scholar 

  • Dugas, M. J., Gagnon, F., Ladouceur, R., & Freeston, M. H. (1998). Generalized anxiety disorder: A preliminary test of a conceptual model. Behaviour Research and Therapy, 36, 215–226.

    Article  CAS  PubMed  Google Scholar 

  • Dugas, M. J., Letarte, H., Rhéaume, J., Freeston, M. H., & Ladouceur, R. (1995). Worry and problem-solving: Evidence of a specific relationship. Cognitive Therapy and Research, 19, 109–120.

    Article  Google Scholar 

  • Dugas, M. J., & Robichaud, M. (2007). Cognitive-behavioral treatment for generalized anxiety disorder: From science to practice. New York, NY: Routledge.

    Google Scholar 

  • Eng, W., & Heimberg, R. G. (2006). Interpersonal correlates of generalized anxiety disorder: Self versus other perception. Journal of Anxiety Disorders, 20, 380–387.

    Article  PubMed  Google Scholar 

  • Eysenck, M. W., & Calvo, M. G. (1992). Anxiety and performance: The processing efficiency theory. Cognition and Emotion, 6, 409–434.

    Article  Google Scholar 

  • Freeston, M. H., Rhéaume, J., Letarte, H., Dugas, M. J., & Ladouceur, R. (1994). Why do people worry? Personality and Individual Differences, 17, 791–802.

    Article  Google Scholar 

  • Gentes, E. L., & Ruscio, A. M. (2011). A meta-analysis of the relation of intolerance of uncertainty to symptoms of generalized anxiety disorder, major depressive disorder, and obsessive-compulsive disorder. Clinical Psychology Review, 31, 923–933.

    Article  PubMed  Google Scholar 

  • Goldwin, M., & Behar, E. (2012). Concreteness of idiographic periods of worry and depressive rumination. Cognitive Therapy and Research, 36, 840–846.

    Article  Google Scholar 

  • Gosselin, P., Ladouceur, R., Morin, C. M., Dugas, M. J., & Baillargeon, L. (2006). Benzodiazepine discontinuation among adults with GAD: A randomized controlled trial of cognitive-behavioral therapy. Journal of Consulting and Clinical Psychology, 74, 908–919.

    Article  PubMed  Google Scholar 

  • Gosselin, P., Ladouceur, R., & Pelletier, O. (2005). Évaluation de l’attitude d’un individu face aux différents problèmes de vie: le questionnaire d’attitude face aux problèmes (QAP) [Evaluation of an individual’s attitude toward daily life problems: the negative problem orientation questionnaire]. Journal de Thérapie Comportementale et Cognitive, 15, 141–153.

    Article  Google Scholar 

  • Hazlett-Stevens, H. (2008). Psychological approaches to generalized anxiety disorder: A clinician’s guide to assessment and treatment. New York, NY: Springer.

    Book  Google Scholar 

  • Hoffman, B., & Schraw, G. (2009). The influence of self-efficacy and working memory capacity on problem solving efficiency. Learning and Individual Differences, 19, 91–100.

    Article  Google Scholar 

  • Kehrer, C., & Linehan, M. M. (1996). Interpersonal and emotional problem-solving skills and parasuicide among women with borderline personality disorder. Journal of Personality Disorders, 10, 153–163.

    Article  Google Scholar 

  • Koerner, N., Tallon, K., & Kusec, A. (2015). Maladaptive core beliefs and their relation to generalized anxiety disorder. Cognitive Behaviour Therapy, 44, 441–455.

    Article  PubMed  Google Scholar 

  • Ladouceur, R., Blais, F., Freeston, M. H., & Dugas, M. J. (1998). Problem-solving and problem orientation in generalized anxiety disorder. Journal of Anxiety Disorders, 12, 139–152.

    Article  CAS  PubMed  Google Scholar 

  • Leigh, E., & Hirsch, C. R. (2011). Worry in imagery and verbal form: Effect on residual working memory capacity. Behaviour Research and Therapy, 49, 99–105.

    Article  PubMed  PubMed Central  Google Scholar 

  • Linehan, M. M. (2014). DBT skills training manual (2nd edn.). New York, NY: Guilford Press.

    Google Scholar 

  • Lyubomirsky, S., & Nolen-Hoeksema, S. (1995). Effects of self-focused rumination on negative thinking and interpersonal problem-solving. Journal of Personality and Social Psychology, 69, 176–190.

    Article  CAS  PubMed  Google Scholar 

  • MacLeod, C., & Donnellan, A. M. (1993). Individual differences in anxiety and the restriction of working memory capacity. Personality and Individual Differences, 15, 163–173.

    Article  Google Scholar 

  • Marx, E. M., Williams, J. M. G., & Claridge, G. S. (1992). Depression and social problem solving. Journal of Abnormal Psychology, 101, 78–86.

    Article  CAS  PubMed  Google Scholar 

  • Mathews, A. (1990). Why worry? The cognitive function of anxiety. Behaviour Research and Therapy, 28, 455–468.

    Article  CAS  PubMed  Google Scholar 

  • McGraw, K. O., & Wong, S. P. (1996). Forming inferences about some intraclass correlation coefficients. Psychological Methods, 1, 30–46.

    Article  Google Scholar 

  • Mennin, D. S., Heimberg, R. G., Turk, C. L., & Fresco, D. M. (2005). Preliminary evidence for an emotion dysregulation model of generalized anxiety disorder. Behaviour Research and Therapy, 43, 1281–1310.

    Article  PubMed  Google Scholar 

  • Metzger, R. L., Miller, M. L., Cohen, M., Sofka, M., & Borkovec, T. D. (1990). Worry changes decision-making: The effect of negative thoughts on cognitive processing. Journal of Clinical Psychology, 46, 78–88.

    Article  CAS  PubMed  Google Scholar 

  • Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990). Development and validation of the Penn State worry questionnaire. Behaviour Research and Therapy, 28, 487–495.

    Article  CAS  PubMed  Google Scholar 

  • Mitchell, J. E., & Madigan, R. J. (1984). The effects of induced elation and depression on interpersonal problem-solving. Cognitive Therapy and Research, 8, 277–285.

    Article  Google Scholar 

  • Molina, S., & Borkovec, T. D. (1994). The Penn State Worry Questionnaire: Psychometric properties and associated characteristics. In G. C. L. Davey & F. Tallis (Eds.), Worrying: Perspectives on theory, assessment and treatment (pp. 265–283). Oxford: Wiley.

    Google Scholar 

  • Moore, M. T., Anderson, N. L., Barnes, J. M., Haigh, E. A., & Fresco, D. M. (2014). Using the GAD-Q-IV to identify generalized anxiety disorder in psychiatric treatment seeking and primary care medical samples. Journal of anxiety disorders, 28(1), 25–30.

    Article  PubMed  Google Scholar 

  • Newman, M. G., Zuellig, A. R., Kachin, K. E., Constantino, M. J., & Cashman, L. (2002). The reliability and validity of the GAD-Q-IV: a revised self-report diagnostic measure of generalized anxiety disorder. Behavior Therapy, 33, 215–233.

    Article  Google Scholar 

  • Oathes, D. J., Squillante, C. M., Ray, W. J., & Nitschke, J. B. (2010). The impact of worry on attention to threat. PLoS ONE, 5, e13411.

    Article  PubMed  PubMed Central  Google Scholar 

  • Parkinson, B., & Simons, G. (2012). Worry spreads: Interpersonal transfer of problem-related anxiety. Cognition and Emotion, 26, 462–479.

    Article  PubMed  Google Scholar 

  • Parkinson, M., & Creswell, C. (2011). Worry and problem-solving skills and beliefs in primary school children. British Journal of Clinical Psychology, 50, 106–112.

    Article  PubMed  Google Scholar 

  • Pawluk, E. J., & Koerner, N. (2013). A preliminary investigation of impulsivity in generalized anxiety disorder. Personality and Individual Differences, 54, 732–737.

    Article  Google Scholar 

  • Pawluk, E. J., & Koerner, N. (2016). The relationship between negative urgency and generalized anxiety disorder symptoms: The role of intolerance of negative emotions and intolerance of uncertainty. Anxiety, Stress, and Coping, 29, 606–615.

    Article  PubMed  Google Scholar 

  • Platt, J. J., & Spivack, G. (1972). Problem-solving thinking of psychiatric patients. Journal of Consulting and Clinical Psychology, 39, 148–151.

    Article  CAS  PubMed  Google Scholar 

  • Provencher, M. D., Dugas, M. J., & Ladouceur, R. (2004). Efficacy of problem-solving training and cognitive exposure in the treatment of generalized anxiety disorder: A case replication series. Cognitive and Behavioral Practice, 11, 404–414.

    Article  Google Scholar 

  • Ramirez, G., & Beilock, S. L. (2011). Writing about testing worries boosts exam performance in the classroom. Science, 331, 211–213.

    Article  CAS  PubMed  Google Scholar 

  • Ree, M. J., French, D., MacLeod, C., & Locke, V. (2008). Distinguishing cognitive and somatic dimensions of state and trait anxiety: Development and validation of the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA). Behavioural and Cognitive Psychotherapy, 36, 313–332.

    Article  Google Scholar 

  • Robichaud, M. (2005). An in-depth examination of social problem-solving ability (Doctoral dissertation). Retrieved from http://spectrum.library.concordia.ca/.

  • Robichaud, M., & Dugas, M. J. (2005a). Negative problem orientation part I: Psychometric properties of a new measure. Behaviour Research and Therapy, 43, 391–401.

    Article  PubMed  Google Scholar 

  • Robichaud, M., & Dugas, M. J. (2005b). Negative problem orientation part II: Construct validity and specificity to worry. Behaviour Research and Therapy, 43, 403–412.

    Article  PubMed  Google Scholar 

  • Sexton, K. A., & Dugas, M. J. (2009). Defining distinct negative beliefs about uncertainty: Validating the factor structure of the intolerance of uncertainty scale. Psychological Assessment, 21, 176–186.

    Article  PubMed  Google Scholar 

  • Sheehan, D., Lecrubier, Y., Sheehan, K. H., Sheehan, K., Amorim, P., Janavs, J., ... & Dunbar, G. (1998). Diagnostic Psychiatric Interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59, 22–33.

    PubMed  Google Scholar 

  • Shrout, P. E., & Fleiss, J. L. (1979). Intraclass correlations: Uses in assessing rater reliability. Psychological Bulletin, 86, 420–428.

    Article  CAS  PubMed  Google Scholar 

  • Startup, H. M., & Davey, G.C.L. (2001). Mood as input and catastrophic worrying. Journal of Abnormal Psychology, 110, 83–96.

    Article  CAS  PubMed  Google Scholar 

  • Stöber, J., & Borkovec, T. D. (2002). Reduced concreteness of worry in generalized anxiety disorder: Findings from a therapy study. Cognitive Therapy and Research, 26, 89–96.

    Article  Google Scholar 

  • Szabo, M., & Lovibond, P. F. (2006). Worry episodes and perceived problem-solving: A diary-based approach. Anxiety, Stress, and Coping, 19, 175–187.

    Article  Google Scholar 

  • Théberge-Lapointe, N., Marchand, A., Langlois, F., Gosselin, P., & Watts, S. (2015). Efficacy of a cognitive behavioural therapy administered by videoconference for generalized anxiety disorder. Revue Européenne de Psychologie Appliquée, 65, 9–17.

    Article  Google Scholar 

  • Verkuil, B., Brosschot, J. F., Borkovec, T. D., & Thayer, J. F. (2009). Acute autonomic effects of experimental worry and cognitive problem-solving: Why worry about worry? International Journal of Clinical and Health Psychology, 9, 439–453.

    Google Scholar 

  • Watkins, E. R. (2008). Constructive and unconstructive repetitive thought. Psychological Bulletin, 134, 163–206.

    Article  PubMed  PubMed Central  Google Scholar 

  • Watkins, E. R., & Moulds, M. (2005). Distinct modes of ruminative self-focus: Impact of abstract versus concrete rumination on problem solving in depression. Emotion, 5, 319–328.

    Article  PubMed  Google Scholar 

  • Williams, J.M.G., Barnhofer, T., Crane, C., & Beck, A. T. (2005). Problem-solving deteriorates following mood challenge in formerly depressed patients with a history of suicidal ideation. Journal of Abnormal Psychology, 114, 421–431.

    Article  PubMed  Google Scholar 

  • Wilson, C., & Hughes, C. (2011). Worry, beliefs about worry and problem-solving in young children. Behavioural and Cognitive Psychotherapy, 39, 507–521.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Naomi Koerner.

Ethics declarations

Conflict of Interest

Elizabeth J. Pawluk, Naomi Koerner, Kathleen Tallon, & Martin M. Antony declare that they have no conflict of interest.

Animal Rights

No animal studies were carried out by the authors for this article

Informed Consent

Informed consent was obtained from all individual participants included in the study

Additional information

Data Availability: Data are available from the corresponding author on reasonable request.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pawluk, E.J., Koerner, N., Tallon, K. et al. Unique Correlates of Problem Solving Effectiveness in Individuals with Generalized Anxiety Disorder. Cogn Ther Res 41, 881–890 (2017). https://doi.org/10.1007/s10608-017-9861-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10608-017-9861-x

Keywords

Navigation