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

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.

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References

  1. 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.

    CAS  Article  PubMed  Google Scholar 

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

    Google Scholar 

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

    Google Scholar 

  4. 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 

  5. 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 

  6. 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 

  7. 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.

    CAS  Article  PubMed  Google Scholar 

  8. 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 

  9. 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.

    CAS  Article  PubMed  Google Scholar 

  10. 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 

  11. 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.

    CAS  Article  PubMed  Google Scholar 

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

    CAS  Article  PubMed  Google Scholar 

  13. 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 

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

    Article  Google Scholar 

  15. 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.

    CAS  Article  PubMed  Google Scholar 

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

    Article  Google Scholar 

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

    Article  PubMed  Google Scholar 

  18. 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 

  19. 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 

  20. 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 

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

    CAS  Article  PubMed  Google Scholar 

  22. 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 

  23. 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 

  24. 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 

  25. 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 

  26. 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.

    CAS  Article  PubMed  Google Scholar 

  27. 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 

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

    Google Scholar 

  29. 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 

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

    Article  Google Scholar 

  31. 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 

  32. 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 

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

    Article  Google Scholar 

  34. 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 

  35. 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 

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

    Google Scholar 

  37. 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 

  38. 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 

  39. 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 

  40. 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.

    CAS  Article  PubMed  Google Scholar 

  41. 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 

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

    Google Scholar 

  43. 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.

    CAS  Article  PubMed  Google Scholar 

  44. 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 

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

    CAS  Article  PubMed  Google Scholar 

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

    CAS  Article  PubMed  Google Scholar 

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

    Article  Google Scholar 

  48. 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 

  49. 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.

    CAS  Article  PubMed  Google Scholar 

  50. 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.

    CAS  Article  PubMed  Google Scholar 

  51. 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 

  52. 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 

  53. 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 

  54. 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 

  55. 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 

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

    Article  PubMed  Google Scholar 

  57. 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 

  58. 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 

  59. 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 

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

    CAS  Article  PubMed  Google Scholar 

  61. 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 

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

    CAS  Article  PubMed  Google Scholar 

  63. 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 

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

  65. 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 

  66. 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 

  67. 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 

  68. 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 

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

    CAS  Article  PubMed  Google Scholar 

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

    CAS  Article  PubMed  Google Scholar 

  71. 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 

  72. 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 

  73. 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 

  74. 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 

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

    Article  PubMed  PubMed Central  Google Scholar 

  76. 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 

  77. 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 

  78. 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 

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Correspondence to Naomi Koerner.

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

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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

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Keywords

  • Worry
  • Generalized anxiety disorder
  • Problem solving
  • Negative problem orientation
  • Intolerance of uncertainty
  • Impulsivity
  • Avoidance