Cognitive analysis of specific threat beliefs and safety-seeking behaviours in generalised anxiety disorder: revisiting the cognitive theory of anxiety disorders
Abstract
Background Generalised anxiety disorder (GAD) has been an uneasy member of the anxiety disorders group since its inclusion in the third edition of the DSM. Multiple theories and treatment protocols for GAD and its defining symptom, excessive worry, have comparable efficacy in treating GAD symptoms. Crucially, these theories of GAD and excessive worry fail to explain when and why worry is excessive and when it is adaptive. Aims In this paper we propose a cognitive behavioural account of the difference between excessive and adaptive states of worry and explore the theme of threat and the function of safety-seeking behaviours as seen in GAD. Specifically, we incorporate the concept of inflated responsibility in a cognitive behavioural analysis of threat appraisal and safety-seeking behaviours in excessive worry and GAD. Conclusion It is proposed that when worry is used as a strategy intended to increase safety from perceived social or physical threat then it should be conceptualised as a safety-seeking behaviour. However, when worry is used as a strategy to solve a problem which the person realistically can resolve or to deal explicitly with the feeling of anxiety then it functions as an adaptive coping behaviour. We also propose that the theme of threat in GAD centres on an inflated sense of responsibility for external everyday situations, and the function of safety-seeking behaviours is to attain certainty that responsibility has been fulfilled. The clinical implications of th…
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Individuals with GAD likely seek reassurance from their partners with the aim of bolstering their feelings of safety and certainty regarding a particular outcome.
“It is likely that individuals with GAD seek reassurance from their partners with the aim of bolstering their feelings of safety and certainty regarding a particular outcome (Gústavsson et al ., 2021; Halldorsson and Salkovskis, 2017; Neal and Radomsky, 2020).”
From Partner symptom accommodation in generalized anxiety disorder: A preliminary examination of correlates with symptoms and cognitive behavioural therapy outcome (2024) · cites this paper as Gústavsson et al., 2021
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- Authors
- Gústavsson, S. M., Salkovskis, P. M., & Sigurðsson, J. F.
- Affiliations
- Reykjavík University (IS)
- University of Oxford (GB)
- Corresponding author
- Gústavsson, Sævar M.
- Venue
- Behavioural and Cognitive Psychotherapy
- Publisher
- Cambridge University Press (CUP)
- Published
- 2021-03-12
- Volume
- 49
- Issue
- 5
- Pages
- 526-539
- ISSN
- 1352-4658 (ISSN-L)
- 1469-1833
- OpenAlex
- W3135693162
- Cited by
- 33
- References
- 72
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 4 · 2023: 5 · 2022: 7 · 2021: 3
- FWCI
- 4.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behavioural and Cognitive Psychotherapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Keywords
- generalized anxiety disorder, excessive worry, safety-seeking behavior, threat appraisal, inflated responsibility, threat beliefs
- MeSH terms
- Adaptation, Psychological, Anxiety, Anxiety Disorders, Cognition, Emotions, Humans
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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