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Worry: A Cognitive Phenomenon Intimately Linked to Affective, Physiological, and Interpersonal Behavioral Processes
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Repetitive negative thinking includes worry and rumination and is both a risk factor for and a common symptom of anxiety and depression.
“Repetitive negative thinking (RNT), which includes worry and rumination, is both a risk factor for and a common symptom of anxiety and depression15–17”
From An exploration into the relationship between insomnia and repetitive negative thinking among cancer survivors. (2025) · cites this paper as [16]
The Introduction (p. 3) identifies chronic worry as central to generalized anxiety disorder, and “Worry and Depression” (p. 12) describes depressive rumination as similar to worry and as a possible factor maintaining depression. The paper does not establish that repetitive negative thinking as a whole is a common symptom of both conditions or a risk factor for developing both. (LLM, conf=0.85)
Experimental — accuracy not yet measuredIn the second, more important process, worries are used consciously or automatically to reduce physically experienced stress associated with intense emotions.
“Im zweiten, wichtigeren Prozess werden Sorgen bewusst oder automatisch eingesetzt, um den mit intensiven Emotionen verbundenen, körperlich erlebten Stress zu reduzieren [Borkovec et al., 1998;Mennin et al., 2002].”
From Wann sind Sorgen pathologisch? (2009) · cites this paper as Borkovec et al., 1998
“Worry Suppresses Somatic Anxiety” (p. 5) reports that worry suppresses cardiovascular responses to threatening images, supporting the claim that it reduces physically experienced anxiety. The cited passages do not establish that worry is used consciously or automatically for this purpose, or characterize it as a second, more important process. (LLM, conf=0.83)
Experimental — accuracy not yet measuredIn the superstitious variant, patients believe that thinking about a feared event beforehand lowers its probability of occurrence, feel better prepared, and gain a sense of safety and control.
“Eine «abergläubische» Variante, bei der Patienten meinen, die Auftretenswahrscheinlichkeit eines befürchteten Ereignisses zu senken, wenn sie sich vorher darüber «Gedanken» gemacht haben.Sie fühlen sich dadurch besser vorbereitet.Dies vermittelt ein Gefühl von Sicherheit und Kontrolle.”
From Wann sind Sorgen pathologisch? (2009) · cites this paper as Borkovec et al., 1998
In “Worry as an Attempt to Avoid Negative Events or to Prepare for the Worst” (pp. 7–8), the paper reports that people believe worrying prepares them for the worst and can make a feared event seem less likely to occur. It describes this as a superstitious association, but does not say that it gives them a feeling of safety and control. (LLM, conf=0.84)
Experimental — accuracy not yet measuredReinforcement learning mechanisms have been suggested to drive anxiety disorders.
“From a theoretical standpoint, reinforcement learning mechanisms have been suggested to drive anxiety disorders [14,15].”
From Clinical Efficacy and Psychological Mechanisms of an App-Based Digital Therapeutic for Generalized Anxiety Disorder: Randomized Controlled Trial (2021) · cites this paper as [15]
The Summary and Conclusion (p. 16) proposes that negative reinforcement can strengthen and maintain worry, and the discussion on p. 8 links learning and reinforcement principles to the origins and maintenance of worry. The paper focuses on worry and generalized anxiety disorder; it does not establish that reinforcement learning mechanisms drive anxiety disorders generally. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThe prevalence of imagery-based repetitive negative thinking is at odds with models arguing that repetitive negative thinking is a verbal-based strategy to avoid distressing intrusive images, but is in line with recent empirical data demonstrating comparable effects on affect between both modalities of repetitive negative thinking.
“Imagery-based RNT was prevalent, at odds with models arguing RNT is a verbal-based strategy to avoid distressing intrusive images (Borkovec et al., 1998), but in line with recent empirical data demonstrating comparable effects on affect between both modalities of RNT (Lawrence & Schwartz-Mette, 2019).”
From Understanding Autistic Adults' Psychological Experiences of Anxiety Problems: A Qualitative Interview Study. (2026) · cites this paper as Borkovec et al., 1998
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Experimental — accuracy not yet measured
Worry can act as experiential avoidance by lowering anxious arousal about feared outcomes, and it is at least partly maintained through negative reinforcement.
“Worry can serve an experiential avoidance function (Borkovec, 1994; Borkovec, Ray, & Stober, 1998) insofar as engaging in worry reduces anxious arousal related to feared potential outcomes; thus, worry is at least partially maintained through negative reinforcement.”
From Intolerance of Uncertainty: A Common Factor in the Treatment of Emotional Disorders (2013) · cites this paper as Borkovec, Ray, & Stober, 1998
Worry itself, as a predominantly verbal-abstract activity, has an emotion-avoidant function.
“Insbesondere Borkovec [Borkovec et al., 1998;Sibrava und Borkovec, 2006] hat in seinen Arbeiten darauf hingewiesen, dass den Sorgen selbst, als vorwiegend verbal-abstrakter Aktivität, eine (emotions-)vermeidende Funktion zukommt.”
From Wann sind Sorgen pathologisch? (2009) · cites this paper as Borkovec et al., 1998
Two variants of avoidance play a role: a superstitious variant and a process to reduce stress.
“Zwei Varianten der Vermeidung spielen eine Rolle [Borkovec et al., 1998]:”
From Wann sind Sorgen pathologisch? (2009) · cites this paper as Borkovec et al., 1998
When worry becomes habitual, its negative reinforcement pathway can spiral out of control.
“As described by Borkovec et al [14,15], when worry becomes habitual, its negative reinforcement pathway can spiral out of control;”
From Clinical Efficacy and Psychological Mechanisms of an App-Based Digital Therapeutic for Generalized Anxiety Disorder: Randomized Controlled Trial (2021) · cites this paper as [15]
Verbalizing a fearful situation can induce less cardiovascular response than visually imagining it, possibly because verbalization serves abstraction and disengagement.
“For example, verbalizing a fearful situation can induce less cardiovascular response than visually imagining the same situation, possibly because verbalizations are used as a strategy for abstraction and disengagement (Borkovec et al., 1998; but also see Newman & Llera, 2011, and Newman, Llera, Erickson, Przeworski, & Castonguay, 2013, who did not find support for this).”
From Toward a Cognitive-Behavioral Classification System for Mental Disorders (2014) · cites this paper as Borkovec et al., 1998
Worrying and rumination become negatively reinforced by reduction in aversive emotions.
“It has been shown that both worrying and rumination become negatively reinforced by the reduction in aversive emotions (Borkovec et al., 1998; Nolen-Hoeksema, Wisco, & Lyubomirsky, 2008).”
From Toward a Cognitive-Behavioral Classification System for Mental Disorders (2014) · cites this paper as Borkovec et al., 1998
Rumination and pessimism likely represent the cognitive components of avoidance and hypervigilance.
“rumination and pessimism likely represent the cognitive components of avoidance and hypervigilance (Borkovec, Ray, & Stober, 1998; Stapinski, Abbott, & Rapee, 2010)”
From A transdiagnostic minority stress treatment approach for gay and bisexual men's syndemic health conditions (2015) · cites this paper as Borkovec et al., 1998
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Metadata
- Authors
- Borkovec, T. D., Ray, W. J., & Stober, J.
- Affiliations
- Pennsylvania State University (US)
- ORCID
- Ray, William J.
- Venue
- Cognitive Therapy and Research
- Published
- 1998-12
- Volume
- 22
- Issue
- 6
- Pages
- 561-576
- ISSN
- 0147-5916 (ISSN-L)
- 1573-2819
- OpenAlex
- W1618820470
- Cited by
- 802
- References
- 59
- Citations by year
- 2026: 27 · 2025: 30 · 2024: 26 · 2023: 26 · 2022: 24 · 2021: 51 · 2020: 29 · 2019: 33 · 2018: 39 · 2017: 37 · 2016: 36 · 2015: 35 · 2014: 38 · 2013: 38 · 2012: 32
- FWCI
- 11.48
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Licence
- Locations
- Cognitive Therapy and Research (publishedVersion)
- Kent Academic Repository (University of Kent) (acceptedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Mind wandering and attention
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- worry, cognitive avoidance, anxiety, depressive affect, caregiver attachment, interpersonal problems, physiological arousal
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