Expanding our conceptualization of and treatment for generalized anxiety disorder: integrating mindfulness/acceptance-based approaches with existing cognitive-behavioral models

Roemer, Lizabeth; Orsillo, Susan M.

doi:10.1093/clipsy.9.1.54

Cited by 545Mindfulness and Compassion InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPersonality Disorders and Psychopathology

Expanding our conceptualization of and treatment for generalized anxiety disorder: integrating mindfulness/acceptance-based approaches with existing cognitive-behavioral models

Roemer, Lizabeth, Orsillo, Susan M.·2002·Clinical Psychology: Science and Practice

DOI 10.1093/clipsy.9.1.54

Open this paper in CoChat — free account

Abstract

Generalized anxiety disorder (CAD) is a chronic, pervasive disorder for which we have yet to develop sufficiently efficacious interventions. In this article we propose that recent research and theory regarding this disorder supports the integration of acceptance-based treatments with existing cognitive-behavioral treatments for CAD to improve the efficacy and clinical significance of such approaches. The bases for this proposal (from both the CAD and the acceptance-based treatment literature) are reviewed, and a new treatment stemming from this conceptual integration is described.

Integrity signals

Registry

OpenAlex · 10.1093/clipsy.9.1.54

Cites

47 of 106 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Roemer and Orsillo advanced a three-part GAD model that could account for the life dissatisfaction and impairment linked to the disorder.
“Roemer and Orsillo[15, 16] propose a three-part model of GAD that may explain the life dissatisfaction and impairment associated with this disorder.”
From The role of values-consistent behavior in generalized anxiety disorder. (2011) · cites this paper as [15]
Experiential avoidance may narrow behavior, as people focus on avoiding uncomfortable internal sensations instead of pursuing valued activities.
“Further, experiential avoidance may lead to a restriction in behavior as individuals become focused on avoiding events and situations that elicit uncomfortable internal sensations rather than pursuing activities consistent with personal values.”
From The role of values-consistent behavior in generalized anxiety disorder. (2011) · cites this paper as [15]
The findings support the GAD theoretical model advanced by Roemer and Orsillo.
“These findings directly lend support to the theoretical model of GAD proposed by Roemer and Orsillo,[15, 39] which suggests that the life impairment in GAD may be partially explained by individuals seeing their internal experiences as distressing, leading to experiential avoidance and a restriction in pursuing activities consistent with personal values.”
From The role of values-consistent behavior in generalized anxiety disorder. (2011) · cites this paper as [15]
Roemer and Orsillo developed a model of generalized anxiety disorder that was informed by research and theory on experiential avoidance and ruminative, self-critical processing in psychopathology.
“Roemer and Orsillo (2002) developed a model of GAD informed by research and theory highlighting the potential roles of experiential avoidance (e.g., Hayes, Wilson, Gifford, Follette & Strosahl, 1996) and ruminative, self-critical processing (e.g., Barnard & Teasdale, 1991) in the development and maintenance of psychopathology.”
From A randomized clinical trial comparing an acceptance-based behavior therapy to applied relaxation for generalized anxiety disorder (2013) · cites this paper as Roemer & Orsillo, 2002
Worry has been framed as anxiety avoidance, experiential avoidance, and uncertainty reduction.
“Worry has been proposed as a way of avoiding anxiety (Borkovec, Robinson, Pruzinsky & DePree, 1983), as a form of experiential avoidance (Roemer & Orsillo, 2002) and a way of reducing uncertainty (Dugas, Gagnon, Ladouceur & Freeston, 1998).”
From The Argentinian version of the cognitive fusion questionnaire: Psychometric properties and the role of cognitive fusion as a predictor of pathological worry (2022) · cites this paper as Roemer & Orsillo, 2002

Acceptance contributes to effective coping with adversity, reduced stress, and improved emotional well-being.
“A growing body of research also suggests that acceptance contributes to effective coping with adversity, reduced stress, and improved emotional well-being.”
From Aspects of acceptance: building a shared conceptual understanding (2024) · cites this paper as Roemer and Orsillo, 2002
Empirical evidence supports the role of EA in the onset and maintenance of emotional disorders such as GAD and depression.
“Empirical evidence supports the role of EA in the onset and maintenance of emotional disorders such as GAD and depression (Roemer and Orsillo, 2002; Boulanger et al., 2010; Ruiz, 2010).”
From A Multiple-Baseline Evaluation of Acceptance and Commitment Therapy Focused on Repetitive Negative Thinking for Comorbid Generalized Anxiety Disorder and Depression (2020) · cites this paper as Roemer and Orsillo, 2002
Exposure to uncertainty may lead to more optimal functioning and should be incorporated into treatment.
“While excessive or unrealistic worry is present in GAD [13], and according to theresearch its function may be to diminish internal distress by decreasing theexperi ence ofuncertainty, theexposure to uncertainty may lead to more optimal functioning and thus it should be incor porated into treatment [15].”
From The effectiveness of acceptance and commitment therapy-based intervention in therapy for mental health disorders - case study (2020) · cites this paper as [15]
The function of worry in an individual with GAD is to decrease the perceived possibility of negative events and to reduce a sense of uncertainty and unpredictability.
“Thefunction ofworry in anindividual with GAD is to decrease theper ceived possibility of the occurrence of negative events and to reduce asense ofuncertainty and unpredictability [15, 16].”
From The effectiveness of acceptance and commitment therapy-based intervention in therapy for mental health disorders - case study (2020) · cites this paper as [15]
In AMW, worry is conceptualised as a form of avoidance.
“In AMW, worry is conceptualised as aform ofavoidance [15].”
From The effectiveness of acceptance and commitment therapy-based intervention in therapy for mental health disorders - case study (2020) · cites this paper as [15]
Mindfulness training may be particularly useful in directly addressing the transdiagnostic mechanisms underlying depression and anxiety such as experiential avoidance, repetitive negative thinking, and emotion regulation, which may not be adequately targeted by CBT on its own.
“Second, emerging evidence from the face-to-face treatment literature suggests that mindfulness training may be particularly useful in directly addressing the transdiagnostic mechanisms underlying depression and anxiety such experiential avoidance (Hayes et al., 1996; Roemer and Orsillo, 2002; Roemer et al., 2013), repetitive negative thinking (Watkins et al., 2007; Kingston et al., 2007), and”
From Online mindfulness-enhanced cognitive behavioural therapy for anxiety and depression: Outcomes of a pilot trial (2018) · cites this paper as Roemer and Orsillo, 2002
Therapeutic mindfulness approaches have shown positive effects in patients with anxiety disorders, posttraumatic stress disorder, substance abuse, eating disorders, depression, and personality disorders.
“After a decade of observations and studies, therapeutic mindfulness approaches have shown positive effects in patients with anxiety disorders [59, 60], posttraumatic stress disorder [61], substance abuse [62, 63], eating disorders [12, 64], depression [53], and personality disorders [41].”
From Mindful emotion regulation: Exploring the neurocognitive mechanisms behind mindfulness (2015) · cites this paper as [60]

Diagnostic and Statistical Manual of Mental Disorders
(2012) · Springer eBooks · doi:10.1007/springerreference_121117 · Cited by 20,769 · see citing works
Diagnostic and Statistical Manual of Mental Disorders
&NA; (1988) · Alzheimer Disease & Associated Disorders · doi:10.1097/00002093-198802020-00022 · Cited by 12,603 · see citing works
Untitled work
(1993) · Cited by 7,136 · see citing works
Untitled work
(1999) · Cited by 5,934 · see citing works
Emotional processing of fear: Exposure to corrective information.
Foa, E. B., & Kozak, M. J. (1986) · Psychological Bulletin · doi:10.1037/0033-2909.99.1.20 · Cited by 5,396 · see citing works
Development and validation of the Penn State Worry Questionnaire
Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990) · Behaviour Research and Therapy · doi:10.1016/0005-7967(90)90135-6 · Cited by 5,099 · see citing works
On Becoming a Person: A Therapist's View of Psychotherapy
Rogers, C. R. (1961) · DigitalGeorgetown (Georgetown University Library) · Cited by 3,637 · see citing works
Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment.
Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.64.6.1152 · Cited by 3,595 · see citing works
Untitled work
(1985) · Cited by 2,882 · see citing works
Ironic processes of mental control.
Wegner, D. M. (1994) · Psychological Review · doi:10.1037//0033-295x.101.1.34 · Cited by 2,609 · see citing works
Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders
(1992) · American Journal of Psychiatry · doi:10.1176/ajp.149.7.936 · Cited by 1,941 · see citing works
Why do people worry?
Freeston, M. H., Rhéaume, J., Letarte, H., Dugas, M. J., & Ladouceur, R. (1994) · Personality and Individual Differences · doi:10.1016/0191-8869(94)90048-5 · Cited by 1,731 · see citing works
Learning theory and behavior.
Mowrer, O. H. (1960) · doi:10.1037/10802-000 · Cited by 1,670 · see citing works
Learning Theory and Behavior
Gonzalez, R. C., & Mowrer, O. H. (1962) · The American Journal of Psychology · doi:10.2307/1419634 · Cited by 1,584 · see citing works
Anxiety and Its Disorders: The Nature and Treatment of Anxiety and Panic
Otto, M. (1989) · Psychosomatics · doi:10.1016/s0033-3182(89)72285-4 · Cited by 1,581 · see citing works
Anxiety Disorders and Phobias: A Cognitive Perspective
Dietch, J. T. (1986) · Psychosomatics · doi:10.1016/s0033-3182(86)72726-6 · Cited by 1,514 · see citing works
How does cognitive therapy prevent depressive relapse and why should attentional control (mindfulness) training help?
Teasdale, J. D., Segal, Z., & Williams, J. M. G. (1995) · Behaviour Research and Therapy · doi:10.1016/0005-7967(94)e0011-7 · Cited by 1,349 · see citing works
The economic burden of anxiety disorders in the 1990s
Greenberg, P. E., Sisitsky, T., Kessler, R. C., Finkelstein, S. N., Berndt, E. R., Davidson, J. R. T., Ballenger, J. C., & Fyer, A. J. (1999) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v60n0702 · Cited by 1,242 · see citing works
Handbook Of Mental Control
Wegner, D. M., & Pennebaker, J. W. (1992) · Cited by 1,231 · see citing works
Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders
Miller, J. J., Fletcher, K., & Kabat-Zinn, J. (1995) · General Hospital Psychiatry · doi:10.1016/0163-8343(95)00025-m · Cited by 1,131 · see citing works
Generalized anxiety disorder: A preliminary test of a conceptual model
Dugas, M. J., Gagnon, F., Ladouceur, R., & Freeston, M. H. (1998) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(97)00070-3 · Cited by 1,072 · see citing works
Beliefs about Worry and Intrusions: The Meta-Cognitions Questionnaire and its Correlates
Cartwright-Hatton, S., & Wells, A. (1997) · Journal of Anxiety Disorders · doi:10.1016/s0887-6185(97)00011-x · Cited by 977 · see citing works
DSM-III-R Generalized Anxiety Disorder in the National Comorbidity Survey
Wittchen, H.-U. (1994) · Archives of General Psychiatry · doi:10.1001/archpsyc.1994.03950050015002 · Cited by 967 · see citing works
Untitled work
(1994) · Cited by 877 · see citing works
Meta-Cognition and worry: A cognitive model of generalized anxiety disorder
Wells, A. (1995) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465800015897 · Cited by 866 · see citing works
Why worry? The cognitive function of anxiety
Mathews, A. (1990) · Behaviour Research and Therapy · doi:10.1016/0005-7967(90)90132-3 · Cited by 827 · see citing works
Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual
Barnaby, B. (2015) · Occupational Medicine · doi:10.1093/occmed/kqv128 · Cited by 816 · see citing works
Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual
Barlow, D. H. (2001) · Cited by 782 · see citing works
Efficacy of applied relaxation and cognitive-behavioral therapy in the treatment of generalized anxiety disorder
Borkovec, T. D., & Costello, E. (1993) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.61.4.611 · Cited by 756 · see citing works
The nature of worry in generalized anxiety disorder: A predominance of thought activity
Borkovec, T. D., & Inz, J. (1990) · Behaviour Research and Therapy · doi:10.1016/0005-7967(90)90027-g · Cited by 634 · see citing works
Principles and Practice of Stress Management
Gauron, E. F. (1986) · American Journal of Psychiatry · doi:10.1176/ajp.143.2.250-a · Cited by 607 · see citing works
Applied relaxation: Description of a coping technique and review of controlled studies
Öst, L.-G. (1987) · Behaviour Research and Therapy · doi:10.1016/0005-7967(87)90017-9 · Cited by 605 · see citing works
Preliminary reliability and validity of the generalized anxiety disorder questionnaire-IV: A revised self-report diagnostic measure of generalized anxiety disorder
Newman, M. G., Zuellig, A. R., Kachin, K. E., Constantino, M. J., Przeworski, A., Erickson, T., & Cashman-McGrath, L. (2002) · Behavior Therapy · doi:10.1016/s0005-7894(02)80026-0 · Cited by 553 · see citing works
Untitled work
(1994) · Cited by 553 · see citing works
The Cognitive Psychophysiology of Emotion
Lang, P. J. (2019) · Routledge eBooks · doi:10.4324/9780203728215-10 · Cited by 518 · see citing works
Mindfulness-based cognitive therapy reduces overgeneral autobiographical memory in formerly depressed patients
Williams, J. M. G., Teasdale, J. D., Segal, Z. V., & Soulsby, J. (2000) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.109.1.150 · Cited by 516 · see citing works
Mindfulness-based cognitive therapy reduces overgeneral autobiographical memory in formerly depressed patients.
Williams, J. M., Teasdale, J. D., Segal, Z. V., & Soulsby, J. M. (2000) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.109.1.150 · Cited by 512 · see citing works
Worrying: Perspectives on theory, assessment and treatment
Carmin, C. N. (1995) · Clinical Psychology Review · doi:10.1016/0272-7358(95)90175-2 · Cited by 500 · see citing works
Interpersonal outcome of cognitive behavioral treatment for chronically suicidal borderline patients
(1994) · American Journal of Psychiatry · doi:10.1176/ajp.151.12.1771 · Cited by 494 · see citing works
Perceived functions of worry among generalized anxiety disorder subjects: distraction from more emotionally distressing topics?
Borkovec, T. D., & Roemer, L. (1995) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/0005-7916(94)00064-s · Cited by 469 · see citing works
Self-citation
Thought suppression and psychopathology
Purdon, C. (1999) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(98)00200-9 · Cited by 454 · see citing works
Worrying: Perspectives on theory, assessment and treatment.
Davey, G. C. L., & Tallis, F. (1994) · Wiley eBooks · Cited by 451 · see citing works
Comorbidity among anxiety disorders: Implications for treatment and DSM-IV.
Brown, T. A., & Barlow, D. H. (1992) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.60.6.835 · Cited by 447 · see citing works
Efficacy of a cognitive-behavioral treatment for generalized anxiety disorder: Evaluation in a controlled clinical trial
Ladouceur, R., Dugas, M. J., Freeston, M. H., Léger, E., Gagnon, F., & Thibodeau, N. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.6.957 · Cited by 446 · see citing works
Anxiety disorders: psychological approaches to theory and treatment
(1999) · Choice Reviews Online · doi:10.5860/choice.36-5351 · Cited by 419 · see citing works
The Impact of Acceptance Versus Control Rationales on Pain Tolerance
Hayes, S. C., Bissett, R. T., Korn, Z., Zettle, R. D., Rosenfarb, I. S., Cooper, L. D., & Grundt, A. M. (1999) · The Psychological Record · doi:10.1007/bf03395305 · Cited by 388 · see citing works
The effect of worry on cardiovascular response to phobic imagery
Borkovec, T. D., & Hu, S. (1990) · Behaviour Research and Therapy · doi:10.1016/0005-7967(90)90056-o · Cited by 386 · see citing works
Thought Suppression and Psychopathology
Najmi, S., & Wegner, D. M. (2015) · Routledge eBooks · doi:10.4324/9780203888148.ch26 · Cited by 371 · see citing works
Anticipatory anxiety and risk perception
Butler, G., & Mathews, A. (1987) · Cognitive Therapy and Research · doi:10.1007/bf01183858 · Cited by 365 · see citing works
Comparison of behavior therapy and cognitive behavior therapy in the treatment of generalized anxiety disorder.
Butler, G., Fennell, M. J. V., Robson, P., & Gelder, M. (1991) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.59.1.167 · Cited by 365 · see citing works
Comparison of behavior therapy and cognitive behavior therapy in the treatment of generalized anxiety disorder
Butler, G., Fennell, M., Robson, P., & Gelder, M. (1991) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.59.1.167 · Cited by 365 · cited 1× · see citing works
“For instance, Butler, Fennell, Robson, and Gelder (1991) found a treatment with cognitive restructuring, relaxation, and in vivo exposure was more effective than one with relaxation and in vivo exposure alone.”
Background
Mindfulness: A Proposed Common Factor
Martin, J. R. (1997) · Journal of Psychotherapy Integration publication discontinued · doi:10.1023/b:jopi.0000010885.18025.bc · Cited by 348 · see citing works
Principles and practice of stress management
Lehrer, P. M., Woolfolk, R. L., Sime, W. E., & Barlow, D. H. (1984) · Cited by 345 · see citing works
Untitled work
(2001) · PubMed · Cited by 332 · see citing works
Systematic desensitization as training in self-control.
Goldfried, M. R. (1971) · Journal of Consulting and Clinical Psychology · doi:10.1037/h0031974 · Cited by 332 · see citing works
Comorbidity among anxiety disorders: Implications for treatment and DSM-IV..
Brown, T. A., & Barlow, D. H. (1992) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.60.6.835 · Cited by 320 · see citing works
Learning and Behavior Therapy
O’Donohue, W. (1997) · Medical Entomology and Zoology · Cited by 316 · see citing works
Rule-Governed Behavior
(1989) · doi:10.1007/978-1-4757-0447-1 · Cited by 316 · see citing works
The empirical basis of generalized anxiety disorder
Brown, T. A., Barlow, D. H., & Liebowitz, M. R. (1994) · American Journal of Psychiatry · doi:10.1176/ajp.151.9.1272 · Cited by 311 · see citing works
Chronic anxiety : generalized anxiety disorder and mixed anxiety-depression
Rapee, R. M., & Barlow, D. H. (1991) · Guilford Press eBooks · Cited by 268 · see citing works
Vagal tone in generalized anxiety disorder and the effects of aversive imagery and worrisome thinking
Lyonfields, J. D., Borkovec, T. D., & Thayer, J. F. (1995) · Behavior Therapy · doi:10.1016/s0005-7894(05)80094-2 · Cited by 247 · see citing works
Phenomenology and Course of Generalised Anxiety Disorder
Yonkers, K. A., Warshaw, M. G., Massion, A. O., & Keller, M. B. (1996) · British Journal of Psychiatry · doi:10.1192/bjp.168.3.308 · Cited by 242 · see citing works
Worry and the incubation of intrusive images following stress
Wells, A., & Papageorgiou, C. (1995) · Behaviour Research and Therapy · doi:10.1016/0005-7967(94)00087-z · Cited by 229 · see citing works
Fear imagery and text processing
Vrana, S. R., Cuthbert, B. N., & Lang, P. J. (1986) · Psychophysiology · doi:10.1111/j.1469-8986.1986.tb00626.x · Cited by 223 · see citing works
Behavioral treatment of generalized anxiety disorder
Barlow, D. H., Rapee, R. M., & Brown, T. A. (1992) · Behavior Therapy · doi:10.1016/s0005-7894(05)80221-7 · Cited by 221 · see citing works
Oxford Textbook of Psychopathology
(2008) · doi:10.1093/oso/9780195374216.001.0001 · Cited by 214 · see citing works
The miracle of mindfulness : a manual on meditation
Hanh, T. N., Warren, M. R., & Vo, D. M. (1991) · Medical Entomology and Zoology · Cited by 213 · see citing works
Preliminary tests of a cognitive model of generalized anxiety disorder
Wells, A., & Carter, K. (1999) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(98)00156-9 · Cited by 213 · see citing works
Oxford textbook of psychopathology
Bouman, T. K., Eifert, G. H., & Lejuez, C. W. (1999) · Oxford University Press eBooks · Cited by 197 · see citing works
Effects of suppressing thoughts about emotional material.
Roemer, L., & Borkovec, T. D. (1994) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.103.3.467 · Cited by 196 · see citing works
Self-citation
An Investigation of Worry Content among Generally Anxious Individuals
Roemer, L., MOLINA, S., & Borkovec, T. D. (1997) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199705000-00005 · Cited by 193 · see citing works
Self-citation
Untitled work
(2000) · Cited by 185 · see citing works
The peripheral sympathetic nervous system. Its role in normal and pathologic anxiety.
Hoehn‐Saric, R., & McLeod, D. R. (1988) · PubMed · Cited by 182 · see citing works
Worry is reasonable: The role of explanations in pessimism about future personal events.
MacLeod, A. K., Williams, J. M. G., & Bekerian, D. A. (1991) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.100.4.478 · Cited by 181 · see citing works
Worry is reasonable: The role of explanations in pessimism about future personal events.
MacLeod, A. K., Williams, J. M., & Bekerian, D. A. (1991) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.100.4.478 · Cited by 180 · see citing works
Anxiety Disorders: Psychological Approaches to Theory and Treatment.
Bowers, W. A. (2000) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-200004000-00019 · Cited by 179 · see citing works
Untitled work
(1991) · Cited by 178 · see citing works
Phasic heart period reactions to cued threat and nonthreat stimuli in generalized anxiety disorder
Thayer, J. F., Friedman, B. H., Borkovec, T. D., Johnsen, B. H., & MOLINA, S. (2000) · Psychophysiology · doi:10.1111/1469-8986.3730361 · Cited by 172 · see citing works
Recommendations for a cost-offset model of psychotherapy allocation using generalized anxiety disorder as an example.
Newman, M. G. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.4.549 · Cited by 167 · see citing works
Anxiety and Anxiety Disorders
Karasic, D. H. (2013) · PsycEXTRA Dataset · doi:10.1037/e555372011-001 · Cited by 166 · see citing works
Effects of psychotherapy on comorbid conditions in generalized anxiety disorder.
Borkovec, T. D., Abel, J. L., & Newman, H. (1995) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.63.3.479 · Cited by 165 · see citing works
Effects of psychotherapy on comorbid conditions in generalized anxiety disorder.
Borkovec, T. D., Abel, J. L., & Newman, H. (1995) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.63.3.479 · Cited by 165 · see citing works
Worry, problem elaboration and suppression of imagery: the role of concreteness
Stöber, J. (1998) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(98)00027-8 · Cited by 162 · see citing works
The Peripheral Sympathetic Nervous System
Hoehn‐Saric, R., & McLeod, D. R. (1988) · Psychiatric Clinics of North America · doi:10.1016/s0193-953x(18)30504-5 · Cited by 159 · see citing works
Beliefs about the consequences of worrying
Davey, G. C. L., Tallis, F., & Capuzzo, N. (1996) · Cognitive Therapy and Research · doi:10.1007/bf02227910 · Cited by 158 · see citing works
Thoughts, images, worry, and anxiety
Freeston, M. H., Dugas, M. J., & Ladouceur, R. (1996) · Cognitive Therapy and Research · doi:10.1007/bf02229237 · Cited by 148 · see citing works
Assessing the field effectiveness of acceptance and commitment therapy: An example of the manipulated training research method
Strosahl, K. D., Hayes, S. C., Bergan, J., & Romano, P. (1998) · Behavior Therapy · doi:10.1016/s0005-7894(98)80017-8 · Cited by 137 · see citing works
Helping people change
Bacon, T. R. (2003) · Industrial and Commercial Training · doi:10.1108/00197850310463797 · Cited by 129 · see citing works
Integrating Acceptance and Mindfulness into Existing Cognitive-Behavioral Treatment for GAD: A Case Study
Orsillo, S. M., Roemer, L., & Barlow, D. H. (2003) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(03)80034-2 · Cited by 113 · see citing works
Self-citation
Worry Themes in Primary GAD, Secondary GAD, and Other Anxiety Disorders
Dugas, M. J., Freeston, M. H., Ladouceur, R., Rhéaume, J., Provencher, M. D., & Boisvert, J.-M. (1998) · Journal of Anxiety Disorders · doi:10.1016/s0887-6185(98)00013-9 · Cited by 111 · see citing works
Cost of anxiety disorders: Impact of comorbidity
Souêtre, E., Lozet, H., Cimarosti, I., Martin, P., CHIGNON, J. M., Adès, J., Tignol, J.-P., & DARCOURT, G. (1994) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(94)90145-7 · Cited by 101 · see citing works
Evaluation of the Ratings Comprising the Associated Symptom Criterion of DSM-III-R Generalized Anxiety Disorder
Marten, P. A., Brown, T. A., Barlow, D. H., Borkovec, T. D., Shear, M. K., & Lydiard, R. B. (1993) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199311000-00005 · Cited by 96 · see citing works
Generalized anxiety disorder: neurobiological and pharmacotherapeutic perspectives
Connor, K. M., & Davidson, J. R. T. (1998) · Biological Psychiatry · doi:10.1016/s0006-3223(98)00285-6 · Cited by 92 · see citing works
Generalized Anxiety Disorder
Borkovec, T. D., & Roemer, L. (1994) · Springer eBooks · doi:10.1007/978-1-4899-1456-9_13 · Cited by 74 · see citing works
Self-citation
Content Analysis of Worrisome Streams of Consciousness in Anxious and Dysphoric Participants
Molina, S., Borkovec, T. D., Peasley, C., & Person, D. C. (1998) · Cognitive Therapy and Research · doi:10.1023/a:1018772104808 · Cited by 68 · see citing works
A 5-year follow-up study of generalized anxiety disorder and panic disorder.
Woodman, C., Noyes, R., Black, D., Schlosser, S. S., & Yagla, S. (1999) · Journal of Nervous and Mental Disease · doi:10.1097/00005053-199901000-00002 · Cited by 58 · see citing works
Anxiety management: Developing effective strategies
Butler, G., Gelder, M., Hibbert, G., Cullington, A., & Klimes, I. (1987) · Behaviour Research and Therapy · doi:10.1016/0005-7967(87)90059-3 · Cited by 38 · see citing works
Cognitive-behavioral treatment of borderline personality disorder
Tait, A. (1997) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(96)00357-1 · Cited by 35 · see citing works
Psychotherapy indications and outcomes
Janowsky, D. S. (1999) · Cited by 33 · see citing works
Psychotherapy Indications and Outcomes
Clemens, N. A. (2000) · Psychiatric Services · doi:10.1176/appi.ps.51.5.683 · Cited by 33 · see citing works
Dialectical behavior therapy for borderline personality disorder: Efficacy, specificity, and cost effectiveness.
Linehan, M. M., Kanter, J. W., & Comtois, K. A. (1999) · Cited by 29 · see citing works
Modern forms of meditation
Carrington, P. (1984) · Cited by 26 · see citing works
Compulsive Behavior in Generalized Anxiety Disorder and Obsessive-Compulsive Disorder
Townsend, M. H., Weissbecker, K., Barbee, J. G., Peña, J. M., Snider, L. M., Tynes, L. L., Tynes, S. F., Boudoin, C., Green-Leibovitz, M. I., & Winstead, D. K. (1999) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199911000-00009 · Cited by 25 · see citing works
Untitled work
Metzger (1990) · doi:10.1002/1097-4679(199001)46:1
A metacognitive model and therapy for generalized anxiety disorder
Wells, A. (1999) · Clinical Psychology & Psychotherapy · doi:10.1002/(sici)1099-0879(199905)6:2
Group cognitive and contextual therapies in treatment of depression
Zettle, R. D., & Rains, J. C. (1989) · Journal of Clinical Psychology · doi:10.1002/1097-4679(198905)45:3

Flagged first, then by citations

Sorted by citations

Mindfulness-based interventions in context: Past, present, and future.
Kabat-Zinn, J. (2003) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy/bpg016 · Cited by 8,612 · see citing works
Mindfulness-based interventions in context: Past, present, and future
Kabat-Zinn, J. (2003) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy.bpg016 · Cited by 8,615 · see citing works
Mindfulness: A proposed operational definition.
Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., Segal, Z. V., Abbey, S., Speca, M., Velting, D., et al. (2004) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy.bph077 · Cited by 7,234 · see citing works
Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies
Hayes, S. C. (2004) · Behavior Therapy · doi:10.1016/s0005-7894(04)80013-3 · Cited by 2,493 · see citing works
Measuring experiential avoidance: A preliminary test of a working model
Hayes, S. C., Strosahl, K., Wilson, K. G., Bissett, R. T., Pistorello, J., Toarmino, D., Polusny, M. A., Dykstra, T. A., Batten, S. V., Bergan, J., et al. (2004) · The Psychological Record · doi:10.1007/bf03395492 · Cited by 2,140 · see citing works
Uncertainty and anticipation in anxiety: an integrated neurobiological and psychological perspective
Grupe, D. W., & Nitschke, J. B. (2013) · Nature Reviews Neuroscience · doi:10.1038/nrn3524 · Cited by 2,007 · see citing works
Mindfulness and Emotion Regulation: The Development and Initial Validation of the Cognitive and Affective Mindfulness Scale-Revised (CAMS-R)
Feldman, G., Hayes, A., Kumar, S., Greeson, J., & Laurenceau, J.-P. (2007) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-006-9035-8 · Cited by 1,630 · see citing works
The Toronto Mindfulness Scale: Development and validation
Lau, M. A., Bishop, S. R., Segal, Z. V., Buis, T., Anderson, N. D., Carlson, L., Shapiro, S., Carmody, J., Abbey, S., & Devins, G. (2006) · Journal of Clinical Psychology · doi:10.1002/jclp.20326 · Cited by 1,456 · see citing works
Mindful emotion regulation: an integrative review
Chambers, R., Gullone, E., & Allen, N. B. (2009) · Clinical Psychology Review · doi:10.1016/j.cpr.2009.06.005 · Cited by 1,360 · see citing works
Preliminary evidence for an emotion dysregulation model of generalized anxiety disorder
Mennin, D. S., Heimberg, R. G., Turk, C. L., & Fresco, D. M. (2005) · Behaviour Research and Therapy · doi:10.1016/j.brat.2004.08.008 · Cited by 919 · see citing works
Distress tolerance and psychopathological symptoms and disorders: A review of the empirical literature among adults.
Leyro, T. M., Zvolensky, M. J., & Bernstein, A. (2010) · Psychological Bulletin · doi:10.1037/a0019712 · Cited by 868 · see citing works
Effects of suppression and acceptance on emotional responses of individuals with anxiety and mood disorders
Campbell-Sills, L., Barlow, D. H., Brown, T. A., & Hofmann, S. G. (2006) · Behaviour Research and Therapy · doi:10.1016/j.brat.2005.10.001 · Cited by 845 · see citing works
The impact of intensive mindfulness training on attentional control, cognitive style, and affect
Chambers, R., Lo, B. C. Y., & Allen, N. B. (2008) · Cognitive Therapy and Research · doi:10.1007/s10608-007-9119-0 · Cited by 855 · see citing works
Experiential avoidance as a functional dimensional approach to psychopathology: An empirical review
Chawla, N., & Ostafin, B. (2007) · Journal of Clinical Psychology · doi:10.1002/jclp.20400 · Cited by 805 · see citing works
Acceptance and Commitment Therapy, Relational Frame Theory, and the Third Wave of Behavioral and Cognitive Therapies – Republished Article
Hayes, S. C. (2016) · Behavior Therapy · doi:10.1016/j.beth.2016.11.006 · Cited by 785 · see citing works
Clarifying the construct of mindfulness in the context of emotion regulation and the process of change in therapy.
Hayes, A. M., & Feldman, G. (2004) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy.bph080 · Cited by 759 · see citing works
A novel theory of experiential avoidance in generalized anxiety disorder: A review and synthesis of research supporting a contrast avoidance model of worry
Newman, M. G., & Llera, S. J. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2011.01.008 · Cited by 598 · see citing works
Acceptability and suppression of negative emotion in anxiety and mood disorders.
Campbell-Sills, L., Barlow, D. H., Brown, T. A., & Hofmann, S. G. (2006) · Emotion · doi:10.1037/1528-3542.6.4.587 · Cited by 579 · see citing works
Inside the Mindful Mind: How Mindfulness Enhances Emotion Regulation Through Improvements in Executive Control
Teper, R., Segal, Z. V., & Inzlicht, M. (2013) · Current Directions in Psychological Science · doi:10.1177/0963721413495869 · Cited by 554 · see citing works
Mindfulness-based cognitive therapy for generalized anxiety disorder
Evans, S., Ferrando, S., Findler, M., Stowell, C., Smart, C., & Haglin, D. (2008) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2007.07.005 · Cited by 559 · see citing works
Development of a Measure of Experiential Avoidance: The Multidimensional Experiential Avoidance Questionnaire
Gámez, W., Chmielewski, M., Kotov, R., Ruggero, C., & Watson, D. (2011) · Psychological Assessment · doi:10.1037/a0023242 · Cited by 524 · see citing works
Clinical handbook of mindfulness
(2009) · doi:10.1007/978-0-387-09593-6 · Cited by 543 · see citing works
A component analysis of cognitive-behavioral therapy for generalized anxiety disorder and the role of interpersonal problems.
Borkovec, T. D., Newman, M. G., Pincus, A. L., & Lytle, R. (2002) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.70.2.288 · Cited by 565 · see citing works
Current theoretical models of generalized anxiety disorder (GAD): Conceptual review and treatment implications
Behar, E., DiMarco, I. D., Hekler, E. B., Mohlman, J., & Staples, A. M. (2009) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2009.07.006 · Cited by 505 · see citing works
Mindfulness-based relapse prevention for alcohol and substance use disorders
Witkiewitz, K., Marlatt, G. A., & Walker, D. (2005) · Journal of Cognitive Psychotherapy · doi:10.1891/jcop.2005.19.3.211 · Cited by 514 · see citing works
The effects of acceptance versus suppression of emotion on subjective and psychophysiological response to carbon dioxide challenge in patients with panic disorder
Levitt, J. T., Brown, T. A., Orsillo, S. M., & Barlow, D. H. (2004) · Behavior Therapy · doi:10.1016/s0005-7894(04)80018-2 · Cited by 479 · see citing works
Self-citation
How to handle anxiety: The effects of reappraisal, acceptance, and suppression strategies on anxious arousal
Hofmann, S. G., Heering, S., Sawyer, A. T., & Asnaani, A. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.02.010 · Cited by 464 · see citing works
Further Psychometric Validation of the Mindful Attention Awareness Scale (MAAS)
MacKillop, J., & Anderson, E. J. (2007) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-007-9045-1 · Cited by 456 · see citing works
Emotion dysregulation in generalized anxiety disorder: A comparison with social anxiety disorder
Turk, C. L., Heimberg, R. G., Luterek, J. A., Mennin, D. S., & Fresco, D. M. (2005) · Cognitive Therapy and Research · doi:10.1007/s10608-005-1651-1 · Cited by 443 · see citing works
A mindfulness-acceptance-commitment-based approach to athletic performance enhancement: theoretical considerations
Gardner, F. L., & Moore, Z. E. (2004) · Behavior Therapy · doi:10.1016/s0005-7894(04)80016-9 · Cited by 416 · see citing works
MINDFULNESS AND EMOTION REGULATION IN DEPRESSION AND ANXIETY: COMMON AND DISTINCT MECHANISMS OF ACTION: Research Article: Mindfulness and Emotion Regulation
Desrosiers, A., Vine, V., Klemanski, D. H., & Nolen-Hoeksema, S. (2013) · Depression and Anxiety · doi:10.1002/da.22124 · Cited by 392 · see citing works
“[42–44] For example, nonacceptance of emotional responses has been highly associated with generalized anxiety disorder (GAD) diagnosis,[7, 45] and nonacceptance of emotions has been found to predict comorbidity between GAD and social anxiety disorder.”
Background
Mindfulness and emotion regulation difficulties in generalized anxiety disorder: preliminary evidence for independent and overlapping contributions
Roemer, L., Lee, J. K., Salters-Pedneault, K., Erisman, S. M., Orsillo, S. M., & Mennin, D. S. (2009) · Behavior Therapy · doi:10.1016/j.beth.2008.04.001 · Cited by 392 · see citing works
Self-citation
Conceptualizing mindfulness and acceptance as components of psychological resilience to trauma
Thompson, R. W., Arnkoff, D. B., & Glass, C. R. (2011) · Trauma, Violence, & Abuse · doi:10.1177/1524838011416375 · Cited by 387 · see citing works
Anxiety, anxiety disorders, tobacco use, and nicotine: A critical review of interrelationships.
Morissette, S. B., Tull, M. T., Gulliver, S. B., Kamholz, B. W., & Zimering, R. T. (2007) · Psychological Bulletin · doi:10.1037/0033-2909.133.2.245 · Cited by 380 · see citing works
The effects of acceptance versus control contexts on avoidance of panic-related symptoms
Eifert, G. H., & Heffner, M. (2003) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2003.11.001 · Cited by 375 · see citing works
Evidence of broad deficits in emotion regulation associated with chronic worry and generalized anxiety disorder
Salters-Pedneault, K., Roemer, L., Tull, M. T., Rucker, L., & Mennin, D. S. (2006) · Cognitive Therapy and Research · doi:10.1007/s10608-006-9055-4 · Cited by 356 · see citing works
Self-citation
Fear and avoidance of internal experiences in GAD: Preliminary tests of a conceptual model
Roemer, L., Salters, K., Raffa, S. D., & Orsillo, S. M. (2005) · Cognitive Therapy and Research · doi:10.1007/s10608-005-1650-2 · Cited by 344 · see citing works
Self-citation
DBT, FAP, and ACT: How empirically oriented are the new behavior therapy technologies?
Hayes, S. C., Masuda, A., Bissett, R., Luoma, J., & Guerrero, L. F. (2004) · Behavior Therapy · doi:10.1016/s0005-7894(04)80003-0 · Cited by 342 · see citing works
The role of fear of anxiety and intolerance of uncertainty in worry: An experimental manipulation
Buhr, K., & Dugas, M. J. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2008.12.004 · Cited by 334 · see citing works
The Science of Cognitive Therapy
Hofmann, S. G., Asmundson, G. J. G., & Beck, A. T. (2013) · Behavior Therapy · doi:10.1016/j.beth.2009.01.007 · Cited by 336 · see citing works
The case for mindfulness‐based approaches in the cultivation of empathy: Does nonjudgmental, present‐moment awareness increase capacity for perspective‐taking and empathic concern?
Block‐Lerner, J., Adair, C., Plumb, J. C., Rhatigan, D. L., & Orsillo, S. M. (2007) · Journal of Marital and Family Therapy · doi:10.1111/j.1752-0606.2007.00034.x · Cited by 318 · see citing works
Self-citation
Gaps in accessing treatment for anxiety and depression: challenges for the delivery of care
Collins, K. A., Westra, H. A., Dozois, D. J. A., & Burns, D. D. (2004) · Clinical Psychology Review · doi:10.1016/j.cpr.2004.06.001 · Cited by 322 · see citing works
Treating Anxiety With Mindfulness: An Open Trial of Mindfulness Training for Anxious Children
Semple, R. J., Reid, E. F. G., & Miller, L. (2005) · Journal of Cognitive Psychotherapy · doi:10.1891/jcop.2005.19.4.379 · Cited by 326 · see citing works
Acceptance and commitment therapy and cognitive behavioral therapy for anxiety disorders: Different treatments, similar mechanisms?
Arch, J. J., & Craske, M. G. (2008) · Clinical Psychology: Science and Practice · doi:10.1111/j.1468-2850.2008.00137.x · Cited by 310 · see citing works
Acceptance and commitment therapy in the treatment of posttraumatic stress disorder
Orsillo, S. M., & Batten, S. V. (2005) · Behavior Modification · doi:10.1177/0145445504270876 · Cited by 311 · see citing works
Self-citation
Craving to quit: Psychological models and neurobiological mechanisms of mindfulness training as treatment for addictions.
Brewer, J. A., Elwafi, H. M., & Davis, J. H. (2013) · Psychology of Addictive Behaviors · doi:10.1037/a0028490 · Cited by 303 · see citing works
Mindfulness-Based Parent Training: Strategies to Lessen the Grip of Automaticity in Families With Disruptive Children
Dumas, J. E. (2005) · Journal of Clinical Child & Adolescent Psychology · doi:10.1207/s15374424jccp3404_20 · Cited by 285 · see citing works
Mindfulness-Based Cognitive Therapy: Theory and Practice
Sipe, W. E. B., & Eisendrath, S. J. (2012) · The Canadian Journal of Psychiatry · doi:10.1177/070674371205700202 · Cited by 285 · see citing works
An Open Trial of an Acceptance-Based Behavior Therapy for Generalized Anxiety Disorder
Roemer, L., & Orsillo, S. M. (2007) · Behavior Therapy · doi:10.1016/j.beth.2006.04.004 · Cited by 282 · see citing works
Self-citation
The psychological and neurophysiological concomitants of mindfulness forms of meditation
Ivanovski, B., & Malhi, G. S. (2007) · Acta Neuropsychiatrica · doi:10.1111/j.1601-5215.2007.00175.x · Cited by 284 · see citing works
Spirituality, mindfulness and substance abuse
Leigh, J., Bowen, S., & Marlatt, G. A. (2005) · Addictive Behaviors · doi:10.1016/j.addbeh.2005.01.010 · Cited by 282 · see citing works
The Effectiveness of the Learning to BREATHE Program on Adolescent Emotion Regulation
Metz, S. M., Frank, J. L., Reibel, D., Cantrell, T., Sanders, R., & Broderick, P. C. (2013) · Research in Human Development · doi:10.1080/15427609.2013.818488 · Cited by 269 · see citing works
Mindfulness and Counseling Self‐Efficacy: The Mediating Role of Attention and Empathy
Greason, P. B., & Cashwell, C. S. (2009) · Counselor Education and Supervision · doi:10.1002/j.1556-6978.2009.tb00083.x · Cited by 272 · see citing works
A PILOT STUDY OF GROUP MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) FOR COMBAT VETERANS WITH POSTTRAUMATIC STRESS DISORDER (PTSD): Research Article: Mindfulness-Based Cognitive Therapy for Combat PTSD
King, A. P., Erickson, T. M., Giardino, N. D., Favorite, T., Rauch, S. A. M., Robinson, E., Kulkarni, M., & Liberzon, I. (2013) · Depression and Anxiety · doi:10.1002/da.22104 · Cited by 266 · see citing works
Further validation of a cognitive-behavioral model of generalized anxiety disorder: diagnostic and symptom specificity
Dugas, M. J., Marchand, A., & Ladouceur, R. (2005) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2004.02.002 · Cited by 258 · see citing works
Acceptance and commitment: Implications for prevention science
Biglan, A., Hayes, S. C., & Pistorello, J. (2008) · Prevention Science · doi:10.1007/s11121-008-0099-4 · Cited by 240 · see citing works
Meta-Analysis of Cognitive-Behavioral Treatments for Generalized Anxiety Disorder: A Comparison With Pharmacotherapy.
Mitte, K. (2005) · Psychological Bulletin · doi:10.1037/0033-2909.131.5.785 · Cited by 239 · see citing works
A laboratory-based study of the relationship between childhood abuse and experiential avoidance among inner-city substance users: the role of emotional nonacceptance
Gratz, K. L., Bornovalova, M. A., Delany-Brumsey, A., Nick, B., & Lejuez, C. W. (2007) · Behavior Therapy · doi:10.1016/j.beth.2006.08.006 · Cited by 233 · see citing works
Evidence-based psychological treatments for late-life anxiety
Ayers, C. R., Sorrell, J. T., Thorp, S. R., & Wetherell, J. L. (2007) · Psychology and Aging · doi:10.1037/0882-7974.22.1.8 · Cited by 235 · see citing works
Some methodological and statistical issues in the study of change processes in psychotherapy
Laurenceau, J., Hayes, A. M., & Feldman, G. C. (2007) · Clinical Psychology Review · doi:10.1016/j.cpr.2007.01.007 · Cited by 228 · see citing works
Mindfulness-based Mind Fitness Training: A Case Study of a High-Stress Predeployment Military Cohort
Stanley, E. A., Schaldach, J. M., Kiyonaga, A., & Jha, A. P. (2011) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2010.08.002 · Cited by 226 · see citing works
“Mind the Trap”: Mindfulness Practice Reduces Cognitive Rigidity
Greenberg, J., Reiner, K., & Meiran, N. (2012) · PLoS ONE · doi:10.1371/journal.pone.0036206 · Cited by 214 · see citing works
Mindfulness, acceptance, and emotion regulation: perspectives from Monitor and Acceptance Theory (MAT)
Lindsay, E. K., & Creswell, J. D. (2019) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2018.12.004 · Cited by 220 · see citing works
CALM Pregnancy: results of a pilot study of mindfulness-based cognitive therapy for perinatal anxiety
Goodman, J. H., Guarino, A., Chenausky, K., Klein, L., Prager, J., Petersen, R., Forget, A., & Freeman, M. (2014) · Archives of Women's Mental Health · doi:10.1007/s00737-013-0402-7 · Cited by 198 · see citing works
“(3) The nature of worry in GAD is future directed and therefore training in presentfocused mindful awareness may provide a useful alternative way of responding for individuals with GAD (Roemer and Orsillo 2002).”
Acceptance and Commitment Therapy in the treatment of anxiety: A systematic review
Swain, J., Hancock, K., Hainsworth, C., & Bowman, J. (2013) · Clinical Psychology Review · doi:10.1016/j.cpr.2013.07.002 · Cited by 207 · see citing works
Treating comorbid anxiety and depression: psychosocial and pharmacological approaches
Coplan, J. D. (2015) · World Journal of Psychiatry · doi:10.5498/wjp.v5.i4.366 · Cited by 207 · see citing works
The role of avoidance of emotional material in the anxiety disorders
Salters-Pedneault, K., Tull, M. T., & Roemer, L. (2004) · Applied and Preventive Psychology · doi:10.1016/j.appsy.2004.09.001 · Cited by 205 · see citing works
Self-citation
First-line Treatment: A Critical Appraisal of Cognitive Behavioral Therapy Developments and Alternatives.
Arch, J. J., & Craske, M. G. (2009) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2009.05.001 · Cited by 208 · see citing works
Changes in mindfulness and emotion regulation in an exposure-based cognitive therapy for depression
Kumar, S., Feldman, G., & Hayes, A. (2008) · Cognitive Therapy and Research · doi:10.1007/s10608-008-9190-1 · Cited by 206 · see citing works
One Year Follow-Up of Mindful Sport Performance Enhancement (MSPE) With Archers, Golfers, and Runners
Thompson, R. W., Kaufman, K. A., De Petrillo, L. A., Glass, C. R., & Arnkoff, D. B. (2011) · Journal of Clinical Sport Psychology · doi:10.1123/jcsp.5.2.99 · Cited by 191 · see citing works
Mindful emotion regulation: Exploring the neurocognitive mechanisms behind mindfulness
Grecucci, A., Pappaianni, E., Siugzdaite, R., Theuninck, A., & Job, R. (2015) · BioMed Research International · doi:10.1155/2015/670724 · Cited by 177 · see citing works
Meditation experience predicts less negative appraisal of pain: electrophysiological evidence for the involvement of anticipatory neural responses
Brown, C. A., & Jones, A. K. P. (2010) · Pain · doi:10.1016/j.pain.2010.04.017 · Cited by 175 · see citing works
Mindfulness training for smoking cessation: Moderation of the relationship between craving and cigarette use
Elwafi, H. M., Witkiewitz, K., Mallik, S., IV, T. A. T., & Brewer, J. A. (2013) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2012.11.015 · Cited by 161 · see citing works
Emotional avoidance and panicogenic responding to a biological challenge procedure
Karekla, M., Forsyth, J. P., & Kelly, M. M. (2004) · Behavior Therapy · doi:10.1016/s0005-7894(04)80017-0 · Cited by 163 · see citing works
A Cognitive Model of Generalized Anxiety Disorder: the Role of Intolerance of Uncertainty
Koerner, N., & Dugas, M. J. (2006) · Worry and its Psychological Disorders · doi:10.1002/9780470713143.ch12 · Cited by 163 · see citing works
Treating chronic worry: Psychological and physiological effects of a training programme based on mindfulness
Delgado, L. C., Guerra, P., Perakakis, P., Vera, M. N., Reyes del Paso, G., & Vila, J. (2010) · Behaviour Research and Therapy · doi:10.1016/j.brat.2010.05.012 · Cited by 156 · see citing works
A randomized clinical trial comparing an acceptance-based behavior therapy to applied relaxation for generalized anxiety disorder
Hayes-Skelton, S. A., Roemer, L., & Orsillo, S. M. (2013) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0032871 · Cited by 153 · see citing works
“Roemer and Orsillo (2002) developed a model of GAD informed by research and theory highlighting the potential roles of experiential avoidance (e.g., Hayes, Wilson, Gifford, Follette, & Strosahl, 1996) and ruminative, self-critical processing (e.g., Barnard & Teasdale, 1991) in the development and…”
MethodSelf-citation
Narcissistic Personality Disorder
Campbell, W. K., & Baumeister, R. F. (2006) · Practitioner’s Guide to Evidence-Based Psychotherapy · doi:10.1007/978-0-387-28370-8_42 · Cited by 160 · see citing works
Acceptance: An Historical and Conceptual Review
Williams, J. C., & Lynn, S. J. (2010) · Imagination, Cognition and Personality · doi:10.2190/ic.30.1.c · Cited by 155 · see citing works
Mindfulness-based treatments for co-occurring depression and substance use disorders: what can we learn from the brain?
Brewer, J. A., Bowen, S., Smith, J. T., Marlatt, G. A., & Potenza, M. N. (2010) · Addiction · doi:10.1111/j.1360-0443.2009.02890.x · Cited by 141 · see citing works
“(9,18) Mindfulness is also a central part of Dialectical Behavior Therapy (DBT) for individuals with borderline personality disorder,(19) Acceptance and Commitment Therapy (ACT) (20) for individuals with a variety of mental health problems, and Spiritual Self-Schema (3-S) therapy designed for clients with SUDs.”
Cognitive-behavioral treatment for generalized anxiety disorder: Current status and future directions
Dugas, M. J., & Koerner, N. (2005) · Journal of Cognitive Psychotherapy · doi:10.1891/jcop.19.1.61.66326 · Cited by 143 · see citing works
Managing unwanted intrusive thoughts in obsessive–compulsive disorder: Relative effectiveness of suppression, focused distraction, and acceptance
Najmi, S., Riemann, B. C., & Wegner, D. M. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.02.015 · Cited by 133 · see citing works
Mindfulness-based Group Therapy for Women with Provoked Vestibulodynia
Brotto, L. A., Basson, R., Smith, K. B., Driscoll, M., & Sadownik, L. (2015) · Mindfulness · doi:10.1007/s12671-013-0273-z · Cited by 131 · see citing works
Chronic avoidance helps explain the relationship between severity of childhood sexual abuse and psychological distress in adulthood
Rosenthal, M. Z., Hall, M. L. R., Palm, K. M., Batten, S. V., & Follette, V. M. (2005) · Journal of Child Sexual Abuse · doi:10.1300/j070v14n04_02 · Cited by 128 · see citing works
Intolerance of uncertainty, fear of anxiety, and adolescent worry
Dugas, M. J., Laugesen, N., & Bukowski, W. M. (2012) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-012-9611-1 · Cited by 127 · see citing works
Mindfulness-based cognitive therapy for generalized anxiety disorder: a preliminary evaluation
Craigie, M. A., Rees, C. S., Marsh, A., & Nathan, P. (2008) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s135246580800458x · Cited by 125 · see citing works
Distress and avoidance in generalized anxiety disorder: Exploring the relationships with intolerance of uncertainty and worry
Lee, J. K., Orsillo, S. M., Roemer, L., & Allen, L. B. (2010) · Cognitive Behaviour Therapy · doi:10.1080/16506070902966918 · Cited by 124 · see citing works
Self-citation
Acceptance as a coping reaction: Adaptive or not?
Nakamura, Y. M., & Orth, U. (2005) · Swiss Journal of Psychology · doi:10.1024/1421-0185.64.4.281 · Cited by 122 · see citing works
Intolerance of uncertainty and perceived threat
Bredemeier, K., & Berenbaum, H. (2008) · Behaviour Research and Therapy · doi:10.1016/j.brat.2007.09.006 · Cited by 119 · see citing works
Integrating Acceptance and Mindfulness into Existing Cognitive-Behavioral Treatment for GAD: A Case Study
Orsillo, S. M., Roemer, L., & Barlow, D. H. (2003) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(03)80034-2 · Cited by 113 · see citing works
Self-citation
Integrating Mindfulness Meditation with Cognitive and Behavioural Therapies: The Challenge of Combining Acceptance- and Change-Based Strategies
Lau, M. A., & McMain, S. F. (2005) · The Canadian Journal of Psychiatry · doi:10.1177/070674370505001310 · Cited by 112 · see citing works
A systematic review of anxiety amongst people with Multiple Sclerosis
Butler, E., Matcham, F., & Chalder, T. (2016) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2016.10.003 · Cited by 111 · see citing works
Mindfulness-Based Interventions for Youth With Anxiety: A Systematic Review and Meta-Analysis
Borquist-Conlon, D. S., Maynard, B. R., Brendel, K. E., & Farina, A. S. J. (2019) · Research on Social Work Practice · doi:10.1177/1049731516684961 · Cited by 111 · see citing works
Effectiveness of a mindfulness-based cognitive therapy program as an adjunct to pharmacotherapy in patients with panic disorder
Kim, B., Lee, S.-H., Kim, Y. W., Choi, T. K., Yook, K., Suh, S. Y., Cho, S. J., & Yook, K.-H. (2010) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2010.03.019 · Cited by 102 · see citing works
Mindfulness meditation and relaxation training increases time sensitivity
Droit‐Volet, S., Fanget, M., & Dambrun, M. (2014) · Consciousness and Cognition · doi:10.1016/j.concog.2014.10.007 · Cited by 105 · see citing works
Mindful Parenting: A Call for Research
Sawyer Cohen, J. A., & Semple, R. J. (2010) · Journal of Child and Family Studies · doi:10.1007/s10826-009-9285-7 · Cited by 102 · see citing works
The Effects of Worry in Daily Life: An Ecological Momentary Assessment Study Supporting the Tenets of the Contrast Avoidance Model
Newman, M. G., Jacobson, N. C., Zainal, N. H., Shin, K. E., Szkodny, L. E., & Sliwinski, M. J. (2019) · Clinical Psychological Science · doi:10.1177/2167702619827019 · Cited by 96 · see citing works
A quantitative meta-analysis of fMRI studies investigating emotional processing in excessive worriers: Application of activation likelihood estimation analysis
Weber-Goericke, F., & Muehlhan, M. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.09.049 · Cited by 97 · see citing works
Selective attentional bias towards pain-related threat in fibromyalgia: preliminary evidence for effects of mindfulness meditation training
Vago, D. R., & Nakamura, Y. (2011) · Cognitive Therapy and Research · doi:10.1007/s10608-011-9391-x · Cited by 93 · see citing works
The Role of Acceptance and Mindfulness in the Treatment of Insomnia
Lundh, L.-G. (2005) · Journal of Cognitive Psychotherapy · doi:10.1891/jcop.19.1.29.66331 · Cited by 112 · see citing works

Treating generalized anxiety disorder with cognitive-behavioral therapy.
Lang, A. J. (2004) · PubMed · Cited by 23 · see citing works
Randomized controlled trial of acceptance and commitment therapy versus traditional cognitive behavior therapy for social anxiety disorder: Symptomatic and behavioral outcomes
Herbert, J. D., Forman, E. M., Kaye, J. L., Gershkovich, M., Goetter, E., Yuen, E. K., Glassman, L., Goldstein, S., Hitchcock, P., Tronieri, J. S., et al. (2018) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2018.07.008 · Cited by 36 · see citing works
Review of A CBT-practitioner’s guide to ACT: How to bridge the gap between cognitive behavioral therapy and acceptance & commitment therapy.
Jacobs, A. M., & Antony, M. M. (2009) · Canadian Psychology/Psychologie canadienne · doi:10.1037/a0017573 · Cited by 1 · see citing works
Evaluation of the effectiveness of cognitive-behavioral therapy and acceptance and commitment -therapy of psychosocial needs of veterans
Farid, A. A., Mirmohammadali, M., Ahadi, H., et al. (2020) · مجله طب جانباز · doi:10.52547/ijwph.12.3.157 · Cited by 3 · see citing works
The effectiveness of family mode deactivation therapy, cognitive behavioral therapy, and acceptance-commitment therapy on depression and anxiety of adolescent girls with behavioral problems
Javadi, S., Golparvar, M., & Izadi, R. (2020) · DOAJ (DOAJ: Directory of Open Access Journals)

Authors: Roemer, L., & Orsillo, S. M.
Affiliations: University of Massachusetts Boston (US)
Boston University (US)
ORCID: Roemer, Lizabeth
Orsillo, Susan M.
Venue: Clinical Psychology: Science and Practice
Publisher: American Psychological Association (APA)
Published: 2002
Volume: 9
Issue: 1
Pages: 54-68
ISSN: 0969-5893 (ISSN-L)
1468-2850
DOI: 10.1093/clipsy.9.1.54
OpenAlex: W2098474483
Cited by: 545
References: 106
Citations by year: 2026: 4 · 2025: 7 · 2024: 11 · 2023: 10 · 2022: 15 · 2021: 21 · 2020: 28 · 2019: 13 · 2018: 23 · 2017: 23 · 2016: 31 · 2015: 17 · 2014: 28 · 2013: 36 · 2012: 23
FWCI: 28.03
Type: journal article
Language: en
Open access: closed
Licence: doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 4991 d)
Locations: Clinical Psychology Science and Practice (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords: generalized anxiety disorder, mindfulness-based interventions, acceptance and commitment therapy, cognitive behavioral therapy, treatment integration, conceptual blending, treatment efficacy

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 ›

Are you an author, or do you see a problem with this page? Request a review

Expanding our conceptualization of and treatment for generalized anxiety disorder: integrating mindfulness/acceptance-based approaches with existing cognitive-behavioral models

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Cites

Cited by

Related

Record

About these checks