The DOI matches its Crossref record; 108 of the 109 references it cites were found in a registry or an index.
Expanding our conceptualization of and treatment for generalized anxiety disorder: integrating mindfulness/acceptance-based approaches with existing cognitive-behavioral models
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.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
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?
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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
In the citing paper
“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
In the citing paper
“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
In the citing paper
“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
In the citing paper
“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]
In the citing paper
“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 the citing paper
“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]
In the citing paper
“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
In the citing paper
“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]
Citations
Cites
Diagnostic and Statistical Manual of Mental Disorders
(2012) · Springer eBooks · doi:10.1007/springerreference_121117 · Cited by 20,772
Diagnostic and Statistical Manual of Mental Disorders
&NA; (1988) · Alzheimer Disease & Associated Disorders · doi:10.1097/00002093-198802020-00022 · Cited by 12,603
(1993) · Cited by 7,136
(1999) · Cited by 5,934
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
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
On Becoming a Person: A Therapist's View of Psychotherapy
Rogers, C. R. (1961) · DigitalGeorgetown (Georgetown University Library) · Cited by 3,997
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
(1985) · Cited by 2,882
Ironic processes of mental control.
Wegner, D. M. (1994) · Psychological Review · doi:10.1037//0033-295x.101.1.34 · Cited by 2,609
Research works printed but not linked: 11
- American Psychiatric Association, 1980, Diagnostic and statistical manual of mental disorders
- Borkovec, 1999, June, The nature andpsychosocial treatment of generalized anxiety disorder
- Craske, 1992, Mastery of your anxiety and worry
- Follette, 1994, Acceptance and change: Content and context in psychotherapy, 255
- Greenberg, 1987, Emotions in psychotherapy
- Hayes, 1999, Buddhist philosophy and CBT
- 1994, Acceptance and change: Content and context in psychotherapy
- Heffner, 2000, The effects of acceptance and control contexts on avoidance of an aversive event
- Linehan, 1994, Acceptance and change: Content and context in psychotherapy, 73
- Marlatt, 1994, Acceptance and change: Content and context in psychotherapy, 175
- Wells, 1999, A metacognitive model and therapy for generalized anxiety disorder, Clinical Psychology and Psychotherapy, 6, 86, 10.1002/(SICI)1099-0879(199905)6:2<86::AID-CPP189>3.0.CO;2-S · DOI · Paper page
Cited by
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 8,615
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
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
Hayes, S. C. (2004) · Behavior Therapy · doi:10.1016/s0005-7894(04)80013-3 · Cited by 2,493
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
Metadata
- Authors
- Roemer, L., & Orsillo, S. M.
- Affiliations
- University of Massachusetts Boston (US)
- Boston University (US)
- Venue
- Clinical Psychology: Science and Practice
- Published
- 2002
- Volume
- 9
- Issue
- 1
- Pages
- 54-68
- ISSN
- 0969-5893 (ISSN-L)
- 1468-2850
- OpenAlex
- W2098474483
- Cited by
- 621
- References
- 104
- Citations by year
- 2026: 9 · 2025: 12 · 2024: 15 · 2023: 15 · 2022: 20 · 2021: 28 · 2020: 37 · 2019: 25 · 2018: 28 · 2017: 25 · 2016: 35 · 2015: 20 · 2014: 31 · 2013: 40 · 2012: 26
- FWCI
- 28.53
- Type
- journal article
- Language
- en
- Open access
- closed
- 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