Preface

We all worry about things to some degree—and, indeed, many people find it beneficial to think about how they might deal with challenging future events. Of course thinking about future events need not take the form of worry, and important distinctions have been made between worry and other types of thinking. Despite the normality of worry it can become a pervasive daily activity and develop a number of features that make it disabling and a source of extreme emotional discomfort. For example, (1) worrying becomes a chronic and pathological activity that is not only directed at major life issues (e.g. health, finances, relationships, work-related matters), but also to many minor day-to-day issues and hassles that others would not perceive as threatening, (2) worrying is perceived as uncontrollable—the individual experiencing pathological worry usually feels they cannot control either the onset or termination of a worry bout, and (3) worrying is closely associated with catastrophising leading to increasing levels of anxiety and distress, which can seem to make the problem worse rather than better. Worry is the cardinal diagnostic feature of generalised anxiety disorder (GAD), but is also a prominent feature of most other anxiety disorders, including specific phobias, obsessive-compulsive disorder, panic disorder, and PTSD.

This volume covers the nature, theory, assessment, and treatment of worry and illustrates the role of worry and its treatment across a range of disorders. The audience for whom this book is intended is clinical psychologists, clinical researchers, students studying clinical or abnormal psychology at advanced level, postgraduate research students involved in clinical research and experimental psychopathology, and those employed in disciplines closely related to clinical psychology (e.g. psychiatry, psychiatric nursing, counselling). The book is divided into four parts designed to give an up-to-date and inclusive overview of all important aspects of worrying, including the nature of worry across a range of disorders, the assessment of worry, contemporary theories of worry, and methods of treatment for worrying. Chapters are written by international experts in each of these areas, and we believe the book will provide an invaluable resource for both researchers and practitioners.

In Part I, The Nature of Worry, there are chapters covering the epidemiology of worry and generalised anxiety disorder (Holaway, Rodebaugh &

Heimberg), the role of worry and rumination in depression (Papageor-giou), and in anxious psychopathology generally (Purdon & Harrington). This section also covers the role that information processing biases play in pathological worrying (Matthews & Funke), and describes the nature of worry in older adults (Wetherell) and in children and adolescents (Cartwright-Hatton).

Part II looks in some detail at the assessment of worry, including the uses and psychometric properties of the Penn State Worry Questionnaire (Startup & Erickson), the Anxious Thoughts Inventory and closely related concepts (Wells). It also includes a thorough discussion of assessment in generalised anxiety disorder (Turk & Wolanin), as well as some potential clinical and research uses of the catastrophising interview procedure (Davey).

Part III deals with recent theories accounting for the development and maintenance of pathological worry and generalized anxiety disorder. Chapters in this section focus on concepts that include the role of meta-cognition (Wells), and intolerance of uncertainty (Koerner & Dugas) in maintaining chronic and pathological worrying. Chapters also address the causes of the perseverative nature of pathological worrying (Davey), and the view that worry serves an anxiety-maintaining avoidant function (Sibrava & Borkovec).

The final part deals with the treatment of pathological worrying, and the approaches described include Metacognitive Therapy (Wells), Applied Relaxation and Cognitive Therapy (Borkovec), Cognitive-Behavioral treatments targeting intolerance of uncertainty (Robichaud & Dugas), and Pharmacological treatments (Anderson & Palm). Because pathological worrying is a characteristic of a range of psychological disorders, the treatment of worry across disorders using a case-formulation approach is presented (King). Finally, the effectiveness of worry treatments is reviewed in chapters discussing the efficacy of psychological treatments for generalised anxiety disorder (Fisher) and the predictors of treatment outcome (Durham).

As an edited volume, we hope this book provides an integrated set of contributions reflecting conceptual and practical methods for understanding, assessing and working with worry and its associated dysfunctions.

Graham Davey Adrian Wells July 2005

Part!

THE NATURE OF WORRY

Chapter 1

Conquering Fear In The 21th Century

Conquering Fear In The 21th Century

The Ultimate Guide To Overcoming Fear And Getting Breakthroughs. Fear is without doubt among the strongest and most influential emotional responses we have, and it may act as both a protective and destructive force depending upon the situation.

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