The Sref Model Of Worry

We conclude with a brief overview of an integrated cognitive model of attention and emotional distress that accommodates many of the empirical findings previously discussed. The S-REF model (Matthews & Wells, 2000; Wells & Matthews, 1994) begins with a three-level cognitive architecture comprising (1) stable declarative and procedural self-knowledge, (2) an executive system implementing controlled processing of self-referent information, including appraisal and coping processes, and (3) a set of lower level networks supporting stimulus-driven, "automatic" processing. The executive is activated by self-discrepancies that elicit reappraisal of the stimulus and a search for viable coping options. The processing routines run by the executive are shaped by generic routines accessed from self-knowledge, including metacognitive self-knowledge that assigns meaning to the person's awareness of their own thoughts, and may initiate thought control strategies. The executive influences behavior by biasing ongoing lower-level processing. It continues to operate until the self-discrepancy is removed.

Within such a system, worry states represent prolonged activity of the self-referent executive system as it attempts to resolve self-discrepancy related to themes of threat and personal vulnerability. The S-REF model isolates several independent cognitive factors that may increase the likelihood and duration of state worry episodes:

(1) The accessibility and organization in memory of items of self-knowledge pertaining to threat that bias selective attention and appraisal, and heighten threat salience. These include self-knowledge that guides secondary appraisal of personal ineffectiveness (cf. Craske, 2003).

(2) Metacognitive beliefs that focus attention on internal thoughts and their apparent consequences (Wells, 2000).

(3) Dynamic factors that perpetuate awareness of self-discrepancy, including intolerance of uncertainty (Dugas et al., 2004), elevated evidence requirements (Tallis et al., 1991), and spreading activation processes that support catastrophizing (Provencher et al., 2000).

(4) Preferences for coping through such processes as active monitoring for threat (though cf., Yovel & Mineka, 2005), and emotion-focused strategies such as self-criticism and avoidance.

Stable biases of these various kinds cause individual differences in dispositional worry, overlapping somewhat with general trait anxiety and neuroticism (Matthews et al., 2000). Importantly, traits relate to packages of biases that may be located in multiple, independent components of the architecture, given unity by their common functional orientation towards, in the case of dispositional worry, anticipation and preparation for threat (Matthews et al., 2003; Matthews & Zeidner, 2004). Traits such as neuroticism and dispositional metacognitive beliefs influence state worry in interaction with situational factors that may facilitate or inhibit the various process factors just listed.

The role of worry processes in clinical anxiety pathology is largely beyond the scope of this chapter (see Matthews & Wells, 2000; Wells, 2000 for more detailed accounts), but we will indicate two differences between normal and pathological states of elevated worry. First, recent work using the DSSQ shows that worry and emotional distress are rather easily dissociated in experimental studies in nonclinical samples. The modest correlations (0.2-0.3) typically observed in these studies represent the influence on the two state dimensions of personality traits such as neuroticism on both dimensions, as well as the effects of emotion-focused coping. By contrast, worry and anxious emotion may be more strongly interrelated in clinical patients. Wells' (2000) model of GAD suggests that metaworry itself is a source of distress, and the person's awareness of their own emotional state may breed further worries.

Second, dynamic person-situation interaction that promotes perseverative worry may be a unique feature of clinical anxiety (Wells, 2000; Wells & Matthews, 1994). In particular, worry may substitute for other more effective forms of coping so that the person never engages with the outside world in order to address the problem directly, with several harmful consequences. The person foregoes the opportunity to acquire the skills needed for problem-solving—and the confidence to deploy those skills when threatened—maintaining beliefs in personal ineffectiveness. Continued worry, without any problem resolution, is also likely to strengthen and elaborate the threat schemas that initially contributed to vulnerability to worry, blocking adaptive restructuring of self-knowledge. By contrast, subclinical worriers retain more flexibility in the allocation of attention that interrupts the worry cycle.

Finally, the S-REF model accommodates the various consequences of worry for performance previously described. "Direct" consequences of worry stem from its functional role in supporting threat preparation, for example in focusing attention on perceived threats. Positive effects of worry may reflect somewhat idiosyncratic metacognitive beliefs about worry as a motivating force. "Indirect" consequences of worry are a consequence of the drain on available attentional resources and working memory resulting from self-referent executive processing.

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