Cognitive‐Behavioral Models of Generalized Anxiety Disorder (GAD)

This chapter provides a more historical background on the study of worry. It summarizes the theories and research that inspired Borkovec and colleagues' foundational ideas. The chapter contrasts models of distal processes and models of proximal processes, a distinction that has been applied to other psychopathologies. At the heart of the cognitive avoidance model of generalized anxiety disorder (GAD) are the notions that individuals with GAD avoid mental imagery and the emotions associated with the imagery; and that worry is a behavior that facilitates this avoidance. The self-regulatory executive function model (S-REF) describes a pernicious processing mode called the cognitive attentional syndrome, which prevents the down-regulation of negative thoughts and feelings by heightening self-focused attention, activating unhelpful self-beliefs and self-appraisals, and causing less efficient cognitive functioning. The cognitive model of pathological worry aims to describe the causal mechanisms leading to and maintaining episodes of worry.