In the cognitive model of GAD (Borkovec; Wells), what metacognitive beliefs distinguish pathological worry from normal worry, and which therapeutic technique directly targets these beliefs?
- A Overestimation of threat probability; systematic desensitisation
- B Positive and negative metacognitive beliefs about worry (e.g., 'Worrying helps me cope' and 'My worrying is uncontrollable'); metacognitive therapy ✓
- C Depressive attributional style (internal, stable, global); behavioural activation
- D Interoceptive conditioning to somatic anxiety cues; interoceptive exposure
Explanation
Wells' metacognitive model of GAD proposes that individuals hold positive metacognitive beliefs about worry ('It helps me prepare and cope') and negative metacognitive beliefs ('My worrying is dangerous and uncontrollable'). The positive beliefs trigger worry as a coping strategy; the negative beliefs generate meta-worry (worrying about worrying), maintaining the disorder. Metacognitive therapy (MCT) targets these metacognitive beliefs directly through techniques such as detached mindfulness, postponing worry, and attention training, rather than modifying the content of worry itself.
Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.
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