A controlled clinical trial on the dynamics of worrying in generalized anxiety disorders

Worries are everyday phenomena known to everybody. They are anticipatory thoughts related to specific potential problems in the future, associated with cognitive rehearsal of how to prevent or solve negative developments. There is also pathological worrying as described in the context of generalized anxiety disorder (GAD). Worrying can be described in regard to the content, be it daily hassles or severe problems in life. Additionally, there are formal aspects of worrying like frequency or subjective controllability.

To investigate formal characteristics of worrying 30 patients, who were treated with cognitive behavior therapy because of generalized anxiety disorder, were assessed before and after treatment with the “dynamics of worrying scale”, which asks for frequency, intensity, fluency, controllability, necessity, and self-creation of worrying. Additionally, a control group of 27 patients without GAD was recruited.

GAD patients indicated significantly and relevantly higher frequency, intensity, fluency of worrying, and lower controllability. GAD patients see in comparison to controls that they have a personal tendency to worry and that worries are unnecesssary.

The results support that worrying is a core feature of GAD. Formal dynamics of worrying differentiate between GAD patients and controls. This shows the importance of formal rather than content aspects of worrying. The fact that GAD patients have some insight in their problem is important for treatment. The dynamics of worrying scale is a useful instrument to specifically measure formal thought disorders in GAD.