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Clinical Psychology Review 33 (2013) 10411056

Contents lists available at ScienceDirect

Clinical Psychology Review

Systematic information processing style and perseverative worry


Suzanne R Dash , Frances Meeten, Graham C L Davey
University of Sussex, Brighton, UK

H I G H L I G H T S

Similar psychological states and appraisals inuence worry and systematic processing.
Increased sufciency thresholds and systematic processing help to understand worry.
Systematic processing may be a transdiagnostic process across perseverative disorders.
Incorporating the HSM in models of worry provides new therapeutic opportunities.

a r t i c l e

i n f o

Article history:
Received 19 April 2013
Received in revised form 13 August 2013
Accepted 19 August 2013
Available online 27 August 2013
Keywords:
Worry
Perseveration
Systematic processing
Sufciency threshold

a b s t r a c t
This review examines the theoretical rationale for conceiving of systematic information processing as a proximal
mechanism for perseverative worry. Systematic processing is characterised by detailed, analytical thought about
issue-relevant information, and in this way, is similar to the persistent, detailed processing of information that
typies perseverative worry. We review the key features and determinants of systematic processing, and examine the application of systematic processing to perseverative worry. We argue that systematic processing is a
mechanism involved in perseverative worry because (1) systematic processing is more likely to be deployed
when individuals feel that they have not reached a satisfactory level of condence in their judgement and this
is similar to the worrier's striving to feel adequately prepared, to have considered every possible negative
outcome/detect all potential danger, and to be sure that they will successfully cope with perceived future
problems; (2) systematic processing and worry are inuenced by similar psychological cognitive states and
appraisals; and (3) the functional neuroanatomy underlying systematic processing is located in the same brain
regions that are activated during worrying. This proposed mechanism is derived from core psychological processes and offers a number of clinical implications, including the identication of psychological states and appraisals
that may benet from therapeutic interventions for worry-based problems.
2013 Elsevier Ltd. All rights reserved.

Contents
1.
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8.

Introduction . . . . . . . . . . . . . . . . . . . .
Dual-process models of information processing
. . . .
The heuristicsystematic model of information processing
Processing style summary . . . . . . . . . . . . . .
Application of the HSM
. . . . . . . . . . . . . . .
Factors affecting the deployment of systematic processing
The sufciency threshold . . . . . . . . . . . . . . .
Raised sufciency thresholds in worriers
. . . . . . .
8.1.
Negative mood . . . . . . . . . . . . . . . .
8.2.
Accountability . . . . . . . . . . . . . . . .
8.3.
Responsibility . . . . . . . . . . . . . . . .
8.4.
Desire for control . . . . . . . . . . . . . . .
8.5.
Need for cognition . . . . . . . . . . . . . .
8.6.
Intolerance of uncertainty . . . . . . . . . . .
8.7.
Low problem-solving condence . . . . . . . .

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Corresponding author at: School of Psychology, University of Sussex, Brighton BN1 9QH, UK. Tel.: +44 1273 876650.
E-mail address: s.dash@sussex.ac.uk (S.R. Dash).
0272-7358/$ see front matter 2013 Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.cpr.2013.08.007

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S.R. Dash et al. / Clinical Psychology Review 33 (2013) 10411056

Motivation for systematic processing


. . . . . . .
9.1.
Accuracy motivation . . . . . . . . . . . .
9.2.
Defence motivation . . . . . . . . . . . .
9.3.
Impression motivation . . . . . . . . . . .
10.
Summary . . . . . . . . . . . . . . . . . . . .
11.
Similarities between worry and systematic processing
12.
Worry as a form of systematic processing
. . . . .
13.
Systematic processing and models of worry
. . . .
13.1. Cognitive models . . . . . . . . . . . . .
13.2. Emotion-based models
. . . . . . . . . .
13.3. Integrated affect and cognition models . . .
14.
Clinical implications . . . . . . . . . . . . . . .
15.
Summary and concluding remarks . . . . . . . . .
Acknowledgements . . . . . . . . . . . . . . . . . .
References
. . . . . . . . . . . . . . . . . . . . . .

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Worry retards reaction and makes clear-cut decisions impossible


Amelia Earhart

1. Introduction
Worry is dened as a chain of thoughts and images, negatively
affect-laden and relatively uncontrollable (Borkovec, Robinson,
Pruzinsky, & DePree, 1983, p. 10). These negative thoughts are aimed
at anticipating threats (Mathews, 1990) and solving problems (Davey,
1994). Worry thoughts can be catastrophic in nature (Davey & Levy,
1998a), and include themes of personal inadequacy (Davey & Levy,
1998b). Excessive, uncontrollable worry is the cardinal feature of generalized anxiety disorder (GAD) (American Psychiatric Association, 2000,
DSM-IV-TR, 4th ed., text rev.), but perseverative worry also plays a role
in the anxious apprehension surrounding social and performance situations seen in social anxiety, in the concerns about panic attack symptoms in panic disorder, and in the fears about bodily symptoms in
hypochondriasis (Purdon & Harrington, 2006). Furthermore, worry
has been implicated in checking and doubting subtypes of obsessive
compulsive disorder (OCD) (Tallis & DeSilva, 1992). Worry also predicts
treatment outcomes in psychosis; worry signicantly predicted persecutory delusions at three-month follow-up, with those scoring higher
on measures of worry at baseline showing less symptom improvement
(Startup, Freeman, & Garety, 2007). The pervasive nature of perseverative worry across psychopathologies emphasises the need for an understanding of the mechanisms of worry and effective strategies for the
clinical management of worry-based presentations.
In the past 15 years, numerous variables have been shown to
increase worry perseveration. However, little is known about the mechanisms accounting for the impact of these variables on worry perseveration. One possible mechanism is systematic processing, which is dened
as a comprehensive, analytic orientation1 in which perceivers access
and scrutinize all useful information in forming their judgments
(Chaiken, Liberman, & Eagly, 1989, p. 212) a process that would undoubtedly result in the worrier2 devoting extended periods of time to
considering a chain of worry thoughts. This article reviews systematic
information processing, a processing style that shares many formulistic

1
The use of the word orientation suggests a general tendency to use this information
processing style.
2
The term worrier is used in this paper to refer, predominantly, to individuals who experience worry with a high frequency (i.e., they would score above average on the Penn
State Worry Questionnaire developed by Meyer et al. (1990)). However, Ruscio, Borkovec
and Ruscio (2001) demonstrated using taxometric analytic methods that normal and
pathological worry are best conceptualised as occupying the extreme end of a single continuum, rather than as discrete entities. Consequently, it is anticipated that systematic processing will play a role in anyone who is worrying, including in the bouts of worry
displayed by low frequency worriers.

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similarities with worry. Firstly, systematic processing is characterised by


detailed, analytical thought about issue-relevant information (Chaiken
et al., 1989), and in this way, is similar to the persistent, detailed processing of information that characterises perseverative worry. Secondly, both
worry and systematic processing arise through subjectively unconscious/
non-deliberative means (Borkovec et al., 1983; Chen & Chaiken, 1999).
Thirdly, systematic processing is more likely to be deployed when individuals feel that they have not reached a satisfactory level of condence
in their judgement (Chaiken et al., 1989), and this is similar to the
worrier's striving to feel adequately prepared (Borkovec & Roemer,
1995), to have considered every possible negative outcome/ to detect all
potential danger (Mathews, 1990), or to be sure that they will successfully
cope with perceived future problems (Davey, Hampton, Farrell, &
Davidson, 1992). Fourthly, systematic processing and worry are
inuenced by similar psychological cognitive states and appraisals, including negative mood, responsibility, desire for control and accountability (Ambady & Gray, 2002; Bohner, Moskowitz, & Chaiken, 1995; Brain
et al., 2008; Johnston & Davey, 1997; Maheswaran & Chaiken, 1991;
Roemer & Borkovec, 1993; Startup & Davey, 2003; Tetlock, 1983). Lastly,
there is evidence that the functional neuroanatomy underlying systematic processing and worry is the same, with both associated with left frontal
lobe activation (Borkovec, Ray, & Stber, 1998; Leynes, 2002; Leynes &
Phillips, 2008; Nolde, Johnson, & Raye, 1998). This most likely reects
that systematic processing and worry are both verbal-based forms of analytical thought (Carter, Johnson, & Borkovec, 1986; Evans, 2008). Despite
there being a convincing case for considering the role that systematic processing plays in worry, it should be noted that systematic processing and
worrying are not the same thing. Both represent forms of effortful, analytic thought, but systematic processing is deployed in a broad range of tasks
with personal and social signicance (e.g., forming attitudes, Martin &
Hewstone, 2003). Furthermore, worry is dened by cognitive and emotional experiences that are not uniformly encountered in other contexts
where systematic processing occurs. For more detail on how worry and
systematic processing differ, see the section headed Worry as a form of
systematic processing). Given the structural similarities of these two phenomena, the purpose of this review is to explain the theoretical rationale
behind conceiving of systematic information processing having a role in
worry as a proximal mechanism involved in the initiation and maintenance of perseverative worry and its iterative style. Systematic processing
does not negate the theoretical importance of the variables that have previously been identied as worry promoters; rather it offers a theoretical
framework for understanding how these different variables lead worriers
to engage in perseverative worry (see the Systematic processing
and Models of Worry Cognitive models section for a description of
empirically-supported models of worry, and a discussion of how the
HSM may t into these models). The key determinants of systematic
processing will be covered, alongside consideration of the application of
systematic processing to perseverative worry and existing models of
worry-based pathology.

S.R. Dash et al. / Clinical Psychology Review 33 (2013) 10411056

2. Dual-process models of information processing


The 1970s and 1980s saw advances in dual-process models of
information processing, which were invoked to account for numerous
research ndings in the social cognition literature that appeared contradictory to one another (Petty & Wegener, 1999). For example, negative
mood states often inhibited attitude change (e.g. Zanna, Kiesler, &
Pilkonis, 1970, cited in Petty & Wegener, 1999), but on some occasions
they facilitated attitude change (e.g. Leventhal, 1970, cited in Petty &
Wegener, 1999). A number of different dual-process theories have
been proposed (Chaiken & Trope, 1999; Evans, 2008) but they share
in common the assumption that human cognition relies on two modes
of processing information: (1) a fast associative processing mode that
has low cognitive effort requirements, and (2) a slower mode based
on detailed processing which requires high levels of cognitive effort. Despite this shared assumption, the dual-process models differ in regard to
their exact denitions of these two processing modes and the relationship between the two processing modes (Chaiken & Trope, 1999).
The two dominant dual-process models to emerge from the social
cognition literature are the elaboration likelihood model (ELM, Petty &
Cacioppo, 1986) and the heuristicsystematic model (HSM; Chaiken
et al., 1989). The ELM is based on a continuum of elaboration, which refers to the extent that a person will think about issue-relevant arguments. At one end of the ELM continuum, the individual will elaborate
extensively and generate a lot of issue-relevant thoughts. At the other
end of the continuum, individuals will rely on peripheral cues to make
their judgement, such as how many points an argument contains, and
will not elaborate on issue-relevant ideas. The ELM contains two processing routes: the central route (elaboration) and the peripheral
route (minimal elaboration). The central route requires time, effort,
and ability, as recipients try to integrate the message arguments with
their existing knowledge. Conversely, the peripheral route is utilised
when motivation is low, or there are constraints on time and ability.
The peripheral route involves forming attitudes based upon peripheral
cues such as the source of an argument, the number of arguments, or
the length of an argument. In a test of the ELM, Petty and Cacioppo
(1984) manipulated argument strength and the number of arguments
that were presented, as well as participant involvement. They observed
a three-way interaction, with low involvement participants forming
more extreme attitudes following a greater number of arguments, regardless of the strength of the arguments, whereas the high involvement participants showed more extreme attitudes for the large
number of strong arguments, but crucially, not for the large number of
weak arguments.
Around the time that the ELM was gaining attention, Chaiken and
colleagues published theoretical and empirical papers in support of another dual-process model, the heuristicsystematic model (HSM). This
model contained one processing route that was essentially identical to
the central route of the ELM. Within the HSM, this was called systematic
processing. The second processing route was termed heuristic processing, and differed slightly from the peripheral route of the ELM in that
people were perceived to use heuristics, simple rules of thumb, in
order to assess the validity of messages. Examples of such heuristics include experts can be trusted, and length [of arguments] implies
strength.
The ELM and the HSM have similarities: (1) both include a process
requiring motivation and capacity, and a process that can occur when
there are low levels of motivation and/or capacity, (2) both incorporate
a least-effort assumption, namely that humans will use the minimal
cognitive resources that they can while still meeting their goal (see
The sufciency threshold section), and (3) both acknowledge that motivational (e.g., task importance) and cognitive (e.g., existing knowledge) factors can inuence processing (Chen & Chaiken, 1999). The
predominant difference between the ELM and the HSM is the way in
which the two processing routes are hypothesised to relate to one another. In the ELM, the central and peripheral routes are deemed

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mutually exclusive. In the HSM, systematic and heuristic processing


can co-occur simultaneously, meaning that they can interact with one
another, have additive effects, and bias one another.
Furthermore, the HSM allows for multiple motives (accuracy,
defence and impression motives; see the Motivation for systematic
processing section) within its multiple-motive framework, whereas
the ELM accounts solely for accuracy-motivated individuals (Chen &
Chaiken, 1999). When considering how dual-process models of information processing may apply to the worry context, it is preferable to
consider multiple motives. This is because worriers can hold a number
of different goals for their worrying. To illustrate, it has been suggested
that individuals engage in worry to (1) avoid emotionally-aversive
stimuli (Borkovec & Inz, 1990), (2) detect danger (Mathews, 1990),
(3) feel prepared for negative outcomes (Borkovec & Roemer, 1995),
(4) cope with problems (Davey et al., 1992), and (5) do as much as possible about what is worrying them (Davey, Startup, MacDonald, Jenkins,
& Patterson, 2005). While Bohner, Erb, and Siebler (2008) argue that the
ELM provides a more complete account of the low-intensity processing
mode, the HSM allows multiple-motives. Consequently, the HSM provides a dual-process account3 of information processing that is better
suited to accounting for how information is systematically processed
by worriers, and thus the HSM has been chosen as the dual-process
model of focus.

3. The heuristicsystematic model of information processing


Judgements, such as making a decision or forming an attitude, are integral to human cognition. In relation to worry, such judgements may
include assessing whether a situation is threatening, generating what
if? scenarios, and determining whether one is prepared for a potentially
negative outcome. Social cognition models, such as the HSM, acknowledge that individuals are not passive recipients of information when
making such judgements, but rather they can process information
with varying degrees of cognitive effort. As reported above, the HSM incorporates two processing styles: systematic processing and heuristic
processing. Systematic processing involves a detailed analysis of information relevant to an individual's judgement. Chen, Shechter, and
Chaiken (1996) dene systematic processing as comprehensive analysis of judgement-relevant information (p. 262). Individuals who systematically process pay attention to all relevant information (Chen &
Chaiken, 1999), although which information is considered to be relevant will vary, and is affected by an individual's motivation and goals.
Chaiken et al. (1989) conceptualise systematic processing as the highend of the data processing continuum, and, as such, they state that it requires more than marginal (p. 212) amounts of cognitive capacity and
effort.
In different situations, people may focus on a subset of available information which enables the use of simple decision rules or cognitive
heuristics to formulate their judgements and decisions. This is heuristic
processing, and has been contrasted with systematic processing as a
more limited processing mode that demands much less cognitive effort
and capacity (Chaiken et al., 1989, p.213). Heuristic processing is only
feasible when heuristic cues are available to the individual. Heuristic
cues are dened by Chaiken et al. (1989) as any variable whose
judgemental impact is hypothesised to be mediated by a simple decision rule (p.216). One heuristic that has received a great deal of attention is the availability heuristic (Tversky & Kahneman, 1973). In ten
studies, Tversky and Kahneman (1973) built a convincing case that
the ease of retrieval of information inuences estimates of probability
and frequency. One such example was a study in which participants
3
Some authors, e.g., Kruglanski, Thompson and Spiegel (1999), champion singleprocess models, arguing that forming judgements on the basis of heuristic or systematic
processing reects the same underlying process, an if-then process. Chen and Chaiken
(1999) disagree, arguing that systematic processing is not solely if-then processing, and
that it involves integrating many, possibly contradictory, if-then associations.

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S.R. Dash et al. / Clinical Psychology Review 33 (2013) 10411056

were asked to estimate whether a letter, e.g. k, more frequently occurred as the rst or third letter in words in the English language.
According to Tversky and Kahneman (1973), the letter k is twice as
likely, in a standard piece of text, to be the third letter in a word as it
is to be the rst letter. However, Tversky and Kahneman (1973) found
a signicant bias for participants selecting that the letter was more likely to occur in the rst position than the third position in a word. Tversky
and Kahneman (1973) argued that this is because it is cognitively easier
to think of words that begin with k than have k as the third letter. Numerous other heuristics have been identied, including the warm glow
heuristic (Monin, 2003), the audience response heuristic (Axsom, Yates,
& Chaiken, 1987), and the expertise heuristic (Ratneshwar & Chaiken,
1991). However, a list of heuristics does not in itself provide evidence
that heuristics require less cognitive effort than optimal processing
strategies. Consequently, Shah and Oppenheimer (2008) sought to dene the processes operating within heuristics that translate into less effort consumption, and they argue in their effort-reduction framework
that heuristics primarily serve the purpose of reducing the effort with
a task (p.207). Shah and Oppenheimer (2008) review evidence
supporting ve ways that heuristics serve to reduce the cognitive effort
that a task requires: (1) examining fewer cues, (2) reducing the difculty associated with retrieving and storing cue values, (3) simplifying the
weighting principles for cues (i.e., an equal weight is assigned to each
cue, rather than weighing up the validity of each cue), (4) integrating
less information, (5) examining fewer alternatives. A thorough examination of heuristic denition and mechanisms of operation is beyond
the scope of this review on the role of systematic processing in worry,
but interested readers are referred to a recent review by Gigerenzer
and Gaissmaier (2011).

felt was needed to make a decision about health risks, the more likely it
was that systematic processing would be deployed. Trumbo (2002) applied the HSM to risk perception and found that the model had good
predictive power for an individual's risk perception. Systematic processing was found to consistently predict signicantly higher risk estimates,
whereas heuristic processing led to lower risk estimates. What is more,
in a psychopathology context, the notion of heuristic and systematic
processing has successfully been applied to an understanding of autism
spectrum disorders (ASD). For example, De Martino, Harrison, Knafo,
Bird, and Dolan (2008) found that individuals with ASD were signicantly less inuenced by message framing (whether monetary-based
outcomes were presented as a loss or a gain), which is a heuristic cue,
than individuals without ASD.
The application of the HSM to contexts beyond the persuasion setting raises the possibility that applying the HSM to understanding
worry perseveration may also be fruitful. Indeed, systematic processing
has already been invoked in explanations of the role of negative mood
(Davey, 2006b), and as many as can stop rule deployment (Startup &
Davey, 2001) in perseverative worry (see Systematic processing and
models of worry section for detail on as many as can stop rules).
There is evidence that highly anxious people use systematic, rather
than heuristic processing (Hale, Lemieux, & Mongeau, 1995), which
suggests that it may be of relevance in understanding other processes,
such as worry, that are linked to the anxiety disorders (although
worry and anxiety are separable constructs, see Davey et al. (1992)).
Furthermore, a recent experiment has successfully applied the sufciency threshold concept of the HSM to perseverative worry (Dash & Davey,
2012).
6. Factors affecting the deployment of systematic processing

4. Processing style summary


To summarise, systematic processing leads to judgements formed on
the basis of careful examination of arguments, and includes the integration of all useful evidence with information already held by the individual. In contrast, heuristic processing is less effortful, and involves the
assimilation of knowledge into existing knowledge structures, such as
scripts and schemas. A similar processing style distinction was also applied in Beevers' (2005) dual process model of depression, suggesting
that attention to different forms of processing may be important in understanding a range of psychopathologies.
Apart from their distinctively different modes of operation, psychophysiological studies also suggest that systematic and heuristic processing may be supported by functionally distinct brain processes, with
systematic and heuristic processing associated with activation of the
left and right frontal lobes, respectively (Leynes, 2002; Leynes &
Phillips, 2008; Nolde et al., 1998). The processing styles are similar in
that neither is assumed to be wholly objective, and both can enable individuals to achieve their processing goals.
5. Application of the HSM
The HSM was originally derived as a model of persuasion (Chaiken
et al., 1989), but has since been applied to risk perception (Trumbo,
1999) and decision-making, including decision-making in clinical
health contexts (Steginga & Occhipinti, 2004). Although a full review
of the broader application of the HSM is beyond the scope of this review
article, some examples are provided to demonstrate that the key principles of the HSM apply beyond the persuasion setting. For example, the
sufciency threshold principle (see The sufciency threshold section for
more detail) has been extended to health/risk settings. Kahlor,
Dunwoody, Grifn, Neuwirth, and Giese (2003) demonstrated that the
notion that a negative discrepancy between actual and desired condence will promote systematic processing extends to health risk perception. They found that the wider the gap between an individual's
understanding of risk and the level of understanding that the individual

Systematic processing requires greater cognitive effort than heuristic processing, and consequently will only occur when an individual is
motivated to expend cognitive resources on processing information.
As such, an individual's level of motivation is an important determinant
of whether systematic processing is deployed. What is more, the explicit
and implicit goals that an individual has for processing worry-related
information (e.g., resolving a problem, preparing for a negative outcome, holding concurrent negative and positive beliefs about worry),
will inuence the point at which individuals feel they have processed
the information thoroughly enough. The next section focuses on the
sufciency threshold principle and motivation, the two key principles
that determine whether systematic processing is deployed.
7. The sufciency threshold
A central feature of the HSM is the sufciency threshold principle,
which recognizes the trade-off between cognitive efciency and task
goals. While efciency is important, individuals exert whatever level
of effort is required to attain a sufcient degree of condence that
they have satisfactorily accomplished their processing goals (Chaiken
et al., 1989). The least effort principle is an essential component of understanding which information processing style individuals will use,
and is the basis for the HSM's sufciency threshold principle. Psychologists such as Allport (1954) argued that individuals constrain their processing in order to preserve cognitive resources and make their way
through an information-laden world. Related to the principle of least effort, some theorists argue that humans are cognitive misers, constrained
by limited cognitive capacity, and forced to take shortcuts where possible to maintain efciency (e.g. Fiske & Taylor, 1991). However, the use
of the cognitive miser concept to explain why systematic processing requires high levels of motivation has been criticised for failing to account
for how systematic processing can also occur in low-motivation settings
(Maheswaran & Chaiken, 1991). Indeed, as highlighted by Hirsch and
Mathews (2012), among others, it is unclear why excessive worry
about low probability events [i.e., low-motivation settings] persists

S.R. Dash et al. / Clinical Psychology Review 33 (2013) 10411056

when it causes frequent mental distress, with so little apparent benet


(p. 636). Models of worry need to account for why large amounts of
time and effort are devoted to processing unlikely negative outcomes,
situations which would normally be deemed low-motivation settings.
The HSM's sufciency threshold offers an explanation for effortful processing in low-motivation settings (Chaiken et al., 1989), which will
now be outlined.
The HSM provides a fuller account of the role of motivation in determining processing style by employing the concept of a sufciency
threshold. The sufciency threshold principle extends the work of
Simon (1957) who introduced the idea of satiscing. Individuals
choose the rst option that addresses most of their needs, rather than
selecting the optimal solution nding a course of action that is
good enough (Simon, 1957, p. 205). Individuals must balance the
need to minimise processing demands (maintain cognitive efciency)
with the desire to maximize condence that they have achieved their
task goals (e.g. anticipating negative outcomes). While an individual
will rarely be able to achieve complete condence that they have
achieved their goals for processing information (e.g. anticipated all possible negative outcomes), they can strive for a subjectively desired level
of condence. Within the HSM, this desired amount of condence is
termed the sufciency threshold, and it is conceptualised as falling
along a continuum. Chaiken et al. (1989) state that the exact positioning
of the sufciency threshold (i.e., amount of condence required) will
vary depending on the individual and the situation. Likewise, an
individual's actual level of condence will vary as a function of individual and situational factors, and may change as new information is encountered and processed. The discrepancy between actual condence
and desired condence is critical when determining which type of processing will be used: according to the sufciency principle, motivation
for systematic processing is a positive function of the negative discrepancy that exists between actual condence and the sufciency threshold (Maheswaran & Chaiken, 1991, p. 14). Once an individual reaches
a level of condence that matches (or exceeds) their sufciency threshold, cognitive effort should cease. However, while an individual's actual
condence is below the sufciency threshold, cognitive effort should be
expended in an attempt to reduce the discrepancy between desiredand actual condence levels. Consequently, even in situations that
would typically be considered low-motivation settings, worriers may
be motivated to expend large amounts of cognitive effort if their subjective level of condence is lower than their desired level of condence.
Chen and Chaiken (1999) highlight predictions that can be drawn
from the sufciency threshold principle. Firstly, systematic processing
is more probable as the discrepancy between actual and desired condence increases. Consequently, situations where this gap is widened,
such as when an individual's sufciency threshold is increased, or actual
condence levels are decreased, should result in greater deployment of
systematic processing. Evidence for this comes from the nding that
systematic processing is more likely when the task is more important
(with the assumption that this is associated with an increase in the
amount of condence that an individual desires) as shown by Darke
et al. (1998) or when actual condence is reduced, such as was shown
by introducing information that contradicted what was indicated by
the heuristic cues (Maheswaran & Chaiken, 1991).
Factors that are understood to increase the deployment of systematic processing, such as feeling accountable for one's decisions (e.g.,
Tetlock, 1983), can be understood to operate by raising an individual's
sufciency threshold and increasing the amount of condence that the
individual feels is necessary. The sufciency principle suggests that individuals will engage in greater amounts of systematic processing when
heuristic processing (or small amounts of systematic processing) does
not confer the desired level of condence. This is because systematic
processing is generally thought to provide greater condence in judgements (Bohner et al., 1995; Chaiken et al., 1989; Chen, Duckworth, &
Chaiken, 1999; Chen et al., 1996). Alter, Oppenheimer, Epley, and Eyre
(2007) demonstrated that when an individual experiences difculty

1045

processing a message (e.g., the font is degraded or they are instructed


to form a furrowed brow implying that they are processing a complex
message), they show reduced reliance on heuristic cues. The authors
argue that metacognitive experiences of difculty act as an alarm bell
that activates more analytic forms of processing (i.e., systematic
processing). See the section on Wells' Metacognitive Model of worry
(p. 43) for more information on metacognition. Additionally, a metaanalysis conducted by Kraus (1995) found three studies which supported the idea that attitudes based on direct experience show greater
attitudebehaviour consistency. Originally, this nding was interpreted
by Fazio and colleagues as indicating that attitudes based on direct experience are held with greater condence (Kraus, 1995). In support of
this, Pieters and Verplanken (1995) examined intentionbehaviour
consistency in a longitudinal study of voting intentions and behaviour.
They found that involvement with elections (measured by the
coming elections are very important to me and (reverse-scored)
I don't care who will win the elections in September) signicantly positively predicted an individual's condence in voting intentions
(measured by How condent are you that you actually will vote for
the party you just indicated?). This suggests that individuals place
greater condence in judgements made when they have more
involvement in the issues, which lends support to the notion that
individuals will use systematic processing when they require greater
condence in their judgements.
8. Raised sufciency thresholds in worriers
One of the key principles of the HSM is the sufciency threshold
(i.e., the discrepancy between actual and desired condence in one's
judgements). Many of the variables that have been implicated in raised
sufciency thresholds in the social psychology literature (negative
moods, accountability, responsibility and desire for control) are also relevant to worriers (see Table 1.). We are now going to discuss the variables that have emerged from the social psychology literature, the
evidence that they inuence sufciency thresholds, and the evidence
that these variables play a role in worry processes. We will then explore
the ways in which variables that are relevant to perseverative worry
(intolerance of uncertainty and low problem-solving condence), but
have not yet been explicitly investigated in the context of the HSM,
are also likely to raise sufciency thresholds and thus lead to worriers
deploying systematic processing.
8.1. Negative mood
Negative mood, dened as a dimension of subjective distress and
unpleasurable engagement (Watson, Clark, & Tellegen, 1988, p.1063),
has been shown to increase systematic processing. Numerous studies
have demonstrated that negative mood states are associated with extended cognitive processing (Ambady & Gray, 2002; Batra & Stayman,
1990; Tiedens & Linton, 2001). For example, Bohner, Bless, Schwarz,
and Strack (1988) informed participants that they had either performed
well or poorly on a test. Alongside this, participants were also provided
with information about how likely they were to perform well/poorly
based on the (ctional) percentage scores experienced by previous participants. Bohner et al. (1988) demonstrated that, after receiving negative information about performance on a test, participants generated
more causal reasons for the performance than individuals who received
positive feedback. This effect occurred regardless of how probable the
outcome was. Bohner et al. (1988) argue that this study provides clarity
on previously confounded studies containing negative events that were
less probable, and they suggest that increased causal reasoning when in
a negative mood is not the result of a need to explain unexpected
events. Thus, Bohner et al. (1988) suggested that the ndings may be
due to a general systematic approach to information processing when
in a negative mood state and they hypothesised three possible reasons
for why a negative mood state results in greater causal reasoning.

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S.R. Dash et al. / Clinical Psychology Review 33 (2013) 10411056

Table 1
Evidence for variables that increase systematic processing (or decrease heuristic processing) and play a role in increased worry levels.
Variable

Area of research

Authors

Negative mood

Systematic
processing

Ambady and Gray (2002): Study 4

Worry

Accountability

Systematic
processing

Worry

Responsibility

Systematic
processing

Worry
Need for cognition Systematic
processing

Worry

Desire for control

Systematic
processing
Worry

Key ndings

Sad mood participants were less accurate in their ratings (indicating deliberative processing) compared
to the neutral and sad mood + cognitive load conditions.
Bodenhausen, Sheppard, and
Sad mood group were less reliant on stereotype cues (a heuristic cue) than the anger mood group.
Participants in the failure condition felt worse than participants in the success condition, and those in
Kramer (1994): Study 1
the failure condition generated more items on a thought listing task (indicating systematic processing)
Bohner et al. (1988)
regardless of expectancy.
Tiedens and Linton (2001): Study 3 Disgust mood group participants were more likely to use stereotype information (heuristic cue) than
fear mood group participants.
Johnston and Davey (1997)
Negative bulletins increased sadness and anxiety, and were associated with more worry catastrophising
steps than positive or neutral bulletins.
Startup and Davey (2001): Study 1 Negative mood group showed signicantly higher worry catastrophising than the positive or neutral
mood groups.
Livingston and Sinclair (2008)
Participants who felt accountable were less likely to demonstrate prejudiced views (less use of heuristic
cues) but only in low-prejudice individuals.
Tetlock (1983)
Participants who were aware of their accountability before viewing the information were not affected
by the order of information presented, whereas those unaware that they were accountable prior to
viewing the information demonstrated a primacy effect.
Brain et al. (2008)
Self-accountability (blamed self) was a signicant predictor of worry 6 months after screening results
were disclosed (Time 3).
Sweet and Pelton-Sweet (2008)
Accountability was associated with anxiety, e.g. Please don't be mad if it's wrong; I'm nervous (p.32).
Bohner et al. (1995)
Responsibility has been included in theoretical accounts of effortful, systematic processing, e.g. Bohner
Uleman (1989)
et al. (1995) and Uleman (1989), but empirical studies where responsibility has been measured/
manipulated need to be conducted in future.
Startup and Davey (2003)
Experimentally increasing responsibility resulted in greater worry levels.
Batra and Stayman (1990)
Positive mood reduced elaboration of thoughts but this was moderated by need for cognition, with the
effect stronger for those low in need for cognition.
Cacioppo et al. (1983): Study 1
The effect of argument quality on message evaluation had a greater impact in high (vs. low) need for
cognition participants. High (vs. low) need for cognition participants reported expending more
cognitive effort and had greater recall of the message arguments.
Davey, Tallis, and Capuzzo (1996): When using an as many as can stop rule (I must do as much as possible), high worriers showed greater
Study 2
perseveration than low worriers and experienced greater negative mood.
Startup and Davey (2001): Study 2 When using an as many as can stop rule (I must do as much as possible), high worriers showed greater
perseveration than low worriers and experienced greater negative mood.
Swann, Stephenson, and Pittman
Individuals who underwent control deprivation sought more information than those who felt in control.
(1981)
Information utility played a role, with those who believed that the information would be useful seeking
more than those who did not.
Borkovec (1994)
Five themes emerged following interviews with worriers about what function their worry served:
attempts to control the environment (p.16) (superstitious avoidance of catastrophe; actual
avoidance of catastrophe) and attempts to control oneself (emotions and/or behaviours) (p. 16)
(avoidance of deeper emotional topics; coping preparation; motivating device).

Firstly, enhanced causal reasoning may serve a protective function;


searching for causal reasons makes it more likely that the individual
will identify external and self-irrelevant causes. Secondly, it may enable
individuals to avoid similar states in the future. Lastly, Bohner et al.
(1988) suggest that causal thinking reduces the intensity of emotions,
and can function as a mood control strategy. These theorised reasons
for increased processing when in a negative mood bear a remarkable
similarity to the theory that worry is deployed as a coping strategy for
avoiding negative outcomes (Borkovec, 1994) and negative emotional
experiences (Borkovec & Inz, 1990), as well as tting with beliefs that
worriers hold, such as worrying helps me to avoid problems in the
future (Wells & Cartwright-Hatton, 2004).
Pathological worriers experience negative mood frequently
(e.g. Meyer, Miller, Metzger, & Borkovec, 1990). The association between negative mood and worry may emerge from the negative cognitive processes associated with chronic worrying such as negative
outcome anticipation (Szab & Lovibond, 2002), processing negative
thoughts (Borkovec et al., 1998), catastrophising (Davey, 2006a), and
personal inadequacy appraisals (Davey & Levy, 1998b). However, a
number of studies support the view that, rather than simply being a
consequence of worrying, negative mood is a causal contributor.
Johnston and Davey (1997) found that inducing a negative mood
resulted in signicantly more catastrophising steps (each step is akin to
a catastrophic worry thought) being generated during a catastrophising
interview than positive or neutral moods. This and similar studies
(e.g., Startup & Davey, 2001) demonstrate that negative mood has
a causal effect on worry perseveration, and is not simply an outcome of

worrying. The endemic negative mood experienced by high worriers is


likely to trigger systematic processing.
There are a number of outcomes of experiencing persistent negative
moods that make it more likely that worriers will be motivated to use
systematic processing. Firstly negative mood states are associated with
increased performance standards (Cervone, Kopp, Schaumann, &
Scott, 1994; Scott & Cervone, 2002). Negative moods are also associated
with an increased desire on the part of the individual experiencing the
negative mood to try to understand and repair their mood (Schwarz &
Clore, 1983). Furthermore, the negative moods experienced by worriers
(e.g. sadness and anxiety) are related to uncertainty, and this can result
in systematic processing (Tiedens & Linton, 2001), see the sections on
Intolerance of uncertainty and Cognitive models for more information
on the role that uncertainty plays in worry.
Dash and Davey (2012) examined the role that mood plays in
sufciency thresholds in a worry context. Participants were induced
into either a negative or neutral mood state and then indicated the extent that they would feel accountable, responsible, want control, and
have a high need for cognition within a worry context. An individual's
sufciency threshold (estimated by summing the scores for appraisals
of accountability, responsibility, desire for control, and need for cognition)
indicates the likelihood that they will engage in systematic processing,
with a higher sufciency threshold indicating a greater likelihood. Individuals induced into a negative mood state had a signicantly higher sufciency threshold than individuals induced into a neutral mood state, and
the sufciency threshold was found to mediate the association between
negative mood and self-reported worry.

S.R. Dash et al. / Clinical Psychology Review 33 (2013) 10411056

8.2. Accountability
Accountability is dened as the pressure to justify one's opinions to
others. It promotes effortful information processing in an attempt to
avoid judgements that could cause embarrassment (e.g., Livingston &
Sinclair, 2008). Experimental manipulations of accountability involve
informing the high accountability group that they will need to justify
their ideas to others (e.g. Erb, Pierro, Mannetti, Spiegel, & Kruglanski,
2007). Tetlock (1983) argued that if the participant is aware of the
views of the individual that they are accountable to, then they can
adopt a heuristic-style approach and simply select the socially acceptable viewpoint. However, if the participant is unaware of the views of
the person they are accountable to then they may wish to engage in
more effortful processing so that they can successfully justify their
views. According to the accountability hypothesis proposed by Tetlock
(1983), effortful processing should occur in the group of individuals
who are justifying their views to an individual whose views are unknown, but not when they are justifying their ideas to an individual described as liberal or conservative. In the latter groups, Tetlock predicted
that a tactical attitudinal shift would occur, with the participant moving
the attitudes that they have to justify closer to that of the liberal or conservative person. Tetlock carried out such an experiment; participants
were either told that they would have to justify their views to a group
whose views were known (liberal or conservative) or unknown, or
they were not told that they would have to justify their ideas. The pattern of results obtained by Tetlock (1983) supported the hypotheses
outlined above, and suggests that accountability only motivates more
effortful information processing when the heuristic of agreeing with
the other person's views is not available.
The notion of individuals striving to nd socially-acceptable
viewpoints ts with the existence of socially-motivated worries (see
Impression motivation, p.35), whereby worriers endorse items such as
I worry about saying or doing the wrong thing among strangers.
What is more, accountability has been shown to inuence worry; feelings
of accountability were found to predict the worry levels of women undergoing cancer screening (Brain et al., 2008). Consequently, feelings of
accountability in worriers as identied by Brain et al. (2008) will lead to
worriers having raised sufciency thresholds.

1047

participants induced into a neutral mood (Tiedens & Linton, 2001).


Chaiken et al. (1989) reported that participants given sole responsibility
versus shared responsibility for evaluating messages were more motivated to engage in systematic processing.
Responsibility consistently emerges in factor analyses of worry content, appraisals and beliefs (Cartwright-Hatton & Wells, 1997; Langlois,
Freeston, & Ladouceur, 2000; Sugiura, 2007), and experimentally increasing responsibility increases worrying (Startup & Davey, 2003).
What is more, worriers report feeling responsible for negative outcomes
(Davey et al., 1992), which may cause the worrier to systematically process any information that they perceive to be related to potential negative outcomes.
8.4. Desire for control
Desire for control is the motive to control events in one's life and systematic processing may be deployed in an attempt to maximize control
(Burger & Cooper, 1979). Maheswaran and Chaiken (1991) report that
situational factors, such as control deprivation, and dispositional factors,
like desire for control, increase the extensiveness of message processing,
and they postulate that this is due to raised sufciency thresholds, with
the consequence that more systematic processing is required in order to
meet the sufciency threshold. Kofta and Sedek (1998) suggest that a
loss of control motivates an individual to deploy cognitive resources in
an attempt to try to regain control, and that a loss of control may in
fact free up cognitive resources for deployment in effortful processing.
Desire for control is also related to worry; clinical descriptions highlight worriers' desire to control unwanted thoughts (e.g. Roemer &
Borkovec, 1993; Wells, 1995). Borkovec (1994) explored the functionality of worry by asking worriers what purposes their worry had. Five
themes emerged, which Borkovec (1994) categorised as representing
attempts to control the environment (p.16) (superstitious avoidance
of catastrophe; actual avoidance of catastrophe) and attempts to control oneself (emotions and/or behaviours) (p. 16) (avoidance of
deeper emotional topics; coping preparation; motivating device). Evidently worriers strive to control the external world and their reactions
to it, and this high desire for control will result in raised sufciency
thresholds, making it more likely that systematic processing of worryrelated information will be deployed.

8.3. Responsibility
8.5. Need for cognition
Responsibility is closely related to task importance and, as such, is
another factor that is associated with systematic processing. Salkovskis,
Rachman, Ladouceur and Freeston (1992, cited in Salkovskis, Richards,
& Forrester, 1995) dene responsibility as the belief that one has
power which is pivotal to bring about or prevent subjectively crucial
negative outcomes (p. 285). Manipulations of responsibility include
informing participants that their responses will have a large inuence
(e.g., [your responses] may inuence the budget received by such students) versus no inuence (e.g., your responses are of no real importance beyond the purpose of this experiment) (e.g., Startup & Davey,
2003). Bohner et al. (1995) have suggested that responsibility increases
systematic processing by increasing task importance and raising sufciency thresholds. Some authors have linked responsibility to Tetlock's
(1983) conception of accountability. For example, individuals may engage in responsible processing when they are consciously concerned
about their reputation as a thinker (Uleman, 1989). Uleman (1989) suggests that systematic processing can form part of responsible processing, in which individuals are motivated to scrutinise information with
greater intentional control to ensure that it meets accountability standards (for others and themselves). Worriers appear to hold worry in
high regard, as a method of responsible processing, endorsing items
such as worrying is a sign of a good person and I would be selsh if I
never worried (Cartwright-Hatton & Wells, 1997). Interestingly, perceptions of responsibility are affected by mood states; individuals induced into a negative mood reported feeling more responsible than

Need for cognition (NFC) is dened as a need to structure relevant


situations in meaningful, integrated ways (Cohen, Stotland, & Wolfe,
1955, p. 291), and individuals who possess high levels of NFC are likely
to nd systematic processing less aversive in terms of its cognitive expenditure. The ways in which an individual wishes to structure information to make it meaningful and integrated vary as a function of
individual and situational factors (Cohen et al., 1955). Batra and
Stayman (1990) found that high NFC individuals demonstrated greater
elaboration of ideas relating to a message. Cacioppo, Petty, and Morris
(1983) provided individuals with messages varying in argument quality. Participants who were high NFC showed a greater impact of argument quality on their post-message attitudes, indicating that they had
deployed systematic processing to a greater extent than their low NFC
counterparts. Cohen et al. (1955) suggest that situations in which an
individual is unable to achieve the amount of cognition that they desire,
such as situations that are ambiguous, create frustration. What is more,
Cohen et al. (1955) demonstrated that individuals who are high/medium NFC more readily identify situations as being ambiguous than lowNFC individuals. This raised perception of ambiguity is likely to increase
an individual's desire to systematically process information.
Meyer et al. (1990) did not nd evidence to suggest that worriers
have a high dispositional level of NFC generally, but there are indications
that, when it comes to thinking about worry-relevant information, perseverative worriers prefer to think about the information and nd

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S.R. Dash et al. / Clinical Psychology Review 33 (2013) 10411056

meaning. For example, high worriers are more likely to endorse as


many as can stop rules, which specify that a task should be completed
fully and properly (e.g., Startup & Davey, 2001). For more information
on as many as can stop rules, see Integrated affect and cognition
models section. Worriers also endorse beliefs that worry helps to plan
the future more effectively (Cartwright-Hatton & Wells, 1997), and
provides the opportunity to analyse situations and work out the pros
and cons (Davey, Tallis, & Capuzzo, 1996). The desire that worriers
have to think through issues related to worries, in part because of the
belief that worrying is useful, will raise their sufciency threshold and
increase the amount of effortful thinking that is required.
8.6. Intolerance of uncertainty
As noted in the introduction to this section, it is not just the variables
identied in the social psychology literature (negative mood, accountability, responsibility, desire for control, and need for cognition) that
affect an individual's sufciency threshold; variables linked to perseverative worry may also affect sufciency thresholds. One such variable is
intolerance of uncertainty (IU) (Ladouceur, Talbot, & Dugas, 1997),
which was dened by Ladouceur, Blais, Freeston, and Dugas (1998) as
the way in which an individual perceives information in uncertain
situations and responds to this information with a set of cognitive,
emotional and behavioral reactions (p. 141). More recently, IU was dened by Koerner and Dugas (2008) as a dispositional characteristic
that arises from a set of negative beliefs about uncertainty and its
connotations and consequences (p. 631). IU appears to be underpinned
by two factors (for a review, see Birrell, Meares, Wilkinson, & Freeston,
2011). These have been interpreted as representing prospective IU
(anxiety about encountering uncertainty) and inhibitory IU (paralysis
in the face of uncertainty) (Carleton, Norton, & Asmundson, 2007;
McEvoy & Mahoney, 2011). Prospective IU appears to be associated
with worry and compulsions, whereas inhibitory IU is more associated
with social anxiety, panic and agoraphobia, and depression (McEvoy &
Mahoney, 2011). This highlights that IU is a transdiagnostic construct,
but focusing on specic aspects of IU may be fruitful in understanding
specic symptoms, such as worry.
Worriers frequently couch their worries in the form of what if?
questions and because most worries are based on negative things that
might happen in the future, it is difcult for the individual to know
whether they will or won't occur. This not knowing is experienced as
an unpleasant state and gives rise to IU. A number of studies have demonstrated that IU correlates with trait worry4 (e.g., Buhr & Dugas, 2006).
In Dugas, Gagnon, Ladouceur, and Freeston's (1998) cognitive model of
GAD, IU plays a central role, and is posited to drive what if?
questioning (see the Cognitive models section on the IU model of
worry). High IU individuals hold processing biases that result in the perception of ambiguous or uncertain events as threatening and intolerable
(Butler & Mathews, 1983, 1987), despite the low probability of such
events actually occurring (Ladouceur et al., 1997). Signicantly, given
these processing biases, high IU individuals also perceive negative
events as more probable in uncertain situations than low IU individuals
(MacLeod, Williams, & Bekerian, 1991). In addition, perhaps as a strategy for identifying possible negative outcomes, high IU individuals seek
more information before making decisions that they are condent
with (Carleton, Sharpe, & Asmundson, 2007).
Chaiken et al. (1989) state that seeking out and integrating all
relevant information is characteristic of systematic processing, and as
reviewed above, information-seeking is characteristic of high IU individuals. Searching for more information has been used as an indicator of
systematic processing in a number of studies (e.g. Grifn et al., 2008),
which suggests that high IU is associated with the deployment of systematic processing. Given that high IU individuals require more information
4
De Bruin et al. (2007) found that, while IU predicted trait worry, there was little, if any
association between IU and idiosyncratic worry bouts.

than their low IU counterparts in order to be condent in their decision


making (Carleton, Sharpe, & Asmundson, 2007; Ladouceur et al., 1997;
Tallis, Eysenck, & Mathews, 1991), high IU individuals may have high sufciency thresholds (i.e., lower condence levels than they desire). One
strategy that individuals may activate in an attempt to minimise this discrepancy is to seek more information, which may result in the use of
what if? thinking in an attempt to consider all possible negative outcomes of a given ambiguous situation.
IU is also implicated in raised sufciency thresholds through its association with desire for control. There is evidence suggesting a link between IU and desire for control, in the context of psychopathology.
Freeston, Rhaume, Letarte, Dugas, and Ladouceur (1994) emphasise
the role of control processes in their description of the manifestation
of IU as behavioural attempts to control the future and avoid uncertainty (p.799). This is reected in the dominant measure of IU, the Intolerance of Uncertainty Scale (Freeston et al., 1994), which includes items
that assess attempts to control future events. Sookman and Pinard
(2002) demonstrated an association between IU in OCD and a need
for control. Furthermore, Moulding and Kyrios (2007) found that IU
could be predicted by an individual's control cognitions, and that desire
for control was correlated with the obsessivecompulsive sub-domain
of IU and perfectionism. Evidence of an association between IU and a
strong desire for control has also been found in the context of anorexia
nervosa (Sternheim, Konstantellou, Startup, & Schmidt, 2011). It has
been suggested that the association between a desire for control and
IU might arise because of a form of IU described as a need to know
what will happen (Niceli & Castelfranchi, 2001), and Mushtaq, Bland,
and Schaefer (2011) suggest that the perception and estimation of uncertainty might play a key role in monitoring processes and the evaluation of the need for control (p.249). Thus, IU may raise sufciency
thresholds due to its effects on desire for control, and subsequently result in more systematic processing. Linked to this, worriers also have elevated evidence requirements (Tallis et al., 1991), which will raise their
desired level of condence in their judgements. As such, one way that IU
might be related to extended worry bouts is through raised sufciency
thresholds, which lead the individual to process worry-relevant information in a detailed manner.
8.7. Low problem-solving condence
Another variable associated with perseverative worry that also has
implications for an individual's sufciency threshold is problemsolving condence. Problem-solving condence is dened as an
individual's self-assurance in a wide range of problem-solving activities,
a belief and trust in one's problem-solving abilities (general problemsolving self-efcacy) and coping effectiveness (Heppner & Lee, 2002,
p. 347). Problem-solving is pivotal to the way in which some authors
dene worrying. Davey (1994) describes worrying as a constructive
and appropriate task-oriented process that contributes to the solving
of problems and the reduction of anxiety (p.327). Problem-solving
has been postulated as the adaptive form of worry (Borkovec et al.,
1983; Mathews, 1990) and worriers endorse the belief that worrying
is a useful process for solving problems. For example, worriers are
more likely to report believing that worrying helps me to solve problems (Cartwright-Hatton & Wells, 1997) and worrying gives me the
opportunity to analyze situations and work out the pros and cons
(Davey, Tallis, & Capuzzo, 1996), than non-worriers. Davey et al.
(1992) suggest that worry is deployed as a coping strategy aimed at
solving problems, but argue that it is when this adaptive, problemsolving worry is disrupted that pathological worry occurs. Davey et al.
(1992) suggest two ways in which the problem-solving process may become disrupted in chronic worriers. Firstly, they suggest that worriers
may adopt an emotion-focused coping strategy, rather than coping
strategies aimed at dealing with the cause of the stress. This is reected
in Robichaud and Dugas' (2005) assertion that worriers have a negative
problem-orientation, which they dene as a set of dysfunctional

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attitudes toward social problem-solving (p.391). Individuals who possess negative problem-orientations are more likely to experience high
levels of worry, and emotional problem-orientation has been identied
as a stronger predictor of worry than cognitive or behavioural indicators
(Dugas, Freeston, & Ladouceur, 1997). Secondly, Davey et al. (1992)
suggest that worriers may have low problem-solving condence (PSC),
which prevents successful closure of the worry process.
Worriers may not feel condent that they have met the goals for
their worrying (i.e., they may have a raised sufciency threshold) due
to the relationship between worry and low problem-solving condence.
Within the HSM, Chaiken et al. (1989) emphasise that when individuals
have not met their sufciency threshold, they are more likely to deploy
systematic information processing. The amount of condence that individuals have in their judgement can be represented by a judgemental
condence continuum. At one point on this continuum is the amount
of condence that an individual desires in the judgement that they are
making, such as whether they have worried as much as possible
(i.e., the sufciency threshold). Another important point on this continuum is the amount of condence that individuals currently have in their
judgement (i.e., their actual amount of condence). When there is a
negative discrepancy between these two points, with actual condence
being lower than desired condence, individuals are motivated to try to
minimise this discrepancy. Worriers with low PSC are likely to have a
large discrepancy between their desired level of condence and their
actual level of condence. The sufciency principle suggests that individuals will engage in greater amounts of systematic processing (i.e., detailed, integrative processing) when heuristic processing (or small
amounts of systematic processing) does not confer the desired level of
condence (Chaiken et al., 1989). This is because systematic processing
is generally thought to provide greater condence in our judgements
(Bohner et al., 1995; Chaiken et al., 1989; Chen et al., 1996; Chen
et al., 1999).
Petty, Briol, and Tormala (2002) suggest that metacognitions
individuals' thoughts and awareness of their own thoughts and thought
processes, such as how condent they are in their thoughts play an
important role in forming judgements. They found that when individuals were condent in the validity of their thoughts, valenced cognitive
responses were more predictive of attitudes. When problem-solving
condence is low, individuals have greater feelings of uncertainty
(Tormala, Rucher, & Seger, 2008). This uncertainty means that individuals with low problem-solving condence are more likely to feel that
they have not met their sufciency threshold (i.e., their actual condence in their judgement is lower than their desired condence), meaning that low problem-solving condence should result in a greater
deployment of systematic processing. A number of studies have indicated that when individuals feel uncertain, they are more likely to deploy
detailed processing (e.g., Weary & Jacobson, 1997). This is probably
because when individuals feel certain, they feel condent that they
have sufcient knowledge, whereas when they feel uncertain, they are
not condent that they have sufcient knowledge, and so seek more information. In the case of the worrier, this may lead to reassurance seeking, searching for more information, and/or extended bouts of thought
about worry-relevant issues.
There are a number of problem-solving based reasons for anticipating that worriers will deploy systematic processing. Firstly, worriers exhibit low problem-solving condence (Belzer & Maydeu-O., 2002;
Davey, 1994; Davey & Levy, 1998a; Davey et al., 1992), and this increases the likelihood that their judgements will be deemed inadequate.
Secondly, worriers frequently couch their worries in terms of personal
inadequacy (Davey & Levy, 1998a, 1998b), which is likely to give rise
to the belief that their judgements may not be accurate or effective.
Lastly, worriers have been identied as having negative problemorientation (Dugas et al., 1997; Robichaud & Dugas, 2005). A negative
problem-orientation is dened as perceived threat of problems to
well-being, self-inefcacy or doubt over one's problem-solving ability,
the tendency to be pessimistic about the outcome, and low frustration

1049

tolerance (Robichaud & Dugas, 2005, p. 391), and therefore is a characteristic that will reduce an individual's actual condence.
9. Motivation for systematic processing
The sufciency threshold is just one of the factors inuencing
whether individuals deploy systematic information processing. The second key factor is the individual's level of motivation. Individuals are
economy-minded, and as long as valid heuristic cues are present in
the environment, systematic processing will only occur when the individual is sufciently motivated to justify the extra cognitive expenditure.
A number of motivational factors have been identied (accuracy-,
defence- and impression-motivation) and were incorporated into the
multiple-motive framework of the HSM (Chaiken et al., 1989). These
are typically linked to the goals that an individual has for processing
the information. It should be acknowledged that the HSM assumes
that both systematic and heuristic processing can enable an individual
to satisfy their motivational goals (Chaiken et al., 1989), however, this
review will be limited to occasions when systematic processing is
deployed. Individuals are likely to hold more than one motive, and the
descriptions below should be considered to refer to a primary motivation, rather than a sole motivating force (Chen & Chaiken, 1999).
9.1. Accuracy motivation
Chaiken et al. (1989) originally formulated the HSM around the goal
of assessing the validity of persuasive messages. They describe accuracy
motivation as the desire to form or to hold valid, accurate attitudes
(p.214). In worriers, this may relate to the assessment of all threat information when assessing whether a negative outcome could occur.
Characteristics of worriers increase the likelihood that they are
motivated to ensure that their appraisal/judgement of a situation is
accurate and valid (i.e., they possess high levels of accuracy motivation). For example, worriers believe that worrying is a necessary process to engage in to avoid future threats and problems (e.g. Davey,
Tallis, & Capuzzo, 1996). Furthermore, worriers believe that it is important to think about the issues as much as possible when worrying.
One theoretical perspective that has shed light on worriers' motivation to do as much as possible is the mood-as-input hypothesis
(Davey, 2006b; Meeten & Davey, 2011) (Please see the Integrated affect and cognition models section for more detail on this model.), as
evidenced by their endorsement of the use of the as many as can stop
rule for worry. The as many as can stop rule is adopted by worriers
when they engage in an open-ended worry bout; it is a goal that worriers
hold, either implicitly or explicitly, to continue worrying until they have
done as much as possible to deal with or resolve the worry. For example,
an individual whose goal is to feel prepared would continue worrying
until they felt they had done all that they could to feel prepared. This deployment of as many as can goal-directed stop rules supports the notion
that worriers will be motivated to attain accurate judgements of whether
an issue has been fully resolved (Davey et al., 2005).
9.2. Defence motivation
Individuals can be motivated by a desire to form or to defend particular attitudinal positions (p. 234, Chaiken et al., 1989). This is known as
defence motivation. Individuals who are motivated to defend particular
attitudinal positions have the goal of conrming the validity of these
particular attitudinal positions and disconrming the validity of any
other attitudinal positions. Individuals who are defence-motivated and
utilise systematic processing will do so selectively. Defence-motivated
systematic processing involves focusing on attitude-relevant information that backs the attitudinal position that the individual wishes to
preserve. Alternatively, it may include focusing on information that opposes the unsupported attitudinal position, and lead to less favourable
interpretations of information that opposes the favoured position or

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supports alternative positions. Giner-Sorolila and Chaiken (1997) found


that students relied on heuristic cues when their viewpoints were supported by such cues, but used systematic processing when hostile heuristic cues were presented.
Defence motivation could come into play when worriers seek to defend the beliefs that they hold about worrying. Worry is an unpleasant
experience, and chronic worriers experience increasing distress as a
worry bout progresses (Vasey & Borkovec, 1992). Cognitive dissonance
theory would predict that worriers would hold some positive beliefs
about why they worry in order to integrate the negative experience of
worry with the compulsion to worry, and thus maintain a sense of internal consistency (Festinger, 1957). Indeed, a number of authors have
identied that chronic worriers hold positive beliefs about deploying
worry as a coping strategy, including beliefs such as worrying keeps
me in control, in order to get something done I have to worry about
it, worrying gives me the opportunity to analyse situations and work
out the pros and cons, and by worrying, I reorganise and plan my
time better (e.g. Borkovec, Hazlett-Stevens, & Diaz, 1999; CartwrightHatton & Wells, 1997; Davey, Tallis, & Capuzzo, 1996; Wells & Carter,
1999). Thus, worriers may process information about their worries in
a way that allows them to continue to hold these positive beliefs
about the utility of worry. Additionally, worriers hold a number of
strong beliefs about the negative consequences of worry, such as worrying increases my anxiety and so decreases my performance, worrying makes me irrational, and worrying distorts the problem I have
and so I am unable to solve it (Davey, Tallis, & Capuzzo, 1996). Altering
the beliefs that worriers hold about worrying forms a central tenet of
metacognitive therapy for GAD (e.g. Wells, 1999) (see the Cognitive
Models section for more information on the metacognitive model of
worry). Thus worriers may process information about their worries in
a way that allows them to maintain both positive and negative beliefs
about worrying.

9.3. Impression motivation


The third processing goal identied in Chaiken et al.'s (1989)
multiple-motive framework is impression motivation. Impressionmotivated individuals have a desire to express attitudes that will be
socially acceptable to potential evaluators, both real and imagined
(Chaiken et al., 1989, p. 234). Thus when individuals are impressionmotivated their processing goal is to assess whether a particular attitudinal position is more socially-acceptable than alternatives. What is
considered socially-acceptable will vary from situation to situation.
The desire to hold a socially-acceptable attitude is typically heightened
when individuals believe that they may have to share it with others or
justify it to others. Furthermore, Chaiken et al. (1989) suggest that impression motivation is more likely when individuals are made aware
of interpersonal relationships, or when the identities or group membership of signicant others is emphasised. Chaiken et al. (1989) suggest
that high levels of impression-motivation can manifest in both systematic and heuristic processing. If an individual's attitudinal position is
known, an individual can use a simple agreement heuristic, such as
agreement facilitates liking. But similarly, they may apply systematic
processing to ensure that their ideas are socially acceptable.
Impression-motivated attitudes are strategic, and although they can
become internalised, they more frequently reect concessions to situational pressures and usually revert to original positions when the situational pressures are removed. When processing systematically to
achieve the goal of assessing whether an attitudinal position is socially
acceptable, the individual gives more extensive consideration to the
detail of the attitudinal messages, and whether they are sociallyacceptable. Chen et al. (1996) found that when participants were
instructed to have a pleasant interaction with another individual,
impression-motivated individuals expressed attitudes that were similar
to those of their partner, reecting the use of the go along to get along

heuristic. It was also found that use of this heuristic biased subsequent
systematic processing in impression-motivated participants.
Impression motivation also appears to be a feature of chronic
worriers. The Anxious Thoughts Inventory (Wells, 1994), which was
designed as a multidimensional measure of worry, includes a social
worry subscale. The social worry subscale consists of items such as I
worry about saying or doing the wrong thing among strangers and I
worry that people don't like me. Individuals with GAD were found to
be comparable to individuals with social anxiety on the social worry
subscale, highlighting the importance of social worries in GAD (Wells
& Carter, 2001). Furthermore, Purdon and Harrington (2006) highlight
the role of worry-type processes in social anxiety, which they claim
has anticipatory anxiety as a hallmark feature.
10. Summary
There is evidence to suggest that worriers have raised sufciency
thresholds as they (1) experience negative mood, (2) are intolerant of
uncertainty, (3) have a discrepancy between their desired condence
and actual condence in their judgements, (4) feel accountable and responsible, (5) and desire control of, and have a high need for cognition
about worry-relevant information. What is more, (6) worriers are motivated to ensure that judgements that they make about worries are accurate, t with their understanding of the world, and are socially acceptable.
Consequently worriers have a high propensity to deploy systematic processing during worry bouts.
11. Similarities between worry and systematic processing
There are many similarities between systematic processing as an effortful form of information processing and chronic worrying. For example as outlined above, systematic processing is associated with raised
sufciency thresholds. Individuals will exert increasing levels of analytical effort to attain a degree of condence that they have achieved their
processing goals and appraisals relevant to responsibility and accountability contributing to raising this sufciency threshold. Similar processes appear to underlie perseverative worry. First, chronic worriers
possess personality characteristics that will raise the threshold for feeling condent that goals associated with judgements and decisions have
been successfully met (e.g., perfectionism, IU, inated concerns over
mistakes) (Dugas et al., 1997; Frost, Marten, Lahart, & Rosenblate,
1990; Pratt, Tallis, & Eysenck, 1997; Stber & Joormann, 2001). Worriers
also exhibit cognitive appraisal processes known to facilitate systematic
processing, such as feelings of responsibility and accountability for outcomes (Wells & Carter, 2001; Wells & Papageorgiou, 1998).
Secondly, metacognitive approaches to understanding pathological
worry argue that chronic worriers possess metacognitive beliefs that
worrying is a necessary process to engage in to successfully avoid future
threats (Borkovec et al., 1999; Davey, Tallis, & Capuzzo, 1996; Wells,
1995), and such beliefs will inevitably raise sufciency thresholds to ensure that whatever level of effort is required is deployed to successfully
engage with the worry and achieve the necessary levels of condence
that the worry has been dealt with.
In addition to these processing similarities, systematic processing
and worrying appear to share similar functional brain characteristics.
Systematic processing appears to be supported by a functionally distinct
brain process located in the left frontal lobes (Leynes, 2002; Leynes &
Phillips, 2008; Nolde et al., 1998), and studies have reported evidence
that increases in worrying are associated with increased left hemisphere frontal activation (Borkovec et al., 1998). Furthermore, successful treatments for worry-related diagnoses such as GAD lead to
signicant reductions in left hemisphere activation (Hoehn-Saric,
Schlund, & Wong, 2004). This is consistent with systematic processing
and worrisome thought both being predominantly left hemisphere activities (Carter et al., 1986) involved in the systematic, verbal processing
of information. What is more, high worriers have been shown to have

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1051

restricted working memory capacity during worry (Hayes, Hirsch, &


Mathews, 2008; Leigh & Hirsch, 2011) and this may reect the fact
that perseverative worriers are employing a more effortful cognitive
strategy than low worriers, and thus have less available working memory capacity.

metacognitive model, and the cognitive model of worry), models with


a primary emotional/affective focus (the emotion dysregulation and
the acceptance based models) and integrative models placing equal emphasis on cognition and emotion (the avoidance model, and the moodas-input model) (Behar et al., 2009).

12. Worry as a form of systematic processing

13.1. Cognitive models

While systematic processing and worrying share many factors in


common, they are not the same thing. Both represent forms of effortful,
analytic thought, but systematic processing is deployed in a broad range
of judgement tasks having both personal and social signicance. For example, systematic processing can be deployed in decision making, such
as treatment decisions in prostate cancer (Steginga & Occhipinti, 2004),
and when forming attitudes (Martin & Hewstone, 2003). Systematic
processing also plays a role when processing risk information (Kahlor
et al., 2003) and when deciding who to vote for (Forehand, Gastil, &
Smith, 2004). Systematic processing can be an adaptive strategy to
overcome biases in our cognitive processing and can provide greater accuracy when making judgements that can be misled by heuristics
(Tversky & Kahneman, 1974).
Systematic processing might be viewed as a form of analytic thought
that many individuals might call worrying, but more properly represents constructive problem-solving in which activities such as logical
analysis, problem-solving, information-seeking, and active behavioural
coping all play a central role (Davey, 1994). It is only when this adaptive,
analytical process is thwarted that the characteristics of pathological
worrying begin to emerge (e.g., increasing emotional discomfort,
catastrophising, perceived lack of control over the worry process). If systematic processing is the effortful, analytic, verbally-based thought that
many researchers have also used to dene worrying (Borkovec & Inz,
1990; Freeston, Dugas, & Ladouceur, 1996), then pathological worrying
is additionally dened by those processes that thwart the effectiveness
of systematic processing. Such processes may involve low PSC (Davey,
1994; Davey, Jubb, & Cameron, 1996), metacognitions about the negative consequences of worrying (Wells, 1995), feelings of personal inadequacy (Davey & Levy, 1998b), IU (Dugas, Buhr, & Ladouceur, 2004) and
an avoidance coping style (see Berenbaum, 2010, for some further examples of processes that may thwart closure of the worry process).
Exploring systematic processing as a mechanism of perseverative
worry has the potential to bridge the gap between theories of worry
at the level of clinical constructs, such as IU, and explanations of proximal mechanisms that underlie worry perseveration. Indeed, because
of its theoretical purity as a functionally-distinct effortful form of analytical thought, systematic processing may be a truly transdiagnostic process that is involved in a range of perseverative, pathological thought
processes, including rumination, worrying, brooding, doubting, and
hyper-vigilant scanning to name but a few. A better understanding of
the proximal mechanisms involved in worry perseveration offers the
promise of effective, theoretically-informed and targeted interventions
for worry-based mental health problems.

The cognitive models of worry appear to be consistent with the idea


that worriers hold raised sufciency thresholds (greater discrepancies
between desired and actual condence levels). The IU model of worry
(Dugas et al., 1997; Dugas et al., 2004) proposes that individuals with
high IU nd uncertain or ambiguous situations very distressing, and
that this triggers what if? thinking, as well as a negative problemorientation and heightened cognitive avoidance, which maintains
worry. Recent examinations of the IU construct have shown that IU
has two underlying latent components: prospective IU and inhibitory
IU (Carleton, Norton, & Asmundson, 2007; McEvoy & Mahoney, 2011).
Prospective anxiety is anxiety in anticipation of uncertainty, whereas
inhibitory anxiety is inaction in the face of uncertainty. Given that
systematic processing requires considerable cognitive effort (i.e., it is
characterised by action rather than inaction) it is interesting that prospective IU is a signicant predictor of GAD, whereas inhibitory IU is
not (McEvoy & Mahoney, 2011).
The distinction between systematic and heuristic processing shares
similarities with the top-down and bottom-up processes described by
Hirsch and Mathews (2012) in their cognitive model of worry. In this
model, worry is posited to arise from an interaction between involuntary bottom-up and voluntary top-down processes. Based on evidence
that worriers show biases in attention to threat cues and threat interpretation biases, Hirsch and Mathews incorporate involuntary
bottom-up processes, which they describe as pre-existing biases and
habitual thought patterns (p. 638). Biases allow us to process information with less cognitive effort; if a feature consistent with a threat is
identied, the worrier will identify the situation as a threat, without
analysing and integrating all information about the situation. This is
consistent with Shah and Oppenheimer's (2008) denition of heuristics
as processes that allow decision makers to process information in a less
effortful manner than one would expect from an optimal decision rule
(p. 207). Hirsch and Mathews (2012) describe that role that top-down
processes can have once intrusions are experienced: Intrusions perceived as problems to be resolved tend to provoke efforts to deal with
them taking verbal form, as if searching for possible answers to questions in the form of What if ? (p. 639). This verbal, analytical thinking style in response to intrusions shares similarities with Chaiken
et al.'s (1989) denition of systematic processing as detailed, analytical
thought about issue-relevant information.
The metacognitive model of worry (Wells, 1995, 2006) acknowledges the importance of two kinds of worry. Type 1 worry occurs in response to anxiety-provoking stimuli and is associated with positive
beliefs about worry, such as believing that worry will help the individual
to cope. Type 2 worry is activated during Type 1 worry, and is associated
with negative beliefs about the danger and uncontrollability of worry.
Type 2 worry is then suggested to result in a range of unhelpful strategies deployed in an attempt to control worry, including reassurance
seeking, checking and thought suppression. While it is harder to accommodate negative beliefs within the systematic information processing
model, it may be that the associated distress causes a heightened
negative mood. As reported above, Bohner et al. (1988) suggest that
causal thinking reduces the intensity of emotions, and can function as
a mood control strategy.

13. Systematic processing and models of worry


In order to appreciate the role that conceiving of systematic information processing may have in our understanding of perseverative worry,
it is important to consider current theoretical conceptualisations. Five
prominent models of perseverative worry were identied in a review
by Behar, DiMarco, Hekler, and Staples (2009): the cognitive avoidance
model (Borkovec, 1994), the IU model (Dugas et al., 2004), the
metacognitive model (Wells, 1999), the emotion dysregulation model
(Mennin, Heimberg, Turk, & Fresco, 2002), and the acceptance-based
model (Roemer & Orsillo, 2005). Two additional models are the
mood-as-input model (Davey, 2006b), and Hirsch and Mathews'
(2012) cognitive model of worry. These models can be broadly distinguished into models with a primary cognitive focus (the IU model, the

13.2. Emotion-based models


The utility of detailed, analytical thinking as a vehicle for regulating
emotions (Bohner et al., 1988) also suggests a way that systematic

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processing may t with the emotional theories of worry, i.e., it may be


deployed by individuals in an attempt to understand, regulate or repair
the endemic negative mood experienced by worriers. The emotion
dysregulation model of worry (Mennin, Heimberg, Turk, & Fresco,
2005) incorporates the idea that worry as a form of cognitive avoidance
is driven by an individual's response to, and regulation of, emotional experience. Individuals with GAD experience more intense negative emotions, poorer understanding of emotions, greater negative reactivity to
emotional experiences, and are less effective at self-soothing (Mennin
et al., 2005; Salters-Pedneault, Roemer, Tull, Rucker, & Mennin, 2006).
It is hypothesised that the strategies used by individuals with emotion
dysregulation may actually lead to them feeling worse and this increased negative mood may drive systematic processing (e.g., Ambady
& Gray, 2002; Batra & Stayman, 1990; Tiedens & Linton, 2001). The
acceptance-based model of worry (Roemer & Orsillo, 2005) has four
components including aversive negative reactions to internal experiences, problematic fusion between internal experiences, avoidance
and behavioural restriction. Like the emotional dysregulation model,
this theory is in its infancy and greater research, including longitudinal
designs and experimental manipulation of components of the model,
is required to be condent in the relationship between the components
of the proposed acceptance-based model and perseverative worry
(Behar et al., 2009). Nonetheless, this model also highlights the importance of negative emotional states in worry, and such states have been
shown to raise sufciency thresholds in an experimental study (Dash
& Davey, 2012).
13.3. Integrated affect and cognition models
There are also models that have integrated cognitive and affective
aspects. The avoidance model of worry (Borkovec, 1994) is based on
the idea that worry is a verbal linguistic activity that individuals engage
in to avoid processing more distressing images and the somatic and
emotional activation that would accompany experiencing such images.
Worry is then negatively reinforced because the avoidance of unpleasant imagery leads to positive beliefs in the utility of worry. The linguistic
nature of systematic processing may make it an appealing cognitive
avoidance activity for the worrier. Indeed, the neurobiological overlap
seen in studies that have identied left frontal lobe activation in worry
and systematic processing (Borkovec et al., 1998; Leynes, 2002;
Leynes & Phillips, 2008; Nolde et al., 1998) most likely reects that
both are verbal-based forms of analytical thought (Carter et al., 1986;
Evans, 2008). Verkuil, Brosschot, Borkovec, and Thayer (2009) measured heart rate and heart rate variability during three conditions:
worry, problem-solving about a personally irrelevant issue, and relaxation. Verkuil et al. (2009) found that heart rate was higher and heart rate
variability was lower during the worry and problem-solving conditions
than the relaxation condition. This difference was not accounted for by
the participants' emotional responses (assessed using visual analogue
scales). Consequently, Verkuil et al. (2009) claim that mere mental
load is responsible for at least a part of the physiological effects of
worry (p. 439). This is consistent with the notion that worriers are
using effortful information processing but does not necessarily support
the notion that worriers do this in order to avoid more negative emotional experiences.
Worry is typically open-ended; there is no denite end-point. Consequently, an individual must make a decision about whether to continue with their worry bout, or terminate it. The mood-as-input model of
worry (Davey, 2006b; Meeten & Davey, 2011) suggests that individuals
use their mood to decide if they have met their worry goals According to
the mood-as-input theory, mood provides information about whether
the stop rules have been met (Davey, 2006b). Stop rules are criteria
for deciding when to stop a task, and as such, are conceptualised as decision rules (e.g., Vaughn, Malik, Schwartz, Petkova, & Trudeau, 2006).
For example, if an individual is worrying, they may apply either an as
many as can (AMA) stop rule, whereby they believe that they must

do as much worrying as possible, or a feel like continuing (FLC) stop


rule, which involves stopping when the worry process is no longer
something that they feel like doing (Davey et al., 2005). If individuals
are in a negative mood and using an AMA rule, their negative mood suggests that the task has not been completed as much as possible (positive
mood is usually experienced when a task is completed), and individuals
are likely to persevere at the task. The mood-as-input model is consistent with the idea that worriers have goals which they wish to be condent that they have met (i.e., whether they have done as much as
they can), and is similar to the emotion-based models in that it highlights the importance of negative affect (which can trigger systematic
processing).
The existing models have provided us with a better understanding of
the cognitive and affective components of worry, and the way that affect
and cognition might interact to bring about, or at least maintain, bouts
of worry. However, it is not always clear from these models exactly
how the constructs identied in these models (e.g., intolerance of uncertainty, positive beliefs about worry) lead to an individual generating a
chain of worry thoughts. One of us (GCLD) has argued before that the
details of how such causal relationships are mediated will be found in
proximal explanations of the activity of worrying, which determine the
onset, duration and sequential properties of worry bouts (Davey,
2006b, p. 218). Such proximal explanations need not compete with
existing models of worry, rather they provide an explanation at a different level of elaborative detail. Conceiving a role for systematic processing in perseverative worry offers a way of unifying these different
models through a couple of mechanisms. First, the sufciency threshold
principle holds that the greater the negative discrepancy between desired condence and actual condence (i.e., when desired condence
is lower than actual condence), the more likely it is that an individual
will deploy effortful chains of thought in an attempt to minimise this
discrepancy. Consequently, factors in the models of worry that account
for either increased desired condence and/or lowered actual condence can be understood to increase the discrepancy. Factors from the
models reviewed above that would be expected to raise the desired
amount of condence include intolerance of uncertainty surrounding
negative outcomes (Dugas et al., 2004), holding positive metacognitive
beliefs about the usefulness of worry for managing problems, while concurrently holding beliefs that worry is dangerous (Wells, 1999), and
striving to do as much as possible in the form of the deployment of as
many as can stop rules for worrying (Davey, 2006b). Secondly, many
of these models of worry emphasise the role of negative mood as either
a direct or indirect driving process for perseverative worrying, and it is
well known that negative mood is a trigger for perseverative, effortful
thought in the form of systematic information processing (e.g., Ambady
& Gray, 2002; Batra & Stayman, 1990; Tiedens & Linton, 2001). In
addition, negative mood facilitates the endorsement of cognitive appraisals known to increase systematic as opposed to heuristic processing (Dash & Davey, 2012). As such, the activation of systematic
processing by negative mood states offers a mechanism to explain
how negative mood may activate worrying within a number of theories
of pathological worrying.
Apart from these direct links to theories of worrying, systematic
information processing is a form of decision-making that is well
researched, offers a proximal explanation for the way in which worrying becomes a perseverative and effortful activity, and posits some setting conditions (e.g. raised sufciency thresholds, negative mood) that
trigger worrying. It spans many of the constructs found in contemporary models of worrying, including intolerance of uncertainty, perfectionism, low problem-solving condence, positive beliefs about the
utility of worrying, and attempts to avoid negative mood states.
14. Clinical implications
As outlined in this review, the heuristicsystematic model (HSM)
has important implications for our theoretical views of perseverative

S.R. Dash et al. / Clinical Psychology Review 33 (2013) 10411056

worrying, and we introduce some of these implications for future research here. Firstly, the HSM does not specify what combination of factors that promote or thwart systematic processing manifests in the
deployment of systematic processing. Future work should aim to determine whether the raised sufciency thresholds of worriers result in the
deployment of systematic processing. This will require the development
of procedures that provide a more direct measurement of systematic
processing (c.f. Dash & Davey, 2012) and can be applied to the worry
context. Secondly, while this review article has focused on systematic
processing, the HSM also includes heuristic processing, and the heuristics that are relevant to the worry process should be examined. Such
heuristic cues could include selective engagement with threat cues, as
an example of threat processing biases that worriers possess (Hirsch
et al., 2011), but could also include behaviours such as reassurance seeking (Rector, Kamkar, Cassin, Ayearst, & Laposa, 2011), which ts well
with the notion of the consensus heuristic (O'Keefe, 2002). It is likely
that heuristic processing of threat cues acts to bias the individual's subsequent systematic processing, as shown by Chaiken and Maheswaran
(1994). Lastly, sufciency thresholds should be examined in clinical
populations, with the aim of guiding therapeutic interventions based
on a greater understanding of the variables that drive prolonged
worry bouts.
When considering the therapeutic implications of conceiving of systematic processing as a processing style that occurs in worrying, it is
rst necessary to acknowledge that there will be conditions in which
this is a useful, adaptive processing style. Systematic processing is
more resistant to the sorts of biases and errors that can occur when relying upon heuristic processing (e.g., Tversky & Kahneman, 1974). However, while avoiding errors in thinking is desirable when making
important decisions, such as which house to buy, it is less critical
when thinking about less important issues, such as which sandwich to
buy for lunch. High worriers report more worries about minor things
than low worriers (Roemer, Molina, & Borkovec, 1997), suggesting
that they apply detailed thought to issues that others do not deem necessary. One possible useful application of the HSM to the GAD therapeutic context is that socialisation to two processing modes, an effortful
mode and a less-effortful mode, allows therapists to engage in a dialogue with clients about when effortful processing is warranted and
when it is not.
The application of the HSM to perseverative worrying highlights that
attention should be paid to the appraisals that worriers hold about the
importance of their task, such as feeling accountable (e.g., Brain et al.,
2008) and desiring control (e.g., Freeston et al., 1994), as these appraisals raise sufciency thresholds (e.g., Chaiken et al., 1989), increasing the likelihood that an individual will feel the need to consider
worry thoughts in detail. Thus, conceiving of systematic processing as
a mechanism involved in perseverative worry provides a theoretical
framework for the use of cognitive-behavioural therapy (Covin,
Ouimet, Seeds, & Dozois, 2008) and metacognitive therapy for GAD
(Wells & King, 2006).
Furthermore, Hirsch and Mathews (2012) suggest that the existence
of top-down and bottom-up processes involved in worry perseveration
indicate that the most effective treatments for worry are likely to be
those that tackle both types of processes. Treatments which focus on
cognitive bias modication (Hakamata et al., 2010) may alter bottomup/heuristic-type processing, while those that focus on, for example,
modifying metacognitive beliefs about the usefulness/danger of worry
(Wells & King, 2006) may alter an individual's sufciency threshold,
and subsequent likelihood of deploying systematic processing.
Finally, given that negative mood has been shown to increase sufciency thresholds, and that this was associated with higher levels of
worry (Dash & Davey, 2012), there is a need for treatments that address
the role of low mood and the treatment of comorbid depression in high
worriers. Therapeutic techniques such as behavioural activation may
serve to improve mood (Dobson et al., 2008) and has recently been applied to the treatment of worry in a pilot trial (Chen, Liu, Rapee, & Pillay,

1053

2013). Improved mood, as shown by reduced depression scores in Chen


et al.'s (2013) study, may prevent worriers from entering into a perseverative worry bout.
15. Summary and concluding remarks
Worry can be conceived as a multifaceted phenomenon, consisting
of identifying problems, threat anticipation, and chains of catastrophic,
negative thinking (Borkovec et al., 1983; Davey, 1993, Mathews,
1990). The HSM provides a theoretical basis for understanding how individuals process information. This model has been successfully applied
to persuasion, risk perception and decision-making, and additionally
has relevance to clinical psychopathology. Key dispositional factors
exhibited by worriers negative mood, IU, and low PSC are all likely
to widen the gap between individuals' actual level of condence and
their desired level of condence (the sufciency threshold), and the
HSM suggests that in order to meet their sufciency thresholds, worriers will deploy systematic processing. It is an exciting prospect for
both psychopathology research and clinical practice that raised sufciency thresholds and increased systematic processing may provide a
fuller understanding of the proximal mechanisms underlying perseverative worry an understanding that is derived from core psychological
knowledge which will help to explain why worry is such a universal
phenomenon.
Acknowledgements
We thank the two anonymous reviewers for their helpful comments on an earlier version of this manuscript. This article was written
while GCLD and FM were funded by ESRC grant RES-062-23-2336.
SD was funded by a University of Sussex Graduate Teaching Assistant
Studentship.
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