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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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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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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
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
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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
Worry
Accountability
Systematic
processing
Worry
Responsibility
Systematic
processing
Worry
Need for cognition Systematic
processing
Worry
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).
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.
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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
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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
1050
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
1051
1052
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,
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