ISSN 2043-8087
Journal of Experimental Psychopathology
 Volume 1, Issue 1, 133-145, 2010
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Metacognitive Theory and Therapy for Worry and Generalized Anxiety Disorder: Review and Status

Adrian Wells
School of Psychological Sciences, University of Manchester, UK, & Dept. of Psychology, NTNU, Norway

Volume 1, Issue 1, 2010, Pages 133-145

The metacognitive model of pathological worry and Generalized Anxiety Disorder (GAD) makes a crucial distinction between two types of worry and explains the persistence and uncontrollability of negative thinking as an effect of specific metacognitions. The negative appraisal of worry (meta-worry) and negative beliefs about worry are central to the development of GAD. Furthermore, GAD is associated with paradoxes in mental control such as the use of extended thinking to reduce thinking. Evidence is reviewed that supports major tenets of the model. A specific treatment, metacognitive therapy is described that focuses on modifying metacognitive beliefs and reducing the use of worry to cope with thoughts. The empirical status of the model is reviewed and evidence from recent trials of this treatment is summarized. The treatment appears to be effective and initial trials suggest it is associated with greater levels of recovery than approaches comprised of applied relaxation or cognitive-behavioural treatment focused on intolerance of uncertainty.

Table of Contents
A Description of the Metacognitive Model of GAD
Metacognitive Therapy
Evidence for the effectiveness of treatment
Future Directions

Correspondence to
Adrian Wells, University of Manchester, Division of Clinical Psychology, Rawnsley Building, MRI, Manchester, M13 9WL UK.

Metacognition, worry, generalized anxiety, CBT, treatment, metacognitive therapy

Received 4 May 2010; Revised 17 Sep 2010; Accepted 18 Sep 2010; In Press 31 Oct 2010

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