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Worrying is the mental distress or agitation resulting from anxiety, usually coming from a place of anticipatory fear (terror) or fear coming from a present threat (horror). [1] With more understanding about the situation, worry usually transforms into what is concern, recognizing an uncertain future outcome that could be troubling, without necessarily having fear in that outcome. [2]
Worry is a category of perseverative cognition, i.e. a continuous thinking about negative events in the past or in the future. [3] As an emotion "worry" is experienced from anxiety or concern about a real or imagined issue, often personal issues such as health or finances, or external broader issues such as environmental pollution, social structure or technological change.[ citation needed ] It is a natural response to anticipated future problems. Excessive worry is a primary diagnostic feature of generalized anxiety disorder, but also is pervasive in other psychological disorders, like schizophrenia. [4]
Most people experience short-lived periods of worry in their lives without incident; indeed, a mild amount of worrying has positive effects, if it prompts people to take precautions (e.g., fastening their seat belt or buying insurance) or avoid risky behaviors (e.g., angering dangerous animals, or binge drinking), but with excessive worrisome people they overestimate future dangers in their assessments and in its extremities tend to magnify the situation as a dead end which results in stress. Overestimation happens because analytic resources are a combination of external locus of control, personal experience and belief fallacies. Chronically worried individuals are also more likely to lack confidence in their problem solving ability, perceive problems as threats, become easily frustrated when dealing with a problem, and are pessimistic about the outcome of problem-solving efforts. [5]
Seriously anxious people find it difficult to control their worry and typically experience symptoms like restlessness, fatigue, difficulty in concentrating, irritability, muscle tension and sleep disturbance.
The avoidance model of worry (AMW) theorizes that worry is a verbal linguistic, thought based activity, which arises as an attempt to inhibit vivid mental imagery and associated somatic and emotional activation. [7] This inhibition precludes the emotional processing of fear that is theoretically necessary for successful habituation and extinction of feared stimuli. [8] Worry is reinforced as a coping technique due to the fact that most worries never actually occur, leaving the worrier with a feeling of having successfully controlled the feared situation, without the unpleasant sensations associated with exposure. [9] Noteworthy, studies also show that visual worry, i.e. worrying that occurs in visual modality, is also associated with increased anxiety and other psychopathology symptoms. [10]
This model explains pathological worry to be an interaction between involuntary (bottom-up) processes, such as habitual biases in attention and interpretation favoring threat content, and voluntary (top-down) processes, such as attentional control. Emotional processing biases influence the probability of threat representations into the awareness as intruding negative or positive thoughts. At a pre-conscious level, these processes influence the competition among mental representations in which some correspond to the assertive power of worry with impaired cognitive process and others to the preventive power of worry with attentional control or exhaustive vigilance. The biases determine threatening degree and nature of worry content the worrier attempts to resolve the perceived threat and the redirection of anticipations, responses and coping in such situations. [11]
There are some who respond to mental representations in an uncertain or ambiguous state in regard to the stressful or upsetting event. [12] In this state the worrier is held in a perpetual state of worry. This is because availability of an overwhelming number (maybe 2 or 3, depending upon the worry-prone individual) of possibilities of outcomes which can be generated, it puts the worrier in a threatening crisis and they focus their attentional control voluntarily on the potential negative outcomes, whereas others engage in a constructive problem solving manner and in a benign approach rather than to engage with heightened anticipation on the possible negative outcome. [13]
Greek thinkers such as stoic philosopher Epictetus and Seneca advised against worry. Albert Ellis, the creator of Rational Emotive Behavior Therapy, was inspired by the Stoics’ therapeutic ideas. [14]
The biblical word used in Hebrew for worry (Hebrew : דָּאַג, daag) regards worry as a combined form of fear and sorrow which affects nephesh, the totality of our being. The bible takes a fortitude-strengthening approach regarding worrying e.g. Psalm 94:
In the New Testament, the Gospel of Matthew encourages:
The Greek word used for worry in Matthew is merimnaō, [17] which means to be anxious about, or to be troubled with cares.
St. Paul writes to the Philippian church, "There is no need to worry" [18] and in the pastoral epistles, 2 Timothy 1:7 emboldens:
Similarly James 1:2-4 motivates to face trials of any kind with joy, because they produce endurance (strength and courage). Further Saint Peter reveals his understanding of healthy living in Second Peter 1:3,5–7:
A late Indian spiritual teacher Meher Baba stated that worry is caused by desires and can be overcome through detachment:
The worry system is activated from exposure to a potential triggering event, traumatic experience or vulnerability, this brings worrisome thoughts and feelings which bring about physical stress reactions and response to avoid worrisome behavior, to ensure allostasis. But under the crisis this activity feeds back into the first worrisome thoughts and feelings which generates and strengthens the vicious worry cycle. Relaxation, risk assessment, worry exposure, exercises such as yoga, and behavior prevention may be effective in curbing excessive worry, a chief feature of generalized anxiety disorder. [21] [22] Cognitive behavioral techniques hasn't branched out enough to address the problem holistically but therapy can control or diminish worry. [23]
Anxiety is an emotion which is characterised by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different from fear in that fear is defined as the emotional response to a present threat, whereas anxiety is the anticipation of a future one. It is often accompanied by nervous behavior such as pacing back and forth, somatic complaints, and rumination.
Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. Cognitive behavioral therapy is one of the most effective means of treatment for substance abuse and co-occurring mental health disorders. CBT focuses on challenging and changing cognitive distortions and their associated behaviors to improve emotional regulation and develop personal coping strategies that target solving current problems. Though it was originally designed to treat depression, its uses have been expanded to include many issues and the treatment of many mental health and other conditions, including anxiety, substance use disorders, marital problems, ADHD, and eating disorders. CBT includes a number of cognitive or behavioral psychotherapies that treat defined psychopathologies using evidence-based techniques and strategies.
A phobia is an anxiety disorder, defined by an irrational, unrealistic, persistent and excessive fear of an object or situation. Phobias typically result in a rapid onset of fear and are usually present for more than six months. Those affected go to great lengths to avoid the situation or object, to a degree greater than the actual danger posed. If the object or situation cannot be avoided, they experience significant distress. Other symptoms can include fainting, which may occur in blood or injury phobia, and panic attacks, often found in agoraphobia and emetophobia. Around 75% of those with phobias have multiple phobias.
Anxiety disorders are a cluster of mental disorders characterized by significant and uncontrollable feelings of anxiety and fear such that a person's social, occupational, and personal functions are significantly impaired. Anxiety may cause physical and cognitive symptoms, such as restlessness, irritability, easy fatigue, difficulty concentrating, increased heart rate, chest pain, abdominal pain, and a variety of other symptoms that may vary based on the individual.
Hypochondriasis or hypochondria is a condition in which a person is excessively and unduly worried about having a serious illness. Hypochondria is an old concept whose meaning has repeatedly changed over its lifespan. It has been claimed that this debilitating condition results from an inaccurate perception of the condition of body or mind despite the absence of an actual medical diagnosis. An individual with hypochondriasis is known as a hypochondriac. Hypochondriacs become unduly alarmed about any physical or psychological symptoms they detect, no matter how minor the symptom may be, and are convinced that they have, or are about to be diagnosed with, a serious illness.
Generalized anxiety disorder (GAD) is a mental and behavioral disorder, specifically an anxiety disorder characterized by excessive, uncontrollable and often irrational worry about events or activities. Worry often interferes with daily functioning, and individuals with GAD are often overly concerned about everyday matters such as health, finances, death, family, relationship concerns, or work difficulties. Symptoms may include excessive worry, restlessness, trouble sleeping, exhaustion, irritability, sweating, and trembling.
Behaviour therapy or behavioural psychotherapy is a broad term referring to clinical psychotherapy that uses techniques derived from behaviourism and/or cognitive psychology. It looks at specific, learned behaviours and how the environment, or other people's mental states, influences those behaviours, and consists of techniques based on behaviorism's theory of learning: respondent or operant conditioning. Behaviourists who practice these techniques are either behaviour analysts or cognitive-behavioural therapists. They tend to look for treatment outcomes that are objectively measurable. Behaviour therapy does not involve one specific method, but it has a wide range of techniques that can be used to treat a person's psychological problems.
In applied psychology, interventions are actions performed to bring about change in people. A wide range of intervention strategies exist and they are directed towards various types of issues. Most generally, it means any activities used to modify behavior, emotional state, or feelings. Psychological interventions have many different applications and the most common use is for the treatment of mental disorders, most commonly using psychotherapy. The ultimate goal behind these interventions is not only to alleviate symptoms but also to target the root cause of mental disorders.
In psychology, desensitization is a treatment or process that diminishes emotional responsiveness to a negative, aversive, or positive stimulus after repeated exposure. Desensitization can also occur when an emotional response is repeatedly evoked when the action tendency associated with the emotion proves irrelevant or unnecessary. The process of desensitization was developed by psychologist Mary Cover Jones and is primarily used to assist individuals in unlearning phobias and anxieties. Desensitization is a psychological process where a response is repeatedly elicited in circumstances where the emotion's propensity for action is irrelevant. Joseph Wolpe (1958) developed a method of a hierarchal list of anxiety-evoking stimuli in order of intensity, which allows individuals to undergo adaptation. Although medication is available for individuals with anxiety, fear, or phobias, empirical evidence supports desensitization with high rates of cure, particularly in clients with depression or schizophrenia. Wolpe's "reciprocal inhibition" desensitization process is based on well-known psychology theories such as Hull's "drive-reduction" theory and Sherrington's concept of "reciprocal inhibition." Individuals are gradually exposed to anxiety triggers while using relaxation techniques to reduce anxiety. It is an effective treatment for anxiety disorders.
Exposure therapy is a technique in behavior therapy to treat anxiety disorders. Exposure therapy involves exposing the patient to the anxiety source or its context. Doing so is thought to help them overcome their anxiety or distress. Numerous studies have demonstrated its effectiveness in the treatment of disorders such as generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder (PTSD), and specific phobias.
Rumination is the focused attention on the symptoms of one's mental distress, and on its possible causes and consequences, as opposed to its solutions, according to the Response Styles Theory proposed by Nolen-Hoeksema in 1998.
Interoceptive exposure is a cognitive behavioral therapy technique used in the treatment of panic disorder. It refers to carrying out exercises that bring about the physical sensations of a panic attack, such as hyperventilation and high muscle tension, and in the process removing the patient's conditioned response that the physical sensations will cause an attack to happen.
A persecutory delusion is a type of delusional condition in which the affected person believes that harm is going to occur to oneself by a persecutor, despite a clear lack of evidence. The person may believe that they are being targeted by an individual or a group of people. Persecution delusions are very diverse in terms of content and vary from the possible, although improbable, to the completely bizarre. The delusion can be found in various disorders, being more usual in psychotic disorders.
Panic disorder is a mental and behavioral disorder, specifically an anxiety disorder characterized by reoccurring unexpected panic attacks. Panic attacks are sudden periods of intense fear that may include palpitations, sweating, shaking, shortness of breath, numbness, or a feeling that something terrible is going to happen. The maximum degree of symptoms occurs within minutes. There may be ongoing worries about having further attacks and avoidance of places where attacks have occurred in the past.
Separation anxiety disorder (SAD) is an anxiety disorder in which an individual experiences excessive anxiety regarding separation from home and/or from people to whom the individual has a strong emotional attachment. Separation anxiety is a natural part of the developmental process. It is most common in infants and little children, typically between the ages of six to seven months to three years, although it may pathologically manifest itself in older children, adolescents and adults. Unlike SAD, normal separation anxiety indicates healthy advancements in a child's cognitive maturation and should not be considered a developing behavioral problem.
Safety behaviors are coping behaviors used to reduce anxiety and fear when the user feels threatened. An example of a safety behavior in social anxiety is to think of excuses to escape a potentially uncomfortable situation. These safety behaviors, although useful for reducing anxiety in the short term, might become maladaptive over the long term by prolonging anxiety and fear of nonthreatening situations. This problem is commonly experienced in anxiety disorders. Treatments such as exposure and response prevention focus on eliminating safety behaviors due to the detrimental role safety behaviors have in mental disorders. There is a disputed claim that safety behaviors can be beneficial to use during the early stages of treatment.
Metacognitive therapy (MCT) is a psychotherapy focused on modifying metacognitive beliefs that perpetuate states of worry, rumination and attention fixation. It was created by Adrian Wells based on an information processing model by Wells and Gerald Matthews. It is supported by scientific evidence from a large number of studies.
Jonathan Stuart Abramowitz is an American clinical psychologist and Professor in the Department of Psychology and Neuroscience at the University of North Carolina at Chapel Hill (UNC-CH). He is an expert on obsessive-compulsive disorder (OCD) and anxiety disorders whose work is highly cited. He maintains a research lab and currently serves as the Director of the UNC-CH Clinical Psychology PhD Program. Abramowitz approaches the understanding and treatment of psychological problems from a cognitive-behavioral perspective.
Distress tolerance is an emerging construct in psychology that has been conceptualized in several different ways. Broadly, however, it refers to an individual's "perceived capacity to withstand negative emotional and/or other aversive states, and the behavioral act of withstanding distressing internal states elicited by some type of stressor." Some definitions of distress tolerance have also specified that the endurance of these negative events occur in contexts in which methods to escape the distressor exist.
Marcantonio M. Spada is an Italian-British academic psychologist who has studied the role of metacognition in addictive behaviours and operationalised the constructs of "desire thinking" and the "COVID-19 anxiety syndrome". He is currently Professor of Addictive Behaviours and Mental Health and Dean of the School of Applied Sciences at London South Bank University. He is also editor-in-chief of Addictive Behaviors.
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