Randomized trial examines how cognitive mechanisms predict worry behaviours in undergraduates, suggesting targeted interventions.
OBJECTIVES: The purpose of this study was to examine the extent to which the primary mechanisms implicated in leading models of Generalized Anxiety Disorder (GAD) (i.e. cognitive avoidance, metacognitive beliefs and intolerance of uncertainty) uniquely predict reassurance seeking and other behaviours associated with worry (e.g. checking and avoidance). We hypothesized that each of these mechanisms would uniquely contribute to higher levels of reassurance seeking and other worry behaviours. We also hypothesized that all three mechanisms would interact to predict the highest levels of these behaviours. METHODS: Undergraduate students (N = 204) who self-reported high levels of worry on the Penn State Worry Questionnaire were administered measures of cognitive mechanisms implicated in GAD (Cognitive Avoidance Questionnaire, Metacognitions Questionnaire, Intolerance of Uncertainty Scale), reassurance seeking (Covert and Overt Reassurance Seeking Inventory) and worry-related safety behaviours and avoidance (Worry Behaviours Inventory). Hypotheses were tested via multiple regression. RESULTS: Consistent with the first hypothesis, cognitive avoidance and intolerance of uncertainty uniquely predicted reassurance seeking and worry behaviours; however, metacognitions significantly contributed to reassurance seeking only. Exploratory analyses using the Worry Behaviours Inventory subscales (avoidance vs. safety behaviours) as outcomes demonstrated that the effects of some mechanisms depended on the type of behavioural strategy. Contrary to the second hypothesis, there was no evidence of interactions among the predictors. CONCLUSIONS: All three of the main theorized mechanisms of GAD were sufficient to predict reassurance and at least one type of worry behaviour. Future directions and clinical implications that follow from the results are highlighted.
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Crawford et al. (2026) studied this question.
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