Studies that attempt to models stress have been limited by the ambiguity surrounding the stress concept. To address this conceptual lacuna, this article proposes a new approach to conceptualizing stress. Through a historical survey of ideas relating to stress, clarity will be brought to the conception of stress through a synthesis of insights on the nature of stress arousal, particularly focusing on the dynamic of generation of stress in the mind. Stress, resulting from both positively and negatively appraised events, is experienced in proportion to the certainty with which we assess an impact to something to which we have attachment (Sanskrit, upãdãna), whether physical or ideological. Ultimately, this ancient conception of the psychological dynamic of stress has borne fruit in philosophy, religion, and psychotherapy, making it a sound candidate for a fundamental psychological conception of stress.

This study examined the associations between attachment style and cognitive style and depression and anxiety symptomatology. Using a college sample of 167 participants, the tripartite model of depression and anxiety (Clark & Watson, 1991) was employed to examine whether the construct of negative affectivity could account for the previously reported relationships between insecure attachment style and negative cognitive style and both depression and anxiety. Negative cognitive style and insecure attachment were found to be significantly associated with both depression and anxiety symptomatology. Although negative affectivity effectively accounted for the relationships between negative cognitive style and both depression and anxiety and could explain the relationship between insecure attachment and anxiety, it failed to account for the association between insecure attachment and depression. In addition, negative cognitive style and insecure attachment appeared to be independently and uniquely associated with negative affect, rather than forming a mediational relationship.

Worrying can be distinguished from other forms of negative thinking, and it is a central feature of Generalised Anxiety Disorder (GAD). It is argued that both the occurrence and the appraisal of worrying have potentially damaging consequences for emotional well-being. Worrying is part of a cognitive-attentional syndrome maintaining emotional disturbance, and negative appraisal of worrying is central in GAD. The maintenance of pathological worrying can be linked to particular metacognitive beliefs about worry. In the metacognitive model of GAD (Wells, 1995), erroneous metacognitive beliefs and negative appraisals concerning worry, and resulting responses, are an engine driving specific disorder maintenance loops. The model has important treatment implications, and has led to the development of a metacognitive-focused treatment for GAD which is described.

Among the huge accumulation of psychological books offered in libraries and book stores, a relative few volumes stand out in an otherwise deluge of self-help exhortations, and discuss the psychotherapeutic process itself. Of that small portion, most consist of self-congratulatory case histories from professional therapists. Few volumes come from patients. The author, a long-term psychotherapy patient, briefly summarizes lessons gained in one of the most difficult processes a human can endure. The essay criticizes the current emphasis on psychotropic medication and equates anesthetizing unpleasant emotions, particulary depression, to shooting the messenger. Unpleasant emotions, like physiological pain, act as the body’s signals that something needs attention. Drugging them into insensitivity in the belief that they stem from unbalanced chemistry cures nothing. The argument offers an admittedly more difficult alternative that preserves the natural signal functions of depression, anxiety, and fear.

Patients with advanced cancer often experience debilitating anxiety symptoms that interfere with quality of life and relate to worse medical outcomes. Although cognitive-behavioral therapy (CBT) is an empirically validated, first-line treatment for anxiety disorders, clinical trials of CBT for anxiety typically exclude patients with medical comorbidities in general, and those with terminal illnesses, such as advanced cancer, in particular. Moreover, CBT has generally targeted unrealistic fears and worries in otherwise healthy individuals with clinically significant anxiety symptoms. Consequently, traditional CBT does not sufficiently address the cognitive components of anxiety in patients with cancer, especially negative thought patterns that are rational but nonetheless intrusive and distressing, such as concerns about pain, disability, and death, as well as management of multiple stressors, changes in functional status, and burdensome medical treatments. In this article, we describe a treatment approach for tailoring CBT to the needs of this population. Three case examples of patients diagnosed with terminal lung cancer are presented to demonstrate the treatment methods along with outcome measures for anxiety and quality of life.

Considerable research has supported links between disrupted parental bonding, attachment insecurity, and psychopathology. Still, few studies have attempted to integrate these findings within a broader cognitive theory of anxiety. Two studies are presented that examine the links between cognitive vulnerability to anxiety (i.e., the Looming Maladaptive Style: LMS) and parental bonding (Study 1) and perceived parental attachment orientations during childhood (Study 2). Results of Study 1 suggest that low levels of maternal overprotection and high levels of paternal overprotection significantly predict LMS scores, beyond the effects of current anxious and depressive symptoms. Results of Study 2 suggest that retrospective reports of maternal attachment insecurity are associated with significantly higher LMS scores, anxious and depressive symptoms, adult romantic attachment insecurity, and potentially high-risk relationship behaviors. These results are interpreted from the perspective of the Looming Vulnerability Model of anxiety and may increase understanding of the linkage between childhood developmental antecedents and cognitive risk for anxiety.

Although it has been fairly well established that symptoms of anxiety are often present in patients with irritable bowel syndrome (IBS), less is known about the role of worry and intolerance of uncertainty in this population. This study investigates the relations among these variables in a sample of treatment-seeking IBS patients. Although the results are preliminary, worry does seem to predict gastrointestinal symptom severity and, when combined with a measure of current anxiety, accounts for almost 30% of the variance. Intolerance of uncertainty differentiated diarrhea-predominant IBS patients from constipation-predominant IBS patients. Earlier research has taken a psychiatric perspective on anxiety in IBS patients—the current study may provide some support for shifting our focus to the cognitive biases that may be operating in IBS patients, regardless of the presence of an anxiety disorder. Implications for a cognitive therapy approach to IBS treatment are discussed.

Bowlby’s attachment theory contends that all individuals develop working models of self and significant others, based on early experiences, that have important implications for understanding adult psychopathology. From a social cognitive perspective these “working models” can be conceptualized in terms of relational schemas that have the same functions as other types of schemas (e.g., organizing information, guiding future behavior, etc.). Cognitive vulnerability models have proposed a pessimistic explanatory style that confers vulnerability to depression and a looming maladaptive style that confers vulnerability to anxiety. The present study examines the pattern of relationships between adult romantic attachment, cognitive vulnerabilities to anxiety and depression, self-reported anxious and depressive symptoms, and both general and specific relationship outcomes. Results suggest that higher levels of attachment insecurity were associated with increased psychological symptoms, higher levels of cognitive vulnerabilities, and greater general and relationship impairments. Moreover, cognitive vulnerabilities partially mediated the relationship between adult attachment and anxious and depressive symptoms, suggesting that insecure attachments may represent a developmental antecedent to cognitive vulnerabilities to anxiety and depression.

The present study explored the relationships between metacognitions, negative emotions, and procrastination. A convenience sample of 179 participants completed the following questionnaires: General Procrastination Scale, Decisional Procrastination Scale, Meta-cognitions Questionnaire 30, Penn State Worry Questionnaire and Hospital Anxiety and Depression Scale. A cross-sectional design was adopted and data analysis consisted of correlation and multiple regression analyses. One dimension of metacognitions was found to be positively and significantly correlated with behavioral procrastination. Four dimensions of metacognitions were found to be positively and significantly correlated with decisional procrastination. Positive and significant relationships were also observed between anxiety, depression and behavioral procrastination; and between anxiety, depression, worry, and decisional procrastination. Multiple regression analyses indicated that depression and beliefs about cognitive confidence independently predicted behavioral procrastination, and that depression and positive beliefs about worry independently predicted decisional procrastination. These preliminary results would seem to suggest that metacognitive theory may be relevant to understanding procrastination.

Anxiety sensitivity is the fear of anxiety sensations based on beliefs that they have harmful physical, psychological, or social consequences. Anxiety sensitivity may represent a psychological vulnerability for panic attacks, but much of the research to date has been limited to selective college student or treatment-seeking samples. There is a paucity of research based on representative community-based samples. There is also a lack of longitudinal research in this regard. The current study addressed both of these issues by investigating the impact of anxiety sensitivity in a large community sample (N = 585) assessed longitudinally over a 1-year period. A hierarchical regression model was used to determine whether baseline scores on the Anxiety Sensitivity Index (ASI) could prospectively predict scores on the Beck Anxiety Inventory (BAI), a continuous scale that is largely a measure of panic-related symptomatology. Baseline BAI scores, neuroticism and stressful life events’ main effects, their interaction, and the ASI were all significant predictors of Time 2 BAI scores. The results thereby show that anxiety sensitivity predicts subsequent panic-related symptomatology even after adjusting for the effects of neuroticism, stressful life events, and their interaction.