A qualitative analysis of generalised anxiety disorder : a cognitve behavioural theory perspective

Abstract

Studies indicate that there is room for improvement in the effectiveness of existing cognitive behavioural therapies for generalised anxiety disorder (GAD). GAD patients engage in a range of safety-seeking behaviours (SSB) but the threat belief they are trying to prevent from occurring, is unclear. This study aimed to identify GAD patients threat beliefs and related SSBs using thematic framework analysis. Based on the cognitive behavioural theory of anxiety the hypotheses put forward were that threat beliefs and SSBs would be identified among the participants. Six participants took part in the study. A central threat belief was identified as fear of failure and of inability to cope, and being responsible for it and as a result, be negatively evaluated by others. Participants also engaged in a range of SSBs to gain certainty of having prevented or minimised the consequences of threat. Intolerance for uncertainty seemed to be related to the participants need for certainty when faced with a perceived threat, thus the GAD patients were not intolerant of all uncertainty, but rather in relation to important personal goals. Other themes identified were; attentional biases, I can never make mistakes, inflated sense of responsibility, elevated evidence requirement for certainty, emotions and somatic symptoms. The results of this study may benefit clinicians in the future to better behavioural experiments for GAD patients by testing specific threat beliefs. Keywords: Generalised anxiety disorder, thematic framework analysis, threat belief, safety-seeking behaviour, cognitive behavioural theory.