A cognitive model of generalized anxiety disorder.
GAD may be driven by beliefs about worry itself, so assess and treat those metabeliefs.
01Research in Context
What this study did
Meyer (1999) drew a map of how worry works in generalized anxiety disorder.
The paper says people keep worrying because they believe worry itself is useful.
It is a theory paper, not a treatment test.
What they found
The model shows two layers: first worry about daily problems, then worry-about-worry.
The second layer keeps the loop alive and makes anxiety stick around.
How this fits with other research
Sosa et al. (2022) also give a new lens, but theirs is feedback control loops for all behavior.
Both papers ask you to look past old boxes, yet A zooms in on GAD thoughts while Sosa widens to any response.
Malott (2018) pushes you to ground every move in JABA data; A gives you a story you still need to test with data.
Najdowski et al. (2003) warn against trusting treatment lists without digging into mechanisms; A supplies one clear mechanism to probe.
Why it matters
If your client keeps saying “I must worry or I’ll miss something,” you are hearing the metabelief loop.
Spot it, then run a brief functional assessment: what does the client think worry buys them?
Pick an intervention that targets that belief, not just the surface fear.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Ask one anxious client, “What good thing do you believe worry does for you?” and note the answer.
02At a glance
03Original abstract
A cognitive model of generalized anxiety disorder (GAD) is described. The model asserts that generalized anxiety is an abnormal worry state. In this model, GAD results from the usage of worrying as a coping strategy and subsequent negative evaluation of worrying. The use of worry as a strategy is supported by positive metabeliefs concerning worry, whereas the negative appraisal of worrying (worry about worry) is linked to negative metabeliefs developed out of previous experience. These beliefs center on the themes of uncontrollability of worries and the dangerous consequences of worrying. Negative appraisal of worrying is associated with behavioral and cognitive responses that serve to maintain unwanted thoughts, and preserve dysfunctional beliefs. A review of the literature indicates that the model is consistent with existing data. Predictions and treatment implications of the model are discussed.
Behavior modification, 1999 · doi:10.1177/0145445599234002