The Cognitive Content of Thought-Listed Worry Episodes in Clinic-Referred Anxious and Nonreferred Children

Abstract

We investigated the cognitive content of worry in 8- to 13-year-old clinic-referred anxious (n = 38) and nonreferred (n = 51) children. The children were interviewed individually. They thought-listed their latest worry episodes, rated the uncontrollability of the episodes, and reported on the strategies they used to terminate worry. Content analyses showed that children's worry episodes contained predominantly thoughts reflecting negative outcome anticipation, but other types of thought content also were present. These included problem-solving, ruminating, and self-blaming thoughts. Compared to clinic-referred children, nonreferred children reported more problem solving and less ruminating. In the nonreferred group, increasing age was associated with more problem solving and less ruminating. No such age-related associations were found in the clinic-referred group. The 2 groups did not differ in the types of worry-termination strategies they reported, but clinic-referred children were more likely to keep worrying until the perceived threat was removed. The results suggest that the problem-solving function of worry is still emerging during late childhood and that developmental delays in problem solving may be associated with excessive and uncontrollable worrying.

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