Stop Rules for Worrying & Checking: A Metacognitive Factor in Perseverative Psychopathologies Graham Davey University of Sussex, UK

Collaborators Benie MacDonald Helen Startup Gary Britton Suzanne Dash Frances Meeten Fergal Jones

Introduction  Perseveration is a defining element of many psychopathologies  Examples include worrying (GAD), checking (OCD), rumination (in major depression)  Perseverative activities are usually ‘neutralizing’ activities  Linked to meta-cognitive and global beliefs about how to deal with distressing emotions

What are ‘stop rules’? Relate to Task Motivation Performance Focused OR Task Focused ‘Enough’ OR ‘Enjoy’ ‘As Many as Can’ (AMA) OR ‘Feel Like Continuing’ (FL)

What do we know about stop rules?  Often not easily verbalizable  Can often be derived from dispositional characteristics or meta-beliefs about emotional control strategies  Stop rule type is linked to mood  Stop rules interact with mood to determine perseveration at a task (the ‘Mood-as-Input Hypothesis’, Davey, 2006, Startup & Davey, 2001).

Stop Rule x Mood Interaction Effects  Hawksley & Davey (2010)  Depressive Rumination Task  Participants asked to iterate what had made them feel depressed during a recent episode of depression  Both mood (positive v negative) and stop rule (AMA v FL) were manipulated

Hawksley & Davey (2010)

Perseverative Worrying Manipulating Stop Rule (Startup & Davey, 2001) Stop Rules & Responsibility (Startup & Davey, 2003) Stop Rule deployment in High & Low Worriers (Davey et al., 2005) Do stop rules change during a worry bout? (Davey et al., 2007)

The Catastrophizing Interview 1.I’m worried about not being able to move 2.That I would be attacked in some way 3.That I would not be able to fight back 4.That I would not be able to control what other people did to me 5.That I would feel inadequate 6.That other people would begin to think I was inadequate 7.That in my relationship with those people I would not be respected 8.That I would not have any influence over others 9.That other people would not listen to me 10.That it would cause a loss of self-esteem 11.That this loss of self-esteem would have a negative effect on my relationships with others 12.That I would lose friends 13.That I would be alone 14.That I would have no-one to talk to 15.Because it would mean that I would not be able to share any thoughts/problems with other people 16.That I would not get advice from others 17.That none of my problems would be adequately sorted out 18.That they would remain and get worse 19.That eventually I would not be able to cope with them 20.That eventually my problems would have more control over me than I had over them 21.That they would prevent me from doing other things 22.That I would be unable to meet new people and make friends 23.That I would be lonely

Manipulating Stop Rules in High & Low Worriers

Characteristics leading to the deployment of AMA stop rules

AMA – ‘Enough’FL – ‘Enjoy’ Worry Stop Rule Check List  I must find a solution to this problem, so keep thinking about it.  I must try and think about the worst possible outcome, just in case it happens  I must think everything through properly  What’s done is done, so what’s the point in worrying?  I don’t have time to think about this now  Stop worrying, things always work out for the best.

Davey, Startup, MacDonald, Jenkins & Patterson (2005)

What ends a worry bout? - Mood changes during worrying

Changes in Stop Rule Endorsement

Perseverative Checking Compulsive checkers deploy AMA stop rules (Meyer, Fisher & Wells, 2009) Termination of rituals often based on subjective stop criteria Explanatory constructs such as ‘Inflated Responsibility’ interact with mood (MacDonald & Davey, 2005) It is the goal-directed nature of checking that causes perseveration, not its complexity

MacDonald & Davey (2005) Black = High Responsibility White = Low Responsibility

Stop Rule is not Independent of Mood Negative mood facilitates endorsement of AMA checking stop rules (Gary Britton) Negative mood facilitates endorsement of AMA worry stop rules (Suzanne Dash)

Britton & Davey (2011) Mood & Checking Stop Rules

Dash & Davey (2011) Mood & Worrying Stop Rules

Dash & Davey (2011) Systematic Processing & AMA deployment mediate effect of Negative Mood on Worry Scores

Summary  AMA Stop Rules + Negative Mood = Perseveration  Perseveration is not a Dispositional Style  Perseveration is a Performance Factor caused by a configuration of stop rule and mood  Deployment of AMA stop rules is facilitated by Negative Mood

Future Directions  More Research on Stop Rules in Clinical Populations  Characteristics of Clinical Populations Facilitate Mood-as- Input Processes  Mood-as-Input as a Mechanism for Acquisition of Perseverative Activities  Mood-as-Input as a Transdiagnostic Process  Mood & Stop Rule Awareness Interventions