Therapy focused on the reduction of threat perception (TFRTP) based on the PAMTA and ACT model to decrease pathological worry
DOI:
https://doi.org/10.33064/51crscsh4998Keywords:
anxiety, stress, worry, treatment, acceptance and commitment therapy, generalized anxiety disorderAbstract
Worry is a complex process of great adaptive utility for the human being, which is possible due to the capacity for anticipation and language. According to the PAMTA model (Perception of future threat, Activation, Motivation, Thought and Action), it reduces the probability that we are affected by different threats or mitigate their effects if they occur. However, dysfunctions are frequently observed in the worry process that is associated with different disorders, such as social anxiety, depression and, especially, generalized anxiety disorder. In the present work, the Therapy focused on the reduction of threat perception (TFRTP) is described as an intervention proposal for pathological worry based on the PAMTA model, which sequentially describes different steps to carry out the worry process in an adaptive way and points out different aspects that can make it dysfunctional. Likewise, different proposed acceptance and commitment therapy (ACT) strategies are used. The most novel aspects of the proposed treatment are: 1) it provides a guide to worry adaptively, 2) it places particular emphasis on reducing the perception of threat, in which strategies such as cognitive implosion and radiating circumference are used, and 3) The use of ACT to cope with cognitive fusion and promote psychological flexibility. Finally, some aspects of the intervention are discussed, and the need for further studies to study the efficacy of TFRTP is pointed out.
Downloads
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Assaz, D. A., Roche, B., Kanter, J. W., & Oshiro, C. K. B. (2018). Cognitive Defusion in Acceptance and Commitment Therapy: What Are the Basic Processes of Change? The Psychological Record, 68(4), 405-418. https://doi.org/10.1007/s40732-017-0254-z
Blackledge, J. (2007). Disrupting verbal processes: Cognitive defusion in acceptance and commitment therapy and other mindfulness-based psychotherapies. The Psychological Record, 57, 555-576. https://doi.org/10.1007/bf03395595
Borkovec, T.D. & Lyonfields, J.D. (1993). Worry: Thought suppression of emotional processing. En H. Krohne (Ed.), Vigilance and Avoidance (pp. 101-118). Hogrefe and Huber Publishers.
Borkovec, T. D., Ray, W. J., & Stober, J. (1998). Worry: A cognitive phenomenon intimately linked to affective, physiological, and interpersonal behavioral processes. Cognitive Therapy and Research, 22(6), 561-576. https://doi.org/10.1023/a:1018790003416
Brickman, P. & Campbell, D.T. (1971). Hedonic Relativism and Planning the Good Society. En M.H. Appley (Ed.), Adaptation-Level Theory: A Symposium (pp. 287-302). Academic Press.
Brickman, P., Coates, D., & Janoff-Bulman, R. (1978). Lottery winners and accident victims: Is happiness relative? Journal of Personality and Social Psychology, 36(8), 917-927. https://doi.org/10.1037/0022-3514.36.8.917
Chen, Y.F., Huang, X.Y., Chien, C.H., & Cheng, J.F. (2016). The Effectiveness of Diaphragmatic Breathing Relaxation Training for Reducing Anxiety. Perspectives in Psychiatric Care, 53(4), 329-336. https://doi.org/10.1111/ppc.12184
Citkowska-Kisielewska, A., Rutkowski, K., Mielimaka, M., SobanskI, J. A., & Dembinska, E. (2020). Obsessive-compulsive symptoms in obsessive-compulsive disorder and in generalized anxiety disorder: occurrence and correlations. Journal of Psychiatric Practice, 26(2), 101-119. https://doi.org/10.1097/pra.0000000000000451
Costello E., & Borkovec T.D. (1992). Generalized anxiety disorder. En A. Freeman & F.M. Dattilio (Eds.), Comprehensive Casebook of Cognitive Therapy (pp. 53-60). Plenum Press. https://doi.org/10.1007/978-1-4757-9777-0_4
Davey, G.C. (1994). Pathological worrying as exacerbated problem-solving. En G. Davey, & F. Tallis (Eds.). Worrying: Perspectives on theory, assessment and treatment (pp. 35-59). John Wiley & Sons.
Dugas, M.J., Gosselin, P. & Ladouceur, R. (2001). Intolerance of uncertainty and worry: Investigating specificity in a nonclinical sample. Cognitive Therapy and Research, 25, 551-558. https://doi.org/10.1023/A:1005553414688
Dugas, M. J., & Koerner, N. (2005). Cognitive-behavioral treatment for generalized anxiety disorder: Current status and future directions. Journal of Cognitive Psychotherapy, 19(1), 61-81. https://doi.org/ https://doi.org/10.1891/jcop.19.1.61.66326
Dugas M., Marchand A., & Ladouceur R. (2005). Further validation of a cognitive-behavioral model of generalized anxiety disorder. Diagnostic and symptom specificity. Journal of Anxiety Disorders, 19, 329-343. https://doi.org/10.1016/j.janxdis.2004.02.002
D’Zurilla, T. J., & Nezu, A. M. (2006). Problem-solving therapy: A positive approach to clinical intervention. NY: Springer.
González-Betanzos, F., Trejo-Cruz, V.H., Hermosillo de la Torre, A.E., Rivera-Heredia, M.E., Padrós Blázquez, F. (2023). Escala de Capacidad Adquirida para el Suicidio: propiedades psicométricas de la adaptación al español. Revista iberoamericana de diagnóstico y evaluación psicológica, 4(70), 111-125. https://doi.org/10.21865/RIDEP70.4.09
Jiménez Ros, A. M., Orgambidez Ramos, A., & Pascual Orts, L. M. (2015). Inventario de supresión del pensamiento del “oso blanco” (WBSI): Propiedades psicométricas de la versión portuguesa (Portugal). Revista de Psicopatología y Psicología Clínica, 20(2), 125. https://doi.org/10.5944/rppc.vol.20.num.2.2015.15167
Hayes, S. C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior therapy, 35(4), 639-665. https://doi.org/10.1016/S0005-7894(04)80013-3
Hayes, S. C., Strosahl, K., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. Guilford Press.
Hayes-Skelton, S. A., Calloway, A., Roemer, L., & Orsillo, S. M. (2015). Decentering as a potential common mechanism across two therapies for generalized anxiety disorder. Journal of consulting and clinical psychology, 83(2), 395-404. https://doi.org/10.1037/a0038305
Leahy, R. L., Holland, S. J., & Butler, A. C. (2000). Treatment Plans and Interventions for Depression and Anxiety Disorders. Journal of Cognitive Psychotherapy, 14(4), 409-410. https://doi.org/10.1891/0889-8391.14.4.409
Lee, J. K., Orsillo, S. M., Roemer, L., & Allen, L. B. (2010). Distress and avoidance in generalized anxiety disorder: Exploring the relationships with intolerance of uncertainty and worry. Cognitive Behaviour Therapy, 39, 126-136. https://doi.org/10.1080/16506070902966918
Mennin, D. S., Heimberg, R. G., Turk, C. L., & Fresco, D. M. (2005). Preliminary evidence for an emotion dysregulation model of generalized anxiety disorder. Behaviour research and therapy, 43(10), 1281-1310. https://doi.org/10.1016/j.brat.2004.08.008
Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990). Development and validation of the penn state worry questionnaire. Behaviour research and therapy, 28(6), 487-495. https://doi.org/10.1016/0005-7967(90)90135-6
Padrós Blázquez, F. (2021). El guion de vida como una posible técnica para orientar y aumentar la esperanza de las personas. Acta psiquiátrica y psicológica de América Latina. 67(1), 71-72.
Padrós-Blázquez, F., González-Betanzos, F., Martínez-Medina, M.P., & Wagner-Echeagaray, F.A. (2018). Propiedades Psicométricas del Cuestionario de Preocupación Pensilvania (PSWQ) de las Versiones Original y Reducida en Muestras Mexicanas. Actas Españolas de Psiquiatría, 46(4), 117-124.
Padrós-Blázquez, F., López-Solà, C., Cruz-García, M.A., Martínez-Medina, M.P. (2019). PAMTA Worry Model (Perception of future threat, Activation, Motivation, Thought & Action): Functional and Pathological Worry. Revista Argentina Clínica psicológica, 28(2), 190-198. https://doi.org/10.24205/03276716.2018.1088
Safran, J. D., & Segal, Z. V. (1990). Interpersonal process in cognitive therapy. Basic Books.
Starcevic, V., Berle, D., Milicevic, D., Hannan, A., Lamplugh, C., & Eslick, G. D. (2007). Pathological worry, anxiety disorders and the impact of co-occurrence with depressive and other anxiety disorders. Journal of Anxiety Disorders, 21(8), 1016-1027. https://doi.org/:10.1016/j.janxdis.2006.10.015
Tallis, F., Davey, G. C. L., & Cappuzo, N. (1994). The phenomenology of nonpathological worry: a preliminary investigation. En G. C. L. Davey, & F. Tallis (Eds.), Worrying: perspectives on theory, assessment, and treatment. (pp. 61-91). Wiley.
Velázquez-Díaz, M., Martínez-Medina, M. P., Martínez-Pérez, M., Padrós-Blázquez, F. (2016). Modelos explicativos del Trastorno por ansiedad generalizada y de la preocupación patológica. Revista de Psicología GEPU. 7(2), 156-167.
Wegner, D. M., Schneider, D. J., Carter, S. R., & White, T. L. (1987). Paradoxical effects of thought suppression. Journal of Personality and Social Psychology, 53(1), 5-13. https://doi.org/10.1037/0022-3514.53.1.5
Wells, A. (1999). A cognitive model of generalized anxiety disorder. Behavior Modification, 23, 526-555.
Wilson, K. G., & Luciano, M. C. (2002). Terapia de Aceptación y Compromiso. Un Tratamiento Conductual Orientado a los Valores. Pirámide.
Wilson, K. G., Sandoz, E. K., Kitchens, J., & Roberts, M. (2010). The Valued Living Questionnaire: Defining and measuring valued action within a behavioral framework. The Psychological Record, 60(2), 249-272. https://doi.org/10.1007/BF03395706
Yerkes, R.M., y Dodson, J.D. (1908). The relation of sthrength of stimulus to rapidity of habit formation. Journal of Comparative and Neurological Psychology. 18, 459-482. https://doi.org/10.1002/cne.920180503
Zhang, A., Park, S., Sullivan, J. E., & Jing, S. (2018). The effectiveness of problem-solving therapy for primary care patients' depressive and/or anxiety disorders: A systematic review and meta-analysis. The Journal of the American Board of Family Medicine, 31(1), 139-150. https://doi.org/10.3122/jabfm.2018.01.170270
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Ferran Padrós-Blázquez, Rocío Montoya Pérez, María Patricia Martínez Medina

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Licencia Creative Commons Atribución-NoComercial-CompartirIgual 4.0 Internacional
El lector es libre de compartir o adaptar el material en cualquier medio o formato bajo las condiciones siguientes: (a) debe reconocer adecuadamente la autoría, proporcionar un enlace a la licencia e indicar si se han realizado cambios; (b) no puede utilizar el material para una finalidad comercial y (c) si remezcla, transforma o crea a partir del material, deberá difundir sus contribuciones bajo la misma licencia que el original.
Resumen de la licencia
https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es_ES
Texto completo de la licencia
https://creativecommons.org/licenses/by-nc-sa/4.0/legalcode
Cada autor es responsable del contenido de su artículo. En el caso de un texto colectivo, el primer autor asume la responsabilidad intelectual de los resultados del proceso editorial; los autores son responsables de obtener la licencia de autor para reproducir materiales gráficos o fotográficos que pertenecen a terceros.
Los autores asumen plena responsabilidad en el caso de falsificación de datos o falta de autenticidad en la investigación. Se comprometen, también, a no reutilizar trabajos ya publicados, total o parcialmente, para presentarlos en otra publicación.
Estas condiciones aplican tanto a la versión impresa como a la versión electrónica de la revista.