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Maladaptive Behaviours Associated with Generalized Anxiety Disorder: An Item Response Theory Analysis

Published online by Cambridge University Press:  19 March 2018

Alison E.J. Mahoney*
Clinical Research Unit for Anxiety and Depression, University of New South Wales at St Vincent's Hospital, Sydney, NSW, Australia
Megan J. Hobbs
Clinical Research Unit for Anxiety and Depression, University of New South Wales at St Vincent's Hospital, Sydney, NSW, Australia
Jill M. Newby
Department of Psychology, University of New South Wales, Sydney, NSW, Australia
Alishia D. Williams
Department of Clinical and Health Psychology, Utrecht University, The Netherlands
Gavin Andrews
Clinical Research Unit for Anxiety and Depression, University of New South Wales at St Vincent's Hospital, Sydney, NSW, Australia
*Correspondence to Dr Alison Mahoney, Clinical Research Unit for Anxiety and Depression, University of New South Wales at St Vincent's Hospital, Level 4 O'Brien Centre, 394–404 Victoria Street, Darlinghurst, NSW, Australia, 2010. E-mail:


Background: Cognitive models of generalized anxiety disorder (GAD) suggest that maladaptive behaviours may contribute to the maintenance of the disorder; however, little research has concentrated on identifying and measuring these behaviours. To address this gap, the Worry Behaviors Inventory (WBI) was developed and has been evaluated within a classical test theory (CTT) approach. Aims: As CTT is limited in several important respects, this study examined the psychometric properties of the WBI using an Item Response Theory approach. Method: A large sample of adults commencing treatment for their symptoms of GAD (n = 537) completed the WBI in addition to measures of GAD and depression symptom severity. Results: Patients with a probable diagnosis of GAD typically engaged in four or five maladaptive behaviours most or all of the time in an attempt to prevent, control or avoid worrying about everyday concerns. The two-factor structure of the WBI was confirmed, and the WBI scales demonstrated good reliability across a broad range of the respective scales. Together with previous findings, our results suggested that hypervigilance and checking behaviours, as well as avoidance of saying or doing things that are worrisome, were the most relevant maladaptive behaviours associated with GAD, and discriminated well between adults with low, moderate and high degrees of the respective WBI scales. Conclusions: Our results support the importance of maladaptive behaviours to GAD and the utility of the WBI to index these behaviours. Ramifications for the classification, theoretical conceptualization and treatment of GAD are discussed.

Research Article
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2018 

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