Facilitating symptom reduction and behavior change in GAD: The issue of control

In this commentary we review the theoretical positions of Roemer and Orsillo and identify several key issues. First, the specificity of their arguments to generalized anxiety disorder (GAD) compared to the other anxiety disorders are explored. For example, the proposed distinctions between worry in GAD and worry associated with the other anxiety disorders are examined in light of available empirical evidence. Second, the proposed disjunctions between mental content and both actual experience and emotional/physiological responding are placed in the context of current theoretical and empirical work. Finally, possible therapeutic mechanisms of change for mindfulness/acceptance-based treatments and the roles of control and predictability in anxiety disorder treatment are discussed.