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Journal of Social and Clinical Psychology, Vol. 25, No. 7, 2006, pp. 779-801
RISKIND Cognitive
Looming
ET AL.
Style
THE LOOMING COGNITIVE STYLE:
A COGNITIVE VULNERABILITY
FOR ANXIETY DISORDERS
JOHN H. RISKIND
George Mason University
NATHAN L. WILLIAMS
University of Arkansas
THOMAS E. JOINER, JR.
Florida State University
The model of looming vulnerability identifies a cognitive vulnerability factor for
anxiety disorders. The looming cognitive style is hypothesized as an overarching
cognitive vulnerability to anxiety disorders but is not applicable to depression. The
looming cognitive style refers to a tendency to generate, maintain, and attend to internally generated scenarios of increasing danger and rapidly rising risk. Other
models of threat appraisal may offer a relatively lifeless distillation of the anxious
individual’s phenomenological experience. The subjective sense of looming vulnerability is proposed to elicit anxiety, sensitize the individual to signs of movement and threat, bias cognitive processing, and impede habituation to threat
stimuli (Riskind, 1997a). It also discriminates anxiety and focal fears from
depression. The looming model is presented and relevant empirical evidence is
reviewed.
Considerable research has demonstrated cognitive vulnerability factors
for depression and suggested these factors do not strongly apply to anxiety. More to the point of the present article, there may also be a cognitive
vulnerability to anxiety that is not applicable to depression. Our research program uniquely identifies a cognitive vulnerability factor for a
spectrum of anxiety disorders but not for depression. Our research
stands in contrast to most work on anxiety that has focused on nonspeAddress correspondence to John H. Riskind, Department of Psychology MSN 3F5,
George Mason University, Fairfax, VA 22030–4444; E-mail: [email protected].
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cific or common factors that may not discriminate anxiety from other
problems including depression or even schizophrenia. Alternatively, research on anxiety has focused in a limited way on vulnerability to single
highly specific anxiety syndromes (e.g., panic disorder).
COGNITIVE MODELS OF ANXIETY AND VULNERABILITY
Cognitive models have achieved prominence as ways of conceptualizing anxiety and anxiety disorders. These models provide a foundation
for the development of cognitive–behavioral treatments. The cornerstone of these cognitive models is that anxiety is related to the appraisal
and overestimation of threat represented by environmental or internal
bodily stimuli (e.g., Beck & Clark, 1997). This is in contrast to depression
which centers on ideation relevant to hopelessness and past loss. By
these models, cognitive vulnerability to anxiety disorders hinges on the
development of danger schemas that distort information processing (e.g.,
attention, interpretation, and memory for threat stimuli). Once activated, danger schemas distort processing so that individuals overestimate the magnitude and severity of threat, underestimate coping
resources, overuse compensatory self–protective strategies such as
cognitive or behavioral avoidance.
A CONCEPTUAL CONUNDRUM FOR THEORY
Any adequate model of specific cognitive vulnerability to anxiety must
specify content that discriminates anxiety from depression. According
to cognitive models, threat cognitions are specific to anxiety. Research,
however, indicates that threat cognitions, as well as worry, are nonspecific to anxiety—they are just as strongly related to depression as anxiety
symptoms, contrary to theory. Thus, the need for a fundamentally different way to conceptualize threat or danger cognitions is illustrated by
the difficulty in past studies to reliably distinguish anxiety from depression (e.g., Brown et al., 2001) using standard measures of threat appraisal (e.g., probability) or threat–related automatic thoughts (see
meta–analysis by R. Beck & Perkins, 2001). Threat cognitions seem to
lack discriminating power. Why would this be so?
THE MODEL OF LOOMING VULNERABILITY
According to the looming vulnerability model (LVM), conventional
measures and conceptual representations of threat provide a limited
and lifeless extract of the anxious individual’s phenomenology (e.g.,
Riskind, 1997a; Riskind, Williams, Gessner, Chrosniak, & Cortina,
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2000). To understand anxiety, it is necessary to understand threat in a
more dynamic, ecologically valid and temporalized way. In the phenomenology of anxiety, threats are unfolding and escalating so they are
increasing in risk and danger. This meaning of threat as “looming vulnerability” is aptly caught by Shakespeare in Hamlet:
Hazard so dangerous as doth hourly grow.
—Shakespeare, Hamlet, Act I.
The model of looming vulnerability assumes that to survive, humans,
and all animals, must distinguish threats that are rapidly rising in risk
from those that are decreasing. Fish, fowl, crabs, and human young and
adults all show innate fear response to dynamic looming stimulus arrays (for a review, see Riskind, 1997). Moreover, evolutionary mechanisms that have proved functional are conserved. Mechanisms to
protect against danger and rapidly rising risk that are found across species are likely to be conserved in humans (see Gilbert, 2001, on evolved
defense reactions).
The sense of looming vulnerability refers to a sense that dangers are rapidly rising in risk as they approach through time or through space, or
move toward dreaded ends. The model of looming vulnerability (or
LVM) suggests that static threat estimates featured in most cognitive
theories of anxiety—such as “single–point–in–time” estimates of the
likelihood or severity of harm (Beck, Emery, & Greenberg, 1985; Lazarus
& Folkman, 1984)—represent a relatively lifeless distillation of the anxious individual’s phenomenological experience. Such appraisals are
static snapshot images like photographs. Such static appraisals are constrained to threat in one frozen moment in time and cannot represent the
time course of danger, whether it is fast or slow, or rising or receding. By
contrast, the LVM assumes that the phenomenology of intensifying danger is dynamic, like a motion picture or video image projected onto the
mind, rather than like a static image of a single moment.
The LVM’s modification of the standard cognitive formulation of anxiety identifies important points of refinement, expansion, and modification for theory, assessment, and treatment. For example, the LVM provides a more detailed explanation of the underlying cognitive
mechanisms that explicate the attentional bias associated with anxiety,
as well as anxious individuals’ lack of habituation to fear–relevant stimuli (Riskind, 1997a; Dorfan & Woody, 2006). Thus, the model proposes
that looming vulnerability elicits anxiety, sensitizes the individual to
signs of movement and threat, biases cognitive processing, and impedes
habituation to threat stimuli (Riskind, 1997a). It also discriminates
anxiety and focal fears from depression.
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Looming vulnerability is an important cognitive component of threat
or danger and of the phenomenology of anxiety. At times, such a state of
looming vulnerability accurately corresponds to reality (e.g., when facing an oncoming freight train); at other times it has a modest but vaguer
basis in reality (e.g., intensifying relationship problems); at still other
times, the state is based only on partial or ambiguous cues. Thus, a person’s sense of looming vulnerability can occur either as a result of an objective stimulus or as the result of an acquired cognitive bias to generate
scenarios of rapidly rising risk, or an interaction of both. Our research
program on severe anxiety syndromes focuses on the role of acquired
cognitive biases.
Such biases to experience a sense of looming vulnerability can be manifested in several forms. At a lower level, looming vulnerability has a
more narrow focus that is constrained to one specific class of threat (e.g.,
specific fears of contamination, spiders, or terrorism). For example, individuals who are excessively fearful of spiders generate spontaneous
mental images of spiders moving toward them. Of particular interest in
this article, looming vulnerability is also manifested as a looming cognitive style (or LCS), a more unconstrained and generalized tendency to
construct mental scenarios of rapidly intensifying danger and rising risk
for a variety of situations that can represent threats of physical harm or
social rejection, etc. The LCS is an overarching cognitive vulnerability to
developing many anxiety disorders (Riskind & Williams, 1999a, 1999b;
Riskind, Williams, Gessner, Chrosniak, & Cortina, 2000), but is not
thought to raise risk for depression. The LV model views this common
cognitive vulnerability as a distal, overarching factor that interacts with
the disorder–specific cognitive mechanisms central to each anxiety disorder (e.g., predicting social rejection in social phobia, worry and
catastrophizing in generalized anxiety disorder, etc.). The onset of the
various types of anxiety disorders is precipitated when the person experiences an exaggerated state of intensifying danger and rapidly rising
risk in which threat seems to be dynamically increasing from instant to
instant. Only the specific details need to be filled in to describe which
particular kind of anxiety will likely result.
THE LOOMING COGNITIVE STYLE
According to the LVM, the sense of looming vulnerability can develop
into a trait–like cognitive pattern or LCS (also known as the “looming
maladaptive style”) as a result of repeated or traumatic exposure to certain antecedent conditions (e.g., attachment insecurity in developmental
experiences). Some individuals develop a broad and pervasive cognitive pattern to internally generate scenarios of potential threats as rap-
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idly intensifying. Once activated, this looming cognitive style (LCS) is
assumed to produce the typical phenomenology of rapidly rising danger and risk seen in pathological anxiety. People who are anxiety prone
tend to maintain this tendency to construct mental scenarios and images
of rapidly intensifying danger and rising risk. The LCS functions as a
danger schema that biases information processing, activates worry and
other defensive or compensatory behaviors. It can also participate in a
self–confirming feedback loop such as propelling a stress–generation
effect, so that individuals inadvertently create their own stressful life
events (Shahar, Black, & Riskind, 2004).
Two important demarcations appear necessary here. First, the LCS is
distinguishable from catastrophizing about threat or danger. In our conceptual framework, the LCS acts as a higher–order, trait–like, danger
schema that is the underlying or distal mechanism that leads to proximal
and lower–order ideational activity, such as particular instances of
catastrophizing in specific threat situations. Consistent with this view,
recent research provides evidence that the LCS predicts residualized
gains in catastrophizing over time (Riskind & Williams, 1999b). The reverse was not true, however, in that catastrophizing did not predict
changes in the LCS over time. Second, given the role of catastrophic
cognitions in panic attacks (e.g., Clark, 1988), one may wonder why the
LCS does not unequivocally lead to panic reactions. Our research suggests that LCS serves as a catalyst for panic reactions when the individual experiences “lower–order” stimulus–specific forms of looming
vulnerability to bodily sensations (e.g., Riskind & Chambless, 1999).
ELABORATED SCHEME OF THE PSYCHOLOGICAL
REPERCUSSIONS OF THE LCS
By our model, the painful repercussions of reactions generated by the
LCS reverberate throughout the whole of the cognitive, affective, and
behavioral systems through a series of etiological chains that are related
to anxiety. These chains begin with the LCS (the distal vulnerability) and
proceed through intermediate and proximal cognitions to self–protective behaviors and emotional expressiveness. Our theoretical model of
these etiological chains/causal sequences is shown in the relationships
depicted in the Figure 1.
I. INITIAL PROCESSING
Once the LCS is developmentally established, the vulnerable individual’s information processing is molded and filtered by the bias it creates.
The LCS is assumed to function as a danger schema that biases the pro-
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FIGURE1. Etiological model of the Looming Maldaptive Style
as a cognitive vulnerability to anxiety.
cessing of threat–related information (e.g., selective attention, encoding,
retrieval, interpretation, internal generation of scenarios of rapidly intensifying danger; Riskind et al., 2000; Williams, Riskind, Olatunji, & Elwood, 2004). The effects of the LCS on information processing are
assumed to “trickle down” and affect the whole scope of the person’s
ideational material related to threat, including his or her associations,
expectations, predictions, fantasies, and dreams.
The person’s schema–driven, dynamic mental representations of rapidly intensifying danger are also likely to lead to heightened vigilance
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and an attentional bias for threat. As suggested by the literature on perceptual processes, individuals allocate attentional resources to perceived changes in stimuli, rather than to stimuli themselves (Gibson,
1979). By this logic, cognitively vulnerable individuals, whose experience is structured through a chronic state of looming vulnerability, will
be likely to exhibit an attentional bias for threat and to exhibit heightened states of vigilance, even in the absence of objectively threatening
information. This would not be expected to occur if risk, even if high, is
uniform or staticized and the sources of threat are deemed stable fixtures
of the environment that have permanence and continuity. Were risk perceived as uniform, rather than rising or intensifying, the incentive for individuals to have an attentional bias or heightened vigilance for threat
would be significantly reduced, and they may be likely to habituate to it.
II. SENSE OF URGENT THREAT AND
IMPERATIVE NEED FOR ACTION
According to our model, the mental scenarios of rapidly intensifying
danger generated by the LCS induce an intense feeling of fear and personal vulnerability, and thus lead to an increased sense of time urgency
and imperative need for action, even in the absence of objective danger.
As the anticipation of headlong or rapid destruction builds within the
cognitively vulnerable person, the person’s anxiety and urgency to neutralize or cope with threat escalates. For example, cognitively vulnerable
persons might notice an “absent” look in a lover, and generate expectations of a rapidly rising risk of rejection; or they might hear an engine
noise while driving and generate scenarios of rapidly intensifying peril
of an accident. Irrespective of whether the mental representations of rapidly intensifying danger are accurate or not, the danger is perceived as
more time–urgent and fear–inducing.
III. SELF–PROTECTIVE BEHAVIORS
The sense of rapidly rising risk is likely to evoke greater distress and lead
cognitively vulnerable individuals to engage in various self–protective
behaviors, such as behavioral or cognitive avoidance. Feeling threatened by imperative needs for action on multiple fronts, cognitively vulnerable individuals are likely to select “default” coping strategies that
have the benefit of being fast acting but the liabilities of being extreme
and often unnecessary. This may result in “coping rigidity” (i.e., a narrow tendency to use highly restricted avoidance coping strategies across
situations, including both behavioral and cognitive avoidance; Williams
& Riskind, 2000a; Williams, Riskind, & Long, 1999). There is a clear em-
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pirical link between the LCS and avoidant coping style and coping inflexibility, even when the individual’s level of anxiety is statistically
controlled (e.g., Williams & Riskind, 2000a).
Building on recent research on the role of worry in pathological anxiety, we assume that worry can be characterized as another self–protective process (e.g., Borkovec, 1994) such that fear–related imagery is
translated into less distressing verbal or linguistic form (Borkovec & Inz,
1990). To this end, results of a recent mentation sampling study provide
evidence that higher levels of the LCS are associated with a predominance of imagery–based mental activity during anticipation of an upcoming stressor, whereas worry is associated with a predominance of
lexical activity (Williams, McDonald, & Riskind, 2004). Additionally,
worry, as well as more abstract meta–cognitive activities such as
meta–worry (i.e., worry about the degree to which one is worrying;
Wells, 1995) can absorb so much of the vulnerable person’s mental capacity that these activities may reduce the amount of attention that the
person can allocate to managing frightening mental representations. In
some cases, events can be moving so quickly that worry and
meta–worry cannot provide adaptive, short–term coping options that
serve to lessen, or transform, mental representations of rapidly intensifying danger. Once this threshold is reached, the individual is likely to
engage in wishful thinking or thought suppression as the primary
avoidance strategy. Evidence for these links has been found in several
studies (e.g., Riskind & Williams, in press; Williams, Riskind, Olatunji,
& Tolin, 2004b).
IV. BI–DIRECTIONAL FEEDBACK LOOPS
Finally, the etiological chains related to anxiety often involve bi–directional feedback loops in which cognitive avoidance behavior helps to
maintain individuals’ distorted mental representations of intensifying
danger and their beliefs that they are indeed limited in coping options.
As a consequence, a “confirmation–bias” will be created such that the individual’s faulty primary and secondary appraisals are not only maintained, but also confirmed and strengthened by self–generated
“evidence,” such as by “illusory correlations," thereby catalyzing a vicious self–perpetuating spiral. The LCS can also participate in a
self–confirming feedback loop such as propelling a stress–generation effect, so that individuals inadvertently create their own stressful life
events (for evidence, see Shahar, Black, & Riskind, 2004).
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THE GENERALITY AND SPECIFICITY
OF THE LCS TO ANXIETY DISORDERS
In our model the core cognitive phenomenology of anxiety is captured
by the theme of “looming vulnerability” or rapidly rising risk. Specifically, the sense of looming vulnerability to a potentially uncontrollable
threat is viewed both as a necessary cause of the experience of anxiety
(i.e., it must be above a minimal threshold for any anxiety to occur), and
a sufficient cause for the experience of anxiety (i.e., its occurrence guarantees the anxiety–self–protective response sequence).
The LCS is expected to increase the probability and frequency of such
states of looming vulnerability, and thus confer a heightened risk for developing one or more anxiety disorders. The actual anxiety disorder(or
disorders) that emerges depends on the interaction of the LCS with other
factors (e.g., specific traumas or learning histories) that create “lower order” and more proximal disorder–specific cognitive mechanisms (e.g.,
inflated responsibility for the suppression of threatening intrusive
thoughts in OCD). Alternatively, it is possible that some individuals
learn a “stimulus–specific” form of looming vulnerability without developing a higher–order style that permeates their thinking about
threats. Those with specific phobias of spiders, for example, lack the
generalized LCS, but have stimulus–specific mental representations of
spiders approaching that lead them to generate fearful scenarios and images of rapidly rising risk for spiders. But often, the full–spectrum LCS is
involved and can trickle down to the way that people mentally play out a
range of possible dangers (e.g., spreading contamination, or impending
social rejections; e.g., Riskind & Williams, 2000).
LCS IN PANIC DISORDER
Our model includes several processes by which the LCS is likely to confer higher vulnerability to the development of panic disorder. First,
cognitively vulnerable individuals may suffer impairment in mental
control, and thus are likely to find it more difficult to cope effectively
with catastrophic cognitions and are more likely to engage in faulty
compensatory strategies (e.g., Riskind & Williams, 2000). Second, individuals with the LCS are more likely to generate mental scenarios of rapidly intensifying danger in which relatively mundane physical
sensations lead to imminent catastrophes, such as looming hospitalization or death (cf. anxiety sensitivity). Third, individuals with the LCS are
likely to evidence heightened sensitivity and/or hypervigilance for
signs of potential threats. These consequences of the LCS can be transmitted, through lower–order stimulus–specific forms of looming vul-
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nerability, linked to fears of rapidly intensifying bodily sensations (e.g.,
Riskind & Chambless, 1999).
LCS IN GENERALIZED ANXIETY DISORDER
Cognitive theorists assume that individuals with generalized anxiety
disorder (GAD) have suffered from a chronic and extreme over–activation of danger–related schemata (e.g., Beck & Clark, 1997; Riskind, 2004;
Riskind & Williams, in press). The sense of danger of such people is
finely attuned, leading them to excessive fearful vigilance for threat.
Generalized anxiety disorder patients experience a stream of threatening automatic thoughts that serve as “worry triggers” for maladaptive
worry. The threatening automatic thoughts involve multiple sources of
concern, appraisals that overestimate threat, and sequences of
“catastrophizing” thinking.
Even though generalized anxiety disorder patients are continually experiencing the world around them as filled with threats on many different fronts, behavioral avoidance is usually an ineffective way to reduce
their feelings of fear. Instead, such patients tend to handle the fear that is
induced by the ongoing threatening thoughts by engaging in protracted
cycles of unproductive worry (Borkovec, Ray, & Stoeber, 1998). These
protracted worry cycles are particularly problematic compensatory–behaviors, because they are so continuous and almost impossible for the
person to voluntarily terminate. The phenomenon of worry represents a
type of cognitive avoidance that reduces the emotional and somatic
distress evoked by danger–related cognitions (e.g., Borkovec & Inz,
1990).
The LCS is likely to confer vulnerability to GAD (Riskind, 2005;
Riskind & Williams, in press) by (1) leading the person to generate a continuing stream of threatening, catastrophic scenarios and mental simulations of even relatively mundane events or stimuli; (2) absorbing
attentional control resources of the cognitively vulnerable person that
are required to deal with upsetting thoughts; and (3) prompting the person to engage in protracted worry as a compensatory way of neutralizing—or attenuating—anxiety–related automatic thoughts. The schematic processing bias that the LCS produces will also likely increase
recall and cognitive accessibility of threatening material, and distort appraisals of threat. Individuals who are cognitively vulnerable will be
likely to perceive the world as unpredictable and dynamically intensifying in danger, and to perceive the self as under–prepared to cope with
threat, thereby generating vulnerability to GAD. To this end, results of a
recent mentation sampling study (similar to the Borkovec & Inz, 1990,
study) provide evidence that the LCS is associated with a predominance
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of imagery–based mental experience (Williams, McDonald, & Riskind,
2004). Thus, cognitively vulnerable individuals are likely to experience
more fear–related dynamic imagery that leads to the over–utilization of
worry as a self–protective process. Further, if the specifics of their mental representations of looming content apply to feared negative
emotions such as depression, anxiety, or anger, they generate mental
scenarios of the rapidly intensifying danger of succumbing to such
emotions.
LCS IN SOCIAL PHOBIA
In contemporary cognitive models of social phobia, cognitive processes
related to the threat of potential public embarrassment, criticism, or
scrutiny are seen as key to the production of acute fear responses (Roth &
Heimberg, this issue). Such models propose that social anxiety is associated with privately generated mental distortions of the extent that one is
negatively evaluated by an audience (e.g., Clark & Wells, 1995; Rapee &
Heimberg, 1997). Apart from these fearful distortions, our model hypothesizes that socially phobic individuals may maintain and attend to
frightful dynamic images of the rapidly progressing and intensifying
danger of being scrutinized and negatively evaluated (Riskind, 1997;
Riskind, Williams, Gessner, Crosniak, & Cortina, 2000). According to
the LVM, the LCS is likely to confer vulnerability to social phobia by
mechanisms similar to those in GAD, which, when coupled with early
formative experiences involving acceptance or worthiness based on perfection, will lead the individual to self–generate threatening scenarios of
the rapidly intensifying danger of humiliating catastrophe and rejection
in social and performance situations (for evidence, see Riskind &
Mizrahi, 2000; Williams & Riskind, 2000b).
LCS IN OBSESSIVE-COMPULSIVE DISORDER
Cognitive models of OCD have identified exaggerated appraisals about
the over–importance of intrusive thoughts and an inflated sense of personal responsibility as key to the urge to engage in activities such as
compulsive behavior, neutralizing, thought suppression, reassurance
seeking, and avoidance (Rachman, 1997; Salkovskis, Shafran, Rachman,
& Freeston, 1999). Individuals with OCD may attach exaggerated significance to their intrusive thoughts and regard them as repugnant, threatening, and uncontrollable (Frost & Steketee, 2002). Such individuals also
typically demonstrate paradoxical increases in intrusive thoughts associated with their efforts at cognitive avoidance (e.g., Salkovskis et al.,
1999).
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The LCS may increase risk to obsessive–compulsive disorder by making it more likely that a person will generate scenarios of the rapidly intensifying danger of losing control over harmful impulses (e.g., striking
others) or being contaminated by rapidly spreading contamination. The
LCS also may make OCD more likely by imposing a heavier cognitive
load that impairs the person’s mental control resources. Cognitively vulnerable individuals will be apt to generally overestimate the magnitude
and severity of rapidly intensifying threat in the environment, leading
them to experience correspondingly higher levels of anxiety and distress, and this heightened cognitive load will make it more difficult for
them to suppress unwanted thoughts (for evidence, see, e.g., Williams et
al., 2004b). Also, the LCS may lead the person to generate scenarios of
rapidly rising risk that will heighten the “over–importance” or negative
significance attached to intrusive thoughts (Riskind, Williams, &
Kyrios, 2002).
LCS IN POSTTRAUMATIC STRESS DISORDER
The focus of cognitive models of PTSD is on individuals’ failures to incorporate or process traumatic experiences into their conceptual systems (see Feeny & Foa, in press). In an attempt to separate the self from
the traumatic experience, or to prevent their self– and world–views from
being shattered, these individuals engage in self–protective processes,
such as cognitive avoidance. These processes confer the benefit of maintaining the desired separation of self from experience, but the liability of
requiring enormous cognitive resources and taxing the individual’s cognitive system. The LCS is likely to increase vulnerability to PTSD after
exposure to traumatic events for several reasons. First, as with other anxiety disorders, this style is likely to impose a greater cognitive load on
the individual that will impair efforts at coping effectively with upsetting experiences (e.g., Riskind & Williams, 2000; Riskind et al., 2000). Related to this, and consistent with the model, “flashback” memories of
traumatic events appear to contain “looming” content and motion
(Hellawell & Brewin, 2004). Second, the LCS is likely to provide a structuring of experience that leads the individual to generate mental scenarios and fearful predictions that rapidly rising risk that similar frightful
events will reoccur (e.g., re–victimization).
RESEARCH FINDINGS OF THE CVA PROJECT
Over the past 10 years, numerous studies have provided consistent evidence for the looming vulnerability formulation (see Riskind, 1997, for a
review). Several studies, using video–taped or computer generated
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stimuli or scenarios, have found evidence that phobic individuals exaggerate the extent to which their feared stimuli (spiders or germs) are advancing or moving rapidly toward them (e.g., Riskind, Kelly, Moore,
Harman, & Gaines, 1992; Riskind & Maddux, 1993; Riskind, Moore, &
Bowley, 1995; Williams, Riskind, & Black, 2000). Moreover, these studies indicate that such perceptions of looming danger predict stimul u s – s p e c i f i c l e v e l s o f a n x i e ty , e v e n w h e n c o n tr o l l i n g f o r
stimulus–specific fear. Studies provide evidence of comparable associations between a sense of looming vulnerability and fears of Auto–Immune Deficiency Syndrome (Riskind & Maddux, 1994), fears of pain in
chronic pain patients (Suttenfield, Riskind, & Holt, 1999), fears of psychiatric patients in college students (Riskind & Wahl, 1992), and fears of
performance mistakes by socially anxious professional musicians
(Riskind & Mizrahi, 1999).
A body of evidence also supports the assumption that a sense of looming vulnerability is more than just a correlate of anxiety; it acts to instigate or exacerbate anxiety. Several studies experimentally manipulated
the rapid intensification of danger in the form of looming movement as
an independent variable. Riskind and colleagues (1992, study 3) presented research participants with videotaped scenarios in which tarantulas and rabbits either moved toward the camera, moved away, or were
still. The looming movement of tarantulas enhanced fear and threat–related cognitions and did this far more than it did for rabbits that have
nonthreatening characteristics. The participants viewed the forward
moving tarantulas as more likely to be injurious and as more
uncontrollable than the tarantulas that were still.
Based on these and similar studies that used experimental methods,
Riskind and colleagues devised a self–report questionnaire to assess the
extent to which individuals appraise threat as rapidly rising in risk, progressively worsening, or actively accelerating (i.e., exhibit the LCS;
Riskind et al., 1992; Riskind et al., 2000). Participants are presented with
six brief vignettes describing different types of stressful situations, and
asked to complete a three–item list of questions for each vignette. The
stressful situations include: threat of illness, risk of physical injury, risk
of car breaking down, romantic rejection, public speaking, and social
humiliation.
Numerous studies have supported the convergent validity of the LCS,
indicating that higher scores on LCS are related to higher scores on anxiety scales (rs range from 0.39 to 0.49). The LCS is significantly associated
with several correlates of anxiety, including worry, thought suppression, and behavioral avoidance (e.g., Riskind et al., 2000; Riskind & Williams, 2000; Williams & Riskind, 2000a). Furthermore, the results have
confirmed that the LCS is not simply another measure or proxy for trait
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anxiety. Riskind and colleagues (2000) demonstrated with structural
equation modeling that while the LCS and anxiety are correlated, their
measurement properties clearly distinguish between them. Likewise,
studies have shown that the LCS, though correlating with measures of
neuroticism, negative affect, or negative life events, predicts distinct
variance in anxiety over and above that predicted by these measures
(Riskind et al., 2000). These findings support the incremental value of
the LCS in predicting additional significant and distinct variance in anxiety, even after other variables such as neuroticism or negative
affectivity are controlled.
Evidence for the discriminant validity of the LCS is accruing as well.
Studies have demonstrated the LCS can differentiate between anxiety
and depression—despite the high overlap and correlation commonly
found between these syndromes. In multiple studies, significant correlations between LCS and anxiety remain significant even after the effects of depression scores are statistically removed. But any correlation
between LCS and depression is reduced to nonsignificance after the effects of anxiety scores are controlled. These findings have special importance given the collective lack of compelling evidence in the literature for questionnaire measures of anxiety or threat–related cognition
that relate more to anxiety than to depression, especially in nonclinical
populations (Riskind, 1997; Riskind et al., 1992). A recent meta–analysis (R. Beck & Perkins, 2001) found that anxiety–related automatic
thoughts were just as related to depression. The construct of worry
likewise lacks adequate cognitive–content specificity, in that it is
strongly associated with depression and anxiety, and is a nonspecific,
common correlate of negative affectivity in general (R. Beck, Perkins,
Holder, et al., 2001).
Evidence also indicates that the LCS predicts significant unique variance in current and future anxiety, even after anxiety–relevant cognitive
variables are controlled. For example, LCS predicts significant variance
in anxiety measures beyond the effects accounted for by static predictions of unpredictability, uncontrollability, likelihood, or imminence of
threat (e.g., Riskind, 2000; Riskind et al., 2000). Several longitudinal
studies with follow–ups ranging in duration from one week to four
months found that the cognitive vulnerability significantly predicted
residualized gains in anxiety scores when controlling for anxiety at time
1 (e.g., Riskind, 2000; Riskind et al., 2000, Study 2).
Several short–term prospective studies also support the postulated effects of the cognitive vulnerability on self–protective responses, like
worry, thought suppression, and so forth. These studies have shown
that cognitively vulnerable individuals are more apt to worry in the future in test–retest intervals of from one week (Riskind et al., 2000, Study
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2) to six weeks (Riskind, in press), even after controlling for initial levels
of worry. Similar results on thought suppression have been found (e.g.,
Riskind & Williams, 1999a, 1999b). These correlational results converge
with those of a recent study using experimental methods (Williams, et
al.; Riskind & Williams, 2000), in which cognitively vulnerable individuals reported significantly more intrusive thoughts on an instructed
thought suppression task. Of special interest, the LCS was the single
strongest predictor of thought intrusions and distress. A recent field
study conducted with college athletes found that, compared to other college athletes, cognitively vulnerable athletes were more likely to exhibit
gains in wishful thinking in the weeks immediately before, and just after, competition with other college teams (Murphy, Riskind, & Williams,
2000). Taken collectively, these studies support the hypothesis that the
putative cognitive vulnerability is related to self–protective strategies.
COGNITIVE VULNERABILITY TO ANXIETY DISORDERS
Studies have begun to show the applicability of the LCS to a variety of
anxiety disorders. Riskind and Williams (in press) showed that scores
on the LCS were significantly elevated in a community sample of patients with GAD, as compared to a sample of patients with depressive
disorders or to normal controls. Riskind, Gessner, and Wolzon (1999)
found in a study of inpatients in a detoxification unit for alcohol and substance abuse that those who were diagnosed with GAD had significantly
higher scores on cognitive vulnerability than similar patients who did
not have GAD. Riskind and Mizrahi (2000) conducted a study of professional musicians and found that musicians who were performance anxious generated mental scenarios and expectations of the rapidly
intensifying danger of making humiliating mistakes. Riskind and
Chambless (1999) conducted a study with patients with panic disorder
and found that the tendency to generate mental scenarios of rapidly intensifying somatic symptoms predicted significant variance in both
such symptoms and in agoraphobic cognitions, beyond the effects of
other relevant variables.
A recent study with clinical patients by Tolin, Worhunsky, & Maltby
(2004) found that OCD patients had significantly higher ratings on
looming vulnerability to spreading contamination from garbage cans
and other contamination cites than did nonanxious controls, and panic
disorder patients, who did not differ from each other. These findings
replicate studies with clinical analogue populations (Riskind, Abreu,
Strauss, & Holt, 1997; Riskind, Wheeler, & Picerno, 1997). Tolin et al. also
found that looming vulnerability accounted for the apparent “chain of
contagion” in many OCD patients, who need to avoid a progression
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larger range of potentially contaminated stimuli (e.g., needing to avoid
the clothes that were associated with a contaminant, then needing to
clean the rug where the clothes were dropped, and so on). As expected,
Tolin et al. found that OCD patients seemed to perceive an endless
“chain of contagion” in which successive degrees of removal from the
original object were not rated as less contaminated. In contrast,
nonanxious controls and Panic Disorder patients did not perceive such
endless chains of contagions. Finally, Tolin et al. found that ratings of
looming vulnerability to spreading contamination seemed to fully
mediate the relationship between diagnostic group and the chain of
contagion.
A study by Williams, Shahar, Riskind, and Joiner (2004) examined the
supposition that this cognitive phenomenology underlies the common
features of numerous anxiety disorder symptoms. We hypothesized
that controlling for depressive symptoms, looming vulnerability would
predict a latent factor comprised of indicators of five anxiety disorder
symptoms: Obsessive–Compulsive Disorder (OCD), Posttraumatic
Stress Disorder (PTSD), Generalized Anxiety Disorder (GAD), Social
Phobia, or Fear of Negative Social Evaluation (FNE), and Specific Phobic
Fears (SPF). Measures of these symptoms, of depressive symptoms, and
of looming vulnerability were administered to 123 undergraduates.
Structural equation modeling analyses provided support for our hypothesis, depicting looming vulnerability as an overarching dimension
of vulnerability to anxiety.
LCS AND SCHEMATIC PROCESSING BIAS
Those who are high in the putative cognitive vulnerability would be expected to exhibit more schematic processing biases for threat–related information than would other people. Studies examining memory for
lexical and pictorial threat–related stimuli on both explicit memory
tasks (which make direct reference to studied materials) and implicit
memory tasks (which make no direct reference to such materials) support this view. Results of a study using a homophone task suggested that
the LCS is significantly and uniquely related to the tendency to process
and encode ambiguous verbal information—recordings of homophones
such as “dye” versus “die”—in a threatening manner (e.g., Riskind et al.,
2000, Study 3). This effect, on a measure of implicit memory for threat,
was unique to the LCS and was not related to anxiety itself or to an alternative approach to cognitive vulnerability assessed by static likelihood
estimates of threat. These results suggest that the LCS produces a schematic bias for ambiguous information that cannot be accounted for by
static expectations of threatening situations (e.g., likelihood estimates).
LOOMING COGNITIVE STYLE
795
In another study, Riskind and colleagues (2000, Study 4) tested the effects of the LCS on memory for pictorial threat–related stimuli, using a
laboratory task in which pictorial images were presented. Participants
were presented with neutral (e.g., fish), positive (e.g., flowers), or threatening pictorial images (e.g., a house fire or auto crash) and asked to rate
the extent to which each image was threatening. The study had two measures of explicit memory (a free recall task, a frequency estimation task),
and one measure of implicit memory (a word stem completion task). The
structural equation modeling in the study indicated that cognitively vulnerable individuals do not suppress anxiety–provoking stimuli shortly
after being oriented toward them, but rather are absorbed by them,
which heightens both their implicit and explicit memory for those
stimuli.
A study conducted by Williams, Riskind, and Black (2000) recently investigated the schematic processing effects of the cognitive vulnerability
for pictorial stimuli that differed in both their valence (threatening, neutral, positive) and their level of movement (moving vs. static). Computerized pictorial images were presented, some of which were moving and
some of which were static (e.g., a video clip of an accident occurring versus a picture of a wrecked car). Participants rated each image for level of
threat and their reaction times were recorded in milliseconds, and then
participants completed the series of memory tasks used in the previous
study. As predicted, the more cognitively vulnerable subjects had faster
reaction times when presented with moving stimuli (regardless of valence) and faster reaction times for threatening stimuli (regardless of
movement). Cognitively vulnerable subjects also recalled more moving
than static images and recalled more threatening than neutral or positive
images.
Taken together, these and other recent findings suggest that
cognitively vulnerable individuals exhibit a pervasive bias for threat–related information in schematic information processing, and that this can
be detected in several different types of laboratory tasks. Consistent
with expectations, the LCS is associated in several studies with heightened vigilance for threat–related information and for movement (which
has the potential to intensify danger), heightened accessibility of cognitive danger schemas, and a systematic bias that is manifested in both implicit and explicit memory. Unlike the standard cognitive model, which
conceptualizes the cognitive content of threat in terms of probability estimates about unfortunate or aversive outcomes, our model focuses on
the internal generation of dynamic mental scenarios of rapidly rising
risk and intensifying danger—that is, risk or danger that is increasing
rather than uniform or unvarying (cf. Gray’s [e.g., 1987] neurobiological
theory of anxiety).
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DEVELOPMENTAL ANTECEDENTS
The LVM postulates that developmental antecedents are involved in the
looming cognitive style. A study by Williams and Riskind (2004) examined the pattern of relationships between adult romantic attachment,
cognitive vulnerabilities to anxiety, anxiety symptoms, and both general
and specific relationship outcomes. Results indicated that two types of
insecure adult attachment styles, preoccupied attachments and fearful
attachments (both reflecting a negative view of self in romantic relationships), were associated with higher levels of cognitive vulnerability to
anxiety (i.e., the looming cognitive style) and anxious symptoms. Notably, the looming cognitive style partially mediated the relationships
between the attachment dimensions and anxiety symptoms.
Two studies by Riskind, Williams, Altman, Black, Balaban, & Gessner
(2004) examined the links between the Looming Cognitive Style (LCS)
and parental bonding (Study 1) and perceived parental attachment orientations during childhood (Study 2). Results of the first study suggested that low levels of maternal overprotection and high levels of paternal overprotection significantly predict LCS scores, beyond the
effects of current anxious and depressive symptoms. Results of the second study suggested that retrospective reports of maternal attachment
insecurity is associated with significantly higher LCS scores, anxious
and depressive symptoms, adult romantic attachment insecurity, and
potentially high–risk relationship behaviors. These results are interpreted from the perspective of the LVM and may increase understanding of the linkage between childhood developmental antecedents and
cognitive risk for anxiety.
CLINICAL IMPLICATIONS
The LVM has implications for both assessment and treatment. For example, there is ample evidence that cognitive–behavior therapy has efficacy in treating anxiety disorders. Even so, its success with some
disorders—such as GAD (Riskind, 1997b; Riskind & Williams, 1999a)
and OCD (Rachman et al., Chapter 10)—has only been moderate. Even
the most efficacious cognitive treatments may benefit from consideration of looming vulnerability and the LVM, particularly when therapists work with resistant patients or those for whom standard cognitive
treatment is producing a suboptimal response (Riskind & Williams,
1999a).
The set of etiological chains that we propose for anxiety in the LVM
provide multiple promising points for possible therapeutic or preventative intervention. Immediate, temporary relief may be provided by cog-
LOOMING COGNITIVE STYLE
797
nitive interventions that target the proximal aspects of a patient’s dysfunctional thinking (such as mental scenario generation) about rapidly
intensifying danger; more durable improvement may be provided by
changing underlying cognitive vulnerabilities (the LCS) that play a role
in generating mental scenarios and expectations of rapidly rising risk.
We have coined the term looming management to refer to the various
therapeutic clinical uses of the LVM (Riskind & Williams, 1999a). Clinicians can address the content and quality of internally generated scenarios and expectations of intensifying danger, particularly imagery-based
components, rather than only addressing the individual’s biased way of
looking at static predictions about potential unfortunate events. In a
study of subclinical obsessive compulsives, Riskind and colleagues
(1997) found support for the hypothesis that teaching such individuals
to “freeze” or arrest their “looming” mental representations of the rapidly rising risk of spreading contamination reduces their level of
anxiety.
Riskind and Williams (1999a) proposed a theoretically based framework of guidelines for cognitive–behavioral modification of looming
vulnerability. For example, a clinician can modify the variable of distance (either physical or temporal), “stretching out” patients’ perceptions of distance from danger in their mental scenarios and representations. A second variable the therapist can modify is threat movement.
The therapist, for example, can use imagery–based techniques to interrupt the forward movement of perceived rapidly intensifying danger. A
third variable a therapist can modify with cognitive restructuring is the
velocity with which threat is perceived to be rapidly changing for the
worse.
SUMMARY
The looming vulnerability model and the body of studies it has generated make several unique contributions to our understanding of dysfunctional cognitive processes in anxiety. First, the empirical data so far
indicate that the LCS may constitute a distinct cognitive vulnerability for
anxiety. Second, there is evidence for the view that the LCS is an overarching cognitive vulnerability for the common elements of many anxiety disorders (e.g., generalized anxiety, social anxiety, obsessive
compulsive symptoms), including many of the specific mechanisms involved in different anxiety disorders (e.g., exaggerated responsibility,
anxiety sensitivity, etc.). Third, and related to the preceding points, there
is considerable evidence that LCS produces a strong schematic
processing bias for threat–related information.
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Whereas work has begun to examine the interactions between the LCS
and specific mechanisms implicated in the pathogenesis of particular
disorders (e.g., links from LCS to responsibility in OCD) more steps in
this direction are needed. It is essential to have studies that use behavioral high–risk designs to examine the prospective development of anxiety disorders in cognitively vulnerable individuals who have the LCS.
There is also much that remains to be learned about the developmental
antecedents (e.g., attachment styles, parenting styles, self–defining and
emotional memories), and personality correlates (e.g., harm avoidance,
as in Gray, 1987) of the LCS, as well as its possible role in enhancing fear
conditioning. For example, the LVM suggests that individuals with the
cognitive vulnerability are likely to be more “psychologically prepared”
to acquire rapid and persisting fear conditioning (Riskind, 1997)—particularly when fear–relevant stimuli are presented in dynamic states of
intensification and/or motion.
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