The cognitive attentional syndrome: examining relations with mood and anxiety symptoms and distinctiveness from psychological inflexibility in a clinical sample.

Wells's (2009) metacognitive theory suggests that inflexible and recurrent styles of thinking in response to negative thoughts, feelings, and beliefs underlie mood and anxiety symptoms. Wells termed such styles of thinking as the cognitive attentional syndrome (CAS). Using a clinical sample (N=132) of patients with either a primary mood or anxiety disorder, we examined relations between the CAS and mood (depression) and anxiety (generalized anxiety, social anxiety, obsessive-compulsive, and panic) symptoms. We also examined the distinctiveness of the CAS from the related construct of psychological inflexibility. The CAS shared significant positive associations with all of the assessed symptoms, but appeared particularly relevant to depression and generalized anxiety symptoms. Despite having a strong significant positive correlation with psychological inflexibility, the CAS tended to share unique relations with symptoms after controlling for psychological inflexibility. These results broadly support the purported transdiagnostic importance of Wells's theory and indicate that intervention strategies targeting the CAS might be useful in treating certain disorders.