Alternative hypotheses

Compare mechanisms

Compare function, sequence, patient language, and treatment leverage. The aim is not to choose a label—it is to identify which hypothesis best explains this person’s pattern.

Ask this

Which pattern better explains the sequence, protective function, and consequences: worry or avoidance?

Worry

Worry attempts to prepare for danger but may maintain anxiety by overestimating threat and under-testing coping.

CognitionAffectBehaviour+1

Avoidance

Avoidance reduces distress in the short term but commonly maintains anxiety, trauma responses, functional impairment, and interpersonal narrowing.

BehaviourCognitionTrauma+1

Definition

ARepetitive future-oriented thinking about possible threats, uncertainty, or negative outcomes.

BA pattern of keeping away from internal experiences, situations, people, or tasks that trigger distress or perceived threat.

Core process

AFuture threat simulations create an illusion of preparation while increasing vigilance, arousal, and safety behaviours.

BThreat appraisal activates escape, safety behaviour, suppression, or disengagement, which prevents corrective learning and narrows coping options.

Look for

AWhat-if chains · Reassurance seeking

BMissed appointments · Safety behaviours

Patient language

A“What if something goes wrong?”

B“I just avoid it”

Maintaining cycle

AUncertainty -> worry -> temporary control -> more threat scanning -> more uncertainty

BThreat cue -> anxiety -> avoidance -> relief -> threat belief remains untested

Treatment leverage

ASeparate solvable problems from hypothetical threat loops.

BTarget the relief-maintenance loop and build tolerable approach behaviours.

Check before using

AThe main loop is past-focused rumination rather than future threat simulation.

BWithdrawal is mainly due to low energy, cognitive impairment, environmental barriers, or lack of opportunity.

Formulation language

Worry gives a brief sense of preparation, but it also sustains threat monitoring and prevents uncertainty tolerance.

Open full guide

Formulation language

Avoidance appears to reduce distress briefly, but it also prevents corrective experience and maintains the threat appraisal.

Open full guide

Browse the map Use both hypotheses

Alternative hypotheses

Compare mechanisms

Compare function, sequence, patient language, and treatment leverage. The aim is not to choose a label—it is to identify which hypothesis best explains this person’s pattern.

Ask this

Which pattern better explains the sequence, protective function, and consequences: worry or avoidance?

Worry

Worry attempts to prepare for danger but may maintain anxiety by overestimating threat and under-testing coping.

CognitionAffectBehaviour+1

Avoidance

Avoidance reduces distress in the short term but commonly maintains anxiety, trauma responses, functional impairment, and interpersonal narrowing.

BehaviourCognitionTrauma+1

Definition

ARepetitive future-oriented thinking about possible threats, uncertainty, or negative outcomes.

BA pattern of keeping away from internal experiences, situations, people, or tasks that trigger distress or perceived threat.

Core process

AFuture threat simulations create an illusion of preparation while increasing vigilance, arousal, and safety behaviours.

BThreat appraisal activates escape, safety behaviour, suppression, or disengagement, which prevents corrective learning and narrows coping options.

Look for

AWhat-if chains · Reassurance seeking

BMissed appointments · Safety behaviours

Patient language

A“What if something goes wrong?”

B“I just avoid it”

Maintaining cycle

AUncertainty -> worry -> temporary control -> more threat scanning -> more uncertainty

BThreat cue -> anxiety -> avoidance -> relief -> threat belief remains untested

Treatment leverage

ASeparate solvable problems from hypothetical threat loops.

BTarget the relief-maintenance loop and build tolerable approach behaviours.

Check before using

AThe main loop is past-focused rumination rather than future threat simulation.

BWithdrawal is mainly due to low energy, cognitive impairment, environmental barriers, or lack of opportunity.

Formulation language

Worry gives a brief sense of preparation, but it also sustains threat monitoring and prevents uncertainty tolerance.

Open full guide

Formulation language

Avoidance appears to reduce distress briefly, but it also prevents corrective experience and maintains the threat appraisal.

Open full guide

Browse the map Use both hypotheses