Sociotropy and autonomy have been demonstrated to be a diathesis for depression as well as predictors of treatment outcome. There are few studies, however, that have investigated whether these vulnerability factors change with cognitive therapy (CT) and are associated with outcome in CT. Also, it appears that the autonomy construct may have both positive and negative content and it is important to examine these two aspects of autonomy in treatment. In this study, depressed outpatients (N = 149) were followed from intake to the 12th session of CT. The treatment outcome variables included depression (Beck Depression Inventory), hopelessness (Beck Hopelessness Scale), and sociotropy and autonomy (Sociotropy-Autonomy Scale [SAS]). Using a repeated measures analysis, depression symptoms and hopelessness decreased significantly over time. Both subscales of sociotropy, preference for affiliation and fear of criticism and rejection, were positively associated with depression at intake, and decreased significantly over time in those who responded to treatment. However, independent goal attainment, one subscale of autonomy, increased significantly over sessions and was associated with treatment response. The second subscale of autonomy, sensitivity to others’ control, demonstrated no change. The results suggest that independent goal attainment may be an indicator of psychological health. Implications for future research using the SAS and its subscales in treatment and vulnerability research are described.

These authors appreciate Ellis’ clarification that he encourages REBT therapists to use many of the same principles and methods used by CT therapists. His assertions that many of these elements are done more frequently or thoroughly in REBT than in CT are best evaluated by objective observers via empirical analysis of therapy transcripts, session videotapes, and treatment manuals. Such research would have particular value if it linked therapy methods with treatment outcome and relapse prevention for particular problems. In this regard, Ellis’ recommendation that REBT become more empirical is welcome. Also, these authors clarify the distinction they make between the terms philosophical and philosophically-based; empirically responsive and empirically-based. Finally, the authors applaud Ellis’ major contributions to the field.

This article elaborates on the construct of dysfunctional vulnerability schemas in Obsessive-Compulsive Disorder (OCD)(Sookman & Pinard, 1995,1999; Sookman, Pinard, & Beauchemin, 1994). These schemas are conceptualized as a central mechanism of excessive threat appraisals proposed to be the predominant cognitive problem in anxiety (Beck, 1996; Beck & Clark, 1997). Four domains of beliefs are hypothesized to comprise vulnerability in OCD: Perceived Vulnerability; View of/Response to Unpredictability, Newness, and Change; View of Strong Affect; and Need for Control. A study carried out with 111 subjects indicated that OCD patients more strongly endorsed these beliefs compared with patients with other anxiety disorders, mood disorders, and normal controls. The discriminant function derived from these four belief domains was effective in classifying OCD patients and other subjects into their respective groups. The results support the inclusion of dysfunctional vulnerability beliefs in cognitive assessment and treatment of OCD.

Thirty-two patients diagnosed with generalized anxiety disorder were treated with cognitive therapy. Patients attended weekly one-hour sessions and there was no predetermined duration of treatment. Prior to treatment, each patient was evaluated for a comorbid personality disorder (PD) using the Structured Clinical Interview for the DSM-ffi-R Personality Disorders (SCID-II). Patients completed the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) at the intake evaluation and at their final session. Sixteen of the 32 patients were diagnosed with a comorbid PD at the intake evaluation. A total of 22 patients completed a minimum course of cognitive therapy, which was defined as six sessions. Overall, there was a significant reduction of BAI and BDI scores for patients with and without a PD. There was no significant difference between the two groups. However, patients with a comorbid PD were more likely to drop out of treatment Seven of the 10 dropouts had a comorbid PD as compared to only 9 out of the 22 completers.

The poor reality testing and the thinking disorder in schizophrenia may be attributed to a deficiency in cognitive resources related to the neurobiological deficiencies. Recent therapy and research have demonstrated that, far from being a bizarre psychologically incomprehensible phenomenon, schizophrenia can be understood within our conventional conception of human nature. This humanizing trend is especially evident in the cognitive approaches to this disorder. Research has established that there is a continuum from normal experiences of paranormal beliefs, hallucinations, thinking problems, and withdrawal to their counterpart in schizophrenia. The kinds of biases in schizophrenia are also evident in common social problems such as prejudices and ethnocentrism as well as in interpersonal strife. Dysfunctional attitudes about attachment and performance in schizophrenia form the infrastructure for persecutory delusions and negative symptoms, respectively. Grandiose delusions, on the other hand, are shown to be an overcompensation for a sense of loneliness, inferiority, and vulnerability.