Standard cognitive-behavioral therapy gives most of its emphasis to the targeting of negative cognitions for reduction. Yet there may be cases when simply reducingnegative cognitions may not be enough. In the present article, we present several “optimism training” techniques that may be particularly useful for helping patients by increasingthe frequency of positive cognitions and self-statements that foster optimism and motivate adaptive behavior. Specific case examples for clinical use of the optimism techniques are provided. Results of a preliminary outcome study of optimism training are also provided.
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- Go to article: Links Between Cognitive-Behavioral Hope-Building and Positive Psychology: Applications to a Psychotic Patient
Links Between Cognitive-Behavioral Hope-Building and Positive Psychology: Applications to a Psychotic Patient
Several currently popular theories have emphasized the important role of hope in well-being. This article has outlined one framework for achieving hope via the normalizing and humanizing of patients, and the use of techniques such as priming or accessibility manipulation, reattribution, and other techniques derived from or inspired by current social-cognitive theories. As such they illustrate the possibilities for enriching the repertoire of cognitive therapists that can be offered by merging concepts from positive psychology and social psychology into a more ‘’hopeful’’ cognitive-behavior therapy. This social-cognitive approach is in line with the flexible and integrative underpinnings of cognitive therapy (Alford & Beck, 1996).
- Go to article: Clinical Case Study: Clinical Use of the Looming Vulnerability Construct for Performance Anxiety in a Dance Recital
Clinical Case Study: Clinical Use of the Looming Vulnerability Construct for Performance Anxiety in a Dance Recital
Several recent social phobia models (e.g., Clark & Wells, 1995; Rapee & Heimberg, 1997) share the assumption that sensitivity to the social evaluative context is produced by the socially anxious person’s generation of distorted mental images. These distorted images occur in the form of an external “observer” perspective in terms of how the person imagines being perceived by others. The starting point for the model of looming vulnerability (Riskind, 1997; Riskind, Williams, Gessner, Chrosniak, & Cortina, 2000) is that anxiety is generated not just by static images of such a dreadful moment caught in stop motion (e.g., of being negatively viewed by others), but by the perception that the threat is rapidly advancing and unfolding such that it is increasing in danger. The present case study illustrates the potential utility of this “looming vulnerability” conceptualization for treating a case of severe social performance anxiety in a young woman facing an upcoming dance recital.
- Go to article: Developmental Antecedents of the Looming Maladaptive Style: Parental Bonding and Parental Attachment Insecurity
Developmental Antecedents of the Looming Maladaptive Style: Parental Bonding and Parental Attachment Insecurity
Considerable research has supported links between disrupted parental bonding, attachment insecurity, and psychopathology. Still, few studies have attempted to integrate these findings within a broader cognitive theory of anxiety. Two studies are presented that examine the links between cognitive vulnerability to anxiety (i.e., the Looming Maladaptive Style: LMS) and parental bonding (Study 1) and perceived parental attachment orientations during childhood (Study 2). Results of Study 1 suggest that low levels of maternal overprotection and high levels of paternal overprotection significantly predict LMS scores, beyond the effects of current anxious and depressive symptoms. Results of Study 2 suggest that retrospective reports of maternal attachment insecurity are associated with significantly higher LMS scores, anxious and depressive symptoms, adult romantic attachment insecurity, and potentially high-risk relationship behaviors. These results are interpreted from the perspective of the Looming Vulnerability Model of anxiety and may increase understanding of the linkage between childhood developmental antecedents and cognitive risk for anxiety.
- Go to article: Adult Romantic Attachment and Cognitive Vulnerabilities to Anxiety and Depression: Examining the Interpersonal Basis of Vulnerability Models
Adult Romantic Attachment and Cognitive Vulnerabilities to Anxiety and Depression: Examining the Interpersonal Basis of Vulnerability Models
Bowlby’s attachment theory contends that all individuals develop working models of self and significant others, based on early experiences, that have important implications for understanding adult psychopathology. From a social cognitive perspective these “working models” can be conceptualized in terms of relational schemas that have the same functions as other types of schemas (e.g., organizing information, guiding future behavior, etc.). Cognitive vulnerability models have proposed a pessimistic explanatory style that confers vulnerability to depression and a looming maladaptive style that confers vulnerability to anxiety. The present study examines the pattern of relationships between adult romantic attachment, cognitive vulnerabilities to anxiety and depression, self-reported anxious and depressive symptoms, and both general and specific relationship outcomes. Results suggest that higher levels of attachment insecurity were associated with increased psychological symptoms, higher levels of cognitive vulnerabilities, and greater general and relationship impairments. Moreover, cognitive vulnerabilities partially mediated the relationship between adult attachment and anxious and depressive symptoms, suggesting that insecure attachments may represent a developmental antecedent to cognitive vulnerabilities to anxiety and depression.
The articles in this special issue address empirically the application of attachment theory to cognitive vulnerability models of anxiety and depression. The findings from these studies converge on the theme that attachment theory has considerable utility in potentially extending and refining current cognitive vulnerability models through a consideration of interpersonal context and the cognitive mechanisms by which negative interpersonal experiences may confer increased risk to later anxious and depressive symptoms.
- Go to article: Specific Cognitive Content of Anxiety and Catastrophizing: Looming Vulnerability and the Looming Maladaptive Style
Specific Cognitive Content of Anxiety and Catastrophizing: Looming Vulnerability and the Looming Maladaptive Style
The present study examined the hypothesis, stimulated by the looming vulnerability model of anxiety (Riskind, 1997), that the mental activity of catastrophizing is related to both the general looming maladaptive style and looming vulnerability to potential catastrophes. The looming maladaptive style is a higher-order, more global and abstract characteristic framework that functions as a danger schema to produce cognitive vulnerability to anxiety, whereas looming vulnerability to potential catastrophes is a lower-order sense of looming vulnerability to potential catastrophes in specific situations. In addition, the present study attempted to replicate the findings of Vasey and Borkovec (1992) between catastrophizing, worry, and likelihood, using a self-report version of the structured interview in their study. One hundred thirty-eight undergraduates completed the self-report measure of catastrophizing (LOCO-Q), the looming maladaptive style questionnaire, and several measures of worry. Our results provide strong evidence for the replicability of Vasey and Borkovec’s (1992) findings and provide new evidence for a broader role of looming vulnerability in the cognitive phenomenology of catastrophizing. Specifically, they demonstrate that both looming vulnerability to potential catastrophes and the looming maladaptive style are integrally related to the mental activity of catastrophizing. Further, results suggest the plausibility of a mediated model in which the effects of the general looming maladaptive style are transmitted through specific looming vulnerability to possible catastrophes to produce higher levels of catastrophizing. Additionally, results suggest that the looming maladaptive style is the only variable that significantly predicts gains in catastrophizing over time. The results of this study are consistent with a series of studies that we have conducted in the last several years, demonstrating that the looming maladaptive style functions as a danger schema for threat-related information and produces a cognitive vulnerability to anxiety.
In this article, we analyze the nature of cognitive therapy and explore the likelihood of cognitive processes in other forms of therapy. In minimalist terms, cognitive therapy may often distill down to (1) acknowledging the apparent reality with which the individual is contending, and (2) providing an optional perspective—often the other side of the reversible illusion. Moreover, all therapies may be effective to the degree they promote cognitive change, although cognitive therapy alone explicitly attempts to accentuate cognitive mechanisms of action. Also, frequent suggestions that performance experiences are necessary for cognitive change may be overstated. Finally, the implications of applying some of the criteria for scoring fidelity of cognitive behavior therapy to other therapies, and the utility of importing ideas from social cognition research on two routes of persuasion and cognitive change, are discussed.
- Go to article: Simulated Interpersonal Provocation and Fears of a Loss of Impulse Control as Determinants of Aggressive Mental Intrusions
Simulated Interpersonal Provocation and Fears of a Loss of Impulse Control as Determinants of Aggressive Mental Intrusions
Although cognitive models of obsessive-compulsive disorder focus on the importance of misinterpretations of intrusive thoughts, they have given little attention to where intrusive cognitions come from, suggesting that they are merely “flotsam” of the mind. The present study is a preliminary test of an analysis that attempts to examine whether intrusive thoughts might actually have systematic, functional relationships to internal processes and external circumstances. Specifically, we advance and test the hypothesis that intrusive thoughts with aggressive-harming content can arise because current goals or passage to desired goals are blocked or thwarted, eliciting threat or frustration, most often because of the perceived provocative or threatening actions of other people (whether real or imaginary). On this hypothesis, this can instigate the generation of accompanying spontaneous imagined mental scenarios or fantasies about ways to rid oneself of the threat (e.g., remove the persons who are posing the obstruction). These imagined scenarios and images, elicited by provocation conditions, produce intense, distressing cognitions for individuals who are afraid of impulses. The results of a simulated provocation design provided evidence for this hypothesis.
- Go to article: Beyond Belief: Incremental Prediction of Obsessive-Compulsive Disorder by Looming Vulnerability Illusions
Beyond Belief: Incremental Prediction of Obsessive-Compulsive Disorder by Looming Vulnerability Illusions
Cognitive models argue that obsessions and compulsions arise from distorted beliefs and exaggerated interpretations of intrusive thoughts. While these models have led to important advances, recent research has suggested the need to go beyond the factors the models identify. One new factor to consider may involve looming vulnerability, the production of dynamic mental scenarios of danger outcomes (e.g., contamination, harming, losing wanted possessions) as rushing through time and space and escalating in odds of harm for the self. Looming vulnerability is a different form of cognition that differs from belief factors because it concerns the process of anticipating noxious events as rapidly rising in risk rather than static beliefs about the final end states (e.g., responsibility, perfection). The present study tested looming vulnerability by examining a small cohort of 37 patients with obsessive-compulsive disorder (OCD). Results provide strong preliminary evidence that looming vulnerability in OCD-related themes (e.g., contamination, hoarding, and pure obsessional) contributes significant and substantial variance to the prediction of obsessive compulsive symptom severity on the Yale-Brown Obsessive-Compulsive Scale beyond the effects of beliefs and interpretations. Thus, looming vulnerability may represent a different form of cognitive vulnerability for the development and persistence of clinical obsessions that warrants further investigation.
- Go to article: Cognitive Case Conceptualization and Treatment of Anxiety Disorders: Implications of the Looming Vulnerability Model
Cognitive Case Conceptualization and Treatment of Anxiety Disorders: Implications of the Looming Vulnerability Model
This article describes an approach to cognitive case conceptualization and treatment that is based on the “looming vulnerability” model of anxiety. The model assumes that much of what produces anxiety for people in everyday life, as well as in cases of pathological anxiety, is “looming” from their point of reference, or changing dynamically and step-by-step in time to become increasingly risky. That is, they have a “sense of looming vulnerability” to threat—perceptions of threat as moving toward an endpoint or rapidly rising in risk. Anxious individuals manifest biases in their primary cognitive appraisals (a painful sense that perceived threats are rapidly approaching, changing, or escalating in risk), and in consequence, feel “pressed” to urgently cope with or neutralize the looming threat. The net result of their sense of urgency is that they often select maladaptive, rigid coping strategies (e.g., avoidance and escape) and underestimate their personal efficacy to effectively deal with the oncoming dynamic threats (i.e., biased secondary appraisal). We suggest that anxiety is often based on dynamic, story-like scripts, called progressive threat scripts. The present article identifies several ways that cognitive therapists can conceptualize, identify, and modify features of patients’ mental simulations of present or developing threat (i.e., distance, motion, speed, and perspective). The article also addresses several features of anxious patients’ response to threat that are relevant to cognitive case conceptualization and treatment (i.e., generating alternative simulations, time structuring, proactive coping, and the enhancement of dynamic personal efficacy for dealing with rapidly rising risk).