The self-complexity model (Linville, 1987) predicts that individuals who have numerous self-aspects with little overlap among them will be buffered against the effects of stressful life events and will experience less depression. Despite some evidence to this effect, many replication attempts have failed (cf. Rafaeli-Mor & Steinberg, 2002). The present studies reexamine the self-complexity model, incorporating recent theoretical and methodological critiques of its original formulation (e.g., Brown, Hammen, Wickens, & Craske, 1995; Rafaeli-Mor, Gotlib, & Revelle, 1999). Two prospective studies provide some support for a revised self-complexity hypothesis, which examines separately the effects of differentiation (number of self-aspects) and integration (overlap among them) and considers more carefully the role of stress.
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Adults’ recollections of how often they were teased as children are positively associated with their social anxiety symptoms. It has therefore been suggested that childhood teasing may play a role in the development of social anxiety disorder (SAD). However, existing studies have not determined whether adults with SAD were actually teased more as children or whether their current symptoms have distorted their memories of childhood events. This study examined reports of childhood teasing in adults with SAD before and after cognitive behavioral therapy (CBT). If recollections of childhood teasing are colored by SAD symptoms, then reported frequency of teasing might be more likely to decrease as symptoms improve after CBT. However, if individuals’ memories of teasing are unbiased, they should not substantially change with the reduction of symptoms after CBT. Ninety-one participants with SAD completed the Teasing Questionnaire-Revised (TQ-R) before and after 12 sessions of group CBT. CBT was effective in reducing SAD symptoms, whereas recollections of the frequency of childhood teasing did not change significantly after treatment. These results are consistent with the possibility that recollections of childhood teasing are not substantially biased by symptoms of SAD, and they lend support to previous studies which suggest that adults with SAD endured higher frequencies of teasing as children compared to controls.
Anxiety sensitivity (AS) has been identified as a contributing factor to the development and maintenance of anxiety. Individuals with high AS are sensitive to bodily cues and anxiety-related thoughts and often misinterpret these stimuli as catastrophic or dangerous. Similarly, negative and positive metacognitive beliefs (i.e., beliefs about thinking) are believed to increase internal threat monitoring and the use of maladaptive coping strategies, which may increase the impact of AS on anxiety. As such, the purpose of the present study was to examine the moderating role of metacognitive beliefs on the relationship between anxiety sensitivity and anxiety. Adult participants (N = 417), recruited through an online crowdsourcing website, completed a battery of measures assessing the constructs of interest. Results from multiple linear regression indicated that the relationship between AS and anxiety became significantly stronger as negative and positive metacognitive beliefs increased, thus suggesting that negative and positive metacognitive beliefs may exacerbate the effect of AS on anxiety. The development of risk profiles that incorporate AS and negative and positive metacognitive beliefs may be beneficial for early identification of individuals at high risk for the development of anxiety.
This article describes the specific cognitive behavioral techniques that were employed to treat a client with a 20-year history of compulsive water drinking. It is suggested that working with client’s placement of attention is necessary, especially when there are no ‘thoughts’ to debate with.
- Go to article: The Integrated Neuropsychological Therapy: A Psychotherapy Model Tying Neuropsychology and Cognitive Behavioral Therapy
The Integrated Neuropsychological Therapy: A Psychotherapy Model Tying Neuropsychology and Cognitive Behavioral Therapy
Transdiagnostic cognitive behavioral therapy (CBT) is based on the identification of dysfunctional processes and intervention principles shared across psychopathology. From a neuropsychological perspective, deficits of executive functions and social cognition have been identified as common mechanisms involved in the genesis and maintenance of different psychopathological disorders. The present article describes a new psychotherapy model, the integrated neuropsychological therapy (INPT), built on the principles of transdiagnostic CBT and neuropsychology. Case formulation is operationalized into three levels of functioning, that is, automatic, reflective, and strategic, considering both neuropsychological processes and clinical contents. Treatment planning involves three phases, that is, preparation, enhancement, and change, each consisting of different treatment modules defined according to the above levels of functioning. These modules are selected based on the patient’s profile defined during case formulation. The theoretical foundations of INPT are provided, and a case description is presented, which illustrates the implementation of the treatment model.
- Go to article: Self-Worth Appraisal of Life Events and Beck’s Congruency Model of Depression Vulnerability
Congruency theory predicts that sociotropic and autonomous individuals may experience negative life events differently, focusing primarily on the social and achievement themes of events, respectively. The present study investigated this hypothesis in 175 undergraduate students, who completed measures of sociotropy and autonomy, depressive symptoms, and life event self-worth impact appraisals. Both negative interpersonal and personal failure-related events were related to participants’ senses of self-worth in the social and achievement domains, supporting a continuous model of life event classification. Sociotropy and specific autonomy subfactors showed differential associations with self-worth impact ratings. Recommendations for future research, psychological assessment, and treatment of depressive responses to negative life events in sociotropic and autonomous individuals are discussed.
- Go to article: Reappraisal Bias and Sexual Victimization: Testing the Utility of a Computerized Intervention for Negative Post-Assault Support Experiences
Reappraisal Bias and Sexual Victimization: Testing the Utility of a Computerized Intervention for Negative Post-Assault Support Experiences
Women are at notable risk for negative reactions from others following sexual victimization which serve to intensify negative post-traumatic outcomes. The current study tested the effectiveness of cognitive bias modification-appraisal (CBM-App) training targeting post-traumatic cognitions theorized to be impacted by positive and negative social support with 45 female undergraduates, grouped by experiencing overall positive or negative post-assault support. Whereas all participants experienced improvements in post-traumatic cognitions at 1-week follow-up, a crossover effect for intrusion symptoms was found; CBM-App training reduced intrusions in participants with negative support experiences yet increased intrusions in participants with positive support experiences. While findings highlight the need for careful selection of post-trauma interventions, the study is the first to integrate findings from CBM-App, sexual assault, and social support literature. Socially relevant post-traumatic cognitions appear to be malleable and may be an important focus of treatment for survivors who experienced negative post-assault support.
- Go to article: Should I Relax or Change My Thoughts? A Preliminary Examination of Cognitive Therapy, Relaxation Training, and their Combination with Overanxious Children
Should I Relax or Change My Thoughts? A Preliminary Examination of Cognitive Therapy, Relaxation Training, and their Combination with Overanxious Children
This investigation examined the efficacy of cognitive therapy, relaxation training, and their combination with 4 children (6-15 years of age) diagnosed with DSM-III-R overanxious disorder using a multiple baseline design across subjects. Each intervention contained an exposure component equalized across treatments. All children improved on child and parent pre-post self-report measures as well as parent and independent clinician’s ratings. Treatment gains were maintained at six month follow-up. While all three treatments were associated with diminished anxiety, evidence suggested that interventions were most effective when “matched” to a child’s problematic response class (i.e. cognitive symptoms, somatic symptoms or both). Implications for treatment of childhood anxiety disorders are discussed.
Psychotherapy with paranoid schizophrenics is a hard and often unrewarding task. Individual and group therapies are usually supportive only and are not aimed at changing the paranoid mode of thinking. Although cognitive therapy has been applied in schizophrenic patients, it has not gained wide acceptance.
Cognitive dissonance postulates that individuals experience discomfort and tension when holding two dissonant beliefs simultaneously. We here present the group therapy of six schizophrenic paranoids treated by modified cognitive group therapy implementing cognitive dissonance as the vector of change. A control group of six age- and sex-matched paranoid schizophrenics was treated by supportive group therapy. Analysis of the results, using the Positive and Negative Syndrome Scale (PANSS), during therapy and at follow-up of 4 weeks demonstrates statistically significant improvement in total PANSS score as well as in the positive symptoms subscale.
We investigated three questions related to anger and the treatment of chronic posttraumatic stress disorder (PTSD), utilizing data from a previously published study of cognitive behavioral therapies (CBTs) with female assault victims (Foa, Dancu, Hembree, Jaycox, Meadows, & Street, 1999). The questions were: (1) Do CBTs targeted at PTSD result in a concomitant reduction in anger?, (2) If so, how do these treatments compare with one another?, And (3) Do high levels of pretreatment anger predict poorer outcome on measures of PTSD symptom severity, depression, and general anxiety? Data from the State-Trait Anger Expression Inventory at pretreatment and posttreatment assessments were available for 67 participants randomly assigned to receive prolonged exposure (PE; n = 19), stress inoculation training (SIT; n = 18), combined treatment (PE/SIT; n = 17), or waitlist control (WL; n = 13). Compared to WL, treatments significantly lowered levels of state-anger. Comparisons among active treatments indicated significantly lower state-anger for SIT compared to PE/SIT, but PE did not differ from SIT or PE/SIT. Treatment gains were maintained at follow-up. Pretreatment state-anger was correlated with posttreatment PTSD symptom severity and depression, but multiple regression analyses revealed that pretreatment state-anger did not predict posttreatment PTSD symptom severity or depression beyond the corresponding pretreatment levels of PTSD and depression. A sub-group analysis compared treated participants with clinically significant pretreatment elevations in state-anger (n = 9) to the remainder of the treated participants (n = 45). No significant difference in state-anger was found between groups at posttreatment. The high state-anger group reported greater anger than the low state-anger group at follow-up, but the high state-anger group remained significantly less angry at follow-up than at pretreatment. Thus, CBTs for PTSD reduced anger and pretreatment anger did not reduce the efficacy of these treatments for PTSD and associated psychopathology.