Top

Gepubliceerd in:

03-02-2017 | Original Article

Change in Explanatory Flexibility and Explanatory Style in Cognitive Therapy and its Components

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 4/2017

Abstract

The current study represents a secondary analysis of the dismantling study of cognitive therapy of depression originally conducted by Jacobson et al. (J Consult Clin Psychol 64:295–304, 1996). New analyses examined the role of explanatory flexibility and explanatory style in the recovery from depression. Results indicated that BA treatment responders, but not AT or CT participants evidenced significant improvement in explanatory flexibility, whereas patients from all three study arms, irrespective of responder status demonstrated improvements in explanatory style. Improvement in explanatory flexibility was associated with decreases in symptoms of depression for CT, but not BA or AT, participants. Further, the combination of high explanatory flexibility and low explanatory style conferred maximal protection over relapse. These results suggest that explanatory flexibility is a viable candidate as a process associated with treatment gains in CT. In addition, the results suggest that important cognitive change is possible without an explicit, deliberate focus on the part of the therapist.

volgende artikel Emotional Intensity and Emotion Regulation in Response to Autobiographical Memories During Dysphoria

See the primary source citations for a more elaborated and nuanced discussion of cognitive structures and cognitive products

Affirmative treatment response was also defined as post-treatment BDI scores of <9 and minimal or no depressive symptoms on the LIFE-II interview. Patterns of results were comparable in both classification schemes. For brevity of the current paper, these findings are omitted, but are available from the corresponding author

At the recommendation of an anonymous review, we also conducted a logistic regression with treatment response as the criterion and residual change in generality, explanatory flexibility, condition, and their interactions as covariates. The results of this analysis were that only residual change in generality served as a significant predictor, b = −1.07, SE = 0.63, Wald (df = 1) = 2.89, p < 0.001, while flexibility, condition, and the interactions between residual change in generality, flexibility, and condition, did not

Abramson, L., Metalsky, G. I., & Alloy, L. B. (1989). Hopelessness depression: A theory-based subtype of depression. Psychological Review, 96, 358–372.CrossRef

Abramson, L., Seligman, M., & Teasdale, J. (1978). Learned helplessness in humans: Critique and reformulation. Journal of Abnormal Psychology, 87, 102–109.CrossRefPubMed

Allison, P. D. (1984). Event History Analysis: Regression for Longitudinal Event Data. Newbury Park, CA: Sage Publications.CrossRef

American Psychiatric Association (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: American Psychiatric Association.

Barber, J. P., & DeRubeis, R. J. (1989). On second thought: Where the action is in cognitive therapy for depression. Cognitive Therapy and Research, 13, 441–457.CrossRef

Beck, A. T. (1967). Depression: Causes and treatment. Philadelphia: University of Pennsylvania Press.

Beck, A. T. (1976). Cognitive therapy and the emotional disorders. New York: International Universities Press.

Beck, A. T. (1984). Cognition and therapy. Archives of General Psychiatry, 41, 1112–1114.CrossRefPubMed

Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford.

Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77–100.CrossRef

Bernstein, A., Hadash, Y., Lichtash, Y., Tanay, G., Shepherd, K., & Fresco, D. M. (2015). Decentering and Related Constructs: A Critical Review and Metacognitive Processes Model. Perspectives on Psychological Science, 10(5), 599–617. http://doi.org/10.1177/1745691615594577.

Brosschot, J. F., & Thayer, J. F. (2004). Worry, preservative thinking, and health. In I. Nyklicek, L. Temoshok & A. Vingerhoets (Eds.), Emotional expression and health: Advances in theory, assessment, and clinical application (pp. 99–114). New York: Brunner and Rutledge.

Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd edn.). San Diego: Academic Press.

DeRubeis, R. J., Evans, M. D., Hollon, S. D., Garvey, M. D., Grove, W. M., & Tuason, V. B. (1990). How does cognitive therapy work? Cognitive change and symptom change in cognitive therapy and pharmacotherapy for depression. Journal of Consulting and Clinical Psychology, 58, 862–869.CrossRefPubMed

Elkin, I., Shea, M. T., Watkins, J. T., Imber, S. D., Sotsky, S. M., Collin, J. F., Glass, D. R., Pilkonis, P. A., Leber, W. R., Fiester, S. J., Docherty, J., & Parloff, M. B. (1989). National Institute of Mental Health Treatment of Depression Collaborative Research Program: General effectiveness of treatments. Archives of General Psychiatry, 46, 971–982.CrossRefPubMed

Evans, M. D., Hollon, S. D., DeRubeis, R. J., Piasecki, J., Grove, W. M., Garvey, M. J., & Tuason, V. B. (1992). Differential relapse following cognitive therapy and pharmacotherapy for depression. Archives of General Psychiatry, 49, 802–808.CrossRefPubMed

Ferster, C. B. (1973). A functional analysis of depression. American Psychologist, 28, 857–870.CrossRefPubMed

Frank, E., Prien, R. F., Jarrett, R. B., Keller, M. B., Kupfer, D. J., Lavori, P. W., Rush, A. J., & Weissman, M. M (1991). Conceptualization and rationale for consensus definitions of terms in major depressive disorder: Remission, recovery, relapse, and recurrence. Archives of General Psychiatry, 48, 851–855.CrossRefPubMed

Fresco, D. M., Heimberg, R. G., Abramowitz, A., & Bertram, T. L. (2006). The effect of a negative mood priming challenge on dysfunctional attitudes, explanatory style, and explanatory flexibility. British Journal of Clinical Psychology, 45, 167–183.CrossRefPubMed

Fresco, D. M., Mennin, D.S., Hambrick, J. & Heimberg, R.G. (2009). The effect of a negative mood priming challenge on explanatory flexibility and state emotional intelligence in individuals with and without generalized anxiety disorder. Manuscript under review.

Fresco, D. M., Moore, M. T., van Dulmen, M., Segal, Z. V., Teasdale, J. D., Ma, H., & Williams, J. M. G. (2007a). Initial psychometric properties of the Wider Experiences Questionnaire: A self-report survey of decentering. Behavior Therapy, 38, 234–246.CrossRef

Fresco, D. M., Rytwinski, N. K., & Craighead, L. W. (2007b). Explanatory flexibility and negative life events interact to predict depression symptoms. Journal of Social and Clinical Psychology, 26, 595–608.

Fresco, D. M., Williams, N. L., & Nugent, N. R. (2006). Association of explanatory flexibility and coping flexibility to each other and to depression and anxiety. Cognitive Therapy and Research, 30, 201–210.CrossRef

Fresco, D. M., Moore, M. T., Mennin, D. S., Heimberg, R. G., & Hambrick, J. (2014). Changes in explanatory flexibility among individuals with generalized anxiety disorder in an emotion evocation challenge. Cognitive Therapy and Research, 38, 416–427.CrossRef

Gortner, E. T., Gollan, J. K., Dobson, K. S., & Jacobson, N. S. (1998). Cognitive-behavioral treatment for depression: Relapse prevention. Journal of Consulting and Clinical Psychology, 66, 377–384.CrossRefPubMed

Hamilton, M. (1967). Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 276–296.CrossRef

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guilford.

Hollon, S. D., & Garber, J. (1988). Cognitive therapy. In L. Y. Abramson (Ed.), Social cognition and clinical psychology (pp. 204–253). New York: Guilford.

Hollon, S. D., Kendall, P. C., & Lumry, A. (1986). Specificity of depressotypic cognitions in clinical depression. Journal of Abnormal Psychology, 95, 52–59.CrossRefPubMed

Hollon, S. D., & Kriss, M. R. (1984). Cognitive factors in clinical research and practice. Clinical Psychology Review, 4, 35–76.CrossRef

Ingram, R. E., & Hollon, S. D. (1986). Cognitive therapy for depression from an information processing perspective. In R. E. Ingram (Ed.), Information processing approaches to clinical psychology (pp. 259–281). San Diego: Academic Press.

Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K., Gortner, E., & Prince, S. E. (1996). A component analysis of cognitive-behavioral treatment for depression. Journal of Consulting and Clinical Psychology, 64, 295–304.CrossRefPubMed

Jacobson, N. S., Martell, C.R., & Dimidjian, S. (2001). Behavioral activation treatment for depression: Returning to contextual roots. Clinical Psychology, 8, 255–270.

Kashdan, T. B., & Rottenberg, J. (2010). Psychological flexibility as a fundamental aspect of health. Clinical Psychology Review, 30, 865–878.CrossRefPubMedPubMedCentral

Keller, M. B., Lavori, P. W., Friedman, B., Nielsen, E., Endicott, J., McDonald-Scott, P., & Andreason, N. C. (1987). The longitudinal interval follow-up evaluation: A comprehensive method for assessing outcome in prospective longitudinal studies. Archives of General Psychiatry, 44, 540–548.CrossRefPubMed

Kendall, P. C., & Ingram, R. E. (1989). Cognitive behavioral perspectives: Theory and research on depression and anxiety. In P. C. Kendall & D. Watson (Eds.), Anxiety and depression: Distinctive and overlapping features (pp. 27–53). San Diego: Academic Press.

Lackner, R. J., Moore, M. T., Minerovic, J., & Fresco, D. M. (2015). Explanatory flexibility and explanatory style in treatment-seeking clients with Axis I psychopathology. Cognitive Therapy and Research, 39, 736–743.CrossRefPubMedPubMedCentral

Lewinsohn, P. M. (1974). A behavioral approach to depression. In R. J. Friedman & M. M. Katz (Eds.), The psychology of depression: Contemporary theory and research. Oxford: John Wiley & Sons.

Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.

Martell, C. R., Addis, M. E., & Jacobson, N. S. (2001). Depression in context: Strategies for guided action. New York: Norton & Co.

Moore, M. T., & Fresco, D. M. (2007). Depressive realism and attributional style: Implications for individuals at risk for depression. Behavior Therapy, 38, 144–154.CrossRefPubMed

Peterson, C., Semmel, A., von Baeyer, C., Abramson, L. Y., Metalsky, G. I., & Seligman, M. E. P. (1982). The Attributional Style Questionnaire. Cognitive Therapy and Research, 6, 287–300.CrossRef

Peterson, C., & Villanova, P. (1988). An expanded attributional style questionnaire. Journal of Abnormal Psychology, 97, 87–89.CrossRefPubMed

Rush, A., Beck, A., Kovacs, M., & Hollon, S. (1977). Comparative efficacy of cognitive therapy and pharmacotherapy in the treatment of depressed outpatients. Cognitive Therapy and Research, 1, 17–37.CrossRef

Safran, J. D., & Segal, Z. V. (1990). Interpersonal process in cognitive therapy. New York: Basic Books.

Safran, J. D., Vallis, T. M., Segal, Z. V., & Shaw, B. F. (1986). Assessment of core cognitive processes in cognitive therapy. Cognitive Therapy and Research, 10, 509–526.CrossRef

Segal, Z. V., Gemar, M., & Williams, S. (1999). Differential cognitive response to a mood challenge following successful cognitive therapy or pharmacotherapy for unipolar depression. Journal of Abnormal Psychology, 108, 3–10.CrossRefPubMed

Seligman, M.E.P. (1980). A learned helplessness point of view. In L. Rehm (Ed.), Behavior therapy for depression (pp. 123–142). New York: Academic Press.

Seligman, M. E., Castellon, C., Cacciola, J., Schulman, P., Luborsky, L., Ollove, M., & Downing, R. (1988). Explanatory style change during cognitive therapy for unipolar depression. Journal of Abnormal Psychology, 97(1), 13.CrossRefPubMed

Spitzer, R. L., Williams, J. B. & Gibbon, M. (1987). Instruction manual for the Structured Clinical Interview for DSM—III—R. (Available from the Biometrics Research Department, New York, NY: New York State Psychiatric Institute.

Tabachnik, B. G., & Fidell, L. S. (2013). Using multivariate statistics (6th edn.). Boston: Pearson.

Thayer, J. F., & Lane, R. D. (2002). Perseverative thinking and health: neurovisceral concomitants. Psychology and Health, 17, 685–695.CrossRef

Wilson, K. G., & Murrell, A. R. (2004). Values work in acceptance and commitment therapy: Setting a course for behavioral treatment. In S. C. Hayes, V. M. Follette & M. M. Linehan (Eds.), Mindfulness and acceptance: Expanding the cognitive-behavioral tradition (pp. 120–151). New York: Guilford.

Titel: Change in Explanatory Flexibility and Explanatory Style in Cognitive Therapy and its Components
Publicatiedatum: 03-02-2017
Gepubliceerd in: Cognitive Therapy and Research / Uitgave 4/2017
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-016-9825-6

Bohn Stafleu van Loghum

Deel dit onderdeel of sectie (kopieer de link)

Abstract

Log in om toegang te krijgen

Andere artikelen Uitgave 4/2017

Cognitive Control in Generalized Anxiety Disorder: Relation of Inhibition Impairments to Worry and Anxiety Severity

Erratum to: When Will Bulimics Be Depressed and When Not? The Moderating Role of Attributional Style

Emotional Intensity and Emotion Regulation in Response to Autobiographical Memories During Dysphoria

The Effects of Anger Rumination and Cognitive Reappraisal on Anger-In and Anger-Control

The Cognitive Distortions Questionnaire (CD-Quest): Validation in a Sample of Adults with Social Anxiety Disorder

Decision Justification Theory in Depression: Regret and Self-Blame