Skip to main content
Top
Gepubliceerd in: Cognitive Therapy and Research 6/2018

13-07-2018 | Original Article

Comparing Cognitive Defusion and Cognitive Restructuring Delivered Through a Mobile App for Individuals High in Self-Criticism

Auteurs: Michael E. Levin, Jack Haeger, Woolee An, Michael P. Twohig

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 6/2018

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

There are ongoing questions regarding the similarities and differences in the clinical impact and processes of change for cognitive restructuring and cognitive defusion. This clinical component test compared 87 adults high in self-criticism randomized to a cognitive defusion mobile app, restructuring app, or waitlist condition for 2 weeks. Equivalent improvements were found from the defusion and restructuring apps relative to the waitlist on self-criticism and distress as well as decentering, self-compassion, and dysfunctional attitudes. However, the defusion condition had a more consistent pattern of improvements relative to waitlist. Improvements in cognitive decentering, self-compassion, and dysfunctional attitudes mediated effects for cognitive defusion relative to waitlist. These mediators were inconsistent for cognitive restructuring. Improvements in self-compassion and cognitive decentering correlated with improvements in outcomes in the defusion condition, but not the restructuring condition. Overall, these results suggest mobile apps providing cognitive defusion and cognitive restructuring strategies are equally effective, but work through distinct processes of change.
Literatuur
go back to reference Baiao, R., Gilbert, P., McEwan, K., & Carvalho, S. (2015). Forms of self-criticising/attacking & self-reassuring scale: Psychometric properties and normative study. Psychology and Psychotherapy: Theory, Research and Practice, 88, 438–452.CrossRef Baiao, R., Gilbert, P., McEwan, K., & Carvalho, S. (2015). Forms of self-criticising/attacking & self-reassuring scale: Psychometric properties and normative study. Psychology and Psychotherapy: Theory, Research and Practice, 88, 438–452.CrossRef
go back to reference Bangor, A., Kortum, P. T., & Miller, J. T. (2008). An empirical evaluation of the system usability scale. International Journal of Human-Computer Interaction, 24, 574–594.CrossRef Bangor, A., Kortum, P. T., & Miller, J. T. (2008). An empirical evaluation of the system usability scale. International Journal of Human-Computer Interaction, 24, 574–594.CrossRef
go back to reference Barrera, T. L., Szafranski, D. D., Ratcliff, C. G., Garnaat, S. L., & Norton, P. J. (2016). An experimental comparison of techniques: Cognitive defusion, cognitive restructuring, and in-vivo exposure for social anxiety. Behavioral and Cognitive Psychotherapy, 44, 249–254.CrossRef Barrera, T. L., Szafranski, D. D., Ratcliff, C. G., Garnaat, S. L., & Norton, P. J. (2016). An experimental comparison of techniques: Cognitive defusion, cognitive restructuring, and in-vivo exposure for social anxiety. Behavioral and Cognitive Psychotherapy, 44, 249–254.CrossRef
go back to reference Beck, A. T., & Haigh, E. A. P. (2014). Advances in cognitive theory and therapy: The generic cognitive model. Annual Review of Clinical Psychology, 10, 1–24.CrossRef Beck, A. T., & Haigh, E. A. P. (2014). Advances in cognitive theory and therapy: The generic cognitive model. Annual Review of Clinical Psychology, 10, 1–24.CrossRef
go back to reference Brooke, J. (1996). SUS: A “quick and dirty” usability scale. In P. W. Jordan, B. Thomas, B. A. Weerdmeester & I. L. McClelland (Eds.), Usability evaluation in industry (pp. 189–194). London: Taylor and Francis. Brooke, J. (1996). SUS: A “quick and dirty” usability scale. In P. W. Jordan, B. Thomas, B. A. Weerdmeester & I. L. McClelland (Eds.), Usability evaluation in industry (pp. 189–194). London: Taylor and Francis.
go back to reference Cox, B. J., Walker, J. R., Enns, M. W., & Karpinski, D. C. (2002). Self-criticism in generalized social phobia and response to cognitive-behavioral treatment. Behavior Therapy, 33, 479–491.CrossRef Cox, B. J., Walker, J. R., Enns, M. W., & Karpinski, D. C. (2002). Self-criticism in generalized social phobia and response to cognitive-behavioral treatment. Behavior Therapy, 33, 479–491.CrossRef
go back to reference de Graaf, I. E., Roelofs, J., & Hubers, M. J. H. (2009). Measuring dysfunctional attitudes in the general population: The dysfunctional attitude scale (form a) revised. Cognitive Therapy and Research, 33, 345–355.CrossRef de Graaf, I. E., Roelofs, J., & Hubers, M. J. H. (2009). Measuring dysfunctional attitudes in the general population: The dysfunctional attitude scale (form a) revised. Cognitive Therapy and Research, 33, 345–355.CrossRef
go back to reference Deacon, B. J., Fawzy, T. I., Lickel, J. J., & Wolitzky-Taylor, K. B. (2011). Cognitive defusion versus cognitive restructuring in the treatment of negative self-referential thoughts: An investigation of process and outcome. Journal of Cognitive Psychotherapy: An International Quarterly, 25, 218–232.CrossRef Deacon, B. J., Fawzy, T. I., Lickel, J. J., & Wolitzky-Taylor, K. B. (2011). Cognitive defusion versus cognitive restructuring in the treatment of negative self-referential thoughts: An investigation of process and outcome. Journal of Cognitive Psychotherapy: An International Quarterly, 25, 218–232.CrossRef
go back to reference Fresco, D. M., Moore, M. T., van Dulmen, M., Segal, Z. V., Teasdale, J. D., Ma, H., & Williams, J. M. G. (2007). Initial psychometric properties of the experiences questionnaire: Validation of a self-report measure of decentering. Behavior Therapy, 38, 234–246.CrossRef Fresco, D. M., Moore, M. T., van Dulmen, M., Segal, Z. V., Teasdale, J. D., Ma, H., & Williams, J. M. G. (2007). Initial psychometric properties of the experiences questionnaire: Validation of a self-report measure of decentering. Behavior Therapy, 38, 234–246.CrossRef
go back to reference Gilbert, P., Clark, M., Hempel, S., Miles, J. N. V., & Irons, C. (2004). Criticising and reassuring oneself: An exploration of forms, styles and reasons in female students. British Journal of Clinical Psychology, 43, 31–50.CrossRef Gilbert, P., Clark, M., Hempel, S., Miles, J. N. V., & Irons, C. (2004). Criticising and reassuring oneself: An exploration of forms, styles and reasons in female students. British Journal of Clinical Psychology, 43, 31–50.CrossRef
go back to reference Gilbert, P., & Procter, S. (2006). Compassionate mind training for people with high shame and self-criticism: Overview and pilot study of a group therapy approach. Clinical Psychology and Psychotherapy, 13, 353–379.CrossRef Gilbert, P., & Procter, S. (2006). Compassionate mind training for people with high shame and self-criticism: Overview and pilot study of a group therapy approach. Clinical Psychology and Psychotherapy, 13, 353–379.CrossRef
go back to reference Gillanders, D. T., Bolderston, H., Bond, F. W., Dempster, M., Flaxman, P. E., Campbell, L., et al. (2014). The development and initial validation of the cognitive fusion questionnaire. Behavior Therapy, 45, 83–101.CrossRef Gillanders, D. T., Bolderston, H., Bond, F. W., Dempster, M., Flaxman, P. E., Campbell, L., et al. (2014). The development and initial validation of the cognitive fusion questionnaire. Behavior Therapy, 45, 83–101.CrossRef
go back to reference Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85, 348–362.CrossRef Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85, 348–362.CrossRef
go back to reference Hayes, S. C., & Hofmann, S. G. (2018). Process-based CBT: The science and core clinical competencies of cognitive behavioral therapy. Oakland: New Harbinger. Hayes, S. C., & Hofmann, S. G. (2018). Process-based CBT: The science and core clinical competencies of cognitive behavioral therapy. Oakland: New Harbinger.
go back to reference Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change. New York: The Guilford Press. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change. New York: The Guilford Press.
go back to reference Hayes, S. C., Villatte, M., Levin, M. E., & Hildebrandt, M. (2011). Open, aware, and active: Contextual approaches as an emerging trend in the behavioral and cognitive therapies. Annual Review of Clinical Psychology, 7, 141–168.CrossRef Hayes, S. C., Villatte, M., Levin, M. E., & Hildebrandt, M. (2011). Open, aware, and active: Contextual approaches as an emerging trend in the behavioral and cognitive therapies. Annual Review of Clinical Psychology, 7, 141–168.CrossRef
go back to reference Kazdin, A. E. (1978). Evaluating the generality of findings in analogue therapy research. Journal of Consulting and Clinical Psychology, 46, 673–686.CrossRef Kazdin, A. E. (1978). Evaluating the generality of findings in analogue therapy research. Journal of Consulting and Clinical Psychology, 46, 673–686.CrossRef
go back to reference Larsson, A., Hooper, N., Osborne, L. A., Bennett, P., & McHugh, L. (2016). Using brief cognitive restructuring and cognitive defusion techniques to cope with negative thoughts. Behavior Modification, 40, 452–482.CrossRef Larsson, A., Hooper, N., Osborne, L. A., Bennett, P., & McHugh, L. (2016). Using brief cognitive restructuring and cognitive defusion techniques to cope with negative thoughts. Behavior Modification, 40, 452–482.CrossRef
go back to reference Levin, M. E., Hildebrandt, M., Lillis, J., & Hayes, S. C. (2012). The impact of treatment components suggested by the psychological flexibility model: A meta-analysis of laboratory-based component studies. Behavior Therapy, 43, 741–756.CrossRef Levin, M. E., Hildebrandt, M., Lillis, J., & Hayes, S. C. (2012). The impact of treatment components suggested by the psychological flexibility model: A meta-analysis of laboratory-based component studies. Behavior Therapy, 43, 741–756.CrossRef
go back to reference Longmore, R. J., & Worrell, M. (2007). Do we need to challenge thoughts in cognitive behavior therapy? Clinical Psychology Review, 27, 173–187.CrossRef Longmore, R. J., & Worrell, M. (2007). Do we need to challenge thoughts in cognitive behavior therapy? Clinical Psychology Review, 27, 173–187.CrossRef
go back to reference Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories. Behaviour Research and Therapy, 33, 335–343.CrossRef Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories. Behaviour Research and Therapy, 33, 335–343.CrossRef
go back to reference Luoma, J. B., & Platt, M. G. (2015). Shame, self-criticism, self-stigma, and compassion in acceptance and commitment therapy. Current Opinion in Psychology, 2, 97–101.CrossRef Luoma, J. B., & Platt, M. G. (2015). Shame, self-criticism, self-stigma, and compassion in acceptance and commitment therapy. Current Opinion in Psychology, 2, 97–101.CrossRef
go back to reference Moffitt, R., Brinkworth, G., Noakes, M., & Mohr, P. (2012). A comparison of cognitive restructuring and cognitive defusion s strategies for resisting a craved food. Psychology & Health, 27, 74–90.CrossRef Moffitt, R., Brinkworth, G., Noakes, M., & Mohr, P. (2012). A comparison of cognitive restructuring and cognitive defusion s strategies for resisting a craved food. Psychology & Health, 27, 74–90.CrossRef
go back to reference Mundt, J. C., Marks, I. M., Shear, M. K., & Greist, J. H. (2002). The work and social adjustment scale: A simple measure of impairment in functioning. British Journal of Psychiatry, 180, 461–464.CrossRef Mundt, J. C., Marks, I. M., Shear, M. K., & Greist, J. H. (2002). The work and social adjustment scale: A simple measure of impairment in functioning. British Journal of Psychiatry, 180, 461–464.CrossRef
go back to reference Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments, and Computers, 36, 717–731.CrossRef Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments, and Computers, 36, 717–731.CrossRef
go back to reference Raes, F., Pommier, E., Neff, K. D., & Van Gucht, D. (2011). Construction and factorial validation of a short form of the Self-Compassion Scale. Clinical Psychology & Psychotherapy, 18, 250–255.CrossRef Raes, F., Pommier, E., Neff, K. D., & Van Gucht, D. (2011). Construction and factorial validation of a short form of the Self-Compassion Scale. Clinical Psychology & Psychotherapy, 18, 250–255.CrossRef
go back to reference Rector, N. A., Bagby, R. M., Segal, Z. V., Joffe, R. T., & Levitt, A. (2000). Self-criticism and dependency in depressed patients treated with cognitive therapy or pharmacotherapy. Cognitive Therapy and Research, 24, 571–584.CrossRef Rector, N. A., Bagby, R. M., Segal, Z. V., Joffe, R. T., & Levitt, A. (2000). Self-criticism and dependency in depressed patients treated with cognitive therapy or pharmacotherapy. Cognitive Therapy and Research, 24, 571–584.CrossRef
go back to reference Segal, Z. V., Teasdale, J. D., & Williams, J. M. G. (2004). Mindfulness-based cognitive therapy: Theoretical rationale and empirical status. In S. C. Hayes, V. M. Follette, & M. Linehan (Eds.), Mindfulness and acceptance: Expanding the cognitive-behavioral tradition (pp. 45–65). New York: Guilford Press. Segal, Z. V., Teasdale, J. D., & Williams, J. M. G. (2004). Mindfulness-based cognitive therapy: Theoretical rationale and empirical status. In S. C. Hayes, V. M. Follette, & M. Linehan (Eds.), Mindfulness and acceptance: Expanding the cognitive-behavioral tradition (pp. 45–65). New York: Guilford Press.
go back to reference Torous, J. B., Levin, M. E., Ahern, D., & Oser, M. (2017). Cognitive behavioral mobile applications: Research literature, marketplace data, and evaluation guidelines. Cognitive and Behavioral Practice, 24, 215–225.CrossRef Torous, J. B., Levin, M. E., Ahern, D., & Oser, M. (2017). Cognitive behavioral mobile applications: Research literature, marketplace data, and evaluation guidelines. Cognitive and Behavioral Practice, 24, 215–225.CrossRef
go back to reference Verbeke, G., & Molenberghs, G. (2000). Linear mixed models for longitudinal data. New York: Springer. Verbeke, G., & Molenberghs, G. (2000). Linear mixed models for longitudinal data. New York: Springer.
go back to reference Wackerly, D. D., Mendenhall, W., & Scheaffer, R. L. (2008). Mathematical statistics with applications. Belmont: Thomson Brooks/Cole. Wackerly, D. D., Mendenhall, W., & Scheaffer, R. L. (2008). Mathematical statistics with applications. Belmont: Thomson Brooks/Cole.
go back to reference Wells, A. (2008). Metacognitive therapy: Cognition applied to regulating cognition. Behavioral and Cognitive Psychotherapy, 36, 651–658.CrossRef Wells, A. (2008). Metacognitive therapy: Cognition applied to regulating cognition. Behavioral and Cognitive Psychotherapy, 36, 651–658.CrossRef
go back to reference Yovel, I., Mor, N., & Shakarov, H. (2014). Examination of the core cognitive components of cognitive behavioral therapy and acceptance and commitment therapy: An analogue investigation. Behavior Therapy, 45, 482–494.CrossRef Yovel, I., Mor, N., & Shakarov, H. (2014). Examination of the core cognitive components of cognitive behavioral therapy and acceptance and commitment therapy: An analogue investigation. Behavior Therapy, 45, 482–494.CrossRef
go back to reference Zelkowitz, R. L., & Cole, D. A. .(2018). Self-criticism as a transdiagnostic process in nonsuicidal self-injury and disorered eating: Systematic review and meta-analysis. Suicide and Life-Threatening Behavior (in press). Zelkowitz, R. L., & Cole, D. A. .(2018). Self-criticism as a transdiagnostic process in nonsuicidal self-injury and disorered eating: Systematic review and meta-analysis. Suicide and Life-Threatening Behavior (in press).
go back to reference Zettle, R. D. (2005). The evolution of a contextual approach to therapy: From comprehensive distancing to ACT. International Journal of Behavioral Consultation and Therapy, 1, 77–89.CrossRef Zettle, R. D. (2005). The evolution of a contextual approach to therapy: From comprehensive distancing to ACT. International Journal of Behavioral Consultation and Therapy, 1, 77–89.CrossRef
Metagegevens
Titel
Comparing Cognitive Defusion and Cognitive Restructuring Delivered Through a Mobile App for Individuals High in Self-Criticism
Auteurs
Michael E. Levin
Jack Haeger
Woolee An
Michael P. Twohig
Publicatiedatum
13-07-2018
Uitgeverij
Springer US
Gepubliceerd in
Cognitive Therapy and Research / Uitgave 6/2018
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI
https://doi.org/10.1007/s10608-018-9944-3

Andere artikelen Uitgave 6/2018

Cognitive Therapy and Research 6/2018 Naar de uitgave