Top

Cognitive Therapy and Research

Gepubliceerd in:

19-04-2020 | Original Article

Enhancing Social Connectedness in Anxiety and Depression Through Amplification of Positivity: Preliminary Treatment Outcomes and Process of Change

Auteurs: Charles T. Taylor, Sarah L. Pearlstein, Sanskruti Kakaria, Sonja Lyubomirsky, Murray B. Stein

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 4/2020

Abstract

Background

Anxiety and depressive disorders are often characterized by perceived social disconnection, yet evidence-based treatments produce only modest improvements in this domain. The well-established link between positive affect (PA) and social connectedness suggests that directly targeting PA in treatment may be valuable.

Method

A secondary analysis of a waitlist-controlled trial (N = 29) was conducted to evaluate treatment response and process of change in social connectedness within a 10-session positive activity intervention protocol—Amplification of Positivity (AMP)—designed to increase PA in individuals seeking treatment for anxiety or depression (ClinicalTrials.gov Identifier: NCT02330627). Perceived social connectedness and PA/negative affect (NA) were assessed throughout treatment. Time-lagged multilevel mediation models examined the process of change in affect and connectedness throughout treatment.

Results

The AMP group displayed significantly larger improvements in social connectedness from pre- to post-treatment compared to waitlist; improvements were maintained through 6-month follow-up. Within the AMP group, increases in PA and decreases in NA both uniquely predicted subsequent increases in connectedness throughout treatment. However, experiencing heightened NA throughout treatment attenuated the effect of changes in PA on connectedness. Improvements in connectedness predicted subsequent increases in PA, but not changes in NA.

Conclusions

These preliminary findings suggest that positive activity interventions may be valuable for enhancing social connectedness in individuals with clinically impairing anxiety or depression, possibly through both increasing positive emotions and decreasing negative emotions.

vorige artikel Daily Interpersonal and Noninterpersonal Stress Reactivity in Current and Remitted Depression

volgende artikel The Effects of Alcohol and Depressive Symptoms on Positive and Negative Post-Event Rumination in Social Anxiety

Alleen toegankelijk voor geautoriseerde gebruikers

Participants completed a functional magnetic resonance imaging (fMRI) scan at pre- and post-assessment (data presented elsewhere). Several of the eligibility criteria were implemented to ensure MRI safety and minimize confounding of the imaging findings (e.g., the upper age range was restricted due to changes in brain function that occur later in life).

We thank David Sheehan for giving us permission to use a preliminary version of the MINI for DSM-5 in this study.

We repeated the multilevel modeling analyses without including the four WL subjects who completed treatment following the WL period (i.e., AMP participants only). The pattern of findings and statistical significance was consistent with those reported in the main text for the full analysis sample.

All treatment completers (n = 15) finished at least one follow-up assessment (n = 14 at 3- and 6-month follow-up sessions). Missing data at a given follow-up assessment point were substituted using data from a participant’s last available assessment point (i.e., last observation carried forward). Note that the Greenhouse–Geisser corrected degrees of freedom were used given that Mauchly’s test of sphericity was significant, x²(5) = 18.86, p = 0.002.

We repeated the clinically significant change analysis using normative data from study 2 (M = 89.84, SD = 15.44) and study 3 (M = 91.90, SD = 14.83) reported in Lee et al. (2001). Results were identical to those reported in the main text using study 1 data.

Aderka, I. M., Foa, E. B., Applebaum, E., Shafran, N., & Gilboa-Schechtman, E. (2011). Direction of influence between posttraumatic and depressive symptoms during prolonged exposure therapy among children and adolescents. Journal of Consulting and Clinical Psychology,79(3), 421–425.PubMedPubMedCentral

Alden, L. E., & Trew, J. L. (2013). If it makes you happy: Engaging in kind acts increases positive affect in socially anxious individuals. Emotion,13(1), 64–75.PubMed

Algoe, S. B. (2019). Positive interpersonal processes. Current Directions in Psychological Science,28(2), 183–188.

Algoe, S. B., Fredrickson, B. L., & Gable, S. L. (2013). The social functions of the emotion of gratitude via expression. Emotion,13(4), 605–609.PubMed

Bartlett, M. Y., Condon, P., Cruz, J., Baumann, J., & Desteno, D. (2012). Gratitude: Prompting behaviours that build relationships. Cognition & Emotion,26(1), 2–13.

Bauer, D. J., Preacher, K. J., & Gil, K. M. (2006). Conceptualizing and testing random indirect effects and moderated mediation in multilevel models: New procedures and recommendations. Psychological Methods,11(2), 142–163.PubMed

Baumeister, R. F., & Leary, M. R. (1995). The need to belong: Desire for interpersonal attachments as a fundamental human motivation. Psychological Bulletin, 117(3), 497.PubMed

Beck, J. G. (2014). Interpersonal processes in the anxiety disorders: Implications for understanding psychopathology and treatment. Washington: American Psychological Association.

Bolier, L., Haverman, M., Westerhof, G. J., Riper, H., Smit, F., & Bohlmeijer, E. (2013). Positive psychology interventions: A meta-analysis of randomized controlled studies. BMC Public Health,13, 119.PubMedPubMedCentral

Bomyea, J., Ramsawh, H., Ball, T., Taylor, C., Paulus, M., Lang, A., et al. (2015). Intolerance of uncertainty as a mediator of reductions in worry in a cognitive behavioral treatment program for generalized anxiety disorder. Journal of Anxiety Disorders,33, 90–94.PubMedPubMedCentral

Boumparis, N., Karyotaki, E., Kleiboer, A., Hofmann, S. G., & Cuijpers, P. (2016). The effect of psychotherapeutic interventions on positive and negative affect in depression: A systematic review and meta-analysis. Journal of Affective Disorders,202, 153–162.PubMed

Breukelen, G. J. (2006). ANCOVA versus change from baseline had more power in randomized studies and more bias in nonrandomized studies. Journal of Clinical Epidemiology,59(9), 920–925.PubMed

Cacioppo, J. T., & Cacioppo, S. (2018). The growing problem of loneliness. Lancet,391(10119), 426.PubMedPubMedCentral

Campbell-Sills, L., Norman, S. B., Craske, M. G., Sullivan, G., Lang, A. J., Chavira, D. A., et al. (2009). Validation of a brief measure of anxiety-related severity and impairment: The overall anxiety severity and impairment scale (OASIS). Journal of Affective Disorders,112(1–3), 92–101.PubMed

Carl, J. R., Soskin, D. P., Kerns, C., & Barlow, D. H. (2013). Positive emotion regulation in emotional disorders: A theoretical review. Clinical Psychology Review,33(3), 343–360.PubMed

Chakhssi, F., Kraiss, J. T., Sommers-Spijkerman, M., & Bohlmeijer, E. T. (2018). The effect of positive psychology interventions on well-being and distress in clinical samples with psychiatric or somatic disorders: A systematic review and meta-analysis. BMC Psychiatry,18, 211.PubMedPubMedCentral

Chu, P. S., Saucier, D. A., & Hafner, E. (2010). Meta-analysis of the relationships between social support and well-being in children and adolescents. Journal of Social and Clinical Psychology,29(6), 624–645.

Clark, L. A., & Watson, D. (1988). Mood and the mundane: Relations between daily life events and self-reported mood. Journal of Personality and Social Psychology,54(2), 296–308.PubMed

Cohen, S. (2004). Social relationships and health. American Psychologist,59(8), 676–684.PubMed

Craske, M. G., Meuret, A. E., Ritz, T., Treanor, M., & Dour, H. J. (2016). Treatment for anhedonia: A neuroscience driven approach. Depression and Anxiety,33(10), 927–938.PubMed

Craske, M. G., Meuret, A. E., Ritz, T., Treanor, M., Dour, H. J., & Rosenfield, D. (2019). Positive affect treatment for depression and anxiety: A randomized clinical trial for a core feature of anhedonia. Journal of Consulting and Clinical Psychology,87(5), 457–471.PubMed

Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy,58, 10–23.PubMedPubMedCentral

Crawford, J. R., & Henry, J. D. (2004). The positive and negative affect schedule (PANAS): Construct validity, measurement properties and normative data in a large non-clinical sample. British Journal of Clinical Psychology,43(3), 245–265.PubMed

Cruwys, T., Dingle, G. A., Haslam, C., Haslam, S. A., Jetten, J., & Morton, T. A. (2013). Social group memberships protect against future depression, alleviate depression symptoms and prevent depression relapse. Social Science & Medicine,98, 179–186.

Cuijpers, P., Berking, M., Andersson, G., Quigley, L., Kleiboer, A., & Dobson, K. S. (2013). A meta-analysis of cognitive-behavioural therapy for adult depression, alone and in comparison with other treatments. The Canadian Journal of Psychiatry,58(7), 376–385.PubMed

Cuijpers, P., Karyotaki, E., Weitz, E., Andersson, G., Hollon, S. D., & van Straten, A. (2014). The effects of psychotherapies for major depression in adults on remission, recovery and improvement: A meta-analysis. Journal of Affective Disorders,159, 118–126.PubMed

Czyz, E. K., Liu, Z., & King, C. A. (2012). Social connectedness and one-year trajectories among suicidal adolescents following psychiatric hospitalization. Journal of Clinical Child & Adolescent Psychology,41(2), 214–226.

Dichter, G. S., Felder, J. N., Petty, C., Bizzell, J., Ernst, M., & Smoski, M. J. (2009). The effects of psychotherapy on neural responses to rewards in major depression. Biological Psychiatry,66, 886–897.PubMedPubMedCentral

Dillon, D. G., Rosso, I. M., Pechtel, P., Killgore, W. D., Rauch, S. L., & Pizzagalli, D. A. (2013). Peril and pleasure: An RDoC-inspired examination of threat responses and reward processing in anxiety and depression. Depression and Anxiety,31(3), 233–249.PubMedPubMedCentral

Dunn, B. D., German, R. E., Kazanov, G., Zu, C., Hollon, S. D., & DeRubeis, R. J. (2020). Changes in positive and negative affect during pharmacological treatment and cognitive therapy for major depressive disorder: A secondary analysis of two randomized controlled trials. Clinical Psychological Science,8, 36–51.

Dunn, B. D., Widnall, E., Reed, N., Owens, C., Campbell, J., & Kuyken, W. (2019). Bringing light into darkness: A multiple baseline mixed methods case series evaluation of Augmented Depression Therapy (ADepT). Behaviour Research and Therapy,120, 103418.PubMed

Eisenberger, N. I., & Cole, S. W. (2012). Social neuroscience and health: Neurophysiological mechanisms linking social ties with physical health. Nature Neuroscience,15(5), 669–674.PubMed

Elliot, A. J. (2006). The hierarchical model of approach-avoidance motivation. Motivation and Emotion,30(2), 111–116.

Emmons, R. A., & Mccullough, M. E. (2003). Counting blessings versus burdens: An experimental investigation of gratitude and subjective well-being in daily life. Journal of Personality and Social Psychology,84(2), 377–389.PubMed

Eng, W., Coles, M. E., Heimberg, R. G., & Safren, S. A. (2005). Domains of life satisfaction in social anxiety disorder: Relation to symptoms and response to cognitive-behavioral therapy. Journal of Anxiety Disorders,19(2), 143–156.PubMed

Fredrickson, B. L. (2013). Positive emotions broaden and build. Advances in Experimental Social Psychology,47, 1–53.

Fredrickson, B. L., Cohn, M. A., Coffey, K. A., Pek, J., & Finkel, S. M. (2008). Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Journal of Personality and Social Psychology,95(5), 1045–1062.PubMedPubMedCentral

Fredrickson, B. L., & Joiner, T. (2002). Positive emotions trigger upward spirals toward emotional wellbeing. Psychological Science,13, 172–175.PubMed

Gable, S. L., & Berkman, E. T. (2008). Making connections and avoiding loneliness: Approach and avoidance social motives and goals. In A. J. Elliot (Ed.), Handbook of approach and avoidance motivation (pp. 203–216). New York: Psychology Press.

Gable, S. L., & Reis, H. T. (2010). Good news! Capitalizing on positive events in an interpersonal context. Advances in Experimental Social Psychology,42, 195–257.

Gray, J. A. (1987). The psychology of fear and stress (2nd ed.). New York: Cambridge University Press.

Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour Research and Therapy,44, 1–25.PubMed

Hofmann, S. G., & Smits, J. A. (2008). Cognitive-behavioral therapy for adult anxiety disorders: A meta-analysis of randomized placebo-controlled trials. The Journal of Clinical Psychiatry,69(4), 621–632.PubMedPubMedCentral

Hofmann, S. G., Wu, J. Q., & Boettcher, H. (2014). Effect of cognitive-behavioral therapy for anxiety disorders on quality of life: A meta-analysis. Journal of Consulting and Clinical Psychology,82(3), 375–391.PubMedPubMedCentral

Hollon, S. D., DeRubeis, R. J., Fawcett, J., Amsterdam, J. D., Shelton, R. C., Zajecka, J., et al. (2014). Effect of cognitive therapy with antidepressant medications vs antidepressants alone on the rate of recovery in major depressive disorder: A randomized clinical trial. JAMA Psychiatry,71, 1157–1164.PubMedPubMedCentral

Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspectives on Psychological Science,10, 227–237.PubMed

Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: A meta-analytic review. PLoS Medicine,7, e1000316.PubMedPubMedCentral

Impett, E. A., Gordon, A. M., Kogan, A., Oveis, C., Gable, S. L., & Keltner, D. (2010). Moving toward more perfect unions: Daily and long-term consequences of approach and avoidance goals in romantic relationships. Journal of Personality and Social Psychology, 99(6), 948–963. https://doi.org/10.1037/a0020271.CrossRefPubMed

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

Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology,59, 12–19.PubMed

Jose, P. E., Lim, B. T., & Bryant, F. B. (2012). Does savoring increase happiness? A daily diary study. Journal of Positive Psychology,7(3), 176–187.

Kazdin, A. E. (2007). Mediators and mechanisms of change in psychotherapy research. Annual Review of Clinical Psychology,3(1), 1–27.PubMed

Keltner, D., & Kring, A. M. (1998). Emotion, social function, and psychopathology. Review of General Psychology,2, 320–342.

Kenny, D. A., Korchmaros, J. D., & Bolger, N. (2003). Lower level mediation in multilevel models. Psychological Methods,8(2), 115–128.PubMed

Kok, B. E., Coffey, K. A., Cohn, M. A., Catalino, L. I., Vacharkulksemsuk, T., Algoe, S. B., et al. (2013). How positive emotions build physical health. Psychological Science,24(7), 1123–1132.PubMed

Kring, A. M., Persons, J. B., & Thomas, C. (2007). Changes in affect during treatment for depression and anxiety. Behaviour Research and Therapy,45(8), 1753–1764.PubMed

Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine,16(9), 606–613.PubMedPubMedCentral

Lakens, D. (2013). Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Frontiers in Psychology,4, 863.PubMedPubMedCentral

Lang, P. J. (1995). The emotion probe: Studies of motivation and attention. American Psychologist,50(5), 372–385.PubMed

Layous, K., Chancellor, J., & Lyubomirsky, S. (2014). Positive activities as protective factors against mental health conditions. Journal of Abnormal Psychology,123(1), 3–12.PubMed

Lee, R. M., Draper, M., & Lee, S. (2001). Social connectedness, dysfunctional interpersonal behaviors, and psychological distress: Testing a mediator model. Journal of Counseling Psychology,48(3), 310–318.

Loerinc, A. G., Meuret, A. E., Twohig, M. P., Rosenfield, D., Bluett, E. J., & Craske, M. G. (2015). Response rates for CBT for anxiety disorders: Need for standardized criteria. Clinical Psychology Review,42, 72–82.PubMed

Lyubomirsky, S., King, L., & Diener, E. (2005). The benefits of frequent positive affect: Does happiness lead to success? Psychological Bulletin,131(6), 803–855.PubMed

Lyubomirsky, S., & Layous, K. (2013). How do simple positive activities increase wellbeing? Current Directions in Psychological Science,22, 57–62.

Mackinnon, D. P., Fairchild, A. J., & Fritz, M. S. (2007). Mediation analysis. Annual Review of Psychology,58, 593–614.PubMedPubMedCentral

Mackinnon, D. P., Lockwood, C. M., Hoffman, J. M., West, S. G., & Sheets, V. (2002). A comparison of methods to test mediation and other intervening variable effects. Psychological Methods,7(1), 83–104.PubMedPubMedCentral

Mackinnon, D. P., Lockwood, C. M., & Williams, J. (2004). Confidence limits for the indirect effect: Distribution of the product and resampling methods. Multivariate Behavioral Research,39(1), 99–128.PubMedPubMedCentral

Markowitz, J. C., & Weissman, M. M. (2004). Interpersonal psychotherapy: Principles and applications. World Psychiatry,3(3), 136.PubMedPubMedCentral

Mauss, I. B., Shallcross, A. J., Troy, A. S., John, O. P., Ferrer, E., Wilhelm, F. H., et al. (2011). Don't hide your happiness! Positive emotion dissociation, social connectedness, and psychological functioning. Journal of Personality and Social Psychology,100(4), 738.PubMedPubMedCentral

Mcknight, P. E., & Kashdan, T. B. (2009). The importance of functional impairment to mental health outcomes: A case for reassessing our goals in depression treatment research. Clinical Psychology Review,29(3), 243–259.PubMedPubMedCentral

Moore, R. C., Chattillion, E. A., Ceglowski, J., Ho, J., von Känel, R., Mills, P. J., et al. (2013). A randomized clinical trial of behavioral activation (BA) therapy for improving psychological and physical health in dementia caregivers: Results of the Pleasant Events Program (PEP). Behaviour Research and Therapy,51, 623–632.PubMedPubMedCentral

Nelson, S. K., Layous, K., Cole, S. W., & Lyubomirsky, S. (2016). Do unto others or treat yourself? The effects of prosocial and self-focused behavior on psychological flourishing. Emotion,16(6), 850–861.PubMed

Nieuwenhuis, R., Te Grotenhuis, M., & Pelzer, B. (2012). influence.ME: Tools for detecting influential data in mixed effects models. R Journal,4(2), 38–47.

O’Connell, B. H., O’Shea, D., & Gallagher, S. (2016). Enhancing social relationships through positive psychology activities: A randomised controlled trial. The Journal of Positive Psychology,11(2), 149–162.

Olatunji, B. O., Cisler, J. M., & Tolin, D. F. (2007). Quality of life in the anxiety disorders: A meta-analytic review. Clinical Psychology Review,27(5), 572–581.PubMed

Ramsey, M. A., & Gentzler, A. L. (2015). An upward spiral: Bidirectional associations between positive affect and positive aspects of close relationships across the life span. Developmental Review,36, 58–104.

Renner, F., Cuijpers, P., & Huibers, M. J. H. (2014). The effect of psychotherapy for depression on improvements in social functioning: a meta-analysis. Psychological Medicine,44(14), 2913–2926.PubMed

Saris, I. M. J., Aghajani, M., van der Werff, S. J. A., van der Wee, N. J. A., & Penninx, B. W. J. H. (2017). Social functioning in patients with depressive and anxiety disorders. Acta Psychiatrica Scandinavica,136(4), 352–361.PubMedPubMedCentral

Seligman, M. E., Steen, T. A., Park, N., & Peterson, C. (2005). Positive psychology progress: Empirical validation of interventions. American Psychologist,60(5), 410–421.PubMed

Sewart, A. R., Niles, A. N., Burklund, L. J., Saxbe, D. E., Lieberman, M. D., & Craske, M. G. (2019). Examining positive and negative affect as outcomes and moderators of cognitive-behavioral therapy and acceptance and commitment therapy for social anxiety disorder. Behavior Therapy,56, 1112–1124.

Sin, N. L., & Lyubomirsky, S. (2009). Enhancing well-being and alleviating depressive symptoms with positive psychology interventions: A practice-friendly meta-analysis. Journal of Clinical Psychology,65(5), 467–487.PubMed

Strege, M. V., Swain, D., Bochicchio, L., Valdespino, A., & Richey, J. A. (2018). A pilot study of the effects of mindfulness-based cognitive therapy on positive affect and social anxiety symptoms. Frontiers in Psychology,9, 866.PubMedPubMedCentral

Strong, G., & Aron, A. (2006). The effect of shared participation in novel and challenging activities on experienced relationship quality: Is it mediated by high positive affect? In K. D. Vohs & E. J. Finkel (Eds.), Intrapersonal processes in interpersonal relationships (pp. 342–359). New York: Guilford.

Su, J. C., Lee, R. M., & Oishi, S. (2013). The role of culture and self-construal in the link between expressive suppression and depressive symptoms. Journal of Cross-Cultural Psychology,44(2), 316–331.

Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th ed.). Boston, MA: Allyn & Bacon/Pearson Education.

Taylor, C. T., Lyubomirsky, S., & Stein, M. B. (2017a). Upregulating the positive affect system in anxiety and depression: Outcomes of a positive activity intervention. Depression and Anxiety,34(3), 267–280.PubMedPubMedCentral

Taylor, C. T., Pearlstein, S. L., & Stein, M. B. (2017b). The affective tie that binds: Examining the contribution of positive emotions and anxiety to relationship formation in social anxiety disorder. Journal of Anxiety Disorders,49, 21–30.PubMedPubMedCentral

Taylor, C. T., Pearlstein, S. L., & Stein, M. B. (2020). A tale of two systems: Testing a positive and negative valence systems framework to understand social disconnection across anxiety and depressive disorders. Journal of Affective Disorders,266, 207–214.PubMedPubMedCentral

Trew, J. L. (2011). Exploring the roles of approach and avoidance in depression: An integrative model. Clinical Psychology Review,31(7), 1156–1168.PubMed

Umbersen, D., & Montez, J. K. (2010). Social relationships and health: A flashpoint for health policy. Journal of Health and Social Behavior,51(Suppl), S54–S66.

Vickers, A. J., & Altman, D. G. (2001). Statistics notes: Analysing controlled trials with baseline and follow up measurements. BMJ,323(7321), 1123–1124.PubMedPubMedCentral

Watson, D., Clark, L. A., McIntyre, C. W., & Hamaker, S. (1992). Affect, personality, and social activity. Journal of Personality and Social Psychology,63, 1011–1025.PubMed

Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology,54(6), 1063–1070.PubMed

Waugh, C. E., & Fredrickson, B. L. (2006). Nice to know you: Positive emotions, self–other overlap, and complex understanding in the formation of a new relationship. The Journal of Positive Psychology,1(2), 93–106.PubMedPubMedCentral

Williams, L. A., & Bartlett, M. Y. (2015). Warm thanks: Gratitude expression facilitates social affiliation in new relationships via perceived warmth. Emotion,15(1), 1–5.PubMed

Winer, E. S., Bryant, J., Bartoszek, G., Rojas, E., Nadorff, M. R., & Kilgore, J. (2017). Mapping the relationship between anxiety, anhedonia, and depression. Journal of Affective Disorders,221, 289–296.PubMedPubMedCentral

Titel: Enhancing Social Connectedness in Anxiety and Depression Through Amplification of Positivity: Preliminary Treatment Outcomes and Process of Change
Auteurs: Charles T. Taylor
Sarah L. Pearlstein
Sanskruti Kakaria
Sonja Lyubomirsky
Murray B. Stein
Publicatiedatum: 19-04-2020
Uitgeverij: Springer US
Gepubliceerd in: Cognitive Therapy and Research / Uitgave 4/2020
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-020-10102-7

Bohn Stafleu van Loghum

Deel dit onderdeel of sectie (kopieer de link)

Abstract

Background

Method

Results

Conclusions

Log in om toegang te krijgen

Andere artikelen Uitgave 4/2020

When are Worry and Rumination Negatively Associated with Resting Respiratory Sinus Arrhythmia? It Depends: The Moderating Role of Cognitive Reappraisal

The Effects of Alcohol and Depressive Symptoms on Positive and Negative Post-Event Rumination in Social Anxiety

The Fear of Losing Control in Social Anxiety: An Experimental Approach

Inhibiting the Emergence of Involuntary Musical Imagery: Implications for Improving Our Understanding of Intrusive Thoughts

Daily Interpersonal and Noninterpersonal Stress Reactivity in Current and Remitted Depression

Interpretation Bias in Online and Offline Social Environments and Associations with Social Anxiety, Peer Victimization, and Avoidance Behavior