Cognitive-Behavioural Processes Flashcards
FORMULATION APPROACH: COGNITIVE-BEHAVIOURAL PROCESSES
- occur on formulation-based dimensional approach normality-severe continuum
KUYKEN ET AL (2005) - case-formulation (CBT cornerstone) draws on theory to describe presenting issues
- develops hypotheses/associated frameworks to develop treatment
IDIOGRAPHIC
- focus on individual/presenting symptoms
- hypothesises cause/effect
- precise treatment tailoring
FORMULATION-BASED APPROACH
- dimensional approach
- recognises processes/disorders operating on normality-severe disturbance in gen pop
CATEGORICAL APPROACH
- diagnostic systems tend to use disorder categories to describe those w/psychological disorders
- aim to fit presenting symptoms into disorder category
- qualitative break between those who have a PD/those who don’t
- each disorder = discrete entity from others/normal beh
SOCIAL ANXIETY DISORDER
- 1/5 major anxiety disorders in DSM-5
- overlaps w/APD/common traits ie:
1. shyness
2. negative evaluation fear
SOXIATY ANXIETY DISORDER: CRITERIA
- marked/persistent fear of 1/+ social/performance situations in which person = exposed to unfamiliar people/possible scrutiny (ie. meeting people/public eating/humiliation fear, etc.)
- exposure provokes immediate reaction
- irrational fear = recognised
- feared situation = avoided; interferes w/daily life
TRANSDIAGNOSTIC APPROACH
- focuses on cognition/beh biases across disorders and how processes contribute to disorder maintenance
- short-cuts/heuristic thinking to save time/resources; usually helpful
- ie. large animal growling = dangerous (reasoning) -> run away (behaviour)
- certain short-cuts = characteristic of psychological disorders; contribute to maintenance (causal role)
TRANS APPROACH X PSYCH DISORDERS
- cognition lets us understand personality/psychological disorders/mental illness
- cognitive processes of perceiving/interpreting/planning become distorted in personality disorders
- trans approach has a role to play in personality x psychological disorders overlap via cognition biases
PDs: COGNITION BIASES
- distorted perception of others
- misinterpretation of others’ intentions
- altered social cognitions ie. impaired social judgement
- self-concept distortion ie. lack of stability/low or high self-esteem (narcissism)
COGNITIVE BEH PROCESSES X PSYCH DISORDERS
- particular cognitive beh processes implicated in psych disorder maintenance:
1. attention
2. memory
3. reasoning
SOCIAL PHOBIA: ATTENTIONAL BIASES
- signals of concern hypervigilance (ie. others’ responses to their beh)
- self-focussed attention = ^ internal cue awareness (ie. sweating/trembling); confirms social ineptitude fears
SOCIAL PHOBIA: MEMORY PROCESSES
- selective negative past social event retrieval
- increases anxiety/self-focused attention
SOCIAL PHOBIA: REASONING BIASES
- misinterpretation of situations (before/during/after)
SOCIAL PHOBIA: BEHAVIOURAL BIASES
- avoidance/safety beh prevent disconfirmation of beliefs
- prevents new learning
SELECTIVE ATTENTION
- specific stimuli within external/internal environments selected for further processing
- attentional bias = some people (ie. those w/anxiety disorders) have systematic tendency to attend/avoid particular stimuli class
SELECTIVE ATTENTION: PROCESSES
- evidence indicates most everyday beh triggered/maintained in automatic manner so resources are freed for other actions
AUTOMATIC - eg. distracted by sudden moving object/noise
CONTROLLED - consciously attending to stimulus (ie. someone walking towards you in a street)
SELECTIVE ATTENTION: EXPERIMENTAL PARADIGMS
- researchers developed many for standardised attention measurement
- paradigms provided much info BUT…
- each relies on indirect selective attention measure so misses complexities of IRL situations
ATTENTION BIAS: DETECTION TASKS
- ie. visual search tasks (detection/distraction)
- if individual = prone to attending more to particular stimuli type -> faster detection if located among distractors
CLASSIC STROOP TEST
- YELLOW (red f.), GREEN (black f.), RED (red f.)
- instructions = read aloud colours in which words are printed; ignore content
- compared Reaction Time (RT) when ink colour/name colour = inconsistent VS consistent
- slower to colour name when inconsistent
EMOTIONAL STROOP TEST
- APRIL (light green f.); DEATH (dark green f.); TABLE (red f.)
- instructions = read aloud colour in which words are printed; ignore content
- compare RT when word content = neutral VS disorder related ie. death
EMOTIONAL STROOP TEST: INTERPRETATION DIFFICULTIES
- may induce internal attention ie. reflecting pre-occupation w/themes associated w/emotional word
- may induce emotional reaction that inhibits response -> slow RT
- cognitive avoidance ie. longer RT may reflect suppression attempts of threatening context
DOT PROBE
- selective attention measure indexed by SHORTER response latency -> better/less ambiguous measure
- emotional cue/dot probe (upper/lower) spatial location = balanced across whole task
- faster responses for emotional word VS neutral = indicates selective attention towards emotional info of that nature
EYE TRACKER/VISUAL SCANPATH STUDIES
- other paradigms assess attention indirectly; this is more direct
- directly assesses if people focus gaze over time
- pps = control/schizophrenia/affective disorder
- BUT… we can attend material that we aren’t directly seeing ie. from corner of eye
- disadvantage = cannot measure covert attention to spatial region independent of eye movement
TRANS APPROACH: ATTENTIONAL PROCESSES
HARVEY et al (2004)
- measured attention w/various methods
- 3 attentional processes considered as definitely trans processes:
SELECTIVE ATTENTION
- concern-relevant external stimuli (aka. confirms pre-existing beliefs; interferes w/new info)
- concern-relevant internal stimuli (aka. self-focussed attention)
ATTENTIONAL AVOIDANCE/SAFETY ATTENTION
- prevents habituation/stimuli reappraisal
SOCIAL SECURITY MODEL
CLARK & WELLS (1995)
- key cognitive/beh processes maintaining social phobia:
1. PRIOR
- anticipation/selective retrieval/rumination
2. DURING
- self-focused attention
3. AFTER
- “post-mortem” aka. selective retrieval/negative interpretation/rumination
SOCIAL SECURITY MODEL: PRIOR
- on anticipating social situation individuals w/social phobia selectively retrieve negative info concerning how they think they’re perceived
- ruminate/dwell on info; serves to maintain social anxiety as content = dominated by past social failures
- may lead to situation avoidance/self-focused entering state
SOCIAL SECURITY MODEL: DURING
- self-focused attention = crucial in social phobia maintenance
- self-focused state in people w/social phobia -> info/image usage from internal cues about how they’re negatively evaluated by others
- typically view themselves from others’ assumed perspective (aka. observer perspective images)
- become trapped in closed system where most fear evidence generated from internal cues (ie. trembling/sweating/subjective trouble speaking)
- recurrent images help maintain social phobia as little attention paid to external environment; focus on distorted self-images from observer perspective
SOCIAL SECURITY MODEL: WITHIN SAFETY BEHAVIOURS
SALKOVSKIS (1991)
- avoidance of feared social situation maintains social anxiety via preventing rejection fears before disconfirmation
- avoidance = overt (ie. leaving room)/subtle (ie. avoiding eye contact)
- behs vary; linked to particular feared outcomes (ie. hand tremble fear = glass grip adjustment)
- anxiety reduction intention BUT actually ^ anxiety; attend < to conversation due to excessive self-focus/looking stupid concern
SOCIAL SECUIRITY MODEL: LEAVING SITUATION
- post-mortem = selective retrieval/negative interpretation/rumination
- anxious feelings selective retrieval/negative performance self-perceptions -> overly negative overall interpretation
- ruminating/dwelling on how they came across/what they said/did -> overall negative interpretation
- post-mortem consequence = things seem worse upon reflection > upon immediate leaving -> future event avoidance/safety beh adoption; both enhance/maintain social fears
MEMORY
- 3 processing stages: encoding/storage/retrieval
- each relevant to psychopathology development aka. selective encoding/retrieval; may include recall difficulties ie. amnesia
- factors influence what’s encoded/retrieved (ie. mood/environment/of personal import)
- attention/memory = interact
MEMORY X ATTENTION
- ie. weapon focus effect
LOFTUS (1979) - weapon captures good deal of victim’s attention
- leads to reduced recall ability of other environmental/assailant details
- reduced assailant recognition later
MOOD-CONGRUENT MEMORY
- selective memory form
- selective encoding/retrieval
- occurs while individuals = mood state consistent w/affective material tone
- factor in depression maintenance
- ^ depression = ^ negative event/failure/loss recall
REASONING BIASES
- reasoning = thinking concerned w/deducing conclusions/generating judgements/testing hypotheses in logical/coherent way
- reasoning bias = when thinking about world -> conclusions in systematic/regular manner across time/contexts
- not necessarily dysfunctional; commonly used; help us make sense of world BUT can be dys
- occur across reasoning processes
INTERPRETATIVE REASONING
- reaching conclusion to meaning of ambiguous/open-minded situation in many IRL situations
- many psychological disorders have negative interpretational bias
ATTRIBUTIONAL REASONING
- inferring causes for why particular outcomes occurred on 3 principal dimensions:
1. INTERNAL-EXTERNAL
2. STABLE-TRANSCIENT
3. GLOBAL-LOCAL
EXPECTANCY REASONING
- processes used in predicting future event/outcomes resulting from particular actions/situations likelihood
- some reasoning shortcuts/heuristics implicated in expectancy reasoning ie. availability/representativeness/emotional reasoning
HYPOTHESIS TESTING
- reasoning process used in evaluating if explanations/beliefs = accurate/require revision in new info light
- confirmation bias in general; people tend to be biased toward validating pre-existing beliefs
ATTRIBUTIONAL REASONING: SELF-SERVING BIAS
- people typically attribute:
1. negative events to external/transient/local causes (ie. the other driver didn’t see me)
2. positive events to internal/stable/global causes (ie. I am clever)
ATTRIBUTIONAL REASONING: FUNDAMENTAL ATTRIBUTIONAL BIAS
- people tend to attribute another’s beh to personal disposition while overlooking situational causes/transient influences
ATTRIBUTIONAL REASONING: PESSIMISTIC ATTRIBUTIONAL STYLE
- attributing negative events to internal/stable/global causes
- attributing positive events to external/transient/local causes
- typical of depression (ie. failed exam = I’m stupid; passed = too easy/luck)
EXPECTANCY REASONING
- person’s ability to generate particular event classes indicates availability/accessability in the mentioned events
MACLEOD ET AL (1997) - future thinking task; generate looking forward/not looking forward to events for next week/year/5-10y/time limit
- time limit = availability measure
- patients w/panic disorder/social anxiety = ^ future negative events; rate - ^ likely > controls
- = elevated expectancy for bad things
AVAILABILITY HEURISTIC
TVERSKY & KAHNEMAN (1974)
- likelihood/frequency judgements of events influenced by availability/accessibility of related memories/mental simulations
REPRESENTATIVENESS HEURISTIC
- expectancy/causality/categorisation judgements influenced by extent to which specific event seen as typical of large event group (ie. gamblers fallacy)
EMOTIONAL REASONING HEURISTIC
- evaluative judgements based on emotional feelings/ex-consequentia reasoning
- conclude that there must be danger merely because you feel anxious
THE MAIN HEURISTIC RULES
- broadly accurate/effective/rapid/economical/effortless
- BUT -> consistent judgement biases/underestimating abstract/stat info (ie. ignoring how frequent even occurs (aka. base rate info ie. horoscopes))
1. AVAILABILITY HEURISTIC
2. REPRESENTATIVENESS HEURISTIC
3. EMOTIONAL REASONING HEURISTIC
TRANS APPROACH X REASONING
HARVEY ET AL (2004)
- conclude from experimental evidence review that following reasoning processes = definite transdiagnostic processes:
1. interpretation reasoning
2. expectancy reasoning
3. emotional reasoning
- attributional reasoning is POSSIBLE trans
REVIEW & CRITIQUE
FUSAR-POLI, SOLMI & BRONDINO ET AL (2019)
- 111 studies investigating cognitive/other psych interventions
- 15-91k pps in samples; quality = low/not always transdiagnostic
- trans research review largely restricted focus on anxiety/depressive disorders
- conceptual analysis = trans research affected by conceptual bias
- authors argue = trans approaches not yet delivered credible paradigm shift to impact classification/clinical care
