Cognitive Perspectives Flashcards
Cognition
“the mental action or process of acquiring knowledge and understanding thought, experience, and the senses.”
Cognitive Processing
Analogous to information processing (computing)
Can be automatic and effortful
Attention Pattern Recognition Perception Memory Language Problem-solving and decision-making What happens when these “go wrong”
Diagnostic Criteria for Schizophrenia
Taken from DSM-V
A) Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one must be 1), 2) or 3)
1) Delusions
2) Hallucinations
3) Disorganised Speech
Grossly disorganised or catatonic behaviour
Negative symptoms (e.g. avolition)
Hallucinations
Sensory experience where something is perceived by sight, sound, smell, taste or touch but isn’t present
Auditory hallucinations most common – usually “external” voices
commanding, conversing or commentating
Experienced by 70% of sufferers of psychotic disorders
Visual hallucinations second most common
Abstract form – e.g. shapes and colours
Specific – perceiving a specific person
Patients can be aware that their hallucinations are not real
Delusions
“Firmly held but erroneous beliefs usually involving misinterpretations of perception or experiences”
Experienced by 75% of hospitalised patients with psychotic disorder
Can be bizarre (but not always)
Logical thought processes used to support delusional beliefs despite absurdity of content
Problems integrating perceptions/experiences with existing knowledge/history
Biased information processing
Types of Delusions
Persecution – belief of being spied upon/persecuted/in danger
Grandeur – belief of having fame or power
Control – belief that thoughts/feelings/actions are controlled by external forces
Reference – independent external events are referencing the individual
Nihilistic – some aspect of themselves or world has ceased to exist
Attentional Processes
Attentional processes
Inability to make associations between relevant events orr making irrelevant associations.
Reflect inability to focus attention on relevant environmental aspects (underattention).
Or overattend to irrelevant aspects of the environment.
Schizophrenia sufferers shown to have deficits in the orienting response (response to a change in the environment).
For example, studies that measure Skin Conductance Responses to simple tones – schizophrenics less sensitive
Sufferers also shown to be highly distractible on cognitive tasks.
Same sort of tasks as neurocognitive disorders
Sustained Attention
Selective Attention
Divided Attention
Cognitive Theories continued
Patients with schizophrenia tend to show a bias toward attributing negative life events to external causes.
Make excessively stable (cannot be changed) and global (affect everything) attributions to negative life events.
But also positive events to internal causes and negative events to external causes.
Explains high incidence of reports of persecution in sufferers.
Bentall, R. P., & Kaney, S. (1989).
Used Emotional Stroop Task
Subjects required to name the colours of words as per Stroop Task
But words made up of either words related to negative affect, paranoia, strings of 0’s or neutral words
For example Gloomy Surveillance 00000 Luggage
Patients response times for Paranoid words sig. slower
Cognitive Theories Ext
Morrison (2001) bias toward labelling a “cognitive intrusion” as threatening.
For example, normal auditory hallucination interpreted as “I must be mad”
Leads to negative mood and physiological arousal that lead to more such experiences.
Freeman et al (2002) four factors contribute to emergence and maintenance of delusions
Anomalous experience (hallucination/delusion) with no obvious explanation.
Anxiety, depression & worry creating a bias toward negative thinking and interpretation.
Reasoning bias that seek to find confirmatory evidence of their delusion.
Social factors such as isolation.
Probabilistic Reasoning
Using observations and knowledge to understand an event/situation/person
Similar to inductive reasoning where logical processes that are probable rather than certain lead to conclusions
Can lead to bias in schizophrenia patients
Theory of Mind
Deficits in Theories of Mind (TOM)
Ability to understand our own and others mental states.
Frith (1992) – schizophrenic sufferers thought to have a deficit in being able to infer the beliefs/attitudes/intentions of others.
Corcoran et al (1997) – jokes involving inferring the mental state of others more difficult for deluded individuals to understand
Frith & Corcoran (1996)
Six ToM stories and related questions read to 55 schizophrenia patients
Stories were either First order (a character has false belief about the world) or Second order (a character has a false belief about the belief of another character)
Also explored types of story (circumstantial, deception) and question (beliefs, predictions, explanations)
OCD Diagnosis and Symptoms
Obsessions:
intrusive, repetitive and distressing thoughts, images or urges,
ego-dystonic in nature (i.e. at odds with one’s ego or self-image)
known by the obsessive individual to be the product of their own mind
Compulsions:
repetitive behaviours
or mental rituals (neutralizations)
which are performed in order to decrease the distress caused by the obsessions
Common Subtypes of OCD
The content of these obsessions and compulsions varies
There are some consistent themes. These are known as subtypes or symptom dimensions
Most common include: Checking Doubting Cleaning/ Contamination Symmetry/ Ordering Hoarding Religious (scrupulosity)
Common Fears
What do the fears in these obsessions have in common?
All relate to a fear of being responsible for harm
The Cognitive Model of Obsessions
Salkovskis (1985) proposed a cognitive model of obsessions
Obsessions result from the misinterpretation of negative intrusive thoughts
Spontaneous thoughts that come into one’s mind for no apparent reason, e.g.
Sudden thought that a disaster might happen
Sudden impulse to harm someone
Sudden sexual urge
Inflated Responsibility and Dysfunctional Assumptions about one’s own thoughts play a role
Compulsions occur as a result
Common Cognitive Themes
Attributions and Interpretations – how we interpret thoughts/feelings/events/bodily functions are a common theme in cognitive perspectives to psychopathology
Rumination – perhaps a common theme is a tendency to think deeply and repetitively as a general habit
Then:
Faulty Thinking = Disorder
Vicious Circles
The role of beliefs
Automatic Processing – like reading or driving a car these processes become so automatic that they happen very quickly and effortlessly, meaning they are hard to change
Features of Depression
Emotional
Sadness, misery, dejection, discouraged
Close to tears, loss of sense of humour
Anxiety
Motivational
Loss of interest in hobbies, sex
Lack of initiative, social withdrawal
Behavioural
Slowness of speech and behaviour
Decreased energy, fatigue, stay in bed
Physical Sleep disturbance (middle and terminal insomnia, hypersomnia - difficulty getting back to sleep when waking up in the middle of the night, or early, and oversleeping respectively) Headaches, dizzy spells, indigestion, constipation, general pain
Cognitive
Negative view of the self, the world and the future – pessimism
Inability to think and concentrate or make decisions
Worthlessness, shame and guilt
Cognitive Biases
Bias in thinking and information processing
Negative schema (beliefs that lean toward viewing world and self in a negative way)
Effects selection, encoding, categorisation and evaluation of events
Vicious circle
Stable, originating in early childhood, especially concerning loss
Event in later life “reactivates” negative schema
Negative Triad – self, future, the world. Self-fulfilling prophecy
Evidence for Beck
Stroop task is just one example of the suggested cognitive bias
In adapted tasks the names of colours are replaced with positive, negative and neutral words (e.g. “Success”, “Failed” and “Wood”)
Subjects with depression take longer to name the colour of negative words indicating interference
Dichotic listening procedure (Ingram et al, 1994) – depressed individuals show difficulty ignoring negative words
Memory tasks – negative words, negative info about themselves
Interpretational bias – depression associated with critical self-judgement
Learned Helplessness and Attribution Theories
Seligman (1974) – Research with dogs
Given unavoidable electric shocks
Trained to avoid shocks
History of shocks = couldn’t learn avoidance behaviour
In humans shock replaced with major life trauma
Led to the development of Attribution Theories of Learned Helplessness and Depression
Global-Stable attributional style vulnerability marker for depression
Anxious Cognition
Features involve physical feelings and attributing those feelings to events/objects/situation in a disproportionate way
Why these might occur might not be obvious, with no object of the fear/anxiety necessarily present
Behaviour as a consequence can feed the disorder, for example…
By avoiding social situations
By avoiding the object of phobias
Worry is prominent in the diagnostic criteria
Phobias
Specific type of anxiety…
Extreme, irrational fear of a specific object or situation (Gross)
Typically, the irrationality is acknowledged
Avoidance plays a key role in maintaining the phobia
E.g. If you don’t go in the shed you won’t see a spider
From a behavioural perspective this avoidance is reinforcing, but the actions still need to be explained
So cognition, or how/what the sufferer thinks about the object or situation is also important
Attempts to hide phobia can cause other detrimental effects
Shame, guilt etc.
Agoraphobia
Commonly defined as fear of open spaces.
Most common phobia (60% of all patients with phobias)
Most commonly found in women
But primary fear = fear of leaving the security of the home
Secondary fear = fear of open spaces
Patient tends to be more aware of the secondary fear than the primary one, hence the definition, which also highlights the important of how we think and explain what we are feeling.
Specific Phobias
The behavioural element means that pretty much anything can become a phobia
Usually follows from an unpleasant event with the object at any point on the life span but commonly in childhood
Though some phobias are argued to be hard-wired as an evolutionary development
Preparedness – the genetic preparation to fear something that may have been a threat in our evolutionary past
PTSD
Began as “shell shock” in soldiers who fought in WWI
Then “Combat Fatigues” pre-1980
Before “Post Traumatic Stress Disorder” in DSM-III (1980)
Origins in the experiences of war
But other types of traumas can be the trigger
Anxiety disorder in response to extreme physical or psychological trauma outside of normal human experience
Aspects of PTSD
Presence of one (or more) intrusion symptoms
Memories, dreams, flashbacks, prolonged distress & physical reactions
Memory seems to be the key
How these are reacted to make up the rest of the diagnosis
Cause almost exclusively environmental
Classical conditioning at work (the response to the original event or stimuli)
But not everyone will develop PTSD so other factors thought to be at work, such as individual differences in personal history
Diagnosis can only occur in light of a specific traumatic event, but increasing evidence to show it may not be necessary (e.g. emotional upheavals such as divorce)
Cognitive Aspects of PTSD
Dual representation theory (Brewin et al, 1996):
Symptoms thought to result from a dissociation between autobiographical memory (provide context) and “snapshots” of the event itself
Verbally accessible memory system (VAM) – consciously processes
Situationally accessible memory system (SAM) – unconsciously processed
VAM thought to be impaired, therefore fear in the memory is focused on, impacting on information processing
Without the anchor of the autobiographical memory the “snapshot” are likely to return as involuntary flashbacks
Dual Representation Outcomes
Dual representation theory (Brewin et al, 1996):
Completion/Integration
Recovery through habituation
Reintegration of memories and schemas
Chronic Emotional Processing
Severe and ongoing trauma, lack of support or inability to integrate
Integration not successful
Premature Inhibition of Processing
Inhibition of emotional processing of traumatic memory
Avoidance is key
