Lecture 8 - schemata of the emotional disorders

Question 1

explain the background to schema theory

Answer 1

Beck 1976
schemata - cognitive frameworks for organizing and storing information
facilitates faster processing of information
activaion of schema influences cognitive processing in terms of perception and memory

Question 2

schema and psychopathology

Answer 2

schema are a core element of cognitive theories of emotional disorders
maladaptive schema cause individuals with psychopathology to process information in a biased manner
consequence of biased processing is that symptoms are maintained

Question 3

name and explain three ways we know that schema are biased

Answer 3

interperetations of ambiguous situations - eg neutral stimuli perceived as threatening when anxious
focus of attention on threat - social phobic individuals direct attention towards social threat stimuli to greater degree than non-anxious individuals (Heimrichs and hoffman, 2001)
catastrophising - implications of social events that are negative in valence (Stopa, Clark 2000)

Question 4

automatic process and schemata - name 3

Answer 4

biases in perception
biases in memory
biases in interpretation (logical errors, attributional style)

Question 5

assumptions of schema theory in emotional disorders

Answer 5

individuals prone to develop anxiety or depression either have:
1. more extensive database concerning loss, danger
oe
2. have greater ease of access to such a database

Question 6

schemata of anxious individuals

Answer 6

selevtively attend to environmental cues related to threat
likely to perceive threatening meaning in ambiguous events
KQ: how can the content of schemata be assessed?

Question 7

what are scripts and what can we use them for

Answer 7

scripts - prototypical knowledge about sequence of events that occur in common situations (eg resturant script)
they guide behaviour and are a rich data source for exploring the schematic knowledge sctructures of others

Question 8

what could be some differences between a healthy individual and a social phobics script

Answer 8

social phobic = less concrete, had more events that reflected the experience of anxiety and more negatively toned

Question 9

schemata of depressed individuals

Answer 9

notice failures rather than successes
infer worst from situations that could be interpreted postively
blame self for failures

Question 10

debate of how schema relates to vulnerability in depression (attitudes and thinking)

Answer 10

• stressful life events activate dysfunctional attitudes that lead to onset of depressive symptoms
• extreme thinking = assessed tp extent to which there is total agreement with dysfunctional attitude scale items

Question 11

how does interpretation bias cause its toxic effects

Answer 11

ambiguity about social situatoins is resolved through interpretation
everaert et al 2018 have examined how interpretation bias and inflexibility in changing interpretation bias occurs in depression and social anxiety

Question 12

what is interpretation

Answer 12

semantic process which involves combining different perspectives of a social situation in order to resolve the ambiguity
distortion in interpretation lead to emotional dysregulation

Question 13

interpretation bias in depression

Answer 13

associated with increased negative and decreased positive interpretations (everaert et al 2017)

Question 14

interpretation bias in social anxiety

Answer 14

charatcerized by negative interpretations about ambiguous social cues

Question 15

how do these rigid, unhealthy interpretation biases occur

Answer 15

inflexibility in the formation and maintenance of biased interpretations
flexible interpretations of ambiguous information - combining different aspects of a situation simultaneously and integrating novel information as it becomes available
inflexibile interpretations - difficulty is in revising original interpretations when disconfirming evidence is presented

Question 16

recurrence in depression

Answer 16

depression is the predominant mental health problem worldwide (mental health foundation, 2014)
more than 80% of people with MD have recurrent episodes (kessler et al 1994)
risk of recurrence increases with number of previous episodes (solomon et al 2000)

Question 17

depression and life events

Answer 17

Post (1992) showed that number of life events most strongly associated with first episode of depression
relationship between number of life events and depression is reduced for subsequent episodes

Question 18

extreme thinking and reslapse

Answer 18

total number of total agree responses on depressive cognition
higher levels of post-treatment extreme thinking were associated with more relapse even when controlling for depression severity (Teasdale et al, 2001)

Question 19

utility of schema theory

Answer 19

useful in predicting:

• vulnerability for development of pathology
• vulnerability for relapse

Question 20

utility of schema in predicting vulnerability after trauma

Answer 20

key feature of cognitive accounts of PTSD is way events associated with trauma are appraised
collection of maladaptive appraisals about the trauma and its impact mediates the relationship between reactions to trauma and subsequent experience of Post-traumatic stress syptoms
evidence shows negative cognitions about the trauma and its consequences independently predict long term PTSS over and above initial symptom level

Question 21

what can be done in terms of schema to prevent relapse

Answer 21

change content of schema and then examine how this change related to vulnerability

Question 22

link between cognitive schemata and vulnerability : eating disorders

Answer 22

disorder specific thoughts (control of eating, weight, shape eg Fairburn et al 2003)
cognitive theories of eating disorders argue that dysfunctional schemata contribute to those disordered thoughts

Question 23

tools for assessing schemata in eating disorders

Answer 23

eating disorder velief questionnaire (EDBQ, Cooer et al 1997) - assesses ED-related dysfunctional attitudes

Question 24

two factors that could contribute to eating disordered thinking

Answer 24

rumination
experiential avoidance - unwillingness to experience negative thoughts, feelings and body sensations leads to efforts to avoid these internal processes

Question 25

what is worry?

Answer 25

experienced as similar to talking to oneself about negative outcomes
typically in the form of excessive verbal thoughts as opposed to images (Borkovis and Inz, 1990)
occurs for both GAD individuals as well as non-clinical individuals
relaxation - associated with more imagery for non-clinical and equal imagery for GAD individuals

Question 26

why is worry in thought format

Answer 26

cognitive avoidance of worry theory
- images of negative future events avoided during worry by engaging in worrisome verbal thoughts
as a reuls more worry thoughts intrude later - maintaining the worry cycle

Question 27

conclusion on the neture of shcemata in depression, social anxiety, GAD, trauma and ed’s

Answer 27

depression is associated with extreme thinking
depression and social anxiety associated with interpretation inflexibility and interpretation bias
GAD with worrying thoughts
trauma is associated with malapdative appraisals
changes in eating schemata associated with changes in ED symptoms

Question 28

why is understanding the nature of schemata in the emotional disorders important

Answer 28

design interventions that target these thinking styles