mh 2 Flashcards
subsystems of Anxiety
Cognitive - worry, racing thoughts etc
behavioural - FFF
Physiological (increased blood pressure)
when is anxiety classed as a disorder (rather than an emotion)
interferes with functioning
is prolonged/excessive (6 mnth)
impairs quality of life
basic premise of cognitive theory
dysfunction occurs from how an individual interprets events which in turn influences their behaviours important in maintaining emotional problems
cognition split into 3 areas
automatic thoughts
underlying assumptions
cognitive schemas
negative automatic thoughts NATs
verbal
image
involuntary, rapid, negative
Unhelpful thinking styles- Cognitive distortions
Overgeneralization
Magnification or minimization
mind reading
Arbitrary inference
Overgeneralization
applying a conclusion to a range of situations based on isolated evidence
Magnification or minimization
enlarging / reducing importance of events
Mind reading
assuming poeple are reacting negativly to you despite a lack of evidence
arbitrary inference
Drawing a conclusion without sufficient evidence
schemas
how do they relate to NATs
underlying beliefs and assumptions about self and world based on experience and used to organise and interpret new info stored in memory
- interpreted as absolute truths
Often learned early on in life as a result of childhood experience but can develop or change in later life
NATs (negative automatic thoughts) and distortions in processing reflect the underlying schemas
Clark’s panic model
panic results from catastrophic misinterpretations (CMs) of internal sensations
Trigger stimulus (internal or external)
>
perceived threat
>
apprehension
>
Bodily sensation
>
Interpretation of sensation as catastrophic
>
Perceived threat
How do therapists challenge beleif in CM
- corrective info
- Socratic method
(what makes u think anxiety can cause heart attack) - Behavioural experiments
(hyperventilation provocation)
How effective is CBT
- only ab 50% of patients with GAD recover
- higher recovery rates for panic and social phobia
principles of MCT
“thoughts don’t matter but your response to them does”
Psychological distress is maintained by a style of thinking called the cognitive attention syndrome (CAS)
CAS includes worry, dwelling (rumination), threat monitoring, unhelpful coping strategies
CAS driven by set of metacognitive beliefs
metacognitive beliefs = beleifs about our thinking
2 types of metacognitive beliefs
Negative
Positive
negative metacgnitive beliefs centre around
Uncontrollability of worry.
- i cannot control my worry
- worrying will harm my mind/body
positive metacgnitive beliefs centre around
Benefit/usefulness of worrying
- worrying helps me cope
- if I worry i will be prepared
what did sun et al find in their meta analysis on MCT
NMB seen across psychological disorders. with Uncontrollability and danger being strongest associates
Capobianco meta analysis on metacog beleifs of indivs with physical illnesses
found
NMB associated with increased anxiety and depression across physical illnesses
even after controlling for age, gender, diesease, cognition …
Metacognitive model of GAD
Characteristic of GAD = uncontrolable worry
- Type 1 worry = worry about social, self and world
- Type 1 worry is not enough to cause GAD
GAD ddevelops when negative metacognitive beliefs are activated
- = type 2 worry / meta worry
typical behaviours of GAD
Control process that maintain psychological distress, prolong maladaptive thinking, and maintain maladaptive metacognition.
- More thinking
- Suppression of trigger thoughts
- Reassurance seeking
- avoidance
MCT for GAD
3 stages
Generate (generate case formulation
SHARE (share case formulation)
CHALLENGE
challenge uncontrollability meta beliefs
- evidence, hypotheticals worry postponement, metaphors, experiential exercises (free association)
Efficacy of MCT
Normann & Marina 25 efficacy studies of MCT (15 uncontrolled)
- MCT more effective than waitlist (very large)
- MCT signif more effective than CBT at post treatment and follow up
