The Relationship Between Automatic Thoughts and Irrational Beliefs Predicting Anxiety and Depression

Cognitive behavioral approaches differ in their views on core cognitions and their hypothesized role in the etiology of depression and anxiety. The present study provides empirical evidence regarding the relationship between irrational beliefs and components of automatic thoughts and their role in the etiology of depression and anxiety. The present study utilized newer and improved questionnaires to assess components of irrational belief. Based on prior research by Safren et al. (Cogn Ther Res 24(3):327–344, 2000), a three-factor structure of the combined automatic thought questionnaires were utilized to measure components of automatic thoughts as they relate to depression and anxiety. Factor analytical methods were utilized to confirm the factor structure of the irrational beliefs and automatic thoughts components. Advanced path modeling was utilized to model the relationship between irrational beliefs and automatic thoughts in predicting anxiety and depression. The study used a sample of N = 542 undergraduate psychology students during stressful exam times. Results indicated that the irrational belief Demandingness represents a primary factor, followed by the secondary irrational beliefs as proposed by Rational Emotive Behavioral Theory. Selfdowning beliefs were fully mediated by depressive automatic thoughts in the case of depressive affect. Low frustration tolerance contributed unique variance to anxious and depressive affect that was not fully mediated by automatic thoughts. Results from the present study add empirical evidence that irrational beliefs indeed represent core and intermediary beliefs that lead to specific automatic thoughts, which is congruent with cognitive behavioral theory as proposed by Rational Emotive Behavioral Therapy.     

The relationship between suppression and subsequent intrusions: the mediating role of peritraumatic dissociation and anxiety

Background and objectives: Although previous studies showed that thought and emotion suppression represent risk factors for intrusions development, the mechanisms that explain these relations were less explored. This study aims to examine the relationships between thought and emotion suppression and the symptoms of intrusion following the exposure to a trauma-related event. Moreover, we explored if these relationships would be mediated by peritraumatic state dissociation and state anxiety.

Design and methods: The trauma film paradigm was used and the participants were students (N?=?148) experimentally exposed to an aversive film to model a traumatic experience. Thought and emotion suppression were measured before the trauma exposure. After exposure, the participants completed scales for measuring state dissociation and state anxiety. Intrusive images and thoughts of the film were recorded in the subsequent week using an intrusion diary.

Results: Thought suppression predicted intrusive thoughts frequency, and this effect was mediated by the peritraumatic anxiety. State anxiety predicted both intrusive images and thoughts, while state dissociation only predicted intrusive images.

Conclusions: Intrusive images and intrusive thoughts are different phenomena and they are predicted by different variables. The practical implications of these results for posttraumatic stress disorder treatment and secondary traumatization are discussed.     

Core beliefs,automatic thoughts and response expectancies in predicting public speaking anxiety

The present study examined the relationships between broad core cognitions, situation-specific automatic thoughts, and response expectancies in regard to their relative contributions to public speaking anxiety. Ninety-nine socially anxious participants (mean age = 20.25) completed measures of irrational beliefs and automatic thoughts specific to public speaking. Participants were then announced the task – giving a speech in front of a virtual reality audience – and response expectancies were measured. Subjective anxiety was measured just before the speech. As predicted, response expectancies and negative automatic thoughts specific to public speaking were each found to mediate the relationship between irrational beliefs and public speaking anxiety. Multiple mediation analysis indicated that the core irrational beliefs generated specific beliefs (i.e., response expectancies that primed automatic thoughts) that acted on speech-related anxiety.     

Irrational beliefs in the articulated thoughts of college students with social anxiety

Cognitive conceptualizations of social anxiety emphasize the role of negative self-statements, unrealistic expectations, and irrational beliefs in the development and maintenance of anxiety in social-evaluative situations. Research into these cognitive factors has entailed administration of questionnaires and instructions to subjects to write down their thoughts during a preceding or impending real-life encounter. These methodologies are criticized on several grounds, such as their assessment of abstract, generalized views by the subject of his/her typical way of thinking over a broad range of circumstances; constraints on responses because of experimenter-provided alternatives; and delays between the eliciting events and self-talk such that recall is subject to distortion and forgetting. Reported here is the use of a recently developed paradigm for uncovering thoughts in complex social situations. In the articulated thoughts during simulated situations method, subjects role-play participation in an audiotaped interpersonal encounter and, at predetermined points, verbalize thoughts elicited by a short segment of the fictitious event. The think-aloud data are taped for later content analysis. The purpose of this study was to explore the relationship between irrational beliefs and social anxiety. Results confirm those of two previous related experiments in that subjects articulated thoughts of greater irrationality when confronted with a stressful social-evaluative situation than with a neutral one. In addition, individuals with a tendency to become anxious in social situations articulated more irrational thoughts than did control subjects, confirming the basic assumption of cognitive-behavioral approaches that certain paterns of unrealistic thinking are associated with psychological distress.     

Investigation of the Relationship Between Anxiety Levels of Patients Before Plastic Surgery Operation and Worship Practices in Muslims

There is an increasing interest in the effects of preoperative anxiety on the course and outcomes of surgical treatments and also in the studies about the anxiety-decreasing interventions. The present study aims to identify the relationship between the preoperative anxiety level of the individuals prior to aesthetic surgery operations such as nose, ear, eyelid, and mammoplasty and religious rituals such as performing prayers, fasting, and going to pilgrimage. The frequency of performing the religious rituals was identified through a questionnaire. The questionnaire included questions about the religious rituals such as performing prayers, going to a pilgrimage, and fasting as well as questions about sociodemographic features such as gender, age, and education level of the patients. Preoperative anxiety level was measured using the “Anxiety Specific to Surgery Questionnaire.” The nonparametric Mann–Whitney U test was used for the scale score comparisons of the two independent groups. The scale score comparisons of more than two groups were performed using the Kruskal–Wallis test. The relationships between age and scale scores were analyzed using the Spearman’s correlation coefficient. The study involved 117 patients who were planned to undergo an aesthetic surgery operation. The scale scores were significantly different according to the pilgrimage groups (p = 0.004). The scale scores were significantly different according to the level of fasting (p = 0.022). No significant differences were found between the scales scores of the groups who reported the frequency of performing prayer as never, sometimes or five times (p = 0.515). In conclusion, the present study found that Muslim people who performed religious rituals more often experienced less preoperative anxiety levels in plastic surgeries, which indicates that the belief level is an effective factor in preoperative anxiety levels. The findings of the present study indicate that patients’ beliefs and worship practices should be taken into consideration by doctors, operating room personnel, and even all health workers in order to decrease the anxiety levels of patients who will undergo surgery.

     

Links between rational and irrational beliefs,trait anxiety and fear of COVID 19

IntroductionOur beliefs and knowledge influence the way we act, react, or adapt to an aversive situation such as the current COVID-19 pandemic. The purpose of this study is to explore factors that may influence perceived fear of COVID-19.MethodologyThree hundred and forty-two people from the general population participated in this study. The participants completed an online anamnestic questionnaire that included questions regarding feelings of vulnerability to illness, fear of COVID-19, rational and irrational beliefs about COVID-19, and trait anxiety.ResultsA stepwise regression analysis showed that trait anxiety, irrational and rational beliefs, and having comorbidities linked to severe forms of the disease were associated with perceived vulnerability concerning health and fear of COVID-19.DiscussionThis study seems to underline the importance of pre-existing vulnerabilities that were exacerbated during the pandemic.     

Testing the REBT-I model in athletes: Investigating the role of self-confidence between irrational beliefs and psychological distress

Evidence suggests that, in the general population, instances of poor mental health have increased over recent years and are set to continue to grow. Athletes may experience a plethora of additional stressors, such as injury, de-selection, and competitive anxiety. Prior research has suggested that irrational beliefs may maladaptively influence an athlete’s wellbeing, but little is known about the role of self-confidence in these relationships. The present study aimed to examine the role which self-confidence plays as part of the REBT-I model in athletes. Broadly speaking, it was hypothesised that primary irrational beliefs would relate negatively to self-confidence through secondary irrational beliefs. In turn, self-confidence was hypothesised to relate negatively to competitive anxiety and depressive symptoms. Additionally, irrational beliefs were hypothesised to combine with low self-confidence to relate negatively to competitive anxiety and depressive symptoms. Four hundred and ten athletes (n = 227 females, Mage = 33.91 years, SD = 14.84) completed an online questionnaire pack assessing irrational beliefs, self-confidence, cognitive and somatic competitive anxiety, and depressive symptoms. Using path analysis, the tested hypothesised model demonstrated an excellent fit to the data. Findings demonstrate some support for the REBT-I model in that primary irrational beliefs predict competitive anxiety and depressive symptoms through secondary irrational beliefs. Results extend the REBT-I model by including self-confidence as a mediating factor between depreciation beliefs and competitive anxiety and depressive symptoms. Findings suggest practitioners should be aware of the role that irrational beliefs may have in negatively influencing self-confidence and subsequent depression symptomology in athletes.     

Cognitions related to anxiety: a pilot study of treatment

In general, where anxiety appears to have a specific external focus, such as the situations which are avoided by phobic patients, treatment involving systematic exposure to those situations seems to be effective. This is less appropriate, or even impossible, where anxiety is not dependent on any external circumstance, but is described by the patient as occurring at any time or place, either chronically over long periods, or acutely in the form of ‘panic attacks’. These patients with ‘generalised’ anxiety often describe internal cues for anxiety either in the form of thoughts (e.g. worry over a current problem) or somatic (e.g. chest sensations interpreted as possible heart disease). Beck et al. (1974) has suggested that on interview, all patients diagnosed as suffering from diffuse or generalised anxiety can report specific ideas or other cognitive cues which are associated with anxiety. These usually concern possible traumatic events, such as illness and death, or social rejection. Clearly Beck has in mind the possibility that these cognitions have the effect of inducing anxiety, although even if the validity of the subjective reports were to be accepted, the problem remains of whether the relationship between mood state and cognitions is causal and if so, in which direction it operates. Obviously a causal relationship may also operate in both directions simultaneously, to form a ‘vicious circle’ in which each exacerbates the other. To establish whether there is a sense in which particular cognitions contribute causally to anxious mood, it would be necessary to find a method of manipulating the type or frequency of cognitions thought to be operating in this way.

One obvious possibility is that of ‘thought-stopping’: that is, patients could be taught to identify thoughts which are associated with anxiety and stop them in the usual way (Wolpe, 1973, p. 211) e.g. by' shouting stop, and substituting an alternative thought. The present study was planned as a pilot experiment to determine (i) if appropriate anxiety related cognitions could be elicited from a series of patients with generalised anxiety, (ii) if the reported frequency of such thoughts could be modified by a thought-stopping technique, and (iii) if any changes in thought frequency were associated with improvements in mood.

Clearly there are many ‘non-specific’ features involved in thought-stopping which could also have therapeutic effects on mood. For this reason it was necessary to include an alternative procedure, not directed at reducing thought frequency, but having the same degree of plausibility to patients, and preferably to therapists. The control procedure chosen for this purpose was modelled on desensitisation, in which patients were encouraged to allow the supposedly anxiety-provoking thoughts into their mind and tolerate them, rather than attempt to stop them. In summary, the study employed a relaxation training phase as a base-line, followed by a cross-over design in which the two treatment phases of thought-stopping and ‘cognitive desensitisation’ were given to each patient, in balanced order.     

Cognitive Coping vs Emotional Disclosure in the Treatment of Anxious Children: A Pilot-Study

The present pilot-study was a first attempt to examine the effectiveness of the cognitive component of cognitive behaviour therapy for children with anxiety problems. A total of 24 highly anxious children were assigned to 1 of 2 intervention conditions: a Cognitive Coping intervention, which focussed primarily on the cognitive component of cognitive behaviour therapy, or an Emotional Disclosure intervention in which children were invited to write about their fears and anxious experiences. Children completed self-report questionnaires of anxiety disorders symptoms and worry at 3 points in time: (i) 6 weeks before treatment (i.e. baseline), (ii) at pre-treatment, and (iii) at post-treatment. The results showed, firstly, that levels of anxiety disorder symptoms and worry remained relatively stable over a 6-week waiting period and then decreased substantially after the interventions. This suggests that the children did not suffer from momentary anxiety and worry complaints and that treatments generally were effective in reducing these symptoms. Secondly, although within-group comparisons suggested that treatment effects were somewhat larger in the Cognitive Coping condition than in the Emotional Disclosure condition (effects sizes for anxiety disorders symptoms and worry were, respectively, 1.03 and 0.87 for Cognitive Coping vs 0.54 and 0.39 for Emotional Disclosure), statistical tests could not substantiate this impression, probably due to a lack of power as a result of the small numbers of children in both intervention conditions.     

Inconsistent parenting and anxiety in the child

Abstract

This study has examined children's estimates of dental anxiety and pain before and after a standard dental treatment session consisting of a local analgesic and drilling procedures. A method of assessing intensity of pain while receiving dental treatment was devised, and measures of the child's uncooperativeness and the dentist's supportive behaviour including treatment time was collected. Results showed that there was an immediate reduction in dental anxiety following exposure to dental procedures for those children referred because of their previous uncooperativeness. The reduction in anxiety was not attributed to supportive behaviour of the dentist. Children referred as unco-operative recorded higher pain intensity to comparison children.     

The Relationship among Metacognitions,Attentional Control,and State Anxiety

Abstract

The present study explored the relationship among metacognitions, attentional control, and state anxiety. A convenience sample of 142 undergraduate students completed the Meta-Cognitions Questionnaire-30, the Attentional Control Scale, and the State subscale of the State–Trait Anxiety Inventory 3 weeks before end-of-year examinations. A cross-sectional design was adopted, and data analysis consisted of correlation and hierarchical regression analyses. Correlation analyses showed that three dimensions of metacognition (negative beliefs about thoughts concerning uncontrollability and danger, cognitive confidence, and beliefs about the need to control thoughts) were positively correlated with state anxiety. These same metacognitions were also found to be negatively correlated with attention shifting and, with the exception of cognitive confidence, attention focusing. Both attention focusing and attention shifting were found to be negatively correlated with state anxiety. A hierarchical regression analysis showed that negative beliefs about thoughts concerning uncontrollability and danger and attention focusing independently predicted state anxiety. Overall, these findings support the hypotheses and are consistent with the metacognitive theory of psychological dysfunction in that they show that metacognitions (in the form of negative beliefs about thoughts concerning uncontrollability and danger) and executive control (in the form of attention-focusing) individually contribute to state anxiety. The implications of these findings are discussed.     

Why do new members stop attending health and fitness venues? The importance of developing frequent and stable attendance behaviour

ObjectivesAttendance at health and fitness venues often declines dramatically during the first year of membership. The present study sought to identify factors associated with continued attendance in new members.MethodsA secondary data analysis was conducted on the attendance data of 1726 new members of a health and fitness organisation over the first 12 months of their membership. Associations were assessed between members’ frequency and pattern of attendance during the first quarter of their membership, age, gender, and home location and their attendance levels in the fourth quarter after joining.ResultsThere was a significant reduction in the frequency of attendance over time from a mean of 7.48 times in the first month to a mean of 0.92 in the 12th month after joining. Older age, starting membership in the autumn or spring, frequency of attendance in the first quarter and stability of the context of attendance (i.e., same time and location) in month three were all significantly associated with increased attendance levels in the fourth quarter.ConclusionsThe findings indicate that new members’ early attendance behaviour, in terms of the frequency and the stability of attendance, may be important for supporting continued attendance at health and fitness venues. Interventions to increase longer-term attendance and, in turn, physical activity, should focus on promoting regular and consistent attendance, especially in terms of day, time and location, early on in individuals’ membership of health and fitness venues.     

The paradoxical effects of suppressing anxious thoughts during imminent threat

In line with the ironic processing theory of Wegner (Psychol. Rev. 101 (1994) 34), it is often argued that the suppression of anxiety-related thoughts results in a paradoxical increase of anxiety and thought intrusions, both after and during the thought suppression. In a sample of undergraduate students (14 men, 18 women), we investigated the effects of suppressing anxious thoughts about an imminent painful electrocutaneous stimulus. During thought suppression, self-reported anxiety and frequency of anxious thoughts did not increase, and duration of anxious thoughts decreased. After thought suppression, participants experienced an increase in self-reported anxiety and the frequency of anxious thoughts. There was no effect upon thought duration. The results support the idea that suppression of anxiety-related thoughts may result in a paradoxical increase in anxiety, and may cause and/or maintain anxiety problems.     

Predicting habit: The case of physical exercise

ObjectivesHabit has been an undervalued concept in the behavioral sciences during the past few decades. One reason may be that habit has been equated with behavioral frequency. This leaves out an important characteristic of habits, i.e., the fact that repeated behavior may acquire a degree of automaticity. The present study aimed to demonstrate that exercising habit can be reliably measured, can empirically be distinguished from past frequency of exercising, and can thus be adopted as a meaningful criterion.Design and methodsA longitudinal study was conducted with two measurements one month apart among 111 students. Intentions to exercise, perceived behavioral control of exercising, past exercising frequency, and exercising habit were assessed at both measurements through an internet-based questionnaire. Exercising habit was assessed by the Self-Report Habit Index [Verplanken & Orbell (2003). Reflections on past behaviour: A self-report index of habit strength. Journal of Applied Social Psychology, 33, 1313–1330]), which breaks down the habit concept in the subjective experience of repetition and automaticity.ResultsThe results showed that exercising habit can be reliably measured, is stable over time, and can be distinguished from mere exercising frequency.ConclusionsIn addition to frequency of behavior, measuring habit provides information about the way behavior is executed. An important element of exercising behavior is the decision to go exercise. It is argued that the habit concept is therefore particularly relevant for the initiation of and adherence to exercising. Implications of distinguishing behavioral frequency and habit for interventions are discussed.     

The natural course of anxiety symptoms in early adolescence: factors related to persistence

Background and objectives: Anxiety disorders are the most common mental health problems during childhood and adolescence. This study examined the course of anxiety symptoms in early adolescents from the general population over three phases.

Design: Prospective cohort study.

Methods: Two hundred and forty-two participants (mean-age of 13.52) from a baseline sample of 1514 (mean-age of 10.23) were followed up three times. Of the 1514 children, those with emotional risk and controls without risk constituted the second-phase sample (n?=?562; mean-age of 11.25). The Screen for Child Anxiety Related Emotional Disorders-SCARED was administered in all three phases.

Results: Fifty-six percent and 32% of respondents showed total scores above the SCARED cutoff point at one and three years follow-up, respectively. Eight percent showed fluctuating symptoms. Fifty-five percent of respondents showed high scores for any subtype of anxiety over three years. Social phobia and generalized anxiety symptoms were the most prevalent and persistent. Participants with persistent separation anxiety showed the highest co-occurrence with symptoms of other psychopathological disorders. Participants with persistent anxiety showed lower academic performance. Being male was a protective factor against persistence.

Conclusions: The data support anxiety maintenance during early adolescence. Early adolescence is a critical period which may involve other serious academic, social, and family problems.     

Is academic buoyancy anything more than adaptive coping?

Abstract

Academic buoyancy refers to a positive, constructive, and adaptive response to the types of challenges and setbacks experienced in a typical and everyday academic setting. In this project we examined whether academic buoyancy explained any additional variance in test anxiety over and above that explained by coping. Two hundred and ninety-eight students in their final two years of compulsory schooling completed self-report measures of academic buoyancy, coping, and test anxiety. Results suggested that buoyancy was inversely related to test anxiety and unrelated to coping. With the exception of test-irrelevant thoughts, test anxiety was positively related to avoidance coping and social support. Test-irrelevant thoughts were inversely related to task focus, unrelated to social support, and positively related to avoidance. A hierarchical regression analysis showed that academic buoyancy explained a significant additional proportion of variance in test anxiety when the variance for coping had already been accounted for. These findings suggest that academic buoyancy can be considered as a distinct construct from that of adaptive coping.     

The quiet passenger: Cognitions,avoidance, and onset among people with driving anxiety

BackgroundAnxiety over driving can have consequences for road safety and individual well-being. This area is under-researched in Australia, despite international research suggesting that most drivers experience some level of anxiety over driving.ObjectivesThis study aimed to contribute to the understanding of driving anxiety by 1) confirming the factor structure of two questionnaires designed to understand the concerns (Driving Cognitions Questionnaire: DCQ) and avoidance behaviours (Driving and Riding Avoidance Scale: DRAS); 2) providing evidence of anxiety manifestations in Australian drivers, and 3) understanding whether these differ according to the initial onset of this anxiety.MethodsA total of 1,600 people (77% females; age ranging from 18 to 89 [M = 27.92; ± 13.49], 75% licenced, 20% learning, 5% unlicenced) in Australia who identified as having “some” level of anxiety over driving, completed an online questionnaire regarding their anxiety.ResultsConfirmatory Factor Analyses showed the two-factor structure of the DRAS (general and traffic avoidance; and weather and riding avoidance) and the two-factor structure of the DCQ (crash-related concerns and social and panic related concerns) best fit the data. The most common anxiety onsets were crash involvement (14%), knowing someone who had been in a crash (9%) and due to criticism from others (9%). While no differences emerged between these groups on avoidance behaviour nor on crash concerns, social and panic concerns were higher for the criticism onset group.ConclusionsThe results demonstrate difference sources of anxiety and provide evidence of the importance of interactions with passengers in determining how a driver feels about the driving task.Practical implicationsAvenues for the reduction or avoidance of anxiety are proposed. These include better awareness and education for drivers regarding the importance of positive interactions and/or well as better journey management to avoid triggers of anxiety.     

Performance perceptions and self-focused attention predict post-event processing after a real-life social performance situation

Background and Objectives: Cognitive approaches to social anxiety suggest that an excessive brooding about one's performance in a social situation (post-event processing; PEP) is involved in the maintenance of anxiety. To date, most studies investigating PEP were conducted in laboratory settings. The present study sought to replicate previous findings on predictors of PEP after a naturalistic social performance situation. Methods: Sixty-five students, who had to give an evaluated presentation for credits, completed measures of trait social anxiety. Immediately after their presentation, participants rated state anxiety and attentional focus during the presentation, and provided an overall evaluation of their performance. One week after the presentation, they rated PEP during the preceding week, and reappraised their performance. Results: Regression analyses demonstrated that the performance ratings after and self-focused attention during the presentation were unique predictors of PEP over and above the effects of trait and state anxiety. There was no evidence that PEP was associated with a biased recall of individual performance evaluations. Conclusions: The results support cognitive theories that emphasize the importance of negative self-perceptions in the development of social anxiety and related processes, and underline self-focused attention and self-evaluative processes as important targets during treatment.     

Irrational Beliefs and the Experience and Expression of Anger

The present study assessed rational-emotive theories of anger by examining the interrelationships of irrational beliefs and the experience and expression of anger. An audiotaped anger-provoking scenario was used to determine whether irrational beliefs predicted state anger and hostile thoughts following provocation. After completing measures of irrational beliefs, trait anger, and anger expression and control, 161 college students were exposed to the provoking stimulus, which was followed by measures of state anger and hostile thoughts. Findings showed both low frustration tolerance and awfulizing were related to trait anger, anger suppression, and outward anger expression. Only low frustration tolerance was related to state anger following provocation. However, awfulizing was associated with all hostile thoughts, and both self-directed shoulds and self-worth were associated with derogatory thoughts about others. Only awfulizing had incremental validity over trait anger, and then, only in the prediction of derogatory thoughts.     

Applicability of a cognitive model of worry to children and adolescents

BackgroundIntolerance of uncertainly (IU), cognitive avoidance (CA) and positive beliefs about worry (PB) independently predict worry frequency in older adolescents and adults, and when targeted together in treatment produce significant reductions in both worry and anxiety in this age range. The present study addresses a gap in the literature by testing whether a cognitive model of excessive worry and anxiety incorporating these process variables is applicable to children and adolescents.MethodPrimary and secondary school students (n = 515; aged 7–19 years) completed modified self-report measures of worry frequency, anxiety, IU, CA and PB and a path analysis undertaken to test whether IU was a higher order variable for CA and PB and whether the relationship between IU/CA/PB and anxiety was mediated by worry frequency.ResultsSignificant (bivariate) correlations were observed between the measures of IU, PB, CA, worry and anxiety across the age range. However separate path models had to be fitted for children (aged 7–12 years) and adolescents (aged 13–19) with PB being dropped from the child model. CA was related to anxiety only through worry in children while IU showed direct paths to worry and anxiety in both children and adolescents.ConclusionsCognitive models of persistent worry in adults and older adolescents may, with some modification, have applicability to children. Further testing and refinement of these cognitive models of worry may lead to improvements in existing treatments for anxious youth.