The compatibility heuristic in non-categorical hypothetical reasoning: Inferences between conditionals and disjunctions

A new theory explains how people make hypothetical inferences from a premise consistent with several alternatives to a conclusion consistent with several alternatives. The key proposal is that people rely on a heuristic that identifies compatible possibilities. It is tested in 7 experiments that examine inferences between conditionals and disjunctions. Participants accepted inferences between conditionals and inclusive disjunctions when a compatible possibility was immediately available, in their binary judgments that a conclusion followed or not (Experiment 1a) and ternary judgments that included it was not possible to know (Experiment 1b). The compatibility effect was amplified when compatible possibilities were more readily available, e.g., for ‘A only if B’ conditionals (Experiment 2). It was eliminated when compatible possibilities were not available, e.g., for ‘if and only if A B’ bi-conditionals and exclusive disjunctions (Experiment 3). The compatibility heuristic occurs even for inferences based on implicit negation e.g., ‘A or B, therefore if C D’ (Experiment 4), and between universals ‘All A’s are B’s’ and disjunctions (Experiment 5a) and universals and conditionals (Experiment 5b). The implications of the results for alternative theories of the cognitive processes underlying hypothetical deductions are discussed.     

Reasons Why Rational Emotive Behavior Therapy Is Relatively Neglected in the Professional and Scientific Literature

Although rational emotive behavior therapy (REBT) has been the pioneering cognitive behavior therapy (CBT) of the twentieth century, and although its main methods are very popular among practicing clinicians as well as members of the public, it has been relatively neglected in the professional and scientific literature. Reasons for this neglect are discussed and some steps are suggested to make REBT more effective and more scientifically accepted.     

Reasons Why Rational Emotive Behavior Therapy Is Relatively Neglected in the Professional and Scientific Literature

Although rational emotive behavior therapy (REBT) has been the pioneering cognitive behavior therapy (CBT) of the twentieth century, and although its main methods are very popular among practicing clinicians as well as members of the public, it has been relatively neglected in the professional and scientific literature. Reasons for this neglect are discussed and some steps are suggested to make REBT more effective and more scientifically accepted.     

Indicative and counterfactual ‘only if’ conditionals

We report three experiments to test the possibilities reasoners think about when they understand a conditional of the form ‘A only if B’ compared to ‘if A then B’. The experiments examine conditionals in the indicative mood (e.g., A occurred only if B occurred) and counterfactuals in the subjunctive mood (A would have occurred only if B had occurred). The first experiment examines the conjunctions of events that reasoners judge to be consistent with conditionals, e.g., A and B, not-A and not-B. It shows that people think about one possibility to understand ‘if’ and two possibilities to understand ‘only if’; they think about two possibilities to understand counterfactual ‘if’ and ‘only if’. The second experiment shows that the possibilities people think about when they understand ‘only if’ are in a different temporal order (e.g., B and A) to the possibilities they think about for ‘if’ (A and B). The third experiment shows that people make different inferences from ‘only if’ and ‘if’ conditionals and counterfactuals. The implications of the results for theories of counterfactual conditionals are considered.     

Cognitive Behavior Therapy for Anxious Adolescents: Developmental Influences on Treatment Design and Delivery

Anxiety disorders in adolescence are common and disruptive, pointing to a need for effective treatments for this age group. Cognitive behavior therapy (CBT) is one of the most popular interventions for adolescent anxiety, and there is empirical support for its application. However, a significant proportion of adolescent clients continue to report anxiety symptoms post-treatment. This paper underscores the need to attend to the unique developmental characteristics of the adolescent period when designing and delivering treatment, in an effort to enhance treatment effectiveness. Informed by the literature from developmental psychology, developmental psychopathology, and clinical child and adolescent psychology, we review the ‘why’ and the ‘how’ of developmentally appropriate CBT for anxious adolescents. ‘Why’ it is important to consider developmental factors in designing and delivering CBT for anxious adolescents is addressed by examining the age-related findings of treatment outcome studies and exploring the influence of developmental factors, including cognitive capacities, on engagement in CBT. ‘How’ clinicians can developmentally tailor CBT for anxious adolescents in six key domains of treatment design and delivery is illustrated with suggestions drawn from both clinically and research-oriented literature. Finally, recommendations are made for research into developmentally appropriate CBT for anxious adolescents.     

The Savanna-IQ interaction hypothesis: A critical examination of the comprehensive case presented in Kanazawa's The Intelligence Paradox

Kanazawa (2012b) has recently presented the most comprehensive case yet for his Savanna-IQ Interaction Hypothesis. According to the hypothesis, intelligence is a domain-specific adaptation which has been selected for as humans have moved away from the (evolutionarily familiar) Savanna. As such, ability in ‘evolutionarily novel’ tasks and ‘evolutionarily novel’ preferences are positively correlated with high IQ. This article will present a critical examination of the hypothesis, arguing that there is a strong case against anchoring human nature on the Savanna, the hypothesis predicts contradictory findings, there is empirical evidence against it, it is not falsifiable, and it is not necessary to explain that data which Kanazawa presents.     

Children’s Perspectives of an Enhanced Cognitive-Behavioral Treatment for Child–Parent Dyads With Anxiety Disorders

Prior research has extensively evaluated the efficacy of cognitive-behavioral therapy (CBT) for child anxiety disorders—however, few studies have investigated anxious children’s perspectives and experiences of participating in CBT. This qualitative study explored children’s acceptability of a newly developed enhanced CBT intervention, designed specifically for the treatment of anxiety disorders in children with a clinically anxious parent. The study also explored children’s perceptions and experiences of individual (child only) and joint observational (child–parent) exposure activities that were key to the intervention. Ten children (age range 6–11, M = 8.5 years) and their mothers (age range 34–45, M = 39.5 years) completed in-depth semistructured interviews to investigate child participants’ anticipated and experiential acceptability of the enhanced CBT intervention. Thematic analysis revealed seven major themes broadly reflecting the acceptability, appropriateness, and perceived benefit of the intervention elements, with particular value credited to exposure tasks and the dyadic nature of the intervention. Findings suggest that future experimental evaluation of the enhanced intervention is warranted. Further, the study highlights that CBT for child anxiety disorders, where exposure work is a feature, is acceptable and perceived to be effective by its intended treatment recipients. Trial prospectively registered, preresults, ANZCTR1261900033410.     

First‐line therapy for post‐traumatic stress disorder: A systematic review of cognitive behavioural therapy and psychodynamic approaches

Background

Despite evidence supporting cognitive behavioural therapy (CBT)‐based interventions as the most effective approach for treating post‐traumatic stress disorder (PTSD) in randomised control trials, alternative treatment interventions are often used in clinical practice. Psychodynamic (PDT)‐based interventions are one example of such preferred approaches, this is despite comparatively limited available evidence supporting their effectiveness for treating PTSD.

Aims

Existing research exploring effective therapeutic interventions for PTSD includes trauma‐focused CBT involving exposure techniques. The present review sought to establish the treatment efficacy of CBT and PDT approaches and considers the potential impact of selecting PDT‐based techniques over CBT‐based techniques for the treatment of PTSD.

Results

The evidence reviewed provided examples supporting PDT‐based therapy as an effective treatment for PTSD, but confirmed CBT as more effective in the treatment of this particular disorder. Comparable dropout rates were reported for both treatment approaches, suggesting that relative dropout rate should not be a pivotal factor in the selection of a PDT approach over CBT for treatment of PTSD.

Conclusion/Implications

The need to routinely observe evidence‐based recommendations for effective treatment of PTSD is highlighted and factors undermining practitioner engagement with CBT‐based interventions for the treatment of PTSD are identified.     

Antidepressant Medication: Is It a Viable and Valuable Adjunct to Cognitive-Behavioral Therapy for School Refusal?

Cognitive-behavioral therapy (CBT) is an evidence-based treatment for school refusal. However, some youth do not respond to CBT. The serious risks associated with school nonattendance call for novel approaches to help those who do not respond to CBT. Because school refusal is commonly associated with anxiety disorders, and the combination of CBT and antidepressant medication enhances outcomes in the treatment of anxiety disorders, combined treatment may be effective for school refusal. This narrative review evaluates the current evidence base for adding antidepressant treatment to CBT for school refusal. Six randomized controlled trials (RCTs), two open trials, six case studies/series, and one observational study were identified and reviewed. There is support for combined CBT and imipramine, but this medication is not typically used due to the risk of concerning side effects. Two recent RCTs failed to provide evidence for the superiority of combined CBT and fluoxetine. Further research in this area is required because the extant studies have a number of methodological limitations. Recommendations are provided for clinicians who consider prescribing antidepressant medication or referring for adjunctive antidepressant treatment for school refusal.     

‘At home in the uncanny’: Freud's account of das Unheimliche in the context of his theory of religious belief

This paper serves as an exploration of Freud's comment that one of the functions of religious belief is to make humanity feel ‘at home in the uncanny’ (heimisch im Unheimlichen). The first section examines the context of Freud's comment within The Future of an Illusion. Attention is then shifted to Freud's essay on ‘The “Uncanny”’, and to his conclusion that the ‘uncanny’ is the name for everything that ought to have remained secret and hidden but has come to light. A number of interpretations of the ‘at home’ remark are discussed, and it is suggested that religion might fruitfully be viewed as an attempt to come to terms with humanity's ‘transcendental homelessness’.     

An evaluation of the effectiveness of Diploma-level training in cognitive behaviour therapy

Background

As part of the UK government’s initiative to Increase Access to Psychological Therapies (see http://www.iapt.nhs.uk/for full details of the IAPT programme) there has been an expansion in the provision of post-graduate Diploma training in cognitive behaviour therapy (CBT). Previous evaluations of such training programmes have yielded mixed results but have been limited by small sample sizes and/or limited assessment measures.

Aims

To evaluate the impact of a long-standing Diploma in CBT training programme on a variety of measures of CBT competence.

Method

Trainees’ levels of CBT skill are compared at the beginning and end of CBT training. The effect of therapist factors such as age, professional background and gender on the development of CBT competence is also examined.

Results

Results show that trainees demonstrate higher levels of CBT skills after completing the training than they did before, with the majority achieving pre-determined criteria for competence. Trainees’ gender was not related to their performance but trainees’ age showed a negative association with CBT skill (older trainees performed worse). Trainees’ professional background also had an impact on their level of CBT competence, with trainees who were clinical psychologists demonstrating the highest levels of competence across a range of measures.

Conclusions

CBT Diploma training leads to increases in the level of trainees’ CBT competence, with the majority achieving the levels demonstrated in research trials by the end of training. Thus, this training is likely to lead to improved outcomes for patients. Further research is needed to determine the most efficient ways of enhancing CBT skills.     

An economic perspective on the Reinforcement Sensitivity Theory of personality

Reinforcement Sensitivity Theory postulates personality factors of ‘reward sensitivity’ and ‘punishment sensitivity’ linked to neural systems that control approach and avoidance, respectively. In contrast, behavioural economics distinguishes gain (‘reward’) and loss (‘punishment’) valuation systems that are orthogonal to approach/avoidance behaviour. We combined gain and loss with both their presentation and omission and found evidence for separate gain valuation, loss valuation, approach, and avoidance systems. This suggests that it is possible to integrate valuation/input and behaviour/output views of ‘reward’ and ‘punishment’ in a way that may be of use to both personality theory and economics and so forge closer links between these two major perspectives on decision-making and behaviour.     

Western esotericism: Towards an integrative model of interpretation

Despite the fact that during the last fifteen years we have witnessed the emergence of a research field of ‘Western esotericism’, scholars are still far from agreeing on definitions of ‘esotericism’. For an academic ‘field’, however, that wants to establish international networks and to bring together scholars from various research areas and disciplines, it is highly desirable to provide an interpretational framework in which these different studies find their place. The main argument of this article is that such common ground can be found only when esotericism is seen not as a selection of historical ‘currents’, however defined, but as a structural element of Western culture. After reviewing the most influential approaches to Western esotericism, this article identifies two dimensions of an esoteric discourse: claims of higher knowledge and ways of accessing this ‘truth’. To these dimensions can be added certain world views that are typically involved in there discourses. The interpretative model proposed here aims at critically addressing basic aspects of Western self-understanding including the rhetorics of rationality, science, enlightenment, progress and absolute truth. It postulates that conflicts of religious world views, identities and forms of knowledge lie at the heart of Western cultural history.     

In-Session Stuck Points and Pitfalls of Community Clinicians Learning CBT: Qualitative Investigation

Given the preponderance of evidence supporting the efficacy of cognitive behavior therapy (CBT), there has been an increased emphasis on dissemination to community mental health systems (CMH). Trainers from two large-scale dissemination initiatives (n = 27) were surveyed regarding the common pitfalls and difficulties encountered by CMH clinicians learning CBT. Common pitfalls were organized according to the items of the Cognitive Therapy Rating Scale (CTRS; Young & Beck, 1980) and reviewed. Guided discovery was reported to be the most challenging CBT competency to learn. Qualitative methods were used to construct a grounded theory; trainer responses indicated they viewed the practice of CBT as not only a set of discrete skills, but also a way of thinking. Efforts may be needed to provide support, assistance, and resources to these CMH clinicians as they continue to build CBT competency.     

Are children with Specific Language Impairment competent with the pragmatics and logic of quantification?

Specific Language Impairment (SLI) is understood to be a disorder that predominantly affects phonology, morphosyntax and/or lexical semantics. There is little conclusive evidence on whether children with SLI are challenged with regard to Gricean pragmatic maxims and on whether children with SLI are competent with the logical meaning of quantifying expressions. We use the comprehension of statements quantified with ‘all’, ‘none’, ‘some’, ‘some…not’, ‘most’ and ‘not all’ as a paradigm to study whether Spanish-speaking children with SLI are competent with the pragmatic maxim of informativeness, as well as with the logical meaning of these expressions.Children with SLI performed more poorly than a group of age-matched typically-developing peers, and both groups performed more poorly with pragmatics than with logical meaning. Moreover, children with SLI were disproportionately challenged by pragmatic meaning compared to their age-matched peers. However, the performance of children with SLI was comparable to that of a group of younger language-matched typically-developing children. The findings document that children with SLI do face difficulties with employing the maxim of informativeness, as well as with understanding the logical meaning of quantifiers, but also that these difficulties are in keeping with their overall language difficulties rather than exceeding them. The implications of these findings for SLI, linguistic theory, and clinical practice are discussed.     

Do production patterns influence the processing of speech in prelinguistic infants?

The headturn preference procedure was used to test 18 infants on their response to three different passages chosen to reflect their individual production patterns. The passages contained nonwords with consonants in one of three categories: (a) often produced by that infant (‘own’), (b) rarely produced by that infant but common at that age (‘other’), and (c) not generally produced by infants. Infants who had a single ‘own’ consonant showed no significant preference for either ‘own’ (a) or ‘other’ (b) passages. In contrast, infants’ with two ‘own’ consonants exhibited greater attention to ‘other’ passages (b). Both groups attended equally to the passage featuring consonants rarely produced by infants of that age (c). An analysis of a sample of the infant-directed speech ruled out the mothers’ speech as a source of the infant preferences. The production-based shift to a focus on the ‘other’ passage suggests that nascent production abilities combine with emergent perceptual experience to facilitate word learning.     

A Brief History of Metacognitive Therapy: From Cognitive Science to Clinical Practice

Metacognitive therapy (MCT) is proving to be an effective treatment for anxiety and depression with effects that may exceed CBT. It has been described as a paradigm shift in psychotherapy in its theory-driven cognitive science approach and systematic development and evaluation. MCT was developed by Adrian Wells based on an information processing theory, the Self-Regulatory Executive Function model by Wells and Matthews. MCT theory formulates psychological disorders as sharing common causal factors under the influence of metacognition, representing a particular top-down model of biases in cognitive regulation. A key clinical implication was that a core set of interventions could be developed to impact a wide range of symptoms and disorders. In this paper, we trace the historical development of MCT and the major studies that informed theory and practice with the aim of introducing clinicians and researchers to this area and to understand why the metacognitive approach has developed into a treatment that is proving to be potentially more effective than current gold-standard treatments. In doing so, we will draw out the distinctive features of the approach and explore how this might offer a blueprint for scientific advancement in clinical psychology and psychotherapy.     

Randomized,placebo-controlled trial of cognitive-behavioral therapy alone or combined with sertraline in the treatment of pediatric obsessive–compulsive disorder

Background

To examine the efficacy of sequential sertraline and cognitive-behavioral therapy (CBT) treatment relative to CBT with pill placebo over 18 weeks in children and adolescents with obsessive–compulsive disorder (OCD).

Methods

Forty-seven children and adolescents with OCD (Range = 7–17 years) were randomized to 18-weeks of treatment in one of three arms: 1) sertraline at standard dosing + CBT (RegSert + CBT); 2) sertraline titrated slowly but achieving at least 8 weeks on the maximally tolerated daily dose + CBT (SloSert + CBT); or 3) pill placebo + CBT (PBO + CBT). Assessments were conducted at screening, baseline, weeks 1–9, 13, and 17, and post-treatment. Raters and clinicians were blinded to sertraline (but not CBT) randomization status. Primary outcomes included the Children's Yale-Brown Obsessive–Compulsive Scale, and response and remission status. Secondary outcomes included the Child Obsessive Compulsive Impact Scale–Parent/Child, Children's Depression Rating Scale-Revised, Multidimensional Anxiety Scale for Children, and Clinical-Global Impressions-Severity.

Results

All groups exhibited large within-group effects across outcomes. There was no group by time interaction across all outcomes suggesting that group changes over time were comparable.

Conclusions

Among youth with OCD, there was no evidence that sequentially provided sertraline with CBT differed from those receiving placebo with CBT.

ClinicalTrials.gov Identifier

NCT00382291.     

Therapeutic Relationship

This article addresses the important role of the therapeutic relationship in cognitive-behavioral therapy (CBT). As has been noted from the inception of CBT, there are critical features of both the therapist and the relationship that optimize the likelihood of therapeutic success, and this article briefly describes these features. It is further argued that a successful therapeutic relationship in CBT is not static but is flexible and adaptive both across and within clients, as their needs and concerns vary. A positive therapeutic relationship is viewed within CBT as a necessary but insufficient condition for change, as the relationship serves as a foundation upon which interventions are scaffolded, but that the client’s response to various interventions itself shapes the interactions between therapist and client. Finally, it is argued that the key therapeutic ingredients of CBT are largely teachable, and the article provides several suggestions to promote an effective therapeutic relationship in CBT.