Marital Adjustment and Irrational Beliefs

The present study was designed to determine which aspects of Ellis' irrational beliefs as well as emotional traits (anxiety, curiosity, anger) differentiate couples attending marriage counseling from couples couple not attending marriage counseling as well as levels of marital satisfaction in couples as measured by the Locke-Wallace Marital Adjustment Test. Participants were 61 married couples, 18 of whom were attending marriage counseling and 43 who were not attending marriage counseling. Each partner completed a number of self-report questionnaires containing items measuring irrational /rational beliefs, anger, anxiety and curiosity, and communication skills. Correlational and multiple regression analyses indicate support for Albert Ellis' proposition concerning the importance of individual partner's emotional traits and accompanying irrational beliefs in marital adjustment and dissatisfaction. Self-downing and need for comfort were the dimensions of irrational thinking most strongly related to marital dysfunction. Anger, anxiety but neither curiosity nor communication skills distinguished individuals experiencing or not experiencing marital problems. Implications for relationship counseling are briefly discussed.     

Response Expectancies and Irrational Beliefs Predict Exam-Related Distress

Individual differences in cognitive factors such as response expectancies and irrational beliefs (IBs) have been shown to contribute to variability in distress associated with stressful situations. However, their independent influence on distress when examined within the same study has not been established, nor has the potential of mediational relationships. The purpose of this study was to investigate the contribution of response expectancies and IBs (both general and exam-specific) to exam-related distress in a prospective study. Results revealed that both response expectancies and general IBs separately predicted exam-related distress (p’s<.05; N=105). Observed effects of general IBs were perfectly mediated by, and observed effects of exam-specific IBs were partially mediated by, response expectancies using the Baron and Kenny approach. These data support the view that cognitive factors contribute to psychological distress and are consistent with response expectancy and rational emotive behavior theories. The results suggest that interventions focused on response expectancies and IBs might be an effective means to reduce psychological distress associated with real life stressors such as exams. Future research is needed to determine whether this effect generalizes to other stressful situations. Dr. Montgomery is Director of the Integrative Behavioral Medicine Program at the Mount Sinai School of Medicine. Dr. David is an associate professor at Babes-Bolyai University, in Romania. Dr. DiLorenzo is an assistant professor in the Psychology Department of Stern College. Dr. Schnur is a postdoctoral fellow in the Department of Oncological Sciences at Mount Sinai School of Medicine. This work was supported by the National Cancer Institute (CA81137) and the American Cancer Society (PF-05-098-01-CPPB).     

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.     

Irrational Beliefs as Predictors of Emotional Adjustment after Divorce

The goal of this study was to analyze the role of irrational beliefs and other mediating variables in emotional adjustment after marital separation. Self-esteem and attachment to the ex-spouse were chosen as indicators of emotional adjustment. For this purpose several mediation centres and associations for separated people took part in the project. The results showed that irrational beliefs, as well as length of conflict during marriage, time since divorce and desire of contact with the former spouse, are good predictors of emotional adjustment. It has been suggested that Rational-Emotive-Behavior Therapy can be used in the treatment of divorced people.     

Alexithymia, Irrational Beliefs, and the Rational-Emotive Explanation of Emotional Disturbance

In recent discussions of Rational-Emotive Behavior Therapy (REBT), Ellis has argued that unconscious processes supplement irrational beliefs in explaining psychopathology. The hypothesis of this investigation was that these unconscious processes reflect alexithymia. University students responded to the three factors from the Toronto Alexithymia Scale, the Malouff and Schutte Belief Scale (MSBS), 5 subscales from the Survey of Personal Beliefs, and instruments recording depression, anxiety, and neuroticism. As hypothesized, alexithymia and irrational beliefs predicted greater emotional disturbance while also displaying some small positive correlations with each other. In multiple regressions, both types of variables combined to predict emotional disturbance, with alexithymia explaining the greater amount of variance. Alexithymic difficulties in identifying emotions had uniquely negative mental health implications. The MSBS and the Low Frustration Tolerance subscale were the most noteworthy measures of a pathogenic irrationality. These data supported the claim that the unconscious processes of REBT could be conceptualized in terms of alexithymia.     

Irrational Beliefs and Unconditional Self-Acceptance. III. The Relative Importance of Different Types of Irrational Belief

In two studies, one correlational (N = 158) and one experimental (N = 128), using college students, it was found that Need for Achievement, Need for Approval and Self-Downing were the most important irrational beliefs of the General Attitude and Belief Scale predicting unconditional self-acceptance. The Need for Comfort, Demand for Fairness and Other-Downing subscales were found to be less influential. The findings were discussed in terms of Ellis’ theoretical formulation of four higher-order types of irrational belief processes (demandingness, awfulizing, low-frustration tolerance and self-downing), empirical research on different irrational belief themes, the distinction between ego disturbance and discomfort disturbance in REBT and the distinction between sociotropy and autonomy in different forms of depression.     

The Relations of Cognitive Triad, Dysfunctional Attitudes, Automatic Thoughts, and Irrational Beliefs with Test Anxiety

Previous research has highlighted the important role of cognition in anxiety, including test anxiety. The present study explores the role of cognitive distortions and irrationality in test anxiety by studying the relationships among cognitive triad (core beliefs), dysfunctional attitudes (intermediate beliefs), negative automatic thoughts, irrational beliefs, debilitating test anxiety, and facilitating test anxiety in 138 undergraduates. Multiple regression analyses showed that only the cognitive triad as a whole was a significant predictor of debilitating anxiety. Specifically, negative view of self was a significant predictor of debilitating anxiety. The results supported an expansion of the current cognitive conceptualizations of test anxiety to include the importance of negative self-view. Other implications are also discussed.     

Irrational Beliefs and Unconditional Self-Acceptance. II. Experimental Evidence for a Causal Link between Two Key Features of REBT

In a test of two key features of REBT, causal relationships between irrational beliefs and unconditional self-acceptance were experimentally investigated in a sample of 106 non-clinical participants using a priming technique. Priming participants with statements of irrational belief resulted in a decrease in unconditional self-acceptance whereas priming participants with statements of rational belief resulted in an increase in unconditional self-acceptance. In contrast, priming participants with statements about unconditional self-acceptance did not result in an increase in rational thinking and priming participants with statements about conditional self-acceptance did not result in an increase in irrational thinking. The present study is the first to provide evidence of a causal link between rational/irrational thinking and unconditional/conditional self-acceptance. The findings have important implications for the core hypothesis of REBT and underscore the advantages of experimental over correlational studies in theory-testing.     

The Role of Anxiety Sensitivity and Mindful Attention in Anxiety and Worry About Bodily Sensations Among Adults Living With HIV/AIDS

The current study examined cognitive factors that may be relevant to understanding anxiety and worry about bodily sensations among an HIV/AIDS population. Specifically, this investigation tested the main and interactive effects of anxiety sensitivity and mindful attention on anxious arousal, bodily vigilance, interoceptive fear, and HIV symptom distress among 164 adults with HIV/AIDS. Results indicated that anxiety sensitivity was positively related to anxious arousal, bodily vigilance, and interoceptive fear, but not HIV symptom distress. Mindful attention was negatively related to anxious arousal, interoceptive fear, and HIV symptom distress, but not bodily vigilance. These main effects for anxiety sensitivity and mindful attention were evident after controlling for disease stage, years with HIV, and demographic variables. There were no interactive effects between anxiety sensitivity and mindful attention. Results are discussed in terms of the clinical implications for identifying and treating anxiety and worry about bodily sensations among adults with HIV/AIDS. Limitations of this study include the use of cross-sectional data and self-report assessments.     

Relationships Between Dysfunctional Beliefs and Positive and Negative Indices of Well-Being: A Critical Evaluation of the Common Beliefs Survey-III

The Common Beliefs Survey-III is a factored measure of dysfunctional beliefs and has generally shown satisfactory convergent validity and test–retest reliability [(2001) Journal of Rational-Emotive and Cognitive-Behavior Therapy, 19(2), 89–103). We sought to further establish the utility of the measure by examining the extent the dysfunctional belief subscales related to a wide variety of positive and negative indices of well-being, after controlling for a potential confound, namely, social desirability. Four hundred and fifty-seven university students completed questionnaires that assessed six dimensions of dysfunctional belief, seven negative indices of well-being (depression, anxiety, stress, guilt, hostility, hopelessness, suicidal thinking), three positive indices of well-being (life satisfaction, joviality, state self-assurance), and social desirability. Analyses revealed that lower well-being was associated with (1) beliefs that self-worth is dependent on success, (2) beliefs that self-worth is dependent on approval, (3) demanding beliefs that reflect unrealistically high expectations for events and individuals. Belief variables predicted 14% of the variance in the negative indices but only 7.3% in the positive indices. Stepwise regression revealed that the optimal set of belief predictors depended on the type of well-being predicted. These findings have implications for both theory and practice.     

Changes in Anxiety Control Beliefs Following a Brief CBT Treatment and Their Association With Anxiety Symptom Reduction

Anxiety control beliefs (i.e., beliefs regarding one’s ability to cope with external, fear-inducing threats and internal reactions to those perceived threats) have been found to negatively predict anxiety symptoms in children and adults and to be modifiable by cognitive-behavioral therapy for anxiety disorders. The current study examines whether changes in anxiety control beliefs were seen following a brief, intensive treatment for specific phobias, and whether those changes were associated with improvements in the targeted phobia and comorbid anxiety disorder symptoms. Participants were 135 children and adolescents (M age = 9.01 years, 49% male) who received one-session treatment (OST) with or without parental involvement for their primary specific phobia. Results indicated that self-reported anxiety control beliefs significantly increased following treatment and that these increases significantly predicted reductions in specific phobia severity and symptoms of comorbid anxiety disorders 6 months and 1 year following treatment. Findings illustrate that involvement in a single 3-hour OST was associated with changes in anxiety control beliefs and demonstrate the potential importance of targeting control beliefs in pediatric anxiety treatment.     

Emotion Beliefs and Cognitive Behavioural Therapy for Social Anxiety Disorder

Despite strong support for the efficacy of cognitive behavioural therapy (CBT) for social anxiety disorder (SAD), little is known about mechanisms of change in treatment. Within the context of a randomized controlled trial of CBT, this study examined patients' beliefs about the fixed versus malleable nature of anxiety—their ‘implicit theories’—as a key variable in CBT for SAD. Compared to waitlist (n = 29; 58% female), CBT (n = 24; 52% female) led to significantly lower levels of fixed beliefs about anxiety (M_baseline = 11.70 vs. M_Post = 7.08, d = 1.27). These implicit beliefs indirectly explained CBT-related changes in social anxiety symptoms (κ² = .28, [95% CI = 0.12, 0.46]). Implicit beliefs also uniquely predicted treatment outcomes when controlling for baseline social anxiety and other kinds of maladaptive beliefs (perceived social costs, perceived social self-efficacy, and maladaptive interpersonal beliefs). Finally, implicit beliefs continued to predict social anxiety symptoms at 12 months post-treatment. These findings suggest that changes in patients' beliefs about their emotions may play an important role in CBT for SAD.     

Irrational Beliefs and Basic Assumptions in Bereaved University Students: A Comparison Study

Several authors have argued that the loss of a loved one triggers changes in people's beliefs and assumptions, and that these changes play a role in emotional problems after bereavement. The present study was an attempt to investigate these hypotheses. Thirty students who had been confronted with the death of a parent or sibling, on average nearly 3 years ago, were compared with 30 nonbereaved matched control subjects on different measures assessing basic assumptions and irrational beliefs as defined in REBT. In line with the notion that bereavement has an impact on people's basic assumptions, results showed that bereaved students had a less positive view of the meaningfulness of the world and the worthiness of the self than their nonbereaved counterparts. Also, in accord with the notion that the tendency to think irrationally is likely to increase after a stressful life event, the bereaved were found to have higher levels of irrational thinking. Furthermore, it was found that the degree to which bereaved individuals endorsed general as well as bereavement-specific irrational beliefs was significantly associated with the intensity of symptoms of traumatic grief. Conversely, none of the basic assumptions was associated with traumatic grief. Beliefs reflecting low frustration tolerance explained most variance in traumatic grief. Clinical and theoretical implications of these findings are discussed.     

Irrational Beliefs and Self-Management as Separable Predictors of Anxiety and Depression

Irrational beliefs and self-management are both cognitive-behavioral constructs that are integral in modern Rational-Emotive Behavior Therapy and Self-Management Therapy, respectively. Both irrational beliefs and self-management have been linked to anxiety and depression, and there is evidence for their usefulness for these types of distress. This is the first study to consider irrational beliefs and self-management as simultaneous predictors of anxiety and depression. An outpatient clinical sample (n = 51) completed measures of irrational beliefs, self-management, and emotional symptoms. Results indicated that as simultaneous predictors of fear and worry, self-management did not account for any additional variance accounted for by irrational beliefs. However, both irrational beliefs and self-management predicted unique variance in depression, negative affect, and positive affect. Exploratory analyses with single diagnosis (n = 26) and multiple diagnoses (n = 25) subsamples provided some divergent results. These results are discussed in terms of case conceptualization and potential future applications in the treatment of affective disorders, in particular depression.     

Maladaptive Core Beliefs and their Relation to Generalized Anxiety Disorder

Research has demonstrated that individuals with generalized anxiety disorder (GAD) hold unhelpful beliefs about worry, uncertainty, and the problem-solving process. Extant writings (e.g., treatment manuals) also suggest that other types of maladaptive beliefs may characterize those with GAD. However, these other beliefs have received limited empirical attention and are not an explicit component of cognitive theories of GAD. The present study examined the extent to which dysfunctional attitudes, early maladaptive schemas, and broad self-focused and other-focused beliefs explain significant variance in GAD symptoms, over and above negative and positive beliefs about worry, negative beliefs about uncertainty, and negative beliefs about problems. N = 138 participants classified into Probable GAD and Non-GAD groups completed self-report measures. After controlling for trait anxiety and depressive symptoms, only beliefs about worry, negative beliefs about uncertainty, and schemas reflecting unrelenting standards (e.g., “I must meet all my responsibilities all the time”), the need to self-sacrifice (e.g., “I'm the one who takes care of others”), and less positive views of other people and their intentions (e.g., lower endorsement of views such as “other people are fair”), were unique correlates of Probable GAD versus Non-GAD or GAD severity. Theoretical and clinical implications are discussed.     

存在主义视角下医护人员的死亡焦虑及其应对策略

从存在主义视角出发,探讨医护人员存在的死亡焦虑。通过剖析医护人员的特殊工作场域,揭示死亡焦虑在医护群体中呈现的特异性,即死亡焦虑的高水平及"存在性"特点,并借由分析存在主义心理治疗中所阐释的死亡焦虑的特点及应对方式,如内隐性、直面死亡、觉醒体验以及波动影响等理论,提出对医护人员开展死亡教育、唤起觉醒体验以及有效利用波动影响等应对死亡焦虑的策略,这对于当下从事临床一线的医护人员具有重要意义。     

Couples of Mixed HIV Status

Abstract

As individuals with HIV are living longer due to earlier diagnosis and advances in treatment, they are turning their attention to living with HIV/AIDS. Based on a study (n = 82) that explored how HIV may affect the intimacy of long-term couples of mixed HIV status, psychosocial issues are identified. Key findings include the identification of six themes. They are: (1) fear of HIV transmission, (2) HIV and health status, (3) shifts in emotional intimacy, (4) assumption of care-giver and patient roles, (5) reproductive issues, and (6) a perceived sense of power inequity present between the genders and between HIV positive and HIV negative partners. Implications for the practitioner are discussed.     

死亡凸显效应对临终关怀态度及死亡焦虑的影响

探索死亡凸显效应对护生临终关怀态度及死亡焦虑的影响。将348名护生整群随机分成3组(死亡凸显、丧失亲密关系和对照),用中文版FATCOD-B量表和中文版T-DAS量表评价不同处理方式护生的临终关怀态度和死亡焦虑水平。研究结果显示3组护生间的临终关怀态度得分和死亡焦虑得分差异有统计学意义(P<0.05)。护生临终关怀态度得分死亡凸显组(97.97±7.78)分>丧失亲密关系组(97.39±6.99)分>对照组(94.35±5.65)分。死亡焦虑得分死亡凸显组(38.74±5.01)分<丧失亲密关系组(40.01±6.38)分<对照组(42.88±4.61)分。死亡凸显可以加强护生的世界观和亲社会行为,使护生的临终关怀态度更积极,同时降低护生的死亡焦虑。