Self-Compassion,Self-Esteem,and Irrational Beliefs

Assumptions associated with Rational-Emotive Behavior Therapy (REBT) suggest that self-compassion, but not self-esteem, should be incompatible with irrational beliefs and with the emotional disturbances that they produce. In this study, 184 university students responded to a self-compassion scale along with measures of irrational beliefs, self-esteem, depression, and anxiety. As expected, self-compassion correlated negatively with irrationality, predicted better mental health, and explained inverse connections of self-esteem with irrational beliefs. In support of REBT, the irrationality of low frustration tolerance also partially mediated the inverse self-compassion relationship with anxiety. Other findings for self-esteem and for the irrational belief of self-worth, nevertheless, suggested complexities for the REBT conceptual framework. These data most importantly confirmed self-compassion as part of what REBT would describe as an effective personal philosophy.     

Cognition About Cognition: Metacognitive Therapy and Change in Generalized Anxiety Disorder and Social Phobia

Metacognitive theory and therapy views the persistence of negative beliefs and thoughts as a result of metacognitions controlling cognition. This paper describes, with reference to the treatment of generalized anxiety disorder (GAD) and social phobia, how metacognition contributes to cognitive stability and to change. Metacognitive therapy offers a level of formulation and intervention that does not focus predominantly on challenging the content of negative thoughts and beliefs that are emphasized in traditional cognitive therapy. The focus of treatment in GAD is on erroneous beliefs about worry and unhelpful mental regulation strategies. In treating social phobia, a greater emphasis is placed on modifying attention and worry processes and on configuring processing during and after behavioral experiments.     

Rational Emotive Behavior Therapy and Cognitive Behavior Therapy for Elderly People

Several therapies have been adapted for use with elderly people, including Rational Emotive Behavior Therapy (REBT) and Cognitive Behavior Therapy (CBT). These two therapies emphasize the importance of irrational or dysfunctional beliefs in the creation of emotional disturbance, and tend to use a number of cognitive, emotive, and behavioral methods of disputing and changing these beliefs for more functional ones. Some of the main therapeutic techniques used in REBT and CBT are presented in this paper.     

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.     

Changes in Decentering and Reappraisal Temporally Precede Symptom Reduction During Emotion Regulation Therapy for Generalized Anxiety Disorder With and Without Co-Occurring Depression

Emotion Regulation Therapy (ERT) has demonstrated efficacy in both open and randomized trials for generalized anxiety disorder (GAD) with and without co-occurring depression. An important goal in ERT is to teach clients adaptive emotion regulation, including healthier metacognitive abilities such as decentering and cognitive reappraisal. A few studies thus far have demonstrated a mediating role for these metacognitive abilities in other cognitive behavioral therapies (CBTs) for GAD. However, a drawback to most of these has been the ability to demonstrate a causal role for improved metacognitive abilities in outcome. In the present study, we utilized multilevel time-lagged segment analyses to explore the temporal dynamics between session-by-session changes in metacognition and anxiety outcomes from ERT. Thirty-one young adults diagnosed with GAD with and without co-occurring depression received 16 sessions of ERT. Prior to each session, participants completed questionnaires pertaining to metacognition (i.e., decentering and cognitive reappraisal) and anxiety symptoms (i.e., worry, trait anxiousness, and generalized anxiety). Changes in decentering temporally preceded changes in worry and trait anxiousness of a medium to large magnitude, and changes in cognitive reappraisal temporally preceded changes in all three outcomes of a medium to large magnitude. The reverse direction, where mediators were predicted by outcomes, was nonsignificant. These findings support the notion that adaptive metacognitive emotion regulation is involved in reducing worry and anxiety in GAD. Having a clearer understanding of the temporal dynamics between metacognitive abilities and symptoms of anxiety can inform and improve not only ERT but other CBTs for GAD, as well.     

Exploring the Effects of Rational Emotive Behavior Therapy on the Irrational Beliefs and Self-Determined Motivation of Triathletes

The present study addresses proposals that Rational Emotive Behavior Therapy (REBT) can influence self-determined motivation. Triathletes received REBT education, followed by either Rational Emotive Personal-Disclosure Mutual-Sharing (REPDMS) or Personal-Disclosure Mutual-Sharing. Measurements of irrational beliefs and self-determined motivation were collected prior to REBT (baseline), during the REBT education period, and after the REPDMS session (postintervention). An ABC single-case design was adopted, allowing for statistical and visual analysis of data over time and between groups. Findings indicate that REBT led to decreased irrational beliefs and increased self-determined motivation. REPDMS appeared to have no influence on irrational beliefs over and above REBT education.     

Prospective Relations Between Dysfunctional Metacognitive Beliefs,Metacognitive Strategies,and Anxiety: Results From a Four-Wave Longitudinal Mediation Model

The metacognitive model of psychological disorders suggests that emotional disorders are related to maladaptive metacognitive strategies corresponding to underlying dysfunctional metacognitive beliefs. There is substantial empirical evidence supporting a role of metacognition in psychopathology, but fewer studies have evaluated the metacognitive model using longitudinal data and taken into consideration its differentiation between components and how they are hypothesized to be related to each other. Thus, more specific model evaluation is important as it relates to identifying mechanisms of disorder with a potential to provide clinical advances. In the present study, 868 participants took part in a 4-wave survey and reported on metacognitive beliefs and strategies and anxiety symptoms. Two longitudinal mediation models (forward and reversed causation) were run to test temporal precedence and bidirectional relations. The results indicated that metacognitive beliefs significantly predicted metacognitive strategies, which further predicted anxiety symptoms and mediated the indirect effect in the relationship between metacognitive beliefs and anxiety over time. The relationship between metacognitive beliefs and anxiety symptoms over time were bidirectional, but this relationship was not accounted for by metacognitive strategies. These findings largely support central predictions set forward by the metacognitive model and indicate that metacognitions play a preceding and maintaining role in anxiety.     

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.     

Adverse Working Conditions, Job Insecurity and Occupational Stress: The Role of (Ir)rational Beliefs

Testing of REBT theory in the work environment is a relatively new research domain, with few promising studies, especially in the context of occupational stress. The aim of this study is to explore the role that irrational and rational beliefs play, as factors of cognitive appraisal, in the development of some of the occupational stress indicators, as well as possible interaction between stressful working conditions and irrational beliefs. A sample of 221 Serbian employees, mostly from the private and public sectors, participated in this study. The results of the hierarchical regression analyses indicate that irrational beliefs make an independent contribution to the prediction of distress and burnout, although that contribution is less prominent than that of stressors. Rational beliefs significantly predicted distress, but not work burnout. Finally, no significant interactions were found between stressors and IB/RB. It can be concluded that (ir)rational beliefs play a significant role in distress and burnout prediction, but no support for a diathesis-stress model of cognitive vulnerability to occupational stress has been found in the present study. The results will be discussed in the context of REBT theory and practice.     

Secondary Beliefs: A Mediator between Illness Representations and Coping Behavior in Arthritis Sufferers

The aim of the current study was to investigate the factors of secondary beliefs and illness representations, and their relationship with particular coping strategies used in the management of arthritis, and more specifically, if secondary beliefs, as defined in Rational Emotive Behavioral Therapy (REBT), mediated the relationship between illness representations and coping, as outlined by the Self-Regulatory Model (SRM). A sample of 63 arthritis sufferers aged between 32.0 and 100.1 years was recruited. Participants were asked to complete three questionnaires: Ways of Coping Questionnaire (WOCQ); revised Illness Perception Questionnaire (IPQ-R); Secondary Beliefs Scale (SBS). Analyses revealed that all eight coping strategies measured were significantly related to one or more illness representation, lending support to the SRM. Furthermore, secondary beliefs were found to mediate the relationship between illness representations and coping for three of the strategies measured: confrontive coping, accepting responsibility and seeking social support, while they also appeared to be directly related to the escape-avoidance strategy. Therefore, support for the REBT model was also evidenced. Overall, these results have highlighted the importance of cognitive factors in influencing coping behavior, a finding that could prove useful when designing interventions aiming to promote beneficial coping in arthritis sufferers.     

A pilot randomized trial of metacognitive therapy vs applied relaxation in the treatment of adults with generalized anxiety disorder

Metacognitive Therapy (MCT) and Applied Relaxation (AR) were compared in a pilot treatment trial of generalized anxiety disorder (GAD). Twenty outpatients meeting criteria for DSM-IV-TR GAD were assessed before treatment, after treatment and at 6 m and 12 m follow-up. The patients were randomized and treated individually for 8-12 weekly sessions. There was no drop-out from MCT and 10% at 6 m follow-up from AR. At post-treatment and at both follow-up points MCT was superior to AR. Standardized recovery rates for MCT at post-treatment were 80% on measures of worry and trait-anxiety compared with 10% following AR. At 6 m follow-up recovery rates for MCT were 70% on both measures compared with 10% and 20% for AR. At 12 m follow-up recovery rates for MCT were 80% (worry) and 60% (trait-anxiety) compared with 10% and 20% following AR. The recovery rates for MCT are similar to those obtained in an earlier uncontrolled trial (Wells & King, 2006). The effect sizes and standardized recovery rates for MCT suggest that it is a highly effective treatment.     

Well-Being and Generalized Anxiety in Japanese Undergraduates: A Prospective Cohort Study

Psychological well-being is thought to protect against common mental health problems. This study investigated the buffering effects of psychological well-being on the relationships between cognitive vulnerabilities (fear of anxiety and negative beliefs about worry) and GAD symptoms among 297 Japanese undergraduates (female = 62%, age = 18.91 ± 1.61) in a two-wave prospective cohort study. Participants completed the Generalized Anxiety Disorder Questionnaire for DSM-IV, Center for Epidemiologic Studies Depression Scale, anxiety control subscale of Affective Control Scale, negative belief about worry subscale of Meta-Cognitions Questionnaire, and Nishida’s psychological well-being scale. A moderated regression analysis tested the buffering effect of psychological well-being sub-dimensions on the relationship between cognitive vulnerabilities and generalized anxiety symptoms. Fear of anxiety (β = 0.16, p < 0.01) and negative beliefs about worry (β = 0.16, p < 0.01) at baseline predicted generalized anxiety at follow-up, after controlling for baseline symptoms, and three interaction terms significantly predicted generalized anxiety symptoms. Purpose in life and autonomy buffered the negative relationship between cognitive vulnerabilities and generalized anxiety symptoms. Contrary to the hypothesized relationship, positive relationships with others at baseline facilitated a positive relationship between fear of anxiety and generalized anxiety symptoms. Those results suggested that enhanced Purpose in life and Autonomy dimension of Psychological well-being may be useful in preventing GAD, while the enhanced positive relationship with others dimension of Psychological well-being may facilitate generalized anxiety, as a function of fear of anxiety. In a primary prevention setting, it may be useful to consider the dimensions of Psychological well-being.     

Metacognitions in Triathletes: Associations With Attention,State Anxiety,and Relative Performance

This study investigated how metacognitive beliefs in triathletes covary with state anxiety dimensions, prior to competition. It also examined how metacognitions relate to concentration, after controlling for state anxiety. Regression analyses revealed that specific metacognitive beliefs were differentially predictive of state anxiety dimensions and concentration. When accounting for the state anxiety variables in a hierarchical model predicting concentration, positive beliefs about worry, negative beliefs about worry, and cognitive anxiety remained as significant predictors. Metacognitive beliefs were also found to differ across time-to-event intervals. Overall, the results demonstrated that a metacognitive framework is a viable pathway for future sporting research.     

The Development of a Measure of Irrational/Rational Beliefs

The Attitudes and Belief Scale-2 (ABS-2) developed in the late 1980s, is a measure of Ellis’ irrational and rational beliefs. Although no publication has described the instrument and it has only appeared in conference presentations, many researchers have used the ABS-2 to test REBT. This article describes the development of the ABS-2 and the original research on its psychometric properties. The scale has three factors that represent 24 different cells in a 4 × 2 × 3 factorial model. The first factor, Cognitive Processes, reflects Ellis’ concepts of Demandingness, Awfulizing, Frustration Intolerance, and Self-Downing. The second factor covers irrationally worded items versus rationally worded items. The rationally worded items were written to counter the irrational beliefs. The third factor includes content or life themes about which the person could be concerned, and includes Achievement, Affiliation, and Comfort. The ABS-2 generates a Total Score, a Total Irrationality Score, a Total Rationality score, and Scales scores representing each of the four Cognitive Processes domains and each of the three Content domains. The ABS-2 scores demonstrate adequate to excellent internal consistency, and correlate significantly with measures of depression, anxiety, life satisfaction, selfcontrol, well-being, and measures of internalizing personality disorders. The ABS-2 did not correlate significantly with measures of anger, externalizing personality disorders, mania, and somatoform disorder. An exploratory factor analysis provided weak support for the factor structure of the scale. The ABS-2 scores distinguish between normal and clinical samples. Rationally worded items discriminated between clinical and nonclinical groups much better than did the irrationally worded scales, suggesting that instruments that only assess irrational beliefs might underestimate the support for REBT.     

Muscularity rationality: An examination of the use of Rational Emotive Behaviour Therapy (REBT) upon exercisers at risk of muscle dysmorphia

Research in the area of body image suggests that muscularity dissatisfaction is a prominent concern among men and women. At its apex, this concern manifests into a convoluted and debilitating body image disorder termed muscle dysmorphia (MD), characterised by a marked preoccupation with ones (subjective) muscularity and leanness inadequacy. Prevention of MD is critical, however, empirical evidence informing intervention protocols are profoundly scarce. The principal aim of this study was to examine the effectiveness of a one-to-one Rational Emotive Behaviour Therapy (REBT) intervention, comprising five, 60-min one-to-one sessions, in decreasing MD symptomatology, irrational beliefs and increasing unconditional self-acceptance in a mixed-sex cohort of four exercisers at-risk of MD. A single-case, staggered multiple-baseline across participant A-B design was adopted to examine the effects of REBT. Visual and statistical analyses, and social validation data, indicated reductions in MD, irrational beliefs, and increases in unconditional self-acceptance across all participants from pre-post intervention phases, with reductions upheld at a 6-month follow-up. This study highlights the potential role of rational and irrational beliefs in the onset and maintenance of MD. This study is the first to report the application of a CBT approach to MD symptomology, and has demonstrated the use of REBT as a potential preventative approach for individuals at risk of MD. Practitioners working with individuals at risk of MD should take a benefit-focussed approach to support individuals in developing unconditional self-acceptance beliefs, as well as a problem-focussed approach to support individuals in reducing irrational beliefs.     

Experimental modification of beliefs in obsessive-compulsive disorder: a test of the metacognitive model

Metacognitive beliefs about the threatening meaning and significance of intrusions are fundamental to the development and maintenance of obsessive-compulsive disorder (OCD) in the metacognitive model (Cognitive therapy of anxiety disorders: a practice manual and conceptual guide, Chichester, UK, Wiley, 1997; Emotional disorders and metacognition: innovative cognitive therapy, Chichester, UK, Wiley, 2000). This predicts that reductions in metacognitive beliefs about intrusions will result in decreased anxiety and compulsions. It was hypothesized that brief (5min) exposure and response prevention configured as a behavioural experiment to challenge metacognitive beliefs would lead to reductions in anxiety, thought fusion beliefs and the urge to neutralize. Furthermore, these reductions would be greater than the effects observed in the same exposure and response prevention task, accompanied by a habituation rationale. The results were consistent with the hypotheses. The clinical implications for the treatment of OCD are discussed.     

Comparing the predictive capacity of observed in-session resistance to self-reported motivation in cognitive behavioral therapy

Self-report measures of motivation for changing anxiety have been weakly and inconsistently related to outcome in cognitive behavioral therapy (CBT). While clients may not be able to accurately report their motivation, ambivalence about change may nonetheless be expressed in actual therapy sessions as opposition to the direction set by the therapist (i.e., resistance). In the context of CBT for generalized anxiety disorder, the present study compared the ability of observed in-session resistance in CBT session 1 and two self-report measures of motivation for changing anxiety (the Change Questionnaire & the Client Motivational for Therapy Scale) to (1) predict client and therapist rated homework compliance (2) predict post-CBT and one-year post-treatment worry reduction, and (3) differentiate those who received motivational interviewing prior to CBT from those who received no pre-treatment. Observed in-session resistance performed very well on each index, compared to the performance of self-reported motivation which was inconsistent and weaker relative to observed resistance. These findings strongly support both clinician sensitivity to moments of client resistance in actual therapy sessions as early as session 1, and the inclusion of observational process measures in CBT research.     

元认知视角下的强迫症的特征、模型及干预

强迫症的元认知模型认为, 元认知是理解强迫症病理的关键。强迫症患者存在错误的元认知知识信念、消极的元认知体验及不恰当使用元认知策略等问题。强迫症的元认知疗法强调思维过程(如自我聚焦注意、对担忧不变的思维风格和威胁调节的注意策略等)的重要性, 而非思维的具体内容, 并在个体心理干预、团体心理干预等研究中显示出较好的疗效。未来研究应从认知神经科学等视角考查强迫症的记忆等元认知特征, 并进一步验证和修正强迫症的元认知模型。     

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.     

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.