Effect of thought-stopping on thoughts,mood and corrugator EMG in depressed patients

The immediate effects of thought-stopping applied to depressive thoughts were compared to those of a control procedure in a group of depressed psychiatric day-patients. Thought-stopping had only a weak effect on average in reducing the frequency of depressive thoughts, and no significant effects on depressed mood or corrugator EMG. A small significant effect on anxious mood appeared related to non-specific factors. The results raise the possibility that thought-stopping may have little specific effect in reducing the frequency of unwanted thoughts. Corrugator EMG was significantly related to the frequency of spontaneously occurring depressive thoughts both between and within subjects.     

Panic attacks without fear: An overview*

‘Non-fearful panic disorder’ (NFPD) is a condition that meets DSM III-R criteria for panic disorder but lacks a report of subjective fear or anxiety. Presenting the first comprehensive overview of this issue, the authors describe studies investigating a wide range of apparently overlapping phenomena including NFPD, ‘somatically expressed panic’, ‘non-cognitive panic’, ‘alexithymic panic’, ‘non-clinical panic’, and ‘masked anxiety’. The review shows that such conditions account for from 20 to 40% of the panic disorder found in various medical populations, and that this group resembles conventional panic disorder in cross-sectional comparisons. We emphasize that a ‘triple-response’ model of anxiety is consistent with our conclusion that NFPD should be conceptualized as a panic disorder subtype. Finally, we discuss unresolved issues regarding the construct and predictive diagnostic validity of NFPD.     

Effects of suppression and appraisals on thought frequency and distress

Cognitive theories of obsessions highlight appraisals of personal significance and thought suppression in the development and maintenance of intrusive thoughts. The current study examined the role of personal significance within the context of a thought suppression paradigm. The primary aim was to examine whether suppression would have differential effects for target thoughts appraised as personally meaningful versus relatively unimportant. A blasphemous thought served as the target thought, and highly religious and nonreligious participants were recruited. Participants completed a two-interval thought suppression task; during interval 1 they were randomly assigned to suppress or not suppress the target thought and during interval 2, all participants were given “do not suppress” instructions. Suppression resulted in sustained frequency of thoughts in contrast to the decline in thought frequency observed for non-suppression. Differential effects of suppression were found across the two groups. Moreover, suppression was associated with increased negative mood and anxiety. Results suggest that suppression of personally meaningful thoughts is a counterproductive strategy.     

A longitudinal study of the intrusiveness of cognitions in test anxiety

Medical students who had to undergo an important set of examinations were asked to fill out two questionnaires, the first early in the term, the second 1 or 2 wk before the exams. Students whose anxiety increased substantially between the two questionnaire administrations reported that their thoughts had become more intrusive on a number of parameters including distress, frequency and dismissability. Subjects whose anxiety increased only moderately or not at all reported correspondingly smaller changes in intrusiveness. There was considerable stability in reported cognitions over time, but changes in anxiety were related to changes in reports of thought content. The perceived probability of negative outcomes did not vary over time. These results indicate that changes in anxiety levels over time are related to several parameters of intrusiveness as well as thought content.     

Causing harm and allowing harm: a study of beliefs in obsessional problems

This study investigates two factors hypothesised as relevant to obsessional problems because of the way in which they influence decisions whether or not to act to prevent harm. These are (i) the way in which intrusive thoughts increase the internal awareness of harm, and confront the person with the possibility of taking action to prevent such harm and (ii) the extent to which there is some obvious external factor which increases awareness of the possibility of preventing harm. Obsessional patients, anxious and non-clinical controls completed a scale which systematically measured these factors across a wide range of situations. Results across all situations evaluated confirmed previous findings that both obsessionals and nonobsessionals were more likely to report acting to prevent harm when awareness of it is prompted by an intrusion than when it is not. It was also found that participants in all groups acted more ‘obsessionally’ when a scenario is described in ways which suggest that harm may be by ‘commission’ than when it is described in terms of an ‘omission’. When scenarios about which each individual is most disturbed were analysed, anxious and non-clinical controls continued to differentially rate omission and commission situations; as predicted, this differential was not present for obsessional patients.

It is concluded that obsessionals are more sensitive to omission than are nonobsessionals when considering scenarios about which they are concerned, and that this sensitivity is one factor influencing the decision whether to act to prevent harm.     

Confidence in memory and other cognitive processes in obsessive-compulsive disorder

Previous studies have implicated beliefs about one's memory (i.e., meta-memory), in maintaining the symptoms of obsessive–compulsive disorder (OCD), particularly with respect to checking rituals. However, most research has focused on task- or situation-specific perceptions about memory performance. Expanding on this research, we undertook two studies with analogue and clinical cohorts to examine the relationship between general ‘trait’ beliefs about memory and related processes and OCD symptoms. Trait meta-memory as measured in the current study was conceptualised as a multi-dimensional construct encompassing a range of beliefs about memory and related processes including confidence in one's general memory abilities, decision-making abilities, concentration and attention, as well as perfectionistic standards regarding one's memory. Meta-memory factors were associated with OCD symptoms, predicting OCD symptoms over-and-above mood and other OCD-relevant cognitions. Meta-memory factors were found to be particularly relevant to checking symptoms. Implications for theory and research are discussed.     

Individual differences in the experience of depressive and anxious, intrusive thoughts

Cognitive—clinical theorists such as Beck have implicated various personality traits as vulnerability factors in the experience of negative, distressing cognitions. A cluster analysis, performed on the basis of Ss' responses to a questionnaire specially constructed to assess anxious and depressive thoughts for features such as frequency, sadness, worry, controllability and unacceptability, demonstrated individual differences in the experience of negative cognitions. These differences were associated with varying levels of trait anxiety, dysphoria and obsessionality. Further analysis revealed that trait anxiety and neuroticism were more strongly associated with depressive rather than anxious cognitions. Obsessional complaints evidenced minimal association with anxious thoughts, though a moderate correlation was obtained between the former and depressive self-statements. It is suggested that personality factors are influential in the experience of negative cognitions in a highly specific manner.     

Depressed mood: The role of negative thoughts,self-consciousness,and sex role stereotypes

Research typically finds that depression is twice as common among women as among men. This may relate to differences in socialization that result in different emotions, cognitions, and coping reactions. Sex-role stereotypes, employment and marital status, and differential social pressures may also be significant in making women more vulnerable to the development of depression. Women may have less decision-making power, face more adverse life events, and have limited access to resources, which may lead to feelings of helplessness and low self-esteem. Low self-esteem and negative cognitions about the self in turn may be proximal factors predictive of negative mood. Additionally, women may be more prone to ruminative self-focus rather than active coping, a significant risk factor for depression. This study examined individual predictors of depressed mood for each sex, including coping, self-esteem, negative thoughts, self-consciousness (rumination), as well as social factors such as the endorsement of sex-role stereotypes and decision-making power in the family. Results indicated that social factors were not related to depressed mood in either sex, but were related to coping styles and self-esteem. Depressed mood was associated with individual characteristics, such as avoidant coping styles, social anxiety for women, and ruminative self-focus for men. Regression analysis showed that coping through denial and negative thoughts explained depressed mood, and the latter was particularly true for men. These results point to the significance of examining both individual and social factors when attempting to understand depression in men and women.     

Cognitive mediation in general psychiatric outpatients: a test of the content-specificity hypothesis

We investigated the degree of content specificity evident in the negative cognitions associated with anxiety and depression in two large samples of general psychiatric outpatients. Standardized measures of affect and cognition were analyzed in a multiple regression design. As predicted by Beck's (1967, 1976, 1987) cognitive theory of psychopathology, thoughts of loss and failure were specifically associated with depression, whereas cognitions of harm and danger were uniquely predictive of anxiety. In addition, hopelessness was specific to depression and not to anxiety. Dysfunctional beliefs showed no consistent association with either mood state. The implication of these results, as well as related findings, is discussed in terms of a cognitive perspective on the differentiation of emotional disorders. Also discussed are the methodological difficulties encountered in research on cognitive-affective relationships.     

The contribution of music vs instructions in the Musical Mood Induction Procedure

The relative contribution of the instructions and the music to the effects of the Musical Mood Induction Procedure (MMIP) were investigated. Using an experimental procedure which minimised covert experimenter bias, subjects performed under both elation and depression mood inductions in one of four conditions: music present or absent by mood change instructions present or absent, using a crossover design. Results indicated that instructions were both necessary and sufficient to produce change on mood sensitive measures. Mood change effects were reduced by controlling for the effect of subjects who responded so as not to ‘louse-up’ the experiment. The MMIP seems to be much less musical than the name implies. Further research is needed to determine which aspects of the instructions contribute most to the changes on mood sensitive measures.     

Exploring Relationships Between Negative Cognitions and Anxiety Symptoms in Youth With Autism Spectrum Disorder

Although cognitions are central to the conceptualization and treatment of anxiety in typically developing (TD) youth, there is scant research investigating automatic thoughts and their relationship with anxiety in youth with autism spectrum disorder (ASD). We sought to examine the types of automatic thoughts experienced by youth with ASD and co-occurring anxiety as well as the predictive relationship of anxiety to different types of automatic thoughts in 97 children, ages 8-14 years. We also explored the relationship of automatic thoughts and intolerance of uncertainty. Consistent with prior data, there was a strong relationship between anxiety and automatic thoughts pertaining to social and physical threat. Anxiety and IU were independently associated with thoughts pertaining to personal failure which raises the hypothesis that personal failure may serve as a common pathway between anxiety, IU, and depression in ASD youth. These findings highlight the importance of assessing and treating negative cognitions in youth with ASD and anxiety.     

A clinical trial of continuous, intermittent and overlearning ‘bell and pad’ treatments for nocturnal enuresis

Sixty-one enuretic children were allocated sequentially to ‘standard’, ‘intermittent’ or ‘overlearning’ bell and pad treatment. The results suggest that the ‘overlearning’ modification of standard treatment was successful in bringing about a reduction in the relapse rate. The present status and implications of research into nocturnal enuresis were discussed in the light of the results of the investigation.     

The components of the Maudsley Obsessional-Compulsive Questionnaire

The Maudsley Obsessional-Compulsive Questionnaire was given to 868 Italian students. Response analysis revealed three factors: checking behavior and worries, problems of contamination and cleaning, and doubts and intrusive thoughts. In males a fourth component was also recognized—the ‘obesssional slowness’ which Hodgson and Rachman (1977) found in obsessive patients, but not in normal and neurotic English patients.     

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.     

Attentional control in OCD and GAD: specificity and associations with core cognitive symptoms

Obsessive–compulsive disorder (OCD) and generalized anxiety disorder (GAD) are both defined by excessive negatively-valenced cognitions. Although obsessional thoughts are considered essential to OCD and perseverative worry is considered essential to GAD, these excessive cognitions have been found to co-occur in both disorders. Accordingly, a common diathesis may influence the emergence of excessive thoughts in both disorders. The present study examined deficits in attentional control as a cognitive vulnerability that may contribute to both obsessional thought and perseverative worry. Patients with OCD (n = 30), GAD (n = 29), and non-clinical controls (NCC; n = 29) completed measures of obsessional thoughts, perseverative worry, and attentional control. Deficits in self-reported attentional control were found in both OCD and GAD relative to the NCC. However, attentional control was only related to excessive cognition in the GAD patient group, where deficits were associated with increased perseverative worry. Mediational modeling suggested that trait anxiety mediated the relationship between attentional control and perseverative worry in GAD. Implications of these findings for conceptualizing the role of attentional control in the genesis of excessive cognitions in OCD and GAD are discussed.     

Frequency as a moderating variable in self-report measures of negative cognition

Based on responses to the Distressing Thoughts Questionnaire, subjects' most frequent depressive and anxious cognitions were selected and compared with representative low frequency thought statements. The high frequency cognitions were more emotionally intense, uncontrollable and unacceptable than the low frequency thoughts. Although high frequency anxious items were rated as more frequent than high frequency depressive statements, no differences were evident in emotional intensity and controllability. Furthermore thoughts of loss and failure were specifically predictive of dysphoria only when high frequency cognitive items were utilized. The implications of these findings for cognitive assessment issues were discussed.     

Parents' cognitions and expectations about their pre‐school children: The contribution of parental anxiety and child anxiety

This study investigated the relative associations between parent and child anxiety and parents' cognitions about their children. One hundred and four parents of children aged 3–5 years completed questionnaires regarding their own anxiety level, their child's anxiety level and their cognitions about the child, specifically parents' expectations about child distress and avoidance, and parents' perceived control over child mood and behaviour. Both parent anxiety and parent report of child anxiety were significantly associated with parents' cognitions. Specifically, parent report of child anxiety correlated significantly with parent locus of control generally and, more specifically, with parental expectations and perceived control of child anxious mood and behaviour. Parent anxiety correlated significantly with locus of control and parents' expectations of child anxious mood and behaviour. Furthermore, when both child and parent anxiety were taken into account, only parental anxiety remained significantly associated with parental locus of control and perceived control of child anxious behaviour. For parents' perceived control of child anxious mood, only child anxiety remained significantly associated. The results suggest that parents' perceived control over their children's behaviour may primarily reflect parental anxiety, rather than child anxiety. Parental anxiety may, therefore, present an important target for interventions that aim to change parent's cognitions and behaviour.     

Electrical aversion therapy with alcoholics: An analogue study

Chronic alcoholic patients matched on age, education and length of problem drinking were assigned to one of three treatment conditions, with 10 subjects in each group: (1) Electrical Aversion Conditioning (high shock paired with alcohol sips); (2) Control Conditioning (very low shock paired with alcohol sips); and (3) Group Therapy (confrontation psychotherapy). Groups 2 and 3 were included to control for possible ‘attention-placebo’ and expectancy factors involved in the conditioning procedures. Subjects in each group were given instructions designed to produce high expectancy for therapeutic success. Pre-post measures of alcohol consumption and attitudes toward alcohol were obtained using an analogue ‘taste test’ assessment procedure. No statistically significant differences in reduced alcohol consumption or attitudes toward alcohol were found among the groups. Trends in the data support the contention that effects of electrical aversion may be more related to such factors as therapeutic instructions, expectancy, specificity of the procedure or experimental demand characteristics than to conditioning factors.     

Selecting a best multiattribute alternative with partial information about attribute weights

Use of approximate weights would greatly simplify decision analysis under certainty since detailed weight elicitation could be avoided. This paper examines the degree to which rank order information about weights can be used to identify a best alternative, or falling uniqueness prescribes an easily implemented rule for selecting a ‘best’ alternative. The prescribed rule uses as weights the centroid of the feasible region defined by the rank order information. In conjunction with the rule, the value of the rank order information can be determined using an ‘expected gain from weight precision’ (EGWP) measure, analogous to ‘expected value of perfect information’ in decision analysis under uncertainty.