The variability of client,therapist and clinic in psychotherapy outcomes: A three-level hierarchical model

This article investigates the percentage of variance in psychotherapy outcomes explained by the case-mix variables for individual cases, by the therapist (therapist effects), and what additional variance is explained by the clinic with which the therapist is affiliated. While there has been substantial recent research regarding therapist effects, very little has been published regarding clinic-level effects after controlling for therapist effects. The study utilised the largest sample reported to date, using data from 28 clinics with a minimum of 2,000 cases in a clinical range of severity of symptoms with pre-post change scores on an outcome questionnaire. Only cases treated by a therapist with at least 30 cases were included. These selection criteria resulted in a case count of 156,258 clients treated by 874 therapists located at 28 clinics. After controlling for differences in case mix using diagnosis and intake score (severity of symptoms), the resulting analyses indicated that 5.21% of the variance in treatment outcome was explained by the therapist, while another 1.13% of the variance was associated with the clinic. Findings are discussed with implications for practice and policy.     

The extended ramp model: A biomimetic model of behaviour arbitration for lightweight cognitive architectures

In this article, we present an idea for a more intuitive, low-cost, adjustable mechanism for behaviour control and management. One focus of current development in virtual agents, robotics and digital games is on increasingly complex and realistic systems that more accurately simulate intelligence found in nature. This development introduces a multitude of control parameters creating high computational costs. The resulting complexity limits the applicability of AI systems. One solution to this problem it to focus on smaller, more manageable, and flexible systems which can be simultaneously created, instantiated, and controlled. Here we introduce a biologically inspired systems-engineering approach for enriching behaviour arbitration with a low computational overhead. We focus on an easy way to control the maintenance, inhibition and alternation of high-level behaviours (goals) in cases where static priorities are undesirable. The models we consider here are biomimetic, based on neuro-cognitive research findings from dopaminic cells responsible for controlling goal switching and maintenance in the mammalian brain. The most promising model we find is applicable to selection problems with multiple conflicting goals. It utilizes a ramp function to control the execution and inhibition of behaviours more accurately than previous mechanisms, allowing an additional layer of control on existing behaviour prioritization systems.     

A cognitive model of insomnia

Insomnia is one of the most prevalent psychological disorders, causing sufferers severe distress as well as social, interpersonal, and occupational impairment. Drawing on well-validated cognitive models of the anxiety disorders as well as on theoretical and empirical work highlighting the contribution of cognitive processes to insomnia, this paper presents a new cognitive model of the maintenance of insomnia. It is suggested that individuals who suffer from insomnia tend to be overly worried about their sleep and about the daytime consequences of not getting enough sleep. This excessive negatively toned cognitive activity triggers both autonomic arousal and emotional distress. It is proposed that this anxious state triggers selective attention towards and monitoring of internal and external sleep-related threat cues. Together, the anxious state and the attentional processes triggered by it tricks the individual into overestimating the extent of the perceived deficit in sleep and daytime performance. It is suggested that the excessive negatively toned cognitive activity will be fuelled if a sleep-related threat is detected or a deficit perceived. Counterproductive safety behaviours (including thought control, imagery control, emotional inhibition, and difficulty problem solving) and erroneous beliefs about sleep and the benefits of worry are highlighted as exacerbating factors. The unfortunate consequence of this sequence of events is that the excessive and escalating anxiety may culminate in a real deficit in sleep and daytime functioning. The literature providing preliminary support for the model is reviewed and the clinical implications and limitations discussed.     

A cognitive model of planning

This paper presents a cognitive model of the planning process. The model generalizes the theoretical architecture of the Hearsay-ll system. Thus, it assumes that planning comprises the activities of a variety of cognitive “specialists.” Each specialist can suggest certain kinds of decisions for incorporation into the plan in progress. These include decisions about: (a) how to approach the planning problem; (b) what knowledge bears on the problem; (c) what kinds of actions to try to plan; (d) what specific actions to plan; and (e) how to allocate cognitive resources during planning. Within each of these categories, different specialists suggest decisions at different levels of abstraction. The activities of the various specialists are not coordinated in any systematic way. Instead, the specialists operate opportunistically, suggesting decisions whenever promising opportunities arise. The paper presents a detailed account of the model and illustrates its assumptions with a “thinking aloud” protocol. It also describes the performance of a computer simulation of the model. The paper contrasts the proposed model with successive refinement models and attempts to resolve apparent differences between the two points of view.     

Schizophrenic troubles of personal identity: A cognitive model

A cognitive approach to the psychiatric clinic raises the problem of conceptual articulation between the pathological phenomena observed in clinic and models derived from cognitive sciences.

The theoretical approach of H. von Foerster linking communication, language and personal identity in a common formalism seems to constitute a pertinent framework for such articulation.     

Achievement motivation and its constructs: A cognitive model

The first section of this paper introduces a set of constructs, develops a cognitive model of motivation, and derives specific propositions for the case of achievement motivation. The model describes functional relationships among expectancies, instrumentalities, incentive values, and valences, each of which is calculated separately for situations, actions, and outcomes. Each valence is calculated with reference to an outcome's anticipated consequences, both immediate and delayed. The model draws on, but reworks and extends, Expectancy × Value Theory, Bolles' Psychological Syllogism, Instrumentality Theory, Achievement Motivation Theory, and Causal Attribution Theory. The second section examines the model's fit to the body of data that bears on a central area of research in achievement motivation, namely task preferences. The last section scrutinizes the motive construct as a summary concept and divides it into six parameter sets which represent sources of individual differences.I wish to thank Eric Klinger for a judicious translation of the paper into English which has considerably improved the original; Herbert Götzl, Uwe Kleinbeck, and Julius Kuhl for helpful comments; and Rosemarie Tweer for assistance in reanalyzing 31 studies on task preference.     

Exploring client contribution in a cognitive intervention for test anxiety

Aim: To study client contributions in cognitive therapy. Specifically, to study ways of making an intervention against test anxiety work, based on interviews with 32 test‐anxious university students. Method: Interviews after their first examination following the intervention were analysed using a thematic analysis. Results: Although most participants reacted positively to the intervention, concerns emerged that adopting positive self‐statements might be deceptive. Concerns about the untruthfulness of positive self‐statements led clients to generate several possible resolutions, namely, to examine flaws in negative self‐statements, to realise that there is more than one realistic way to construe things, to consider the evidence in the form of reduced anxiety, to consider manageable steps, and to seek interpersonal validation of positive self‐statements. Conclusions: The results offer concrete resolutions developed by clients that might be useful for other clients who have reservations about positive self‐statements.     

A cognitive probability model for learning

A quantitative model for the behavior of albino rats in choice-making situations is presented. The model, which is based upon a cognitive conceptualization of the learning process, is shown to yield predictions which are equivalent to those produced by the linear operator stochastic models at the asymptotic limit but which differ from these during early trials in the learning situation.     

A cognitive model of musical sight-reading

The author, a professional flutist and psychologist, interviewed four pianists noted for their sight-reading abilities. The results of the interviews are considered from several points of view. Sight-reading is analyzed as a problem in pattern recognition: a movement from a sonata by Handel is used to illustrate the principle of scanning for familiar patterns. The close relationship between musical sight-reading and the reading of conventional texts is also suggested. Finally, drawing on the findings of other studies, a cognitive model of musical sight-reading is proposed. The schematic model of interlocking information-processing systems explains the differences between skilled and unskilled sight-readers; it also explains why some experienced, professional musicians are poor sight-readers. Verification of the model is provided in an additional section in which conversations with unskilled sight-readers are reported.     

A cognitive model of pathological worry

We present an evidence-based model of pathological worry in which worry arises from an interaction between involuntary (bottom-up) processes, such as habitual biases in attention and interpretation favouring threat content, and voluntary (top-down) processes, such as attentional control. At a pre-conscious level, these processes influence the competition between mental representations when some correspond to the intended focus of attention and others to threat distracters. Processing biases influence the probability of threat representations initially intruding into awareness as negative thoughts. Worry in predominantly verbal form then develops, influenced by conscious processes such as attempts to resolve the perceived threat and the redirection of attentional control resources to worry content, as well as the continuing influence of habitual processing biases. After describing this model, we present evidence for each component process and for their causal role in pathological worry, together with implications for new directions in the treatment of pathological worry.     

The one-interview client

A census of National Marriage Guidance Council cases showed that a third of them lasted for one interview only. This finding was met with some surprise by the counsellors. An investigation into one-interview cases was therefore undertaken, with the result that several distinct categories were identified. In some cases one interview seems to be all that is needed by the client.     

Enacting the aesthetic: A model for raw cognitive dynamics

Phenomenology and the Cognitive Sciences - One challenge faced by aesthetics is the development of an account able to trace out the continuities and discontinuities between general experience and...     

A cognitive model of suicidal behavior: Theory and treatment

With some prominent exceptions, much of the research designed to elucidate the nature, prevalence, and correlates of suicidal behavior has been conducted from an atheoretical perspective. Conversely, psychological theories to explain suicidal behavior are largely untested by rigorous experimental designs. We propose a cognitive model of suicidal behavior that is grounded in the empirical literature on cognitive and behavioral correlates of and risk factors for suicidal behavior. In addition, we demonstrate the manner in which the theoretical components are targeted in cognitive therapy for suicidal patients. We highlight aspects of the model with less empirical support, and we propose ways those constructs can be tested in future research.     

The mapping model: a cognitive theory of quantitative estimation

How do people make quantitative estimations, such as estimating a car's selling price? Traditionally, linear-regression-type models have been used to answer this question. These models assume that people weight and integrate all information available to estimate a criterion. The authors propose an alternative cognitive theory for quantitative estimation. The mapping model, inspired by the work of N. R. Brown and R. S. Siegler (1993) on metrics and mappings, offers a heuristic approach to decision making. The authors test this model against established alternative models of estimation, namely, linear regression, an exemplar model, and a simple estimation heuristic. With 4 experimental studies the authors compare the models under different environmental conditions. The mapping model proves to be a valid model to predict people's estimates.     

The development of reading impairment: a cognitive neuroscience model

This review discusses recent cognitive neuroscience investigations into the biological bases of developmental dyslexia, a common disorder impacting approximately 5 to 17 percent of the population. Our aim is to summarize central findings from several lines of evidence that converge on pivotal aspects of the brain bases of developmental dyslexia. We highlight ways in which the approaches and methodologies of developmental cognitive neuroscience that are addressed in this special issue-including neuroimaging, human genetics, refinement of cognitive and biological phenotypes, neural plasticity and computational model-can be employed in uncovering the biological bases of this disorder. Taking a developmental perspective on the biological bases of dyslexia, we propose a simple cascading model for the developmental progression of this disorder, in which individual differences in brain areas associated with phonological processing might influence the specialization of visual areas involved in the rapid processing of written words. We also discuss recent efforts to understand the impact of successful reading interventions in terms of changes within cortical circuits associated with reading ability.     

A computational cognitive model of syntactic priming

The psycholinguistic literature has identified two syntactic adaptation effects in language production: rapidly decaying short-term priming and long-lasting adaptation. To explain both effects, we present an ACT-R model of syntactic priming based on a wide-coverage, lexicalized syntactic theory that explains priming as facilitation of lexical access. In this model, two well-established ACT-R mechanisms, base-level learning and spreading activation, account for long-term adaptation and short-term priming, respectively. Our model simulates incremental language production and in a series of modeling studies, we show that it accounts for (a) the inverse frequency interaction; (b) the absence of a decay in long-term priming; and (c) the cumulativity of long-term adaptation. The model also explains the lexical boost effect and the fact that it only applies to short-term priming. We also present corpus data that verify a prediction of the model, that is, that the lexical boost affects all lexical material, rather than just heads.     

A cognitive model of posttraumatic stress disorder

Posttraumatic stress disorder (PTSD) is a common reaction to traumatic events. Many people recover in the ensuing months, but in a significant subgroup the symptoms persist, often for years. A cognitive model of persistence of PTSD is proposed. It is suggested that PTSD becomes persistent when individuals process the trauma in a way that leads to a sense of serious, current threat. The sense of threat arises as a consequence of: (1) excessively negative appraisals of the trauma and/or its sequelae and (2) a disturbance of autobiographical memory characterised by poor elaboration and contextualization, strong associative memory and strong perceptual priming. Change in the negative appraisals and the trauma memory are prevented by a series of problematic behavioural and cognitive strategies. The model is consistent with the main clinical features of PTSD, helps explain several apparently puzzling phenomena and provides a framework for treatment by identifying three key targets for change. Recent studies have provided preliminary support for several aspects of the model.