Création de l’Échelle de Distorsions Cognitives pour adultes (EDC-A) : étude des propriétés psychométriques en population générale et association avec l’anxiété et la dépression

IntroductionCognitive distortions contribute to the maintenance of inappropriate cognitive schemas and play a role in the emergence of pathologies such as anxiety and depression. We developed the Cognitive Distortion Scale for Adults in order to identify distortions in individuals’ reasoning. The main objectives of this study were: (1) to study the psychometric properties of the Cognitive Distortion Scale for Adults, (2) to identify cognitive distortions associated with anxiety and depression in the general population.MethodThe study involved 916 participants (151 men and 765 women) aged 18 to 85-years. The participants completed the Cognitive Distortion Scale for Adults. The tool presents 42 mini scenarios with a daily life situation and a proposition concerning a cognitive distortion. Participants must give their degree of agreement (0 to 10) with this one. Seven cognitive distortions are operationalized (dichotomous reasoning, disqualification of one of the poles, arbitrary focusing, omission of the neutral, requalification in the other pole, maximization and minimization). They also completed the Hospital Anxiety and Depression Scale. Both scales were available online on the Internet. The total duration of the test was approximately 10 minutes. A group of 35 participants completed the two scale 15 days apart.ResultsThe sub-dimensions of EDC-A obtain Cronbach alphas higher than .65 and EDC-A has a coherent factor structure. The scale has good temporal stability. Anxiety is predicted by dichotomous reasoning, disqualification of one of the poles, arbitrary focusing and maximization. Depression is predicted by dichotomous reasoning, arbitrary focusing, omission of the neutral and requalification in the other pole. Anxiety and depression are associated with negative cognitive distortions in reasoning. However, depression is also associated with positive cognitive distortions. Subjects with depression produce more varied cognitive distortions than subjects with anxiety.DiscussionThe Cognitive Distortion Scale for Adults shows promising psychometric properties. Further studies will need to be conducted to confirm these results. Anxiety would be related to biased information treatment of negative information, whereas depression would be related to more comprehensive biased information treatment, both negative and positive information. Anxiety would be related to suboptimal functioning of reasoning abilities; depression would be more characterized by a structural deficit of reasoning abilities.     

Introduction

According to cognitive therapy as espoused by Aaron T. Beck, the transfer and maintenance of behavioral and cognitive skills into practical and sustainable real-life application ultimately determines positive therapeutic outcomes. However, the optimal process for ensuring this transfer and maintenance has not been explicitly studied. This particular series of C&BP adds to the growing body of literature on cognitive therapy for complex and chronic problems. A case conference and supervision recommendations are presented as a resource for cognitive and behavioral practice. The focus of this series is the integration of homework assignments into therapy. Developing a collaborative therapeutic relationship and individualized cognitive conceptualization were part of the original formulation of standard cognitive therapy (A. T. Beck, Rush, Shaw, & Emery, 1979), and are essential foundations to therapeutic work with challenging patient problems (J. Beck, 2005). Therefore, in keeping with the spirit of cognitive therapy, this series of C&BP places emphasis on the therapeutic collaboration and cognitive conceptualization processes that greatly enhance the effective use of homework assignments.     

The factor structure of the Beck Depression Inventory-II: an evaluation

The Beck Depression Inventory-II (BDI-II) is a frequently used scale for measuring depressive severity. BDI-II data (404 clinical; 695 nonclinical adults) were analyzed by means of confirmatory factor analysis to test whether the factor structure model with a somatic-affective and cognitive component of depression, formulated by Beck and colleagues, has a good fit. We also evaluated 10 alternative models. The fit of Beck's model was not good for all criteria. Three of the alternative models had a better fit in both samples, but none of these met all criteria for good fit. Of the alternatives with a better fit, we selected the only model with unidimensional subscales, which assesses a somatic, affective, and cognitive dimension. For this model, which we recommend, as well as for Beck' original model, a good fitting structure containing 15 and 16 items was developed with an item-deletion algorithm.     

Clark,D. A., & Beck,A. T. (2012) The Anxiety and Worry Workbook: The Cognitive Behavioral Solution New York: The Guilford Press

This article reviews The Anxiety and Worry Workbook: The Cognitive Behavioral Solution by D. A. Clark and A. T. Beck (2012). This workbook offers readers a thorough introduction to a classic, though updated, cognitive behavioral therapy (CBT) approach for anxiety in a self-directed format. The first 8 chapters provide meticulous coverage of cognitive therapy strategies for identifying cognitive distortions relevant to anxiety-inducing thoughts, collecting evidence against such threatening thoughts, and developing alternative statements, as well as detailed explanation of behavioral strategies for reducing safety behaviors and conducting self-guided exposures to feared stimuli. It may therefore appeal to diverse readers who struggle with a range of anxiety problems, but is particularly suited to individuals with symptoms of panic disorder, social phobia, or generalized anxiety. The final 3 chapters discuss specific applications for each of these common conditions. The workbook offers straightforward CBT strategies made accessible via use of engaging metaphors, a wealth of worksheets, and numerous case examples. Moreover, it educates readers about cognitive constructs particularly relevant to specific disorders (e.g., anxiety sensitivity in panic disorder, fear of negative evaluation in social phobia). In summary, this “first self-help workbook for anxiety by the originator of cognitive therapy” does not strive to break new ground, but thoroughly equips the anxious yet self-motivated individual to combat threatening thoughts and engage fears with courage.     

Cognitive Reappraisal

A central tenet of Beck’s cognitive therapy (or cognitive behavior therapy) of the emotional disorders is that change in negative thought and beliefs is necessary for clinically significant symptom reduction in anxiety, depression, and other psychological conditions. Cognitive restructuring, a uniquely Beckian innovation, is a treatment strategy that directly targets cognitive reappraisal as the change mechanism responsible for symptom reduction. This commentary considers the origins of cognitive reappraisal in Beck’s cognitive therapy through the lens of cognitive restructuring and what treatment process research tells us about the mechanisms of change in cognitive restructuring.     

The development of a scale to measure cognitive distortions in bulimia

The Bulimia Cognitive Distortions Scale (BCDS) was developed to measure irrational beliefs and cognitive distortions associated with bulimia. The final 25-item scale was found to have excellent internal consistency with high item to total correlations and a coefficient alpha of .97. Factor analysis revealed two clear factors measuring cognitive distortions related to automatic eating behaviors and to physical appearance. Data attesting to the convergent and divergent validity of the BCDS are also presented. With 110 subjects (55 bulimics, 55 controls), a discriminant analysis revealed the BCDS to be the only significant variable in predicting group membership, correctly classifying 93.6% of all subjects. The BCDS was also predictive of severity of bulimia as measured by the frequency of binge eating episodes. The potential of the BCDS as both a diagnostic and research instrument is discussed.     

The Development of a Scale to Measure Cognitive Distortions in Bulimia

The Bulimia Cognitive Distortions Scale (BCDS) was developed to measure irrational beliefs and cognitive distortions associated with bulimia. The final 25-item scale was found to have excellent internal consistency with high item to total correlations and a coefficient alpha of .97. Factor analysis revealed two clear factors measuring cognitive distortions related to automatic eating behaviors and to physical appearance. Data attesting to the convergent and divergent validity of the BCDS are also presented. With 110 subjects (55 bulimics, 55 controls), a discriminant analysis revealed the BCDS to be the only significant variable in predicting group membership, correctly classifying 93.6% of all subjects. The BCDS was also predictive of severity of bulimia as measured by the frequency of binge eating episodes. The potential of the BCDS as both a diagnostic and research instrument is discussed.     

The Interpersonal Cognitive Distortions Scale: development and psychometric characteristics

In this study, an Interpersonal Cognitive Distortions Scale was developed to assess cognitive distortions in individuals' interpersonal relationships. The sample comprised 425 university students. A factor analysis yielded three factors: Interpersonal Rejection, Unrealistic Relationship Expectation and Interpersonal Misperception. To examine construct validity the correlations between the scores on the Interpersonal Cognitive Distortions Scale and the Automatic Thoughts Scale (.54), the Irrational Belief Scale (.54), and the Conflict Tendency Scale (.53) were estimated. The first factor, the second factor, and the total scale discriminated married individuals who had low and high conflict intensity and conflict frequency. The reliability of the scale was estimated by performing a test-retest correlation (.74). Cronbach internal consistency coefficient alpha was .67.     

Cognitive specificity in internalizing and externalizing problems in community and clinic-referred children

Examined whether cognitive features in Beck's (1967) model of depression and his cognitive content-specificity hypothesis (Beck, Brown, Steer, Eidelson, & Riskind, 1987) are broadband specific features that distinguish internalizing problems from externalizing problems. From a community (n = 389; 196 boys, 193 girls; age M = 9.98, SD = 1.52) and clinic (n = 82; 55 boys, 27 girls; age M = 10.42, SD = 2.91) sample, 4 groups were defined on behavioral measures and then examined on cognitive measures: externalizing only (n = 33), internalizing only (n = 41), comorbid externalizing and internalizing (n = 53), and control (neither externalizing nor internalizing; n = 35). Both the internalizing only and comorbid groups reported significantly more cognitive disturbances (negative cognitive triad, cognitive processing distortions, and "depressive" and "anxious" thought content) than both of the externalizing only and control groups in both the community and clinic samples. The results were not related to either overall level of psychopathology (as reported by mothers) or social desirability in children's reporting. These findings suggest that the cognitive features in Beck's model distinguish internalizing from externalizing problems and add to a growing literature that calls for further conceptual refinement of cognitive models for understanding both narrow-band and broadband syndromes.     

Relations between self-serving cognitive distortions, psychopathic traits, and antisocial behavior in a non-clinical sample of adolescents

The aim of the present study was to assess the relative contributions self-serving cognitive distortions and psychopathic traits to adolescent antisocial behavior. Participants were 972 high-school students who completed self-report questionnaires. Hierarchical multiple regression analyses showed that self-serving cognitive distortions, psychopathic traits, as well as their interaction term were significant predictors of antisocial behavior in both genders after adjustment for the main other cognitive, psychopathological and sociofamilial variables. High levels of self-serving cognitive distortions were associated with more extensive antisocial behavior among participants with higher scores on psychopathic traits. This result may have implications for prevention and treatment.     

Relations between self-serving cognitive distortions,psychopathic traits,and antisocial behavior in a non-clinical sample of adolescents

The aim of the present study was to assess the relative contributions self-serving cognitive distortions and psychopathic traits to adolescent antisocial behavior. Participants were 972 high-school students who completed self-report questionnaires. Hierarchical multiple regression analyses showed that self-serving cognitive distortions, psychopathic traits, as well as their interaction term were significant predictors of antisocial behavior in both genders after adjustment for the main other cognitive, psychopathological and sociofamilial variables. High levels of self-serving cognitive distortions were associated with more extensive antisocial behavior among participants with higher scores on psychopathic traits. This result may have implications for prevention and treatment.     

Cognitive Errors as Predictors of Adaptive and Maladaptive Perfectionism in Children

Cognitive distortions such as dichotomous evaluation of performance, selectively focusing on perceived failures, and discounting successes are proposed to be key maintaining mechanisms in clinical perfectionism, but no existing research has investigated the relationship between perfectionism and cognitive errors in children. The current study assessed the associations between dimensions of perfectionism as assessed by the Adaptive/Maladaptive Perfectionism Scale (AMPS) and children??s cognitive errors controlling for negative and positive affect to provide information about cognitive features associated with perfectionism in children and construct-related evidence for the AMPS. A non-clinical sample of 204 children completed the AMPS, the Children??s Negative Cognitive Errors Questionnaire, and measures of positive and negative affect. The AMPS sensitivity to mistakes scale was correlated robustly with catastrophizing, overgeneralization, personalizing, and selective abstraction. Cognitive errors were significant predictors of maladaptive perfectionism even after controlling for negative affect. However, cognitive errors did not predict adaptive perfectionism after controlling for positive affect. These findings highlight the role of negative thinking styles in maladaptive perfectionism in children and point to the potential usefulness of interventions that focus jointly on maladaptive perfectionism and negative cognitive styles.     

Cognitive bias in acute stress disorder

Cognitive bias was investigated in survivors of motor vehicle accidents with either acute stress disorder (ASD; n=17) or no ASD (n=17). Participants completed the acute stress disorder interview, the Beck depression inventory, the Beck anxiety inventory, the impact of event scale, and a probability questionnaire (PQ) and a cost questionnaire (CQ) within four weeks of their accident. ASD participants exaggerated both the probability of negative events occurring, and the adverse cost of those events more than non-ASD participants. IES-Avoidance scores were the only significant predictors of both PQ and CQ scores. Findings are discussed in terms of the role of cognitive errors in posttraumatic adjustment.     

Depression and cognitive style: comparisons between measures

Several instruments have been developed recently to measure cognitive styles associated with depression. At least four of them appear to have an underlying similarity. Each appears to reflect a tendency for respondents to infer a general lack of self-worth (or a continued likelihood of bad events) on the basis of a single discrete failure. The present research was a comparative test of one of these scales against the other three in terms of associations with Beck Depression Inventory (BDI) scores. Though all instruments were significantly correlated with BDI, partial correlations revealed that our generalization scale was a more robust predictor of BDI than were (a) a measure of characterological self-blame, (b) a measure of cognitive bias, and (c) a measure of attributional style.     

Depressogenic cognitive styles: predictive validity, information processing and personality characteristics, and developmental origins.

Two of the major cognitive theories of depression, the theory of Beck [Beck, A. T. (1967). Depression: clinical, experimental and theoretical aspects. New York: Harper & Row. and Beck, A. T. (1987) Cognitive models of depression. Journal of Cognitive Psychotherapy: an International Quarterly, 1, 5-37] and the hopelessness theory [Abramson, Metalsky, & Alloy, (1989) Hopelessness depression: a theory-based subtype of depression. Psychological Review, 96, 358-372], include the hypothesis that particular negative cognitive styles increase individuals' likelihood of developing episodes of depression, in particular, a cognitively mediated subtype of depression, when they encounter negative life events. The Temple-Wisconsin Cognitive Vulnerability to Depression (CVD) project is a two-site, prospective longitudinal study designed to test this cognitive vulnerability hypothesis, as well as the other etiological hypotheses of Beck's and the hopelessness theories of depression. In this article, based on CVD project findings to date, we review evidence that the hypothesized depressogenic cognitive styles do indeed confer vulnerability for clinically significant depressive disorders and suicidality. In addition, we present evidence regarding moderators of these depressogenic cognitive styles, the information processing and personality correlates of these styles and the possible developmental antecedents of these styles. We end with a consideration of future research directions and the clinical implications of cognitive vulnerability to depression.     

Evidence for the construct validities of the Beck Youth Inventories with child psychiatric outpatients

To provide further information about the construct validities of the Beck Youth Inventories of Emotional and Social Impairment, these inventories were administered to 35 female and 65 male outpatients whose ages ranged from 7 to 12 years and who were diagnosed with various psychiatric disorders. The Children's Depression Inventory was also administered, and the children were rated by a parent with the Conners' Parent Rating Scale-Revised: Short Form. The scores on the former inventory were more positively correlated with the scores on the Beck Youth Depression Inventory (r =.81, p<.001) than with scores on the four other Beck Youth Inventories, and those on the Conners Oppositional scale were comparably correlated with the scores on the Beck Youth Disruptive Behavior (r=.49, p<.001) and Anger (r=.41, p<.001) Inventories. These latter correlations were higher than those for scores on the Oppositional scale with the scores on the three other Beck scales.     

Illicit Drug Use,Cognitive Distortions,and Suicidal Ideation Among Homeless Youth: Results From a Randomized Controlled Trial

Illicit drug use and cognitive distortions confer significant risks to youth suicidal thoughts and behaviors. However, there has been limited evidence regarding the efficacy of suicide prevention interventions with homeless youth, especially studies testing whether such interventions can reduce the risk for suicidal ideation associated with illicit drug use. Suicidal homeless youth (N = 150) between the ages of 18 to 24 years were recruited from a drop-in center. Youth were randomly assigned to Cognitive Therapy for Suicide Prevention (CTSP) + Treatment as Usual (TAU) or TAU alone. Youth reported their illicit drug use, cognitive distortions, and suicidal ideation 4 times over 9 months. A multiple-group multilevel structural equation model showed that higher illicit drug use at baseline predicted a slower reduction in cognitive distortions and suicidal ideation in the TAU group. These associations were not found in the CTSP + TAU group, suggesting an interruption of such risk from illicit drug use. Findings suggest that CTSP can reduce the risk of illicit drug use as a treatment barrier towards cognitive distortions and suicidal ideation among homeless youth, with implications to improve treatment efforts and to reduce premature mortality in a vulnerable population.     

Sexual offenders' cognitive distortions as implicit theories

In this article, I argue that sexual offenders' cognitive distortions emerge from underlying causal theories about the nature of their victims. These implicit theories function like scientific theories and are used to explain empirical regularities (e.g., other people's actions) and to make predictions about the world. They are relatively coherent and constituted by a number of interlocking ideas and their component concepts and categories. Following a review of research from other areas in psychology on implicit theories, I consider the implications of this perspective for understanding cognitive distortions in sexual offenders. Finally, I discuss the research and clinical implications of viewing cognitive distortions in offenders as implicit theories.