Testing the REBT-I model in athletes: Investigating the role of self-confidence between irrational beliefs and psychological distress

Evidence suggests that, in the general population, instances of poor mental health have increased over recent years and are set to continue to grow. Athletes may experience a plethora of additional stressors, such as injury, de-selection, and competitive anxiety. Prior research has suggested that irrational beliefs may maladaptively influence an athlete’s wellbeing, but little is known about the role of self-confidence in these relationships. The present study aimed to examine the role which self-confidence plays as part of the REBT-I model in athletes. Broadly speaking, it was hypothesised that primary irrational beliefs would relate negatively to self-confidence through secondary irrational beliefs. In turn, self-confidence was hypothesised to relate negatively to competitive anxiety and depressive symptoms. Additionally, irrational beliefs were hypothesised to combine with low self-confidence to relate negatively to competitive anxiety and depressive symptoms. Four hundred and ten athletes (n = 227 females, Mage = 33.91 years, SD = 14.84) completed an online questionnaire pack assessing irrational beliefs, self-confidence, cognitive and somatic competitive anxiety, and depressive symptoms. Using path analysis, the tested hypothesised model demonstrated an excellent fit to the data. Findings demonstrate some support for the REBT-I model in that primary irrational beliefs predict competitive anxiety and depressive symptoms through secondary irrational beliefs. Results extend the REBT-I model by including self-confidence as a mediating factor between depreciation beliefs and competitive anxiety and depressive symptoms. Findings suggest practitioners should be aware of the role that irrational beliefs may have in negatively influencing self-confidence and subsequent depression symptomology in athletes.     

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.     

Irrational and Metacognitive Beliefs Mediate the Relationship Between Content Beliefs and GAD Symptoms: A Study on a Normal Population

Cognitive Behavioral Therapy (CBT), Rational Emotive Behavior Therapy (REBT) and Metacognitive Therapy (MCT) models show both similarities and differences in conceptualizing anxiety. This work assumes that REBT’s irrational and MCT’s metacognitive beliefs play a mediation role while CBT’s disorder specific content beliefs act as triggers. This hypothesis is tested using a regression model in which metacognitive and irrational beliefs play a mediation role while content disorder beliefs are independent variables. This paper applied this model to generalized anxiety disorder (GAD), a psychiatric diagnosis in which anxiety is the major feature. In GAD, the specific content beliefs are negative problem orientation and intolerance of uncertainty. Therefore, 149 non clinical subjects completed 4 self-report questionnaires: the Negative Orientation to the Problems Questionnaire and the Intolerance of Uncertainty Scale as measures for content cognitive beliefs, the Attitudes and Beliefs Scale for irrational beliefs, and the Metacognitive Questionnaire 30 Items Version for metacognitive beliefs. The generalized anxiety disorder questionnaire was chosen in order to measure anxiety as dependent variable. Regression analyses confirmed that irrational and metacognitive beliefs mediate the relation between cognitive content beliefs and GAD. We clinically interpret mediation as a second level regulation.     

Associations Among Anxiety Disorders and Non-anxiety Disorders,Functional Impairment and Medication in Children and Adolescents

This is a study of comorbid anxiety disorders and how they affect the clinical picture of comorbid cases. The sample consisted of 576 Spanish children aged 8 to 17 years receiving psychiatric outpatient consultation that were evaluated using a semi-structured diagnostic interview for both parents and children. A specific association of homotypic comorbidity among anxiety disorders that was independent of the presence of other disorders was found. There was heterotypic comorbidity between anxiety and depressive disorders, ADHD, anorexia and tic disorders. Relationships between non-anxiety disorders were, in general, independent of anxiety, but anxiety moderated the relationship between ADHD-Conduct disorder and Conduct disorder-enuresis. Comorbid anxiety increased difficulties in social interaction, was related with higher global impairment and had an impact on consultation and medication. Anxiety disorder comorbidity should be well recognized in order not to disregard the treatment of all present disorders.     

Obsessive beliefs and uncertainty in obsessive compulsive and related patients

Background/objectiveThe aim of the present study was to examine obsessive beliefs and intolerance of uncertainty differences among patients Obsessive compulsive disoreder (OCD), trichotillomania, excoriation, generalized anxiety disorder (GAD) and a control group healthy.Method130 participants between the ages of 17 and 62 years (Mean = 29.56, SD = 11.81) diagnosed with OCD (n = 36), trichotillomania (n = 18), excoriation (n = 17), GAD (n = 31) and a healthy control group (n = 28) were evaluated by Obsessive Beliefs Spanish Inventory-Revised and Intolerance of Uncertainty Scale.ResultsThe trichotillomania group presented one of the highest obsessive beliefs highlighting over-importance of thoughts, thought action fusion-moral, importance of controlling one's thoughts. The OCD group also had higher scores in inflated responsibility and thought action fusion-likelihood. The GAD group excelled in inhibitory and prospective uncertainty. The level of depression influenced obsessive beliefs while anxiety affected inhibitory and prospective uncertainty.ConclusionsCognitive variables such as obsessive beliefs and Intolerance of Uncertainty should be considered in the prevention and intervention of obsessive and anxiety disorders.     

Stress mindset in athletes: Investigating the relationships between beliefs,challenge and threat with psychological wellbeing

ObjectiveStress is omnipresent in daily life and can be acutely experienced by athletes due to additional circumstances such as deselection and injury. Trait beliefs athletes have about the stress they experience as well as the cognitive appraisals of this stress may be important in determining psychological wellbeing. The present study aimed to investigate the relationships between stress mindset, irrational beliefs, cognitive appraisals and psychological wellbeing in athletes using path analysis. Broadly speaking, it was hypothesised that stress mindset would relate negatively to depressive symptoms and positively to vitality through appraisals (i.e., challenge and threat), while irrational beliefs would relate to positively to depressive symptoms and negatively to vitality through appraisals.Methods415 athletes (227 females, Mage = 33.86 years, SD = 17.73) completed an online questionnaire pack assessing stress mindset, irrational beliefs, challenge and threat appraisals, depressive symptoms, and vitality. Using path analysis, the tested hypothesised model demonstrated an excellent fit to the data.ResultsFindings demonstrate that the relationships between stress mindset, irrational beliefs and psychological wellbeing is linked by direct and indirect effects of challenge and threat in athletes. Stress mindset was positively associated with challenge and negatively associated with threat, whilst self-depreciation and awfulizing demonstrated significant positive associations with threat. Self-depreciation was found to significantly relate to stress mindset, challenge, threat and depressive symptoms to a greater extent than the other types of irrational beliefs.ConclusionsFindings suggest practitioners should be aware of the role that stress mindset and other irrational beliefs have in potentially influencing athlete psychological wellbeing.     

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.     

Ethno-culture, anxiety, and irrational beliefs

Ellis, Beck, and others in the cognitive therapy tradition maintain that there is a strong correlation between irrational beliefs and nonpsychotic mental health problems such as anxiety. Numerous studies have found that irrational beliefs are correlated with high trait anxiety. In a multi-cultural sample (n = 250; 46.7% Caucasian, 23.6% Asian, 23.6% multi-cultural, and 6.1% of other ethno-cultural backgrounds), these findings are replicated. Profile analysis (MANOVA) results reveals significant relationships between high trait anxiety and seven of the ten irrational beliefs scales on Jones' Irrational Belief Test. Asians are found to be the most anxious, and the relationship between ethno-culture and irrational beliefs was significant on three of the ten scales, with Asians having more irrational beliefs than Caucasians or multi-cultural individuals. However, no interaction is found between anxiety and ethno-culture in their relationship to irrational beliefs. Thus, these results reveal that there are ethno-cultural differences in anxiety and irrational beliefs. Clinical implications of the findings are discussed.     

Ethno-culture, anxiety, and irrational beliefs

Ellis, Beck, and others in the cognitive therapy tradition maintain that there is a strong correlation between irrational beliefs and nonpsychotic mental health problems such as anxiety. Numerous studies have found that irrational beliefs are correlated with high trait anxiety. In a multi-cultural sample (n = 250; 46.7% Caucasian, 23.6% Asian, 23.6% multi-cultural, and 6.1% of other ethno-cultural backgrounds), these findings are replicated. Profile analysis (MANOVA) results reveals significant relationships between high trait anxiety and seven of the ten irrational beliefs scales on Jones' Irrational Belief Test. Asians are found to be the most anxious, and the relationship between ethno-culture and irrational beliefs was significant on three of the ten scales, with Asians having more irrational beliefs than Caucasians or multi-cultural individuals. However, no interaction is found between anxiety and ethno-culture in their relationship to irrational beliefs. Thus, these results reveal that there are ethno-cultural differences in anxiety and irrational beliefs. Clinical implications of the findings are discussed.     

Elevated Appraisals of the Negative Impact of Naturally Occurring Life Events: A Risk Factor for Depressive and Anxiety Disorders

The tendency to appraise naturally occurring life events (LEs) as having high negative impact may be a predisposing factor for the development of depression and anxiety disorders. In the current study, appraisals of the negative impact of recent LEs were examined in relationship to depressive and anxiety disorders in a sample of 653 adolescents who were administered diagnostic and life stress interviews at ages 15 and 20. Participants’ appraisals of the negative impact of LEs reported at age 15 were statistically adjusted using investigator-based ratings to control for objective differences across LEs. Higher appraisals of the negative impact of LEs were associated with both past and current depressive and anxiety disorders at age 15 and predicted subsequent first onsets of depressive and anxiety disorders occurring between ages 15 and 20. In addition, appraisals of the negative impact of LEs were particularly elevated among those experiencing both a depressive and anxiety disorder over the course of the study. The findings suggest that systematically elevated appraisals of the negative impact of LEs are a predisposing factor for depression and anxiety disorders and may represent a specific risk factor for co-morbid depression and anxiety in mid-adolescence and early adulthood.     

The Relationship Between Automatic Thoughts and Irrational Beliefs Predicting Anxiety and Depression

Cognitive behavioral approaches differ in their views on core cognitions and their hypothesized role in the etiology of depression and anxiety. The present study provides empirical evidence regarding the relationship between irrational beliefs and components of automatic thoughts and their role in the etiology of depression and anxiety. The present study utilized newer and improved questionnaires to assess components of irrational belief. Based on prior research by Safren et al. (Cogn Ther Res 24(3):327–344, 2000), a three-factor structure of the combined automatic thought questionnaires were utilized to measure components of automatic thoughts as they relate to depression and anxiety. Factor analytical methods were utilized to confirm the factor structure of the irrational beliefs and automatic thoughts components. Advanced path modeling was utilized to model the relationship between irrational beliefs and automatic thoughts in predicting anxiety and depression. The study used a sample of N = 542 undergraduate psychology students during stressful exam times. Results indicated that the irrational belief Demandingness represents a primary factor, followed by the secondary irrational beliefs as proposed by Rational Emotive Behavioral Theory. Selfdowning beliefs were fully mediated by depressive automatic thoughts in the case of depressive affect. Low frustration tolerance contributed unique variance to anxious and depressive affect that was not fully mediated by automatic thoughts. Results from the present study add empirical evidence that irrational beliefs indeed represent core and intermediary beliefs that lead to specific automatic thoughts, which is congruent with cognitive behavioral theory as proposed by Rational Emotive Behavioral Therapy.     

Neuroticism as a common feature of the depressive and anxiety disorders: a test of the revised integrative hierarchical model in a national sample

The revised integrative hierarchical model of depression and anxiety (S. Mineka, D. Watson, & L. A. Clark, 1998) proposes that high levels of neuroticism are shared between the depressive and anxiety disorders. This perspective was evaluated with data from the National Comorbidity Survey (N = 5,847), a population-based community sample. Analyses were based on both a broadband (i.e., diagnostic class) and a narrowband (i.e., specific disorder) approach. Results supported the model insofar as high neuroticism was shared across the depressive and anxiety disorders and was particularly elevated in people with comorbid depression and anxiety. Results are discussed in terms of their implications for understanding the association between personality and the depressive and anxiety disorders in a community sample and for the revised integrative hierarchical perspective.     

An Open Trial Investigation of a Transdiagnostic Group Treatment for Children With Anxiety and Depressive Symptoms

The current study investigates the feasibility and preliminary outcomes associated with a transdiagnostic emotion-focused group protocol for the treatment of anxiety disorders and depressive symptoms in youth. Twenty-two children (ages 7 to 12; M = 9.79) with a principal anxiety disorder and varying levels of comorbid depressive symptoms were enrolled in an open trial of the Emotion Detectives Treatment Protocol (EDTP; Ehrenreich-May & Bilek, 2009), an intervention adapted from existent unified protocols for the treatment of emotional disorders among adults and adolescents. Results indicate that participants experienced significant improvements in clinician-rated severity of principal anxiety disorder diagnoses (d = 1.38), the sum of all anxiety and depressive disorder severity ratings (d = 1.07), and child-reported anxiety (d = 0.47) and parent-reported depressive symptoms (d = 0.54) at the posttreatment assessment. EDTP had good retention rates and reports of high satisfaction. Thus, preliminary evidence suggests that EDTP is a feasible and potentially efficacious treatment of youth anxiety disorders and co-occurring depressive symptoms. Children experiencing a range of internalizing symptoms may benefit from this more generalized, emotion-focused treatment modality, as it offers flexibility to families and the mental health clinician, while maintaining a concurrent focus on the provision of cognitive-behavioral treatment skills vital to the amelioration of anxiety and depressive disorder symptoms in youth.     

Latent Trait Modeling with the Common beliefs Survey III: Using Item Response Theory to Evaluate an Irrational Beliefs Inventory

Assessment of irrational beliefs by such measures as the Common Beliefs Survey III (CBS) has traditionally relied upon classical test theory assumptions, in which the properties of specific test items are less important than the total test score as the aggregate of all item responses. An alternative approach using item response theory (IRT) methodology allows one to specify the parameters of difficulty and discrimination for each test item. Difficulty levels of CBS items range along a continuum of irrationality, the implied latent trait measured by responses to the questionnaire as a whole. We evaluated the CBS responses of 605 individuals from clinical and college settings, drawing from current and archival data. The original Likert scale ratings were recoded into dichotomous scores. Fourteen of the 54 items were highly or very highly discriminating in distinguishing respondents with high and low irrationality levels. However, discriminating items exhibited a very narrow range of difficulty; most functioned at a point a little above the halfway mark on the continuum of irrationality. Item characteristic curves and test information curves were very similar for female (n = 424) and male (n = 179) respondents. We derived a 4-item screening test for irrationality from our IRT analyses of the 54 CBS items. Further test development, focused on the selection and scaling of items with a much broader range of difficulty, would facilitate evaluation of the hierarchical structure of irrational beliefs. Portions of this paper were presented at the 39th Annual Convention of the Association for Behavioral and Cognitive Therapies, Washington, DC, November, 2005.     

Neuropsychological profiles of children with depressive and anxiety disorders

The neuropsychological functioning of 56 children and young adolescents with diagnoses of unipolar depression (n = 17), anxiety disorder (n = 19), or comorbid anxiety/depressive disorder (n = 20) was examined. The neuropsychological profiles of the three groups were parallel, but not equal in level of performance. The three groups displayed similar patterns of performance with profiles suggesting diminished attention abilities. The groups, however, were not equal in level of performance. While subjects with an anxiety or a depressive disorder were similar in level of performance, subjects with a comorbid anxiety/depressive disorder generally performed worse than those with either an anxiety or depressive disorder alone. There was no significant evidence of asymmetrical cerebral dysfunction in any of the diagnostic groups. Results are discussed in relation to adult models of psychopathology with an emphasis on the importance of considering developmental factors when formulating models of childhood psychopathology.     

Empirical Investigation of the Relationships Between Irrationality,Self-Acceptance,and Dispositional Forgiveness

Milburn (J Ration Emot Cogn Behav Ther 33:325–340, 2015) recently suggested a theoretical link between REBT and forgiving, proposing that irrational beliefs, particularly demandingness and global evaluations of human worth, play a role in lack of forgiveness. The present study investigated a quantitative link between the concepts of irrationality, self-acceptance, and dispositional forgiveness. Four-hundred and thirty-three participants (70% female) participated in a 69-item online survey combining four previously validated scales: Shortened General Attitude and Belief Scale; Heartland Forgiveness Scale; Unconditional Self-Acceptance Questionnaire; and the Transgression Narrative Test of Forgivingness—(with revised response-options). Results indicated moderate and strong negative correlations between irrationality and dispositional forgiveness. Conversely, unconditional self-acceptance was significantly positively correlated with dispositional forgiveness. Regression analyses indicated that subtypes of irrationality and self-acceptance could predict dispositional forgiveness of self, other, and situation. No significant differences were found between sexes. These findings add empirical support to the hypotheses made by Milburn, suggesting that holding irrational beliefs impedes the process of forgiving, and one’s level of self-acceptance predicts one’s disposition to forgive.     

An Investigation of Irrational Beliefs and Death Anxiety as a Function of HIV Status

The present study investigated the relationship of irrational beliefs and death anxiety as a function of human immunodeficiency virus (HIV) status in homosexual and bisexual men. Recruited for this study were 101 HIV-seropositive participants (34 asymptomatic, 30 symptomatic, and 37 symptomatic and diagnosed with AIDS) and a contrast group (40 HIV-seronegative). In the primary analysis, HIV-negative participants in this study could not be differentiated from asymptomatic, symptomatic, and AIDS diagnosed HIV-infected participants on measures of death anxiety and irrational beliefs regardless of the status or severity of illness. In addition, irrational beliefs strongly predicted death anxiety for all participants. Results from post hoc analyses suggested that HIV status produced an interaction effect with level of total irrational beliefs and together predicted death anxiety. Even in these analyses, total irrational beliefs explained more of the variance of death anxiety than HIV status. These results are discussed within the context of the need for expanding cognitive-behavioral treatment options for HIV-infected individuals.     

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.     

Persistent Heightened Cortisol Awakening Response and Adolescent Internalizing Symptoms: A 3-year Longitudinal Community Study

An atypical Cortisol Awakening Response (CAR) has been related to adult anxiety and depression, but little is known about the association between long-term atypical CAR and adolescent anxiety and depression. This study aimed to longitudinally identify subgroups of adolescents with distinct levels of CAR (i.e., adolescents with and without persistent atypical CAR) and to examine their development of anxiety and depressive symptoms over 3 successive years. A community sample of 184 Dutch adolescents (M _age?=?14.99 at T₁, 57 % boys) completed annual salivary cortisol assessments at home at time of awakening, and 30 and 60 min post-awakening (i.e., CAR) for 3 successive years. Adolescents also reported annually on their anxiety and depressive disorder symptoms. Latent Class Growth Analysis suggested two subgroups of adolescents with respect to CAR: a “low” group with stable low levels of AUC_g (Area Under the Curve with respect to the ground) over time and a “high” group with high and increasing levels of AUC_g over time. Controlling for sex, the high and low CAR groups significantly differed in depressive symptoms only, but none of the anxiety disorder symptoms. More specifically, adolescents in the high CAR group showed significantly higher mean levels of depressive symptoms over time compared to adolescents in the low CAR group. These results suggest that persistent heightened CAR is a more consistent, yet modest, correlate of adolescent depressive symptoms than anxiety disorder symptoms.     

Generalized anxiety and panic disorders: Response to Cox, Cohen, Direnfeld, and Swinson (1996)

Contrary to the contention of Cox, Cohen, Direnfeld and Swinson (1996, Behaviour Research and Therapy, 34, 949–954) that the Beck Anxiety Inventory (BAI; Beck & Steer, 1993, Manual for the Beck Anxiety Inventory) measures primarily symptoms associated with panic attacks rather than anxiety in general, we propose that the higher level of anxiety found in patients with panic disorders not only is not an artifact of the BAI's symptom content, but patients with panic disorders truly have more anxiety than patients with other types of anxiety disorders. Furthermore, the BAI contains symptoms present in other anxiety disorders, besides panic disorder, and specifically includes 11 symptoms of generalized anxiety disorder (GAD). The BAI and revised Hamilton Anxiety Rating Scale (HARS-R; Riskind, Beck, Brown & Steer, 1987, Journal of Nervous and Mental Disease, 175, 474–479) scores of 274 (69%) outpatients with panic disorders and 123 (31%) outpatients with GAD were found to differentiate these two diagnostic groups equally and significantly. The panic disorder outpatients had higher scores on both the BAI and the HARS-R than did the GAD patients. Thus, Cox et al.'s (1996) speculation about the BAI's yielding spuriously high levels of anxiety in patients with panic disorders revives an important issue relevant to the relation of panic disorder to GAD.