A Historical and Theoretical Review of Cognitive Behavioral Therapies: From Structural Self-Knowledge to Functional Processes

This paper critically examines the historical conceptualization of cognitive behavioral psychotherapy approaches (CBT) as a direct clinical counterpart of the cognitive revolution. The main “second wave” cognitive psychotherapies, either standard cognitive therapy (CT) or constructivist, in spite of their differences, share a common conceptualization of psychopathological factors as superordinate structural cognitive content belonging to the self: self-beliefs, self-schemata, personality organizations and so on. On the other hand, rational emotive behavior therapy (REBT) is an exception given that in REBT self-knowledge is not the core psychopathological tenet, being rather a derivate mechanism. Moreover, in non clinical cognitive science cognition is conceived as a regulatory function that operates retroactively and not in a hierarchically super- ordered fashion centered on the self. A historical review suggests that in both CT and constructivist model the structuralistic model of self-centered cognition may have emerged for both cultural and scientific reasons: self-centered cognitive models may be more readily understandable to clinicians as they allow for a straightforward identification of operationalizable self-beliefs. The emergence of new “third wave” process-centered CBT approaches may represent a comeback to functionalism, where cognition is considered again a regulatory function and not a structure. In addition, REBT’s interest in dysfunctional evaluations not focused on the self presaged this clinical and scientific turning point toward functionalism.     

Examining adversarial growth in illness: The factor structure of the silver lining questionnaire (SLQ-38)

The Silver Lining Questionnaire (SLQ-38) is purported to measure 10 aspects of adversarial growth in illness. To date however, no empirical evidence exists to support this claim. Hence the aim of this study was to investigate the factor structure of the SLQ-38 in a sample of 560 individuals with multiple sclerosis (MS), cancer, cardiac, and renal disease. The results demonstrate that 24 SLQ-38 items can be factored into five subscales: improved personal relationships, greater appreciation for life, positive influence on others, personal inner strength and changes in life philosophy, all of which are in accordance with the literature on adversarial growth. Individuals with MS experienced lower adversarial growth compared to other illness groups. Gender, age and time since diagnosis were unrelated to adversarial growth in illness. The utility of the revised SLQ-38 is discussed along with suggestions for future research on the convergent and divergent validity of this revised instrument.     

The Contribution of Metacognitions and Attentional Control to Decisional Procrastination

Earlier research has implicated metacognitions and attentional control in procrastination and self-regulatory failure. This study tested several hypotheses: (1) that metacognitions would be positively correlated with decisional procrastination; (2) that attentional control would be negatively correlated with decisional procrastination; (3) that metacognitions would be negatively correlated with attentional control; and (4) that metacognitions and attentional control would predict decisional procrastination when controlling for negative affect. One hundred and twenty-nine participants completed the Depression Anxiety Stress Scale 21, the Meta-Cognitions Questionnaire 30, the Attentional Control Scale, and the Decisional Procrastination Scale. Significant relationships were found between all three attentional control factors (focusing, shifting, and flexible control of thought) and two metacognitions factors (negative beliefs concerning thoughts about uncontrollability and danger, and cognitive confidence). Results also revealed that decisional procrastination was significantly associated with negative affect, all measured metacognitions factors, and all attentional control factors. In the final step of a hierarchical regression analysis only stress, cognitive confidence, and attention shifting were independent predictors of decisional procrastination. Overall these findings support the hypotheses and are consistent with the Self-Regulatory Executive Function model of psychological dysfunction. The implications of these findings are discussed.     

Family Therapy With Irish-Americans

This paper presents a paradigm for understanding the cultural values and family patterns of Irish-American families and offers suggestions for clinical intervention. Families' correspondence to the model described will depend upon their level of acculturation, socioeconomic status, and other contextual factors. The paradigm suggests a number of issues that may create difficulties for the therapist and for the family in therapy. In general, behavioral techniques, Bowen systems therapy, and strategic interventions may be more useful than techniques emphasizing expression of emotions in therapy or direct attempts to alter communication or family behavior in therapy sessions, as used in structural therapy.     

Practicing REBT in Italy: Cultural Aspects

This paper attempts to explore the cultural background for the adoption and practice of REBT by cognitive therapists in Italy since the 1980s. It is not an attempt to capture the history of Italian culture and philosophy from antiquity. Italian therapists tend to prefer the assessment phase of the ABC framework and not fully adopt REBT disputing interventions. They also attempt to link the ABC not only to the here and now but also to clients’ personal development. In our experience, they have combined REBT with constructivism and metacognition. These current features parallel the historical lack of confidence shown by many Italian philosophical thinkers—from Machiavelli to Gianni Vattimo—in the possibility of reducing reality to verification as well as the reproducible rules of logical rationality. The foregoing highlights the interest in exploring the emotional roots of politics, history, and concrete reality in the time frame following the 1980s. Some typical features of Italian social life, such as individualism, hierarchy, remote social distance, and competition can also be thought of as corresponding with the historical features of the way REBT has been adopted and functions in Italy.     

MEASUREMENT ERROR IN RESEARCH ON HUMAN RESOURCES and FIRM PERFORMANCE: HOW MUCH ERROR IS THERE AND HOW DOES IT INFLUENCE EFFECT SIZE ESTIMATES?

Studies of the relationship between human resource (HR) practices and firm performance typically use a single respondent to assess firm level HR practices or HR effectiveness. However, previous research in other substantive areas suggests that rater differences are a potentially important source of measurement error. We demonstrate analytically the potential consequences of both random and systematic measurement error in research on HR and firm performance. However, our main focus is on random error and we show how generalizability theory can be applied to obtain better estimates of reliability by simultaneously recognizing multiple sources (e.g., items, raters) of random measurement error. These more inclusive reliability estimates, in turn, offer the possibility of more precisely quantifying substantive relationships in the HR and firm performance literature. In our sample, reliabilities (as estimated by generalizability coefficients) for single-rater assessments of HR variables were generally below .50. This degree of measurement error, if present in substantive studies on HR and firm performance, could lead to considerable bias, given that an unstandardized regression coefficient is corrected for measurement error in the independent variable by dividing by its reliability coefficient (not its square root). We also found only limited convergent validity between HR and line managers ratings of a second type of HR measure, HR effectiveness. In general, our findings suggest that future researchers need to devote greater attention to measurement error and construct validity issues. Our study provides an example of how generalizability theory can be useful in this pursuit.     

Talkativeness in Cognitively Normal Women at Genetic Risk for Alzheimer’s Disease

Previous research has suggested a correlation between some linguistic patterns and the risk for Alzheimer’s disease (AD). There is increasing clinical need to identify factors that can be used alone or in combination to predict the onset of AD. The purpose of the present study was to explore the association of language skills and genetic risk for Alzheimer’s disease. Oral and written language samples of cognitively normal women with a susceptibility gene for AD (ApoE e4) were compared to those of noncarriers on measures of grammatical complexity, topic relevance, and talkativeness by observers unaware of participant genotypes. Participants included 29 ApoE e4 carriers 49-73 years of age, and 29 e4 noncarriers 48-76 years of age, most of whom had a first-degree relative with AD. Carriers and noncarriers were group matched for age, educational level, and estimated IQ. Participant groups did not differ significantly in language complexity or topic relevance. However, the ApoE e4 group was significantly more talkative than the noncarrier group (p < .05).     

Difference in sensorimotor adaptation to horizontal and vertical mirror distortions during ballistic arm movements

When learning a novel motor task, the sensorimotor system must develop new strategies to efficiently control the limb(s) involved, and this adaptation appears to be developed through the construction of a behavioral map known as an 'internal model'. A common method to uncover the mechanisms of adaptation and reorganization processes is to expose the system to new environmental conditions, typically by introducing visual or mechanical distortions. The present study investigated the adaptation mechanisms of the human sensorimotor system to horizontal and vertical mirror distortions (HMD and VMD) during the execution of fast goal-directed arm movements. Mirror distortions (MDs) were created by means of virtual visual feedback on a computer screen while the movement was executed on a graphics tablet. Twenty healthy adult participants were recruited and assigned to one of two groups of 10 people each. Tests were divided in two subsequent blocks of five trials. The first block consisted of trials with no mirror distortion (NMD), while the second block was recorded when exposing one group to HMD and the other to VMD. Both MDs resulted in kinematic changes: during the tests with the MDs the participants did not reach the performance level found at the NMD test. Motor performance during HMD appeared to be globally better than during VMD and the adaptation process to VMD appeared to be slower than to HMD, but data interpretation was hampered by large within-participant and between-participant variability. In-depth analyses of the data revealed that most of the motor performance information was contained in the direction of movement. The data supported the idea that the internal model for HMD was already partially built.     

REBT in Italy: Dissemination and Integration with Constructivism and Metacognition

This paper describes and critically discusses how rational emotive behavior therapy (REBT) spread among Italian cognitive psychotherapists. In the 1980s Cesare De Silvestri, with the help of Carola Schimmelpfennig, Franco Baldini, and Mario Di Pietro, brought REBT to Italy and eagerly disseminated it. In addition, De Silvestri cooperated with the two leading figures in the Italian clinical cognitive movement, Vittorio Guidano and Gianni Liotti. Guidano and Liotti applied the ABC framework to their constructivist version of cognitive therapy. Given that the large majority of Italian cognitive therapists adopted Guidano and Liotti’s approach, they all started applying the ABC framework and are still applying it today. However, Italian therapists adapted the ABC framework to their constructivist training. For example, Guidano and Liotti interpreted the ABC framework as aimed at promoting cognitive and emotional awareness in clients, while they considered the ‘disputing’ phase to be not compatible with the constructivist principles they held. They also encouraged the application of John Bowlby’s ideas to REBT and the use of life experience report techniques in the ABC. Sandra Sassaroli and Roberto Lorenzini applied George Kelly’s “laddering” technique to the ABC framework, a technique more focused on dilemmatic structures than on REBTian dysfunctional thought. Caselli investigated REBT’s influence on Adrian Wells’ metacognitive version of the ABC. Finally, Ruggiero and Ammendola have made a strong call for “back to Ellis”. This implies that any innovation should involve a more stringent and faithful application of REBT principles.