Cognitive-behavioural Analysis and 1 reatment ot Insomnia

Abstract

Insomnia is a condition characterized by subjective complaints of insufficient sleep and poor daytime functioning. Objective measures of sleep and daytime functioning, however, seldom show evidence of a similar degree of dysfunction. Most insomniacs, for example, do not suffer from sleep deprivation or daytime sleepiness. This discrepancy between subjective and objective measures of sleep and daytime functioning suggests that cognitive factors may play a central role in persistent insomnia. In particular, it is argued that fears about insufficient sleep and its adverse daytime consequences tend to interfere with sleep, thereby causing a vicious cycle which serves to maintain the insomnia. It is also argued that perfectionist standards and other dysfunctional beliefs may predispose people to these kinds of fears. Finally, existing models for cognitive-behavioural treatment of insomnia are criticized for being almost exclusively focused on the night-time aspects of insomnia. If insomnia is maintained by various kinds of vicious cycles involving fears, beliefs, and standards with regard to daytime functioning, these daytime aspects of insomnia should receive more attention in cognitive-behavioural treatment.     

Negative Life Experiences and the Development of Cluster C Personality Disorders: A Cognitive Perspective

Early negative experiences have long been thought to play an important role in the development of personality disorders. Most of the literature regarding these early life experiences has focused on borderline personality disorder, with only occasional focus on other personality disorders. Utilizing cognitive theory of personality disorders (Beck et al., 2004), the authors conceptualize cluster C personality disorders (avoidant, dependent, and obsessive–compulsive). They then critically review the relevant literature on early negative life experiences and later development of these disorders to determine whether the theory is supported by the empirical data. The theory regarding avoidant and dependent personality disorders has limited support, whereas data relating to obsessive–compulsive personality disorder are much weaker. Implications and future research suggestions are discussed.     

Expectations and Attributions in Social Anxiety Disorder: Diagnostic Distinctions and Relationship to General Anxiety and Depression

Contemporary cognitive models suggest that social anxiety disorder arises from a number of cognitive factors, including tendencies to form pessimistic (rather than optimistic) attributions and expectations for socially-related events. These models also assume that the strengths of such attributions and expectations are more closely linked with social anxiety than with general anxiety or depression. To test these assumptions, a battery of self-report measures was completed by participants with a primary diagnosis of generalized social anxiety disorder (n?=?75), panic disorder with agoraphobia (n?=?44), or post-traumatic stress disorder (n?=?59). To examine differences on these cognitive variables, group comparisons were performed controlling for general anxiety, depression and medication status. Social anxiety disorder, compared with panic disorder with agoraphobia and post-traumatic stress disorder, was characterized by lower expectations for positive social events and higher expectations for negative social events. There was no difference among the groups on expectations for non-social positive or negative events. Stable and global attributions for social negative events were more closely associated with social anxiety disorder than with panic disorder with agoraphobia and post-traumatic stress disorder. Correlational analyses also revealed specific relationships among social-cognitive measures and social anxiety, even after controlling for general anxiety and depression. The results are consistent with cognitive models of social anxiety disorder.     

Cognitive Bias Via the Internet: A Comparison of Web‐Based and Standard Emotional Stroop Tasks in Social Phobia

There is accumulating evidence to suggest that social phobia is associated with attentional bias for words related to social threat. Information processing in individuals with social phobia (n = 87) was investigated in the present study using 2 versions of the emotional Stroop task. Results from a standard emotional Stroop task indicated delayed colour naming of socially threatening words relative to neutral words, in line with previous research, whereas results from a Web‐based emotional Stroop task indicated a facilitation effect, with faster manual indication of colour choice for socially threatening words than for neutral words. Possible explanations for these contrasting findings and issues for further research are discussed.     

Experimental and Behavioral Approaches to Alcoholism: Kongressrapport

Hypochondriasis is highly prevalent in medical settings, has detrimental effects for affected individuals, and is associated with high societal costs. Although cognitive behavior therapy (CBT) has been shown to be effective in the treatment of hypochondriasis, it is not widely available because of a lack of properly trained therapists. Therefore, it is essential to evaluate therapy forms that require less therapist time. The authors investigated the effect and economic impact of group CBT delivered in a psychiatric setting among 24 people with hypochondriasis. A within-group design with prolonged baseline was used, and all participants received 10 weeks of group-based treatment. The primary outcome measures were the Health Anxiety Inventory and the Illness Attitude Scales. Results indicate significant improvement on both measures at posttreatment and 6-month follow-up (Cohen's d = 1.03–1.72). Medical and nonmedical costs were substantially lowered. The authors conclude that group-based CBT delivered in a psychiatric setting is an effective and potentially highly cost-effective treatment for hypochondriasis.     

Disentangling the Impact of Resistance and Ambivalence on Therapy Outcomes in Cognitive Behavioural Therapy for Generalized Anxiety Disorder

Resistance and ambivalence about change are increasingly recognized as important determinants of treatment outcomes. Moreover, resistance and ambivalence are thought to be theoretically related in that clients who are more ambivalent about change are more likely to demonstrate resistance to the process and tasks of treatment. In the context of cognitive behavioural therapy (CBT) for generalized anxiety disorder, the present study simultaneously examined early resistance and ambivalence using two observer-based coding systems in order to determine their inter-relationship and, importantly, to investigate their relative contributions to outcome. Resistance was also coded during mid-treatment in order to investigate possible mediation pathways. Early ambivalence (clients’ arguments against change or counter-change talk) was found to be no longer related to outcomes when early resistance was taken into account, suggesting that disharmony in the therapeutic relationship is more important to outcomes than ambivalence per se. Moreover, mid-treatment resistance partially mediated the relationship between early resistance and post-treatment worry severity. That is, higher early opposition to therapist direction is related to poorer outcomes, in part because it is associated with greater resistance during the working phase of CBT. The findings underscore the critical need for therapists to be sensitive to identifying resistance early and throughout treatment.     

行人过街的认知心理过程和模型

随着交通系统的复杂化,行人安全受到的威胁日益增加。本文以行人穿过马路的心理步骤为切入点,对行人观察感知、判断决策方面的研究进行综述。在观察感知方面,主要分析了观察内容、策略及注意失误的原因,在判断决策方面,介绍了内部心理机制中相关的理论模型,包括效用理论、计划行为理论,以及具体行为机制中的可接受间隙理论,并重点分析了具体行为机制里闯红灯行为的影响因素。最后,本文提出了行人过街的认知心理模型,为以后的行人研究提供理论借鉴,为交通安全提供实践依据。     

基于项目自动生成的认知诊断测验开发

认知诊断、项目自动生成是现代心理测量领域的重要发展领域,二者的结合更是心理测量领域亟待开展的重要课题。本研究以小学数学问题解决认知诊断项目自动生成为例,探讨认知诊断领域的项目生成技术及算法。研究发现：(1)计算机自生成的项目参数与原模板参数具有较高的一致性。(2)同一项目模板下生成的不同试题的测量学特征基本不变。(3)同一批被试在自动生成的两份试卷的前、后测的能力( )值高度相关(r=0.811),前、后两次对被试诊断结果的一致性高达86.5%。这表明本文所设计的认知诊断测验项目的自动生成技术及其算法基本可行,小学数学问题解决认知诊断项目的自动生成效果较好。这也为其它认知诊断领域的项目自动生成提供了技术借鉴和支持。     

Collective moral disengagement: Initial validation of a scale for adolescents

Collective moral disengagement refers to shared group beliefs that morally justify negative actions. This study reports an initial validation of the newly developed Classroom Collective Moral Disengagement Scale (CCMDS) for adolescents. This self-report instrument assesses the degree to which mechanisms of moral disengagement are shared by students in their class. Data were collected from two samples of 486 and 654 adolescents attending middle and high schools in Italy. Through exploratory and confirmatory factor analyses the unidimensional structure of the scale was established. Multigroup analyses demonstrated configural, metric and scalar invariance of the model across age and gender groups. The final version of the scale consists of 17 items and it has good internal consistency and validity. It is concluded that the scale is a promising measure for research concerning group level morality.     

共情的性别差异

共情指的是个体在与人交往的过程中共享并理解他人的情绪状态的倾向, 包括认知共情和情绪共情两种成分。共情在学前阶段没有性别差异。进入中小学阶段以后, 共情出现了性别差异。一方面, 共情的性别差异与个体自身的生理成熟有关。随着年龄增长, 两性逐渐趋向生理成熟, 荷尔蒙分泌增加并出现差异, 其中催产素有助于情绪共情, 睾丸酮则与认知共情有负相关, 两性的共情水平也因此有了显著差异。另一方面, 共情的性别差异与社会性别角色倾向有关。女性的性别角色以关注他人为导向, 与共情有直接相关, 男性的性别角色以关注公平公正为导向, 与共情没有相关。当两性习得各自的性别角色以后, 他们的共情表现就出现了差异, 这一差异在情绪共情方面较为突出。有关共情性别差异的研究虽然取得了丰富的成果, 但仍然有进一步深入挖掘的空间, 未来的研究需要在视角上注重从年龄、性别和文化交互作用的角度进行考察, 在理论上考虑从能力和倾向性的维度区分共情, 在内容上丰富对影响性别差异的各项因素的研究。