Manualizing psychotherapy: Aaron T. Beck and the origins of Cognitive Therapy of Depression

Abstract

This paper examines the origins of psychiatrist Aaron T. Beck’s 1979 Cognitive Therapy of Depression (CTOD). CTOD was the first psychotherapy manual designed to be used in a randomized controlled trial (RCT). Making psychotherapy amenable to the RCT design had been a ‘holy grail’ for leading American psychotherapy researchers since the late 1960s. Beck’s CTOD – which standardized his treatment so it could be compared with drug treatments in a clinical trial – delivered that holy grail, and ushered in the manualized treatment revolution. Manuals are now a sine qua non in psychotherapy research. In this paper, I explore some of the personal, political, and economic variables that made the idea of a manual irresistible to Beck and to those who first championed him.     

IN PRAISE OF A LOGIC OF DEFINITIONS THAT TOLERATES Ω‐INCONSISTENCY

I argue that a general logic of definitions must tolerate ω‐inconsistency. I present a semantical scheme, , under which some definitions imply ω‐inconsistent sets of sentences. I draw attention to attractive features of this scheme, and I argue that yields the minimal general logic of definitions. I conclude that any acceptable general logic should permit definitions that generate ω‐inconsistency. This conclusion gains support from the application of to the theory of truth.     

政策执行偏差严重程度对公众地方政府责任判断的影响机制

为探讨地方政府政策执行偏差严重程度对公众地方政府责任判断的影响机制。采用问卷法对728名社会公众进行调查,结果显示：（1）公众地方政府有意性判断和公众地方政府可控归因中介了政策执行偏差严重程度与公众地方政府责任判断之间的关系。（2）政策执行偏差严重程度还通过公众地方政府有意性判断→公众地方政府可控归因的中介链作用于公众地方政府道德责任判断。并对研究的实践启示进行了讨论。     

Does Exposure to Stereotype‐Disconfirming Politicians Reduce the Effect of Stereotypes on Voting? Evidence From Seven Plagiarism Scandals in Germany

We examine whether exposure to several salient counterexamples reduces the effect of stereotypes on voting. By taking advantage of a series of seven plagiarism scandals in Germany—a country with high regard for academic credentials where academic titles (Dr. and Prof.) get printed on ballot papers—we test whether the tendency to vote for candidates with a doctor's title decreased in the wake of the scandals. Using cross‐sectional and longitudinal estimators and controlling for a large range of potential confounders, we find that the electoral advantage of candidates with a doctor's title shrinks from a good half of a percentage point before the scandals down to a third after the scandals. In line with a subtyping hypothesis, the reduction is stronger for candidates from traditional middle‐class parties (i.e., the parties of the politicians who were implicated in the scandals). Neither of these effects turns out to be strong enough to reach statistical significance, however. We conclude that seven negative examples in one legislative term had no noticeable effect on the tendency to select candidates based on academic titles. Our study provides a rare opportunity to test the effect of stereotype‐disconfirming information on electoral behavior. Our results contribute to a literature demonstrating the resilience of stereotypes to disconfirming information. They also suggest that plagiarism affairs are unlikely to reduce electoral incentives for politicians to obtain a fake doctorate.     

UNDERSTANDING PARENTING STRESS AND CHILDREN'S BEHAVIOR PROBLEMS AMONG HOMELESS,SUBSTANCE‐ABUSING MOTHERS

This article tested a model of parenting stress as a mediator between maternal depressive symptoms, emotion regulation, and child behavior problems using a sample of homeless, substance‐abusing mothers. Participants were 119 homeless mothers (ages 18–24 years) and their young children (ages 0–6 years). Mothers responded to questions about their depressive symptoms, emotion regulation, parenting stress, and child behavior problems. A path analysis showed that maternal depressive symptoms were positively associated with child behavior problems through increased parenting stress whereas maternal cognitive reappraisal was negatively associated with child behavior problems through decreased parenting stress. Moreover, maternal expressive suppression was negatively related to child externalizing problems. Findings support the parenting stress theory and highlight maternal parenting stress as a mechanism associated with homeless children's mental health risk. This study has significant implications for understanding the parenting processes underlying child's resilience in the context of homelessness and maternal substance use.     

Action‐semantic and syntactic deficits in subjects at risk for Huntington's disease

Frontostriatal networks play critical roles in grounding action semantics and syntactic skills. Indeed, their atrophy distinctively disrupts both domains, as observed in patients with Huntington's disease (HD) and Parkinson's disease, even during early disease stages. However, frontostriatal degeneration in these conditions may begin up to 15 years before the onset of clinical symptoms, opening avenues for pre‐clinical detection via sensitive tasks. Such a mission is particularly critical in HD, given that patients’ children have 50% chances of inheriting the disease. Against this background, we assessed whether deficits in the above‐mentioned domains emerge in subjects at risk to develop HD. We administered tasks tapping action semantics, object semantics, and two forms of syntactic processing to 18 patients with HD, 19 asymptomatic first‐degree relatives, and sociodemographically matched controls for each group. The patients evinced significant deficits in all tasks, but only those in the two target domains were independent of overall cognitive state. More crucially, relative to controls, the asymptomatic relatives were selectively impaired in action semantics and in the more complex syntactic task, with both patterns emerging irrespective of the subjects’ overall cognitive state. Our findings highlight the relevance of these dysfunctions as potential prodromal biomarkers of HD. Moreover, they offer theoretical insights into the differential contributions of frontostriatal hubs to both domains while paving the way for innovations in diagnostic procedures.     

Increasing the salience of fluency cues does not reduce the recognition memory impairment in Alzheimer's disease!

In Alzheimer's disease (AD), it is now well established that recollection is impaired from the beginning of the disease, whereas findings are less clear concerning familiarity. One of the most important mechanisms underlying familiarity is the sense of familiarity driven by processing fluency. In this study, we attempted to attenuate recognition memory deficits in AD by maximizing the salience of fluency cues in two conditions of a recognition memory task. In one condition, targets and foils have been created from the same pool of letters (Overlap condition). In a second condition, targets and foils have been derived from two separate pools of letters (No‐Overlap condition), promoting the use of letter‐driven visual and phonetic fluency. Targets and foils were low‐frequency words. The memory tasks were performed by 15 patients with AD and 16 healthy controls. Both groups improved their memory performance in the No‐Overlap condition compared to the Overlap condition. Patients with AD were able to use fluency cues during recognition memory as older adults did, but this did not allow to compensate for dysfunction of recognition memory processes.     

From Fathers to Sons: The Intergenerational Transmission of Parenting Behavior among African American Young Men

This study examined the intergenerational transmission of fathering among young, African American fathers in rural communities. A sample of 132 African American young men living in the rural South reported on the quality of their relationship with their biological and social fathers in the family of origin, their own involvement with their young children, and relational schemas of close, intimate relationships. Results of path analyses supported the hypothesized mediational model, such that a better relationship with one's biological (but not social) father predicted increased father involvement in the next generation, and this association was partially mediated through positive relational schema after controlling for a range of covariates. Tests of moderated mediation indicated that the link between relational schema and father involvement was significantly stronger among fathers of girls than fathers of boys. Findings highlight the unique influence of close, nurturing father–child relationships for downstream father involvement, and the role of relational schemas as a mechanism for intergenerational transmission among young, rural, African American fathers of girls.