Validation of idiosyncratic cognitive schema in cognitive case formulations: an intraindividual idiographic approach

This article describes a method for the intraindividual clinical validation of a cognitive case formulation (CCF) involving hypotheses about the patient's idiosyncratic cognitive schema (ICS). The two-stage approach begins by testing the convergent and discriminant validity of the hypothesized ICS against the individual's daily ratings of cognition items using confirmatory dynamic factor analysis. The second stage evaluates the extent to which the ICS factor scores predict daily variability in symptoms and distress and further addresses convergent and discriminant validity by evaluating intraindividual cognitive content specificity and the incremental validity of the idiographic cognition factors compared with nomothetic measures of thoughts/beliefs. This approach to validating idiographic assessment is illustrated with the CCF of a woman with comorbid mood and anxiety disorders.