A review of recent research on cognitive processing indicates that biases in attention, memory, and interpretation, as well as repetitive negative thoughts, are common across emotional disorders, although they vary in form according to type of disorder. Current cognitive models emphasize specific forms of biased processing, such as variations in the focus of attention or habitual interpretative styles that contribute to the risk of developing particular disorders. As well as predicting risk of emotional disorders, new studies haveprovided evidence of a causal relationship between processing bias and vulnerability. Beyond merely demonstrating the existence of biased processing, research is thus beginning to explore the cognitive causes of emotional vulnerability, and their modification.

Cognitive Vulnerability to Emotional Disorders

A short form of the metacognitions questionnaire: properties of the MCQ-30

Cognitive Behavioural Therapy (CBT) has established itself as one of the most effective therapies for treating a wide range of psychological disorders. However, research and treatment in this field typically adopts a DSM driven 'disorder-focused' approach - researchers and clinicians target a specific disorder, try to understand its aetiology and maintenance, and try to develop more effective strategies to treat the disorder. This book proposes an insightful and original approach to understanding these disorders, one that focuses on what they have in common. Instead of examining in isolation, for example, obsessive compulsive disorders, insomnia, schizophrenia, it asks - what do patients with these disorders have in common? It takes each cognitive and behavioural process - attention, memory, reasoning, thought, behaviour, and examines whether it is a transdiagnostic process - i.e., serves to maintain a broad range of psychological disorders. Having shown how these disorders share several important processes, it then describes the practical implications of such an approach to diagnosis and treatment. Importantly it explores why the different psychological disorders can present so differently, despite being maintained by the same cognitive and behavioural processes. It also provides an account of the high rates of comorbidity observed among the different disorders. This book provides a novel review and integration of the empirical literature and gives clinicians and researchers a valuable new theoretical base for assessing and treating psychological disorders. Cognitive Behavioural Therapy (CBT) has established itself as one of the most effective therapies for treating a wide range of psychological disorders. However, research and treatment in this field typically adopts a DSM driven 'disorder-focused' approach - researchers and clinicians target a specific disorder, try to understand its aetiology and maintenance, and try to develop more effective strategies to treat the disorder. This book proposes an insightful and original approach to understanding these disorders, one that focuses on what they have in common. Instead of examining in isolation, for example, obsessive compulsive disorders, insomnia, schizophrenia, it asks - what do patients with these disorders have in common? It takes each cognitive and behavioural process - attention, memory, reasoning, thought, behaviour, and examines whether it is a transdiagnostic process - i.e., serves to maintain a broad range of psychological disorders. Having shown how these disorders share several important processes, it then describes the practical implications of such an approach to diagnosis and treatment. Importantly it explores why the different psychological disorders can present so differently, despite being maintained by the same cognitive and behavioural processes. It also provides an account of the high rates of comorbidity observed among the different disorders. This book provides a novel review and integration of the empirical literature and gives clinicians and researchers a valuable new theoretical base for assessing and treating psychological disorders.

Cognitive Behavioural Processes across Psychological Disorders: A Transdiagnostic Approach to Research and Treatment

The Intolerance of Uncertainty Scale: Psychometric properties of the English version.

The pivotal problem of comorbidity research lies in the psychometric foundation it rests on, that is, latent variable theory, in which a mental disorder is viewed as a latent variable that causes a constellation of symptoms. From this perspective, comorbidity is a (bi)directional relationship between multiple latent variables. We argue that such a latent variable perspective encounters serious problems in the study of comorbidity, and offer a radically different conceptualization in terms of a network approach, where comorbidity is hypothesized to arise from direct relations between symptoms of multiple disorders. We propose a method to visualize comorbidity networks and, based on an empirical network for major depression and generalized anxiety, we argue that this approach generates realistic hypotheses about pathways to comorbidity, overlapping symptoms, and diagnostic boundaries, that are not naturally accommodated by latent variable models: Some pathways to comorbidity through the symptom space are more likely than others; those pathways generally have the same direction (i.e., from symptoms of one disorder to symptoms of the other); overlapping symptoms play an important role in comorbidity; and boundaries between diagnostic categories are necessarily fuzzy.

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Comorbidity: a network perspective.

Further tests of a cognitive model of generalized anxiety disorder: Metacognitions and worry in GAD, panic disorder, social phobia, depression, and nonpatients

Preliminary tests of a cognitive model of generalized anxiety disorder

This study tested the effectiveness of a new cognitive technique involving attention training. A single case systematic replication series (Sidman, 1960) was used to replicate and extend previous findings. In particular the effects of attention training on panic frequency, general anxiety, and beliefs was investigated across two panic disorder cases and one social phobia case, and across different therapists, and settings. A true reversal design was used in one of the cases. In this case attention training was followed by an attentional manipulation incompatible with the hypothesized effects of attention training so that the effects of attention training on target problems could be clearly evaluated on its re-introduction. The results are consistent with those of a previous study (Wells, 1990) and provide preliminary evidence that panic attacks, anxiety and beliefs can be effectively and lastingly reduced by cognitive techniques which do not directly target the content of negative appraisal. © 1997 John Wiley & Sons, Ltd.

Attention training: effects on anxiety and beliefs in panic and social phobia

Studies using the Thought Control Questionnaire (TCQ) have identified maladaptive thought control typified by worry and punishment. In the present study patterns of thought control strategy used by patients with GAD and MDD were compared with each other and with a group of nonpatient controls. The relationship between individual strategies and psychological vulnerability (trait-anxiety) was also examined. GAD and MDD groups could be distinguished from the control group by greater use of worry as a strategy, while the GAD group also used more punishment than either the MDD or control group. The results show evidence of a preponderance of maladaptive control strategies in these patients. In contrast, the control group used more social control and distraction. Worry was an independent positive predictor of trait-anxiety and distraction was an independent negative predictor. The theoretical implications are discussed in the context of the metacognitive model of psychological disorder.

Maladaptive Thought Control Strategies in Generalized Anxiety Disorder, Major Depressive Disorder, and nonpatient Groups and Relationships with Trait Anxiety

A 41-year-old female with schizo-affective disorder presenting with an eight-year history of auditory hallucinations participated in a single case treatment study (A-B-A-B-A-C-B) of the effects of the Attention Training Technique (ATT). No antipsychotic medication was prescribed in this case following a serious adverse reaction in the past. The aim of the study was to test the impact of ATT on the frequency and duration of hallucinations using a repeated return to baseline followed by an alternating treatment design. The alternative intervention consisted of autogenic relaxation instructions. The patient monitored the frequency, duration, and her distress over the voices on a daily basis during baseline and intervention phases across a study period of 80 weeks. Visual analysis of the data showed that ATT when introduced at three phases following baselines or control conditions was associated with a reduction in auditory hallucination frequency and duration compared to the other phases. This contrasted with the autogenic relaxation intervention that was associated with an increase in duration and frequency of voices. The perceived benefits of ATT were maintained for varying periods of time.

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Karin Carter

Papers

Further tests of a cognitive model of generalized anxiety disorder: Metacognitions and worry in GAD, panic disorder, social phobia, depression, and nonpatients

Preliminary tests of a cognitive model of generalized anxiety disorder

Attention training: effects on anxiety and beliefs in panic and social phobia

Maladaptive Thought Control Strategies in Generalized Anxiety Disorder, Major Depressive Disorder, and nonpatient Groups and Relationships with Trait Anxiety

Effects of the Attention Training Technique on Auditory Hallucinations in Schizo-Affective Disorder: A Single Case Study.