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Lee Anna Clark - One of the best experts on this subject based on the ideXlab platform.
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improved Cognitive Content endures for 2 years among unstable responders to acute phase Cognitive therapy for recurrent major depressive disorder
Psychological Medicine, 2015Co-Authors: Jeffrey R Vittengl, Lee Anna Clark, Michael E Thase, Robin B JarrettAbstract:Background. The Cognitive model of depression suggests that Cognitive therapy (CT) improves major depressive disorder (MDD) in part by changing depressive Cognitive Content (e.g. dysfunctional attitudes, hopelessness). The current analyses clarified: (1) the durability of improvements in Cognitive Content made by acute-phase CT responders; (2) whether continuation-phase CT (C-CT) or fluoxetine (FLX) further improves Cognitive Content; and (3) the extent to which Cognitive Content mediates continuation treatments’ effects on depressive symptoms and major depressive relapse/recurrence. Method. Out-patients with recurrent MDD who responded to acute-phase CT ( n = 241) were randomized to 8 months of C-CT, FLX or pill placebo (PBO) and followed for an 24 additional months. Cognitive Content was assessed approximately every 4 months using five standard patient-report measures. Results. Large improvements in Cognitive Content made during acute-phase CT were maintained for 32 months, with 78–90% of patients scoring in normal ranges, on average. Cognitive Content varied little between C-CT, FLX and PBO arms, overall. Small, transient improvements in Cognitive Content in C-CT or FLX compared with PBO patients did not clearly mediate the treatments’ effects on depressive symptoms or on major depressive relapse/recurrence. Conclusions. Outpatients with recurrent MDD who respond to acute-phase CT show durable improvements in Cognitive Content. C-CT or FLX may not continue to improve patient-reported Cognitive Content substantively, and thus may treat recurrent MDD by other paths.
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are improvements in Cognitive Content and depressive symptoms correlates or mediators during acute phase Cognitive therapy for recurrent major depressive disorder
International Journal of Cognitive Therapy, 2014Co-Authors: Jeffrey R Vittengl, Lee Anna Clark, Michael E Thase, Robin B JarrettAbstract:The Cognitive model of depression posits that Cognitive therapy's (CT) effect on depressive symptoms is mediated by changes in Cognitive Content (e.g., automatic negative thoughts, dysfunctional attitudes, failure attributions). We tested improvement and normalization of Cognitive Content among outpatients (N = 523) with recurrent major depressive disorder treated with acute-phase CT (Jarrett & Thase, 2010; Jarrett, Minhajuddin, Gershenfeld, Friedman, & Thase, 2013). We also tested whether improvement in Cognitive Content accounted for subsequent changes in depressive symptoms and vice versa. Five measures of Content improved substantively from pre- to post-CT (median d = 0.96), and the proportions of patients scoring in “healthy” ranges increased (median 45% to 82%). Evidence for Cognitive mediation of symptom reduction was limited (median r = .06), as was evidence for symptom mediation of Cognitive Content improvement (median r = .07). We discuss measurement and design issues relevant to detection of me...
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changes in Cognitive Content during and following Cognitive therapy for recurrent depression substantial and enduring but not predictive of change in depressive symptoms
Journal of Consulting and Clinical Psychology, 2007Co-Authors: Robin B Jarrett, Jeffrey R Vittengl, Kimberly Doyle, Lee Anna ClarkAbstract:: The authors examined the amount and durability of change in the Cognitive Content of 156 adult outpatients with recurrent major depressive disorder after treatment with Cognitive therapy. The pre-post magnitude of change was large for the Attributional Style Questionnaire Failure composite (d = 0.79), Dysfunctional Attitudes Scale (d = 1.05), and Self-Efficacy Scale (d = 0.83), and small for the Attributional Style Questionnaire Success composite (d = 0.30). Changes in Cognitive Content were clinically significant, as defined by their 64%-87% scores overlapping with score distributions from community dwellers. Improvement was durable over a 2-year follow-up. Changes in negative Cognitive Content could be detected early and distinguished responders from nonresponders. In responders, continuation-phase Cognitive therapy was associated with further improvements on only 1 measure of Cognitive Content. Early changes in negative Cognitive Content did not predict later changes in depressive symptoms, which the authors discuss in the context of methodological challenges and the Cognitive theory of depression.
Robin B Jarrett - One of the best experts on this subject based on the ideXlab platform.
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improved Cognitive Content endures for 2 years among unstable responders to acute phase Cognitive therapy for recurrent major depressive disorder
Psychological Medicine, 2015Co-Authors: Jeffrey R Vittengl, Lee Anna Clark, Michael E Thase, Robin B JarrettAbstract:Background. The Cognitive model of depression suggests that Cognitive therapy (CT) improves major depressive disorder (MDD) in part by changing depressive Cognitive Content (e.g. dysfunctional attitudes, hopelessness). The current analyses clarified: (1) the durability of improvements in Cognitive Content made by acute-phase CT responders; (2) whether continuation-phase CT (C-CT) or fluoxetine (FLX) further improves Cognitive Content; and (3) the extent to which Cognitive Content mediates continuation treatments’ effects on depressive symptoms and major depressive relapse/recurrence. Method. Out-patients with recurrent MDD who responded to acute-phase CT ( n = 241) were randomized to 8 months of C-CT, FLX or pill placebo (PBO) and followed for an 24 additional months. Cognitive Content was assessed approximately every 4 months using five standard patient-report measures. Results. Large improvements in Cognitive Content made during acute-phase CT were maintained for 32 months, with 78–90% of patients scoring in normal ranges, on average. Cognitive Content varied little between C-CT, FLX and PBO arms, overall. Small, transient improvements in Cognitive Content in C-CT or FLX compared with PBO patients did not clearly mediate the treatments’ effects on depressive symptoms or on major depressive relapse/recurrence. Conclusions. Outpatients with recurrent MDD who respond to acute-phase CT show durable improvements in Cognitive Content. C-CT or FLX may not continue to improve patient-reported Cognitive Content substantively, and thus may treat recurrent MDD by other paths.
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are improvements in Cognitive Content and depressive symptoms correlates or mediators during acute phase Cognitive therapy for recurrent major depressive disorder
International Journal of Cognitive Therapy, 2014Co-Authors: Jeffrey R Vittengl, Lee Anna Clark, Michael E Thase, Robin B JarrettAbstract:The Cognitive model of depression posits that Cognitive therapy's (CT) effect on depressive symptoms is mediated by changes in Cognitive Content (e.g., automatic negative thoughts, dysfunctional attitudes, failure attributions). We tested improvement and normalization of Cognitive Content among outpatients (N = 523) with recurrent major depressive disorder treated with acute-phase CT (Jarrett & Thase, 2010; Jarrett, Minhajuddin, Gershenfeld, Friedman, & Thase, 2013). We also tested whether improvement in Cognitive Content accounted for subsequent changes in depressive symptoms and vice versa. Five measures of Content improved substantively from pre- to post-CT (median d = 0.96), and the proportions of patients scoring in “healthy” ranges increased (median 45% to 82%). Evidence for Cognitive mediation of symptom reduction was limited (median r = .06), as was evidence for symptom mediation of Cognitive Content improvement (median r = .07). We discuss measurement and design issues relevant to detection of me...
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changes in Cognitive Content during and following Cognitive therapy for recurrent depression substantial and enduring but not predictive of change in depressive symptoms
Journal of Consulting and Clinical Psychology, 2007Co-Authors: Robin B Jarrett, Jeffrey R Vittengl, Kimberly Doyle, Lee Anna ClarkAbstract:: The authors examined the amount and durability of change in the Cognitive Content of 156 adult outpatients with recurrent major depressive disorder after treatment with Cognitive therapy. The pre-post magnitude of change was large for the Attributional Style Questionnaire Failure composite (d = 0.79), Dysfunctional Attitudes Scale (d = 1.05), and Self-Efficacy Scale (d = 0.83), and small for the Attributional Style Questionnaire Success composite (d = 0.30). Changes in Cognitive Content were clinically significant, as defined by their 64%-87% scores overlapping with score distributions from community dwellers. Improvement was durable over a 2-year follow-up. Changes in negative Cognitive Content could be detected early and distinguished responders from nonresponders. In responders, continuation-phase Cognitive therapy was associated with further improvements on only 1 measure of Cognitive Content. Early changes in negative Cognitive Content did not predict later changes in depressive symptoms, which the authors discuss in the context of methodological challenges and the Cognitive theory of depression.
Mark P Jensen - One of the best experts on this subject based on the ideXlab platform.
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the role of Cognitive Content and Cognitive processes in chronic pain an important distinction
The Clinical Journal of Pain, 2017Co-Authors: Mark P Jensen, Beverly E Thorn, James Carmody, Francis J Keefe, John W BurnsAbstract:Objectives:Pain-related Cognitive Content (what people think about pain) and Cognitive processes (how people think about pain; what they do with their pain-related thoughts) and their interaction are hypothesized to play distinct roles in patient function. However, questions have been raised regardi
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The Pain-Related Cognitive Processes Questionnaire: Development and Validation
Pain Medicine, 2017Co-Authors: L. Charles Ward, Beverly E Thorn, Cathryne P. Lang, Toby Newton-john, Dawn M. Ehde, Mark P JensenAbstract:Objective Cognitive processes may be characterized as how individuals think, whereas Cognitive Content constitutes what individuals think. Both Cognitive processes and Cognitive Content are theorized to play important roles in chronic pain adjustment, and treatments have been developed to target both. However, the evaluation of treatments that target Cognitive processes is limited because extant measures do not satisfactorily separate Cognitive process from Cognitive Content. The current study aimed to develop a self-report inventory of potentially adaptive and presumed maladaptive attentional processes that may occur when someone is experiencing pain. Methods Scales were derived from a large item pool by successively applying confirmatory factor analysis to item data from two undergraduate samples (N = 393 and 233). Results Items, which were generated to avoid confounding of Cognitive Content with Cognitive processes, represented nine constructs: Suppression, Distraction, Enhancement, Dissociation, Reappraisal, Absorption, Rumination, Nonjudgment, and Acceptance. The resulting nine scales formed the Pain-Related Cognitive Process Questionnaire (PCPQ), and scale correlations produced four conceptually distinct composite scales: Pain Diversion, Pain Distancing, Pain Focus, and Pain Openness. Internal consistency reliabilities of the nine scales were adequate (α ≥ 0.70) to good, and the four composite scales had α values of 0.79 or higher. Correlations with pain-related criterion variables were generally consistent with putative constructs. Conclusions The developed PCPQ scales offer a comprehensive assessment of important Cognitive processes specific to pain. Overall, the findings suggest that the PCPQ scales may prove useful for evaluating the role of pain-related Cognitive processes in studies of chronic pain.
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a Content review of Cognitive process measures used in pain research within adult populations
European Journal of Pain, 2017Co-Authors: Cathryne P. Lang, Dawn M. Ehde, Toby Newtonjohn, Mark P JensenAbstract:Background and objective Previous research suggests that measures of Cognitive process may be confounded by the inclusion of items that also assess Cognitive Content. The primary aims of this Content review were to: (1) identify the domains of Cognitive processes assessed by measures used in pain research; and (2) determine if pain-specific Cognitive process measures with adequate psychometric properties exist. Databases and data treatment PsychInfo, CINAHL, PsycArticles, MEDLINE, and Academic Search Complete databases were searched to identify the measures of Cognitive process used in pain research. Identified measures were double coded and the measure's items were rated as: (1) Cognitive Content; (2) Cognitive process; (3) behavioural/social; and/or (4) emotional coping/responses to pain. Results A total of 319 scales were identified; of these, 29 were coded as providing an un-confounded assessment of Cognitive process, and 12 were pain-specific. The Cognitive process domains assessed in these measures are Absorption, Dissociation, Reappraisal, Distraction/Suppression, Acceptance, Rumination, Non-Judgment, and Enhancement. Pain-specific, un-confounded measures were identified for: Dissociation, Reappraisal, Distraction/Suppression, and Acceptance. Psychometric properties of all 319 scales are reported in supplementary material. Conclusions To understand the importance of Cognitive processes in influencing pain outcomes as well as explaining the efficacy of pain treatments, valid and pain-specific Cognitive process measures that are not confounded with non-process domains (e.g., Cognitive Content) are needed. The findings of this Content review suggest that future research focused on developing Cognitive process measures is critical in order to advance our understanding of the mechanisms that underlie effective pain treatment. Significance Many Cognitive process measures used in pain research contain a ‘mix’ of items that assess Cognitive process, Cognitive Content, and behavioural/emotional responses. Databases searched: PsychInfo, CINAHL, PsycArticles, MEDLINE and Academic Search Complete. This review describes the domains assessed by measures assessing Cognitive processes in pain research, as well as the strengths and limitations of these measures.
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Cognitions, Metacognitions, and Chronic Pain
Rehabilitation Psychology, 2012Co-Authors: Toshiyuki Yoshida, Mark P Jensen, Ivan R. Molton, Tomoyasu Nakamura, Tatsuyuki Arimura, Chiharu Kubo, Masako HosoiAbstract:PURPOSE: Although the Content of thoughts has received a considerable amount of attention in pain research, the importance of thought processes (metacognitions) has received less attention. METHOD: One hundred twenty-nine individuals with muscular dystrophy and chronic pain completed measures assessing metacognitions and frequency of both catastrophizing and pain control beliefs. RESULTS: Greater use of reappraisal and distraction metacognitions were associated with more perceived control over pain, whereas greater use of worry and punishment metacognitions were associated with more catastrophizing. CONCLUSIONS/IMPLICATIONS: The current findings indicate that metacognitions are associated with both pain control beliefs and catastrophizing and therefore may play an important role in the development or maintenance of pain-related Cognitive Content thought to influence patient functioning. Research is needed to determine whether treatments that encourage changes in both metacognitions and Cognitive Content are more effective than treatments that focus on Cognitive Content alone.
Jeffrey R Vittengl - One of the best experts on this subject based on the ideXlab platform.
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improved Cognitive Content endures for 2 years among unstable responders to acute phase Cognitive therapy for recurrent major depressive disorder
Psychological Medicine, 2015Co-Authors: Jeffrey R Vittengl, Lee Anna Clark, Michael E Thase, Robin B JarrettAbstract:Background. The Cognitive model of depression suggests that Cognitive therapy (CT) improves major depressive disorder (MDD) in part by changing depressive Cognitive Content (e.g. dysfunctional attitudes, hopelessness). The current analyses clarified: (1) the durability of improvements in Cognitive Content made by acute-phase CT responders; (2) whether continuation-phase CT (C-CT) or fluoxetine (FLX) further improves Cognitive Content; and (3) the extent to which Cognitive Content mediates continuation treatments’ effects on depressive symptoms and major depressive relapse/recurrence. Method. Out-patients with recurrent MDD who responded to acute-phase CT ( n = 241) were randomized to 8 months of C-CT, FLX or pill placebo (PBO) and followed for an 24 additional months. Cognitive Content was assessed approximately every 4 months using five standard patient-report measures. Results. Large improvements in Cognitive Content made during acute-phase CT were maintained for 32 months, with 78–90% of patients scoring in normal ranges, on average. Cognitive Content varied little between C-CT, FLX and PBO arms, overall. Small, transient improvements in Cognitive Content in C-CT or FLX compared with PBO patients did not clearly mediate the treatments’ effects on depressive symptoms or on major depressive relapse/recurrence. Conclusions. Outpatients with recurrent MDD who respond to acute-phase CT show durable improvements in Cognitive Content. C-CT or FLX may not continue to improve patient-reported Cognitive Content substantively, and thus may treat recurrent MDD by other paths.
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are improvements in Cognitive Content and depressive symptoms correlates or mediators during acute phase Cognitive therapy for recurrent major depressive disorder
International Journal of Cognitive Therapy, 2014Co-Authors: Jeffrey R Vittengl, Lee Anna Clark, Michael E Thase, Robin B JarrettAbstract:The Cognitive model of depression posits that Cognitive therapy's (CT) effect on depressive symptoms is mediated by changes in Cognitive Content (e.g., automatic negative thoughts, dysfunctional attitudes, failure attributions). We tested improvement and normalization of Cognitive Content among outpatients (N = 523) with recurrent major depressive disorder treated with acute-phase CT (Jarrett & Thase, 2010; Jarrett, Minhajuddin, Gershenfeld, Friedman, & Thase, 2013). We also tested whether improvement in Cognitive Content accounted for subsequent changes in depressive symptoms and vice versa. Five measures of Content improved substantively from pre- to post-CT (median d = 0.96), and the proportions of patients scoring in “healthy” ranges increased (median 45% to 82%). Evidence for Cognitive mediation of symptom reduction was limited (median r = .06), as was evidence for symptom mediation of Cognitive Content improvement (median r = .07). We discuss measurement and design issues relevant to detection of me...
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changes in Cognitive Content during and following Cognitive therapy for recurrent depression substantial and enduring but not predictive of change in depressive symptoms
Journal of Consulting and Clinical Psychology, 2007Co-Authors: Robin B Jarrett, Jeffrey R Vittengl, Kimberly Doyle, Lee Anna ClarkAbstract:: The authors examined the amount and durability of change in the Cognitive Content of 156 adult outpatients with recurrent major depressive disorder after treatment with Cognitive therapy. The pre-post magnitude of change was large for the Attributional Style Questionnaire Failure composite (d = 0.79), Dysfunctional Attitudes Scale (d = 1.05), and Self-Efficacy Scale (d = 0.83), and small for the Attributional Style Questionnaire Success composite (d = 0.30). Changes in Cognitive Content were clinically significant, as defined by their 64%-87% scores overlapping with score distributions from community dwellers. Improvement was durable over a 2-year follow-up. Changes in negative Cognitive Content could be detected early and distinguished responders from nonresponders. In responders, continuation-phase Cognitive therapy was associated with further improvements on only 1 measure of Cognitive Content. Early changes in negative Cognitive Content did not predict later changes in depressive symptoms, which the authors discuss in the context of methodological challenges and the Cognitive theory of depression.
Peter F. Lovibond - One of the best experts on this subject based on the ideXlab platform.
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Worry episodes and perceived problem solving: A diary-based approach
Anxiety Stress and Coping, 2006Co-Authors: Marianna Szabó, Peter F. LovibondAbstract:Thirty-nine university students monitored their naturally occurring worry episodes for 7 days. They rated each episode in terms of six Cognitive Content categories, labeled Negative Outcome Anticipation, Problem-Solving Process, Solution Selection, Self-Blame, Rumination, and Palliative Thoughts. The results reinforced previous findings that a large proportion of the self-reported Cognitive Content of worry reflects problem-solving attempts, and that these attempts can sometimes lead to a selection of subjectively satisfying solutions. Solution Selection was also reported as a frequently used worry termination strategy. Individuals who rated their worry episodes as more uncontrollable reported fewer instances of solution selection and engaged in more negative solution evaluation while worrying. They were also more likely to keep worrying until they became distracted by an external event. Collectively, the data support the notion that normal worry involves problem-solving attempts and suggest that difficulties at the solution evaluation and solution selection stages may be important mechanisms underlying excessive worry.
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The Cognitive Content of thought-listed worry episodes in clinic-referred anxious and nonreferred children.
Journal of Clinical Child and Adolescent Psychology, 2004Co-Authors: Marianna Szabó, Peter F. LovibondAbstract:We investigated the Cognitive Content of worry in 8- to 13-year-old clinic-referred anxious (n = 38) and nonreferred (n = 51) children. The children were interviewed individually. They thought-listed their latest worry episodes, rated the uncontrollability of the episodes, and reported on the strategies they used to terminate worry. Content analyses showed that children's worry episodes contained predominantly thoughts reflecting negative outcome anticipation, but other types of thought Content also were present. These included problem-solving, ruminating, and self-blaming thoughts. Compared to clinic-referred children, nonreferred children reported more problem solving and less ruminating. In the nonreferred group, increasing age was associated with more problem solving and less ruminating. No such age-related associations were found in the clinic-referred group. The 2 groups did not differ in the types of worry-termination strategies they reported, but clinic-referred children were more likely to keep w...
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the Cognitive Content of naturally occurring worry episodes
Cognitive Therapy and Research, 2002Co-Authors: Marianna Szabó, Peter F. LovibondAbstract:Fifty-seven participants were selected to represent a wide range on the dimension of worry proneness. They monitored and listed their worrisome thoughts in a diary for 7 days, and rated the uncontrollability of each recorded worry episode. Content analysis revealed that 48% of worrisome thoughts could be categorized as reflecting a problem-solving process, 17% as anticipation of future negative outcomes, 11% as “rumination,” and 5% as reflecting “palliative” thoughts and “self blame.” The extent of negative outcome anticipation or problem solving did not covary with worry severity. Higher trait worry proneness and more frequent and uncontrollable worrying during the monitoring period were associated with more rumination and fewer reports of successful solutions to problems. The results suggest that worry consists largely of attempted problem solving, and that one possible mechanism in the emergence of pathological worry may be a failure to bring problem solving to a satisfactory conclusion.
