Is the unified-interaction approach to cognitive-behavior modification a reinvention of the wheel?

Schwartz (1982), in reviewing conceptual issues regarding cognitive-behavior modification, has endorsed a unified-interaction approach that includes an emphasis on affect as well as cognition and behavior in therapeutic theory and practice. Although he presents this as a new emphasis, it is one that has had historical roots in rational-emotive therapy (RET) since its inception in 1955 and one that is also presented in the theories and practices of a number of ancient philosophers and modern psychologists.     

Preparing clients for group therapy: A critical review and theoretical formulation

This paper reviews the experimental literature on procedures for preparing clients for group therapy. Procedures which have been used are described, results are summarized, and methodological and conceptual critiques, as well as suggestions for improvement, are provided. Bandura's (1977) model regarding the development of expectations and their influence on behavior is proposed as a conceptual framework. Development of positive selfefficacy and outcome expectations regarding a carefully (theoretically and/or empirically) derived set of “appropriate” client behaviors is suggested as the primary goal of preparatory procedures. Application of this conceptual model is elaborated on and explication of how it can help refine investigation efforts is offered.     

Knowledge,attitudes, and behavior: Correlates of health in childhood diabetes

Childhood diabetes is a life-long chronic illness placing complex and daily demands on the patient and family. Although the role of psychological factors in diabetes has long been recognized, only recently have investigators begun to systematically explore the relationship between parent and child knowledge about diabetes, attitudes toward diabetes, compliance or adherence behaviors, and health status. The available literature is limited, but supportive of further inquiry of this type. Suggestions for future research include: (1) The use and development of psychometrically adequate measures; (2) The use of independent methods of measurement; (3) The development of highly specific measures; (4) The delineation of clear a priori models specifying the nature of relationships between variables; (5) Greater consideration for the effect of psychological variables on patients' health as well as the impact of health status on patients' knowledge, feelings, and behavior; (6) Increased attention to the child's cognitive developmental level and social roles as these relate to daily management tasks and health status; and, (7) Methods for improving the effectiveness of patient intervention programs.     

Reason,emotion, and cognitive therapy

There are two main assumptions implicit in the theory and practice of cognitive therapy. One assumption is that emotional or psychological disturbances are caused largely by illogical or irrational thinking. The second assumption is that the restructuring of cognitions accessible to awareness represents a therapeutic solution. The present paper examines these assumptions in the context of a general theoretical review of the nature of emotion, cognition, and the relation between emotion and cognition. Also included is a discussion of the potential limitations posed by these assumptions for various cognitive therapeutic approaches, including Ellis's rational-emotive therapy, Beck's cognitive therapy of depression, and attribution therapy. Finally, a neomentalistic research strategy is proposed for the clarification of these issues.     

3-7岁麻烦型气质儿童餐桌行为的心理干预

目的：探讨心理干预对3－7岁麻烦型气质儿童的餐桌行为的作用。方法：用CTPS（China Preschool-children Temperament Scale)问卷方式对410名3－7岁儿童的气质类型进行综合评定划分出5个气质类型；对其中50名麻烦型气质儿童的餐桌行为问题进行了3个月的心理干预治疗。并对其餐桌行为做干预前后的偏挑食行为，改善进餐情绪，提高进餐速度有效。结论：心理干预可以纠正儿童的餐桌行为。     

Familial influence on offspring gambling: a cognitive mechanism for transmission of gambling behavior in families

BACKGROUND: The problem-gambling literature has identified a range of individual, cognitive, behavioral and emotional factors as playing important roles in the development, maintenance and treatment of problem gambling. However, familial factors have often been neglected. The current study aims to investigate the possible influence of parental factors on offspring gambling behavior. METHOD: A total of 189 families (546 individuals) completed several questionnaires including the South Oaks Gambling Screen (SOGS) and the Gambling Related Cognition Scale (GRCS). The relationships were examined using Pearson product-moment correlations and structural equation modeling (SEM) analyses. RESULTS: Results showed that generally parents' (especially fathers') gambling cognitions and gambling behaviors positively correlated with offspring gambling behaviors and cognitions. However, SEM analyses showed that although parental gambling behavior was directly related to offspring gambling behavior, parental cognitions were not related to offspring gambling behavior directly but indirectly via offspring cognitions. CONCLUSION: The findings show that the influence of parental gambling cognition on offspring gambling behavior is indirect and via offspring cognitions. The results suggest a possible cognitive mechanism of transmission of gambling behavior in the family from one generation to the next.     

Sex differences in weight loss among adults with Type II diabetes mellitus

The treatment of choice for Type II or non-insulin-dependent diabetes mellitus is a behavioral program for the management of weight. However, compliance with this lifelong dietary regimen is often poor. In the current investigation male and female adults with diagnosed Type II diabetes were randomly assigned to either a behavior modification, a cognitive modification, a cognitive-behavior modification, or a control group. Patients were evaluated in terms of weight, percentage of body fat, and glycosylated hemoglobin measures. Men lost signficantly more weight than women and subjects in the behavior modification group lost more weight and demonstrated greater decreases in diabetes control than subjects in the cognitive-behavior modification, cognitive, and control groups. A significant interaction indicated that diabetic men may benefit more from behavioral weight reduction programs than diabetic women. Several explanations for these findings are considered.This work was supported by Grants K04 HL 00809 and R01 AM 27901 from the National Institutes of Health to Robert M. Kaplan.     

A critique of the theoretical bases of cognitive behavioral theories and therapy

Cognitive-behavior therapy is a generic term for several recent approaches to the treatment of emotional disorders. Although differing somewhat in therapeutic procedures, these therapies appear to share a common theoretical basis: Emotional disorders result from or are at least maintained by an individual's cognitive activity. The aim of the present review is to examine the nature and function of cognition as proposed by cognitive theorists, the available empirical evidence for the importance of cognition in influencing emotional behavior, and the relationship of cognitive-behavioral theories to cognitive-behavior therapy. In each case, the claims of cognitive-behavioral theorists were found to be unsubstantiated. The failure of cognitive-behavioral theorists to use the findings from basic cognitive psychology is noted.     

Clinical science and human behavior

The debate between mentalism/cognitivism and behaviorism is analyzed, and it is concluded that behaviorism is the philosophy more closely associated with psychology as a behavioral science, the cognitive approach being more closely aligned with biological science. Specific objections to mentalistic interpretations of behavioral phenomena are detailed, and examples from clinical psychology are used to show the importance of behavioral approaches in applied domains. It is argued that the relation between behavior theory and clinical psychology is critical to the continued advancement of applied psychology. Behavior analysis is offered as a direct, applied extension of behavior theory as well as a highly practical and effective approach for understanding, explaining, and modifying the factors that contribute to and maintain maladaptive behaviors.     

Commentary: The evolution of evidence-based psychotherapy

What has been identified as a revolution actually represents an evolution, stemming directly from the basic behavioral tenets of the early to mid 20th century. Cognitive-behavior approaches within behavior therapy are not really new. As early as the 1950s a substantial number of behaviorists saw a clear role for cognition and relied on hypothetical constructs to explain behavior. There are at least two major challenges for cognitive-behavior approaches. The first is the assurance of the validity and reliability of the measurement of both outcome and the cognitive factors that are presumed to serve as mediators of the observed effects. As the cognitive factors being studied become more complex, the measurement of the variables of interest becomes more difficult. The second challenge is to be open to new paradigms and approaches that may bring into question well-established concepts. The preeminence of the cognitive-behavioral approach is directly related to the fact that its concepts and methods can be subjected to empirical scrutiny.     

Anger coping intervention for aggressive children: Conceptual models and outcome effects

We review social cognitive models of children's aggressive behavior and cognitive-behavioral interventions based on these models. Findings of the distortions and deficiencies that aggressive children have in their social information processing are presented. Several current issues in social cognition research in this area are reviewed, including (a) applicability of the social cognitive models to severe aggression and to adolescents; (b) role of prior expectations influencing social perception; (c) influence of social goals, cognitive operation style, and arousal on information processing; and (d) the more distal influences of parent behavior and parent social cognition on children's social cognition. An anger coping program consistent with the social cognitive model is presented, and the outcome effects for this intervention and similar cognitive-behavioral interventions are reviewed.     

An integrative formulation-based cognitive treatment of bipolar disorders: application and illustration

An integrative cognitive treatment for mood swings and bipolar disorders is summarized and then illustrated in a clinical case. In essence, it is proposed that multiple, extreme, and conflicting beliefs about changes in internal state, and the reciprocal impact of these beliefs on behavior, physiology, and the social environment, constitute the central mechanism that maintain and escalate bipolar symptoms. Using a case illustration with examples of therapy dialogue, several key aspects of cognitive-behavioral therapy are explained, including the assessment of mood, beliefs, distressing imagery, and recurrent thinking; case formulation; therapeutic techniques; self-awareness; interpersonal factors during therapy; and systemic issues.     

Paranoid thinking, suspicion, and risk for aggression: a neurodevelopmental perspective

This article represents an effort to extend our understanding of paranoia or suspicion and its development by integrating findings across clinical, developmental, and neuroscience literatures. We first define "paranoia" or paranoid thought and examine its prevalence across typically and atypically developing individuals and theoretical perspectives regarding its development and maintenance. We then briefly summarize current ideas regarding the neural correlates of adaptive, appropriately trusting interpersonal perception, social cognition, and behavior across development. Our focus shifts subsequently to examining in normative and atypical developmental contexts the neural correlates of several component cognitive processes thought to contribute to paranoid thinking: (a) attention bias for threat, (b) jumping to conclusions biases, and (c) hostile intent attribution biases. Where possible, we also present data regarding independent links between these cognitive processes and aggressive behavior. By examining data regarding the behavioral and neural correlates of varied cognitive processes that are likely components of a paranoid thinking style, we hope to advance both theoretical and empirical research in this domain.     

On the independence of P300 and the CNV: A short critique of the principal components analysis of Donchin et al. (1975)

Donchin, Tueting, Ritter, Kutas and Heffley (1975) present evidence from a principal components analysis (PCA) that the CNV and P300 are independent. This short critique points out a number of errors in their PCA and presents a reworking of their analysis. A number of further aspects of Donchin et al.'s paper are also discussed. The general value of this contribution in drawing the attention of EP researchers to potential sources of error in the application of factor analysis is emphasised.     

Review of health behaviors and their correlates among young adult cancer survivors

It is imperative that young adult cancer survivors address any modifiable risk factors, given their increased health risks. Unfortunately, few behavioral interventions have been developed for this population. The literature on physical activity, smoking, and alcohol and drug use among young adult cancer survivors was reviewed in order to identify the behaviors most in need of intervention, the most vulnerable subsets of the population, and the health behavior theories that might guide intervention development. This literature indicates that young adult cancer survivors are not meeting physical activity recommendations though smoking and risky drinking appear less pervasive than in the general population. Several demographic and medical characteristics are associated with health behaviors, indicating subsets of the population particularly in need of intervention. The literature also indicates that a few different theories and models (e.g., social cognitive theory, self-determination theory) might be useful in guiding the development of interventions for this population.     

Posttraumatic stress disorder in children. The influence of developmental factors.

Despite the prevalence of childhood trauma, there are currently no developmentally oriented cognitive theories of posttraumatic stress disorder (PTSD). This paper outlines the definitional issues of PTSD in children, reviews the incidence of PTSD in children, and compares PTSD profiles in children and adults. We propose that a cognitive theory of childhood PTSD needs to accommodate developmental factors, including knowledge, language development, memory, emotion regulation, and social cognition, in addition to contextual factors such as family interactions. Implications of these developmental factors for assessment and treatment of traumatized children are discussed.     

Agoraphobia and marital relationship: Theory,treatment, and research

The present paper is a comprehensive review of the literature on the possible interactions between interpersonal, particularly marital factors on the one hand, and agoraphobic behavior on the other. First, some different theoretical formulations are described, followed by a discussion of reports and investigations concerning the agoraphobic's marital relationship. Then, attention is paid to those studies which examine the significance of marital factors in the outcome of exposure-treatment for agoraphobia. The remainder of this paper focuses on practical issues, suggestions, and warnings with respect to the different strategies for treating married agoraphobics. Finally, emphasis is given to methodological aspects of research needs in this area.     

Incorporating the family as a critical context in genetic studies of children: implications for understanding pathways to risky behavior and substance use

The availability of candidate gene markers for biobehavioral traits will undoubtedly result in increasing attention to genetic influences in studies of childhood risk factors for health behaviors. However, a strict emphasis on genomics without consideration of the social contexts that give rise to risky behaviors will miss opportunities to understand more fully the powerful effect of the family on childhood development. This article discusses the rationale for using the family as a critical context for studying the translation of genetic propensity for risky behavior into developmental pathways that span childhood and adolescence. Attention is given to the importance of family environmental factors; the emerging literature on genetic influences on potential intermediate phenotypes; the need for rich and detailed characterizations of both phenotypes and environmental risk factors embedded within genomic studies of children; and implications for interventions and preventions aimed at risky behaviors. Via discussion of these issues, pragmatic considerations of how studying families as a context may facilitate the thoughtful inclusion of children into genetic paradigms are emphasized.     

Nerve injury causes long-term attentional deficits in rats

Human chronic pain sufferers frequently report problems with attention and concentration that affect daily functioning and quality of life. Chronic pain is also commonly associated with anxiety and depression. It is currently not known if the pain causes these co-morbidities, or if they are pre-disposing risk factors for the development of chronic pain. Animal studies suggest a possible causative effect of pain on cognition, but usually tests are conducted during acute ongoing pain when the pain may act as a distracter to normal cognitive and emotional processing. Here we examine long-term effects of nerve injury on cognitive functioning in a rat model, which contributes to better understanding of the relationship between cognitive impairment and chronic pain experience in human populations. This study investigated attentional capability, anxiety-like behavior and sensory functioning 6 months after spared nerve injury (SNI) surgery—a time-point well beyond the acute pain phase and akin to decades of pain experience in humans. Male Long Evans rats subjected to nerve injury remained hypersensitive to sensory stimuli from the time of injury to the 6-month post-injury assessment. At 6 months they were impaired on a visual non-selective, non-sustained attention task and displayed anxiety-like behaviors in the elevated plus maze. These findings show that cognitive disturbances observed during acute pain persist for months in a rodent chronic pain model and suggest that cognitive alterations in chronic pain patients are at least partially caused by the chronic pain state.     

Cognition in childhood anxiety: conceptual,methodological, and developmental issues

Anxiety disorders are one of the most common psychiatric disorders in the general child population and can have significant impact on immediate and long-term functioning. Despite the common use of cognitive-behavioral interventions that target specific, negative thoughts in anxious children, it is unclear that the extant literature clearly documents cognitive aberrations among these children. In this review, conceptual and methodological issues related to the assessment of cognition in anxious children are highlighted and empirical data addressing these areas are evaluated. Furthermore, data addressing cognitive change as a function of treatment outcome is examined, and the impact of cognitive development as a moderating variable is discussed. Finally, areas for future research are presented.