Individualized measurement of irrational beliefs in remitted depressives

Irrational Beliefs, Cognitive Distortions, and Depressive Symptomatology in a College-Age Sample: A Mediational Analysis

Dysfunctional cognitions such as irrational beliefs (IBs) of Ellis' rational emotive behavior therapy (REBT) model and cognitive distortions (CDs) or cognitive errors from Beck's cognitive behavioral therapy (CBT) model are known to correlate with depressive symptomatology. However, most studies focus on one cognitive theoretical model in predicting psychopathology. The current study examined the relationship between both IBs and CDs in predicting depression. A college-age sample of 507 participants completed the Attitudes and Beliefs Scale-2, the Cognitive Distortions Scale, and the Beck Depression Inventory-II. Half of the sample showed minimal depression, while the remaining sample exhibited mild-moderate (37.4%) to severe (11.1%) depression symptomatology. Through regression analyses, the study aimed to examine whether IBs accounted for more of the variance in depression symptomatology after the effects of CDs were considered. Moreover, it tested whether CDs served as a moderator or mediator between IBs and depression. Each of Ellis' IBs (demandingness, awfulizing, self-downing, and low frustration tolerance) accounted for significantly more variance in depression after the variance of CDs was entered with the IB of self-downing explaining the most variance in depression severity. Moreover, while no moderation effect was found, CDs partially mediated the effect of IBs on depression. Both IBs and CDs contributed unique variance in predicting depression. Findings support the clinical notion that IBs and CDs are associated as well as highlight the clinical utility of both conceptualizations of dysfunctional cognitions in explaining depressive symptomatology. Clinicians might consider that each dysfunctional cognition might not be subject to change if not directly targeted. Rather than choosing to focus exclusively on IBs or CDs underlying negative automatic thoughts, psychotherapeutic efforts might benefit from identifying and challenging both types of dysfunctional cognitions.

Scale development: Chinese Irrational Beliefs and Rational Attitude Scale

University study has been considered to be one of the most stressful periods in a person's life. University students may have irrational beliefs that could play a significant role in causing emotional disturbance. Nevertheless, a suitable instrument for measuring irrational beliefs in college students in Chinese society has been lacking. The aim of this study was to construct a culturally relevant scale for measuring irrational beliefs among university students in the Hong Kong Chinese context. The construction of the Chinese Irrational Beliefs and Rational Attitude Scale (CIBRAS) for university students was based on (1) literature review and expert panel review for evaluation on content validity, (2) a pilot test of 200 local Hong Kong university students to determine the scale's psychometric properties and probe the exploratory factor analysis, and (3) confirmatory factor analysis to test for construct validity of the CIBRAS (conducted with a further 655 local Hong Kong university students). The results showed that the five-factor 19-item CIBRAS has good psychometric properties, including good internal consistency (Cronbach's alphas ranging from .64 to .80), content validity (content validity index = .96 for relevance, .94 for clarity, and .94 for representativeness), construct validity (explaining 60.1% of the total variance), and adequate fit indices (normed chi-square = 2.8, comparative fit index = .94, normal fit index = .93, non-normed fit index = .93, incremental fit index = .94, root-mean-square error of approximation = .077, and standardized root-mean residual = .074). The limitations and implications of the study were discussed.

A rational-emotive stress management intervention for reducing job burnout and dysfunctional distress among special education teachers: An effect study

BACKGROUND

Job-related burnout and distress are adverse stress responses which affect individuals in their occupational environment. This study aimed at investigating the effect of a rational-emotive stress management program on job burnout and dysfunctional distress among special education teachers in Nigeria.

METHODS

A pretest-posttest randomized control group design was used. The participants in the study were 54 special education teachers. Data were collected using self-report questionnaires. Participants were allocated to either the treatment group (n = 28 [59.1%]) or the waitlist control group (n = 26 [48.1%]), respectively. A rational-emotive stress management manual was used to deliver the intervention. We statistically analyzed the data collected at three-time points with repeated-measures analysis of variance.

RESULTS

At baseline, the job-related burnout symptoms and distress scores of participants were high. However, an intention-to-treat analysis showed that the rational-emotive stress management intervention program was efficacious in reducing the levels of job-related burnout symptoms and dysfunctional distress among participants assigned to the treatment group, compared to a waitlisted group at post-treatment and follow-up meetings.

CONCLUSION

Our study demonstrates the effectiveness of a rational-emotive stress management intervention in reducing the level of job-related burnout and distress in a sample of special education teachers in Nigeria. Occupational health counsellors and other clinicians with sufficient knowledge of rational-emotive behavior therapy framework are urged to employ this approach in assisting other employees in managing job burnout symptoms, and distress.

Pathogenic beliefs among patients with depressive disorders

INTRODUCTION

Pathogenic belief is a central construct within control-mastery theory, which is an integrated dynamic-cognitive-relational approach in psychotherapy. Pathogenic beliefs result from traumatic life experiences and are considered the root of any psychological disorders presented clinically. Nevertheless, how and what type of pathogenic beliefs are attributed to clinical depressive disorder is unknown. The present study aimed to examine this issue.

PATIENTS AND METHODS

Thirty patients with depressive disorder, who came for psychotherapy at a psychotherapy clinic, were matched based on age and gender with healthy controls who were medical students. The 54-item pathogenic belief scale (PBS) was administered and compared between depressive and control groups using odds ratio (OR).

RESULTS

The depressed group's PBS mean score was significantly higher than the healthy controls (t=3.78, P<0.001). Thirteen of 54 items significantly differed between the two groups with ORs ranging from 3.76 to 16.79. The content of pathogenic beliefs centered on the issues of negative sense of self, lack of self-efficacy and control, and relational difficulties related to feelings of fear and humiliation. Influences of culture and gender differences on pathogenic beliefs were discussed.

CONCLUSION

Pathogenic beliefs relate to depression such that the higher the number of pathogenic beliefs one has, the more the likelihood of having depression. Since the PBS was developed based on clinical data (rather than theory based), cultural issues as well as age and gender may influence the development of pathogenic beliefs. Further study should be warranted and implications for clinical practice are discussed.

Rational Emotive Behavior Therapy (REBT), Irrational and Rational Beliefs, and the Mental Health of Athletes

In this article Rational Emotive Behavior Therapy (REBT) is proposed as a potentially important framework for the understanding and promotion of mental health in athletes. Cognitive-behavioral approaches predominate in the provision of sport psychology, and often form the backbone of psychological skills training for performance enhancement and maintenance. But far from being solely performance-focused, the cognitive-behavioral approach to sport psychology can restore, promote, and maintain mental health. This review article presents REBT (Ellis, 1957), the original cognitive behavioral therapy, as a valuable approach to addressing mental health issues in sport. REBT holds that it is not events that directly cause emotions and behaviors. Rather, it is one's beliefs about the events that lead to emotional and behavioral reactivity. Further, REBT distinguishes between rational and irrational beliefs, and suggests that in response to failure, maltreatment, and misfortune, people can react with either healthy or unhealthy emotional and behavioral responses. The extant research indicates that irrational beliefs lead to unhealthy negative emotions, a range of pathological conditions, and a host of maladaptive behaviors that undermine mental health. Therefore, REBT proposes a process for the reduction of irrational beliefs and the promotion of rational beliefs. The use of REBT in sport is seldom reported in literature, but research is growing. This review article proposes three important areas of investigation that will aid the understanding of irrational beliefs and the application of REBT within sport. These areas are: (1) the influence of irrational beliefs and REBT on the mental health of athletes, (2) the influence of irrational beliefs and REBT on athletic performance, (3) the origins and development of irrational beliefs in athletes. Each area is discussed in turn, offering a critical and progressive review of the literature as well as highlighting research deficits, and recommendations to address each of the three areas of investigation.

Rational-emotive and cognitive-behavior therapy (REBT/CBT) versus pharmacotherapy versus REBT/CBT plus pharmacotherapy in the treatment of major depressive disorder in youth; a randomized clinical trial

Major depressive disorder is a highly prevalent and debilitating condition in youth, so developing efficient treatments is a priority for mental health professionals. Psychotherapy (i.e., cognitive behavioral therapy/CBT), pharmacotherapy (i.e., SSRI medication), and their combination have been shown to be effective in treating youth depression; however, the results are still mixed and there are few studies engaging multi-level analyses (i.e., subjective, cognitive, and biological). Therefore, the aims of this randomized control study (RCT) were both theoretical - integrating psychological and biological markers of depression in a multi-level outcome analysis - and practical - testing the generalizability of previous results on depressed Romanian youth population. Eighty-eight (N=88) depressed Romanian youths were randomly allocated to one of the three treatment arms: group Rational Emotive Behavior Therapy (REBT)/CBT (i.e., a form of CBT), pharmacotherapy (i.e., sertraline), and group REBT/CBT plus pharmacotherapy. The results showed that all outcomes (i.e., subjective, cognitive, and biological) significantly change from pre to post-treatment under all treatment conditions at a similar rate and there were no significant differences among conditions at post-test. In case of categorical analysis of the clinical response rate, we found a non-significant trend favoring group REBT/CBT therapy. Results of analyses concerning outcome interrelations are discussed.

Irrational beliefs at work and their implications for workaholism

INTRODUCTION

This study examined the associations between work-related irrational cognitions and workaholism. For this purpose, a 16-item work-related irrational beliefs questionnaire (WIB-Q) was developed.

METHODS

Employees (n = 913) completed an online survey that included, besides the irrational cognitions scale, measures of negative affect and workaholism.

RESULTS

The results show that four factors could be distinguished, which represent irrational beliefs concerning (1) performance demands, (2) co-workers' approval (3) failure and (4) control. All scales showed good internal consistency. Furthermore, it was found that, after controlling for negative affect, performance demands were associated with workaholism, whereas the remaining types of irrationality were unrelated to workaholism.

CONCLUSIONS

In other words, the findings suggest that interventions for workaholism should target irrational self-oriented performance demands and negative emotions. As Rational Emotive Behavior Therapy focuses on identifying and replacing irrational cognitions, it appears a useful intervention technique for the treatment of workaholics.

Idiographic assessment: conceptual and psychometric foundations of individualized behavioral assessment

Idiographic assessment is the measurement of variables and functional relations that have been individually selected, or derived from assessment stimuli or contexts that have been individually tailored, to maximize their relevance for the particular individual. This article first reviews various definitions and clinical applications of idiographic assessment. Several properties of behavior problems and causal relations provide the conceptual basis for idiographic assessment: (a) differences across persons in the attributes, response systems, and dimensions of a behavior problem, and (b) differences across persons in the causal relations relevant to a particular behavior problem. Because of these individual differences, nomothetic measures often reflect variance that is irrelevant to the targeted construct for the individual. We present a psychometric framework for idiographic assessment by first summarizing why the psychometric principles used to develop standardized measures of nomothetic constructs can create incongruity between the nomothetic measure and the characteristics of the targeted construct for an individual. We then develop a psychometric framework for idiographic assessment that combines components of multilevel modeling (random effects) and confirmatory factor analyses applied to repeated measurements of each individual. We also provide a step-by-step guide for the development and evaluation of an idiographic assessment instrument.

Rational emotive behavior therapy, cognitive therapy, and medication in the treatment of major depressive disorder: a randomized clinical trial, posttreatment outcomes, and six-month follow-up

A randomized clinical trial was undertaken to investigate the relative efficacy of rational-emotive behavior therapy (REBT), cognitive therapy (CT), and pharmacotherapy in the treatment of 170 outpatients with nonpsychotic major depressive disorder. The patients were randomly assigned to one of the following: 14 weeks of REBT, 14 weeks of CT, or 14 weeks of pharmacotherapy (fluoxetine). The outcome measures used were the Hamilton Rating Scale for Depression and the Beck Depression Inventory. No differences among treatment conditions at posttest were observed. A larger effect of REBT (significant) and CT (nonsignificant) over pharmacotherapy at 6 months follow-up was noted on the Hamilton Rating Scale for Depression only.

RESPONSE EXPECTANCIES AND IRRATIONAL BELIEFS PREDICT EXAM-RELATED DISTRESS

Individual differences in cognitive factors such as response expectancies and irrational beliefs (IBs) have been shown to contribute to variability in distress associated with stressful situations. However, their independent influence on distress when examined within the same study has not been established, nor has the potential of mediational relationships. The purpose of this study was to investigate the contribution of response expectancies and IBs (both general and exam-specific) to exam-related distress in a prospective study. Results revealed that both response expectancies and general IBs separately predicted exam-related distress (p's <.05; N = 105). Observed effects of general IBs were perfectly mediated by, and observed effects of exam-specific IBs were partially mediated by, response expectancies using the Baron and Kenny approach. These data support the view that cognitive factors contribute to psychological distress and are consistent with response expectancy and rational emotive behavior theories. The results suggest that interventions focused on response expectancies and IBs might be an effective means to reduce psychological distress associated with real life stressors such as exams. Future research is needed to determine whether this effect generalizes to other stressful situations.

Stability of negative self-structures: A longitudinal comparison of depressed, remitted, and nonpsychiatric controls

To be considered a vulnerability marker for depression, a variable should, in addition to demonstrating sensitivity and specificity, also show evidence of temporal stability (i.e., remain present in the absence of depressive symptomatology). Although many cognitive factors are associated with depression, the majority of them appear to be episode rather than vulnerability markers. This study examined cognitive organization of positive and negative interpersonal and achievement content in clinically depressed, remitted, and nonpsychiatric controls. At initial assessment, a sample of 54 clinically depressed individuals and 37 never-depressed controls completed self-report measures of positive and negative automatic thoughts and two cognitive organizational tasks. They were retested 6 months later when half of the depressed group no longer met diagnostic criteria for major depression. Negative automatic thoughts decreased and positive automatic thoughts increased significantly in individuals who had improved clinically. The organization of negative interpersonal content remained stable despite symptom amelioration, but negative achievement content was less interconnected at follow-up in those patients who had improved. The structure of relational schemas, in particular, appears to be stable and may be an important cognitive vulnerability factor for depression.

Association between plasma inflammatory markers and irrational beliefs; the ATTICA epidemiological study

OBJECTIVE

Recent research data suggest that inflammation and/or depression are associated with the development and progression of cardiovascular disease (CVD). Considering that depression may arise as a response to irrational beliefs according to the Ellis model of psychological disturbances and therapy, we sought to evaluate whether irrational beliefs are associated with plasma inflammatory factors in cardiovascular disease-free people.

METHOD

From May 2001 to December 2002 we randomly enrolled 453 men (23-69 years old) and 400 women (24-71 years old) stratified by age and gender. C-reactive protein, interleukin-6, serum amyloid-A, tumor necrosis factor-alpha and white blood cells were measured in all participants. Detailed dietary characteristics of these people were assessed through a validated food frequency questionnaire. Subjects completed also the irrational beliefs inventory (IBI), which is a brief self-report measure consistent with the Ellis model of psychological disturbance and therapy and the Zung's Depression questionnaire.

RESULTS

The IBI scores were similar in men and women (53+/-11 vs. 53+/-10, p = 0.83). IBI score was positively correlated with C-reactive protein (rho = 0.14, p = 0. 02), interleukin-6 (rho = 0.11, p = 0.02), tumor necrosis factor-alpha (rho = 0.21, p = 0.014) and white blood cell counts (rho = 0.14, p = 0.02). These associations were confirmed even after adjusting for age, sex, years of school, body mass index, physical activity status, depression level and food items consumed by the participants.

CONCLUSION

These findings indicate that irrational beliefs are associated with increased inflammation process, among apparently healthy individuals.

Validität des Fragebogens irrationaler Einstellungen (FIE)

Zusammenfassung. Der Fragebogen irrationaler Einstellungen (FIE) wird zur Diagnostik irrationaler Einstellungen eingesetzt, allerdings sind Validitätsbelege rar. Die vorliegende Untersuchung mit Depressiven (N = 94) und Studenten (N = 97) stellt die Frage nach der faktoriellen und der Kriteriumsvalidität des FIE. Konfirmatorische Faktorenanalysen zeigten, dass sowohl das vierfaktorielle Modell des Autors des Fragebogens für den FIE unzureichend ist als auch ein explorativ gewonnenes zweifaktorielles Modell. Der FIE erweist sich als nützlich, um charakteristische Gedankenkombinationen bei Depressiven aufzudecken, er bedarf jedoch der Revision.

Cognitions in cognitive-behavioral psychotherapies; toward an integrative model

There seems to be a lack of a coherent and integrative theory and theoretically informed manuals in cognitive behavioral therapies that could negatively impact both the program of CBT as a platform for psychotherapy integration, as well as its efficacy and effectiveness. Although CBT is the golden psychological treatment for various disorders, overall, about 30-40% of the patients are still non-responsive to these interventions and various schools debate their status as promoters of the best theoretical view. The objective of the present paper is to use cognitive psychology/science as a tool to clarify several theoretical confusions in CBT, with impact on a coherent science and practice of CBT. As a general conclusion, we believe that CBT has reached preeminence in the clinical field betting on cold cognitions. Despite obvious advantages and accomplishments, this approach seems to loose its heuristic value. We believe that the next phase of CBT development lies in the construct of hot cognitions (which would increase its effectiveness) and in cognitive psychology (which would contribute to a coherent science of CBT beyond various schools). These developments could offer CBT the chance to be a platform for the integration of psychotherapy.

The information-processing approach to the human mind: Basics and beyond

Cognitive psychology attempts to understand the nature of the human mind by using the information-processing approach. In this article, the fundamentals of the cognitive approach will be presented. It will be argued that the human mind can be described at three levels-computational, algorithmic-representational, and implementational-and that the cognitive approach has both important theoretical and practical/clinical implications. Finally, it will be suggested that the study of cognitive psychology can provide a foundation for other fields of social science, including the field of clinical psychology.