Cognitive Content-specificity Research Articles

What does differentiate unwanted mental intrusions in OCD? A phenomenological study of the mental intrusions in OCD, anxiety disorders, and non-clinical groups using the interview technique

Background and objectivesThe study examines the nature of OCD-related unwanted mental intrusions (UMIs) by comparing OCD, anxiety disorders (AD), and healthy control (HC) groups. MethodsThe patients with OCD (n = 50), AD (n = 59), and HC (n = 50) completed a semi-structured interview assessing UMIs, and a set of questionnaires. ResultsOur results provided evidence for the cognitive content specificity of OCD-related unwanted mental intrusions (UMIs) and appraisals. Two patient groups and non-clinical participants reported at least one OCD-related UMI and the groups did not differ from each other in terms of the forms and triggers of UMIs. However, the intrusions were more distressing and persistent in the OCD patients. The patients with OCD placed higher importance on getting UMIs out of their minds and reported higher difficulty in controlling them compared to the other two control groups. Furthermore, control appraisals showed higher relevance to the distressing features of the intrusions. ConclusionsThe results underlined the specificity of obsessive cognitive content and the importance of thought control-related appraisal in defining the distressful features of the mental intrusions seen in OCD. The results were discussed in light of the cognitive specificity model.

The Relationships Between Early Maladaptive Schemas and Youth Mental Health: A Systematic Review

Although early maladaptive schemas (EMS) have been strongly associated with psychopathology in adults, this association is less clear in young people since schemas are still emerging. This systematic review examines the relationship between EMS and psychopathology in young people to assess the degree to which EMS discriminate between psychopathologies, consistent with the cognitive content specificity hypothesis. PsycINFO, MEDLINE, PsycARTICLES, Psychology and Behavioral Sciences Collection, CINAHL Plus, Web of Science, and Scopus databases were systematically searched. Fifty-eight studies were identified for inclusion, with 24,005 participants across all studies. We found evidence of the relationship between EMS and psychopathology in young people. EMS were found to discriminate between depression, anxiety, eating pathology, borderline symptomology, and externalizing behaviors. Findings are discussed in the context of treatment approaches for psychopathology in youth, specifically through an increased understanding of the role of EMS in this developmental period. We also suggest future research directions and discuss the methodological limitations of the studies reviewed, including a bias towards community samples, and a lack of consistency in EMS measures. These findings suggest that EMS may be an important area to target when treating youth presenting with psychological distress.

Development of Anxiety and Depression Inventory for Secondary School Students in Iran (A & D Inventory)

Background: Currently clinicians and researchers in Iran have to use translated western instruments to screen for anxiety and depressive disorders. Although, some western questionnaires translated and adapted for Iranian people have demonstrated suitable validity in Iranian context, considering the difference in the cultural values, it still remains unclear as to whether a realistic picture of this phenomenon in Iranian society has been drawn. Hence, for detecting and monitoring common emotional disorders in Iran, researchers need to reflect the way that young people experience and express this disorder in the Iranian culture. Objectives: This study seeked to address these shortcomings by developing and validating an instrument to measure anxiety and depression among adolescents in Iran with the Tripartiate Model and cognitive content specificity theory serving as the conceptual basis for the instrument development. Materials and Methods: The participants constituted of 579 students from secondary schools, who resided in the north of Iran during years 2011 and 2012. The instrument was developed and validated using exploratory factor analysis (EFA) (Phase II) and confirmatory factor analysis (CFA) (Phase III) to ensure its reliability and validity. Results: The results provide evidence that the developed instrument achieved sound psychometric properties. The hypothesized two-factor model identified via EFA and CFA in the study consisted of 32 items, with 16 items belonging to anxiety and 16 items to depression. The overall reliability value of Cronbach’s Alpha was 0.87. The CFA results showed acceptable goodness-of-fit indices for the revised model. Conclusions: The anxiety and depression (A&D) inventory is a simple, brief, and easy to administer tool. Indeed, the entire 32-item A&D inventory takes no longer to complete than other symptom measures. Therefore, the A&D Inventory can provide differentiated symptoms between anxiety and depression in a very quick and efficient manner for Iranian adolescents.

Development of Anxiety and Depression Inventory for Secondary School Students in Iran (A & D Inventory)

Background: Currently clinicians and researchers in Iran have to use translated western instruments to screen for anxiety and depressive disorders. Although, some western questionnaires translated and adapted for Iranian people have demonstrated suitable validity in Iranian context, considering the difference in the cultural values, it still remains unclear as to whether a realistic picture of this phenomenon in Iranian society has been drawn. Hence, for detecting and monitoring common emotional disorders in Iran, researchers need to reflect the way that young people experience and express this disorder in the Iranian culture. Objectives: This study seeked to address these shortcomings by developing and validating an instrument to measure anxiety and depression among adolescents in Iran with the Tripartiate Model and cognitive content specificity theory serving as the conceptual basis for the instrument development. Materials and Methods: The participants constituted of 579 students from secondary schools, who resided in the north of Iran during years 2011 and 2012. The instrument was developed and validated using exploratory factor analysis (EFA) (Phase II) and confirmatory factor analysis (CFA) (Phase III) to ensure its reliability and validity. Results: The results provide evidence that the developed instrument achieved sound psychometric properties. The hypothesized two-factor model identified via EFA and CFA in the study consisted of 32 items, with 16 items belonging to anxiety and 16 items to depression. The overall reliability value of Cronbach’s Alpha was 0.87. The CFA results showed acceptable goodness-of-fit indices for the revised model. Conclusions: The anxiety and depression (A&D) inventory is a simple, brief, and easy to administer tool. Indeed, the entire 32-item A&D inventory takes no longer to complete than other symptom measures. Therefore, the A&D Inventory can provide differentiated symptoms between anxiety and depression in a very quick and efficient manner for Iranian adolescents.

Specificity of relations between adolescents’ cognitive emotion regulation strategies and symptoms of depression and anxiety

ABSTRACTThe aim of this study was to examine the extent to which cognitive emotion regulation strategies were “common or transdiagnostic correlates” of symptoms of depression and anxiety and/or “specific correlates” distinguishing one problem category from the other. The sample comprised 582 13- to 16-year-old secondary school students. Symptoms of depression and anxiety were measured by the SCL-90, and cognitive emotion regulation strategies were measured by the CERQ, in a cross-sectional design. Multivariate regression analyses were performed. Before controlling for comorbidity, the same cognitive emotion regulation strategies that were related to symptoms of depression were also related to symptoms of anxiety. However, after controlling for comorbid anxiety symptoms, rumination, self-blame (only girls), positive reappraisal, and positive refocusing (the latter two inversely) were uniquely (and significantly) associated with depression symptoms; and after controlling for comorbid depression symptoms, catastrophising and other-blame were uniquely related to anxiety symptoms. The results supported the cognitive content-specificity model, in which anxiety is supposed to be uniquely characterised by thoughts concerning the overestimation of threats and harm, and depression is supposed to be uniquely characterised by negative evaluations of self, and of past and future events.

Assessing Negative Automatic Thoughts: Psychometric Properties of the Turkish Version of the Cognition Checklist

Background:Beck’s theory of emotional disorder suggests that negative automatic thoughts (NATs) and the underlying schemata affect one’s way of interpreting situations and result in maladaptive coping strategies. Depending on their content and meaning, NATs are associated with specific emotions, and since they are usually quite brief, patients are often more aware of the emotion they feel. This relationship between cognition and emotion, therefore, is thought to form the background of the cognitive content specificity hypothesis. Researchers focusing on this hypothesis have suggested that instruments like the cognition checklist (CCL) might be an alternative to make a diagnostic distinction between depression and anxiety.Objectives:The aim of the present study was to assess the psychometric properties of the Turkish version of the CCL in a psychiatric outpatient sample.Patients and Methods:A total of 425 psychiatric outpatients 18 years of age and older were recruited. After a structured diagnostic interview, the participants completed the hospital anxiety depression scale (HADS), the automatic thoughts questionnaire (ATQ), and the CCL. An exploratory factor analysis was performed, followed by an oblique rotation. The internal consistency, test-retest reliability, and concurrent and discriminant validity analyses were undertaken.Results:The internal consistency of the CCL was excellent (Cronbach’s α = 0.95). The test-retest correlation coefficients were satisfactory (r = 0.80, P < 0.001 for CCL-D, and r = 0.79, P < 0.001 for CCL-A). The exploratory factor analysis revealed that a two-factor solution best fit the data. This bidimensional factor structure explained 51.27 % of the variance of the scale. The first factor consisted of items related to anxious cognitions, and the second factor of depressive cognitions. The CCL subscales significantly correlated with the ATQ (rs 0.44 for the CCL-D, and 0.32 for the CCL-A) as well as the other measures of mood severity (all Ps < 0.01). To a great extent, all items of the CCL were able to distinguish the clinical and non-clinical groups, suggesting the scale has high discriminating validity.Conclusions:The current study has provided evidence that the Turkish version of the CCL is a reliable and valid instrument to assess NATs in a clinical outpatient sample.

Cognitive content specificity in anxiety and depressive disorder symptoms: a twin study of cross-sectional associations with anxiety sensitivity dimensions across development.

The classification of anxiety and depressive disorders has long been debated and has important clinical implications. The present study combined a genetically sensitive design and multiple time points to investigate cognitive content specificity in anxiety and depressive disorder symptoms across anxiety sensitivity dimensions, a cognitive distortion implicated in both disorders. Phenotypic and genetic correlations between anxiety sensitivity dimensions, anxiety and depressive disorder symptoms were examined at five waves of data collection within childhood, adolescence and early adulthood in two representative twin studies (n pairs = 300 and 1372). The physical concerns dimension of anxiety sensitivity (fear of bodily symptoms) was significantly associated with anxiety but not depression at all waves. Genetic influences on physical concerns overlapped substantially more with anxiety than depression. Conversely, mental concerns (worry regarding cognitive control) were phenotypically more strongly associated with depression than anxiety. Social concerns (fear of publicly observable symptoms of anxiety) were associated with both anxiety and depression in adolescence. Genetic influences on mental and social concerns were shared to a similar extent with both anxiety and depression. Phenotypic patterns of cognitive specificity and broader genetic associations between anxiety sensitivity dimensions, anxiety and depressive disorder symptoms were similar at all waves. Both disorder-specific and shared cognitive concerns were identified, suggesting it is appropriate to classify anxiety and depression as distinct but related disorders and confirming the clinical perspective that cognitive therapy is most likely to benefit by targeting cognitive concerns relating specifically to the individual's presenting symptoms across development.

Disorder-specific cognitive profiles in major depressive disorder and generalized anxiety disorder

BackgroundThis investigation examines differences in cognitive profiles in subjects with major depressive disorder (MDD) and generalized anxiety disorder (GAD).MethodsData were used from subjects with current MDD (n = 655), GAD (n = 107) and comorbid MDD/GAD (n = 266) diagnosis from the Netherlands Study of Depression and Anxiety (NESDA). The Composite Interview Diagnostic Instrument was used to diagnose MDD and GAD. Cognitive profiles were measured using the Leiden Index of Depression Sensitivity, the Anxiety Sensitivity Index, and the Penn State Worry Questionnaire.ResultsResults showed that differences in cognitive profiles between single MDD and single GAD subjects were present: scores on hopelessness/suicidality and rumination were significantly higher in MDD than GAD, whereas anxiety sensitivity for physical concerns and pathological worry were higher in GAD than MDD. The cognitive profile of comorbid MDD/GAD showed more extreme depression cognitions compared to single disorders, and a similar anxiety profile compared to single GAD subjects.ConclusionsDespite the commonalities in cognitive profiles in MDD and GAD, there are differences suggesting that MDD and GAD have disorder-specific cognitive profiles. Findings of this investigation give support for models like the cognitive content-specificity model and the tripartite model and could provide useful handles for treatment focus.

Cognitive Specificity in Fear and Sad Affect: An Investigation of Emotional Reactivity and Recovery from Experimental Mood Induction

Beck’s (Cognitive therapy of the emotional disorders. New American Library, New York, 1976) cognitive content specificity hypothesis states that anxiety and depression can be differentiated by their thought content. Although Beck extended the hypothesis to normal emotion states, the generalizability of content specificity has not been demonstrated. In the current study 183 students were randomly assigned to view a fearful or sad movie clip, followed by an expressive writing task to induce mood recovery. Positive and negative cognitions and emotional reactivity were assessed before and after the movie clip, as well as after recovery. Only threat/danger cognitions demonstrated specificity after fear induction. Negative and coping loss/failure thoughts exhibited the same pattern of change with induction and recovery across both emotion conditions, thus showing non-specificity. The findings supported the cognitive specificity hypothesis for fear but not normal sad affect. Discussion of the generalizability of the cognitive content specificity hypothesis and its implication for cognitive theories of emotion are considered.

Content Specificity of Threat Interpretation in Anxious and Non-Clinical Children

This study investigated content specificity of children’s threat interpretations in a group of 40 clinically anxious (18 boys, 22 girls; ages 7–14 years) and a group of 40 non-clinical children (19 boys, 21 girls; ages 8–14 years). Associations between disorder-specific threat interpretations (in response to situations selected by each child) and each of six DSM-IV anxiety and depressive disorder symptom domains were examined for each group of children through multivariate regression analyses. Supporting theories of cognitive content specificity, results showed that for clinically anxious children, symptoms of social phobia and panic disorder were significantly and specifically predicted by threat interpretation in response to situations that corresponded to each disorder, while symptoms of separation anxiety were predicted by threat perception in situations relevant to separation anxiety and panic disorder. There was little evidence of cognitive content specificity within the non-clinical group of children. Implications for theories of development of interpretation biases associated with child anxiety disorders are discussed.

Balanced states of mind in psychopathology and psychological well‐being

The balanced states of mind (BSOM) model proposes that coping with stress and psychological well-being is a function of the BSOM ratio of positive thoughts to the sum of positive and negative thoughts. Based on different BSOM ratios, different BSOM categories are constructed to quantitatively differentiate levels of coping with stress and psychological well-being. The cognitive content-specificity hypothesis states that there are unique themes of semantic content in self-reported automatic thoughts particular to depression or anxiety. This study investigated the BSOM model and its cognitive content-specificity for depression, anxiety, anger, stress, life satisfaction, and happiness, based on negative and positive automatic thoughts. Three hundred and ninety-eight college students from Singapore participated in this study. First, BSOM ratio and positive automatic thoughts were positively correlated with life satisfaction and happiness, and negatively correlated with stress, anxiety, depression, and anger. In contrast, negative automatic thoughts were positively correlated with stress, anxiety, depression, and anger, and negatively correlated with life satisfaction and happiness. Second, levels of psychopathology and psychological well-being were statistically differentiable among the BSOM categories for depression, happiness, perceived stress, and life satisfaction; and less statistically differentiable among the BSOM categories for anxiety and anger, as expected based on the BSOM model and cognitive content-specificity hypothesis. Third, the results were more supportive of the BSOM model for depression, followed by happiness, perceived stress, life satisfaction, anxiety, and anger in terms of percentage of variance accounted for by BSOM categories, as expected based on the cognitive content-specificity hypothesis. Taken together, the results suggested that the more moderately positive thoughts one has (balanced by negative thoughts), the better mental health outcomes one has. Implications and limitations of these findings are discussed.

States-of-Mind in Psychopathology and Psychological Well-Being

This study investigated the states-of-mind model of depression, anxiety, anger, life satisfaction and happiness in four ways. Three hundred and ninety-eight undergraduate students from Singapore participated in this study. First, states-of-mind ratio and positive automatic thoughts were positively correlated with life satisfaction and happiness, and negatively correlated with anxiety, depression, and anger. In contrast, negative automatic thoughts were positively correlated with anxiety, depression, and anger, and negatively correlated with life satisfaction and happiness. Second, the BSOM categories based depression-related automatic thoughts was able to significantly differentiate among levels of depression, happiness, life satisfaction, anxiety, and anger in ANOVA and in terms of variance accounted for as indicated by partial Eta squared. Third, the BSOM ratio was the best predictor for happiness and life satisfaction and second best predictor for depression, anxiety, and anger in terms of variance accounted for as indicated by adjusted R2, in comparison to the negative cognition model and positive cognition model. Fourth, both ANOVA results and multiple regression results showed that there is cognitive content-specificity for the BSOM based on depression-related automatic thoughts. Implications and limitations of these findings were discussed.

Cognitive content-specificity in future expectancies: Role of hopelessness and intolerance of uncertainty in depression and GAD symptoms

The present study examined cognitive content-specificity in future-event predictions associated with symptoms of depression and generalized anxiety disorder (GAD). College undergraduates (N=284) completed measures of depression, GAD, and rated their certainty that a given set of positive and negative outcomes were or were not likely to happen in their future. Participants also completed measures of hopelessness and intolerance of uncertainty (IU). Individuals (N=263) completed the same measures again 6 weeks later. Certainty in an absence of positive future outcomes was associated with symptoms of depression but not GAD, and hopelessness mediated this relationship – concurrently and when examining change scores over 6 weeks. Certainty in negative outcomes was concurrently associated with both symptoms of depression and GAD, and hopelessness partially mediated these relationships. IU predicted concurrent increases in depression and GAD symptoms, and negative-outcome certainty partially mediated the IU-depression but not the IU-GAD symptom relationship. Change in certainty did not mediate the relationship between changes in IU and GAD symptoms but partially mediated the relationship between change in IU and depression symptoms over time. Hopelessness appears to play a unique role in the relationship between reduced anticipation of positive future outcomes and depression. Although less clearly suggested by the data, IU may contribute to both depression and GAD symptoms but may do so through different pathways.

FUNCTIONAL NEUROANATOMY OF THE WISCONSIN CARD SORTING TEST IN SCHIZOPHRENIC PATIENTS: AN EVENT-RELATED 3T fMRI STUDY

The present study tested the cognitive content specificity hypothesis (CCSH) to assess whether anxiety and depression can be differentiated on the basis of cognitive disturbance. One hundred and thirty five depressed participants were administered the Beck depression inventory (BDI), the Beck anxiety inventory (BAI), the automatic thoughts questionnaire (ATQ) and the anxious self-statements questionnaire (ASSQ). It was hypothesised that depressive cognitions would be specifically related to, and predictive of, depressive (but not anxiety) symptoms in a depressed sample. Conversely, it was predicted that anxiety cognitions would be specifically related to, and predictive of, anxiety (but not depressive) symptoms in a depressed sample. Results revealed that the ATQ was the sole predictor of the BDI and similarly, the ASSQ was the sole predictor of the BAI. These findings support the CCSH in depression and provide an integrative framework for a greater understanding of the relationship between anxiety and depression.

A Multi-wave Web-based Evaluation of Cognitive Content Specificity for Depression, Anxiety, and Anger

This study tested the cognitive content specificity hypothesis of Beck’s cognitive theory using a web based report of mood and cognitions for that day completed once a week for 5 weeks. The use of a multi-wave design and structural equation modeling allowed for the separation of occasion-specific variability from over-time stability, thereby increasing sensitivity to the relatively brief changes in negative affect typical of student populations. To further increase specificity, an expanded set of cognitive themes was tested for depression, anxiety, and anger. Consistent with models indicating that these mood states share a general negative mood, all cognitions had a significant non-specific relationship to all three mood states. For tests of occasion-specific cognitive content specificity, thoughts of Transgression were incrementally specific to angry mood whereas Defectiveness, Hopelessness, and Abandonment were each specific to depressed mood. Failure was more strongly related to depression and anxiety than anger. Contrary to hypotheses, both Dependence and Vulnerability to Harm were non-specific only.

A test of the cognitive content specificity hypothesis in depression and anxiety

The present study tested the cognitive content specificity hypothesis (CCSH) to assess whether anxiety and depression can be differentiated on the basis of cognitive disturbance. One hundred and thirty five depressed participants were administered the Beck depression inventory (BDI), the Beck anxiety inventory (BAI), the automatic thoughts questionnaire (ATQ) and the anxious self-statements questionnaire (ASSQ). It was hypothesised that depressive cognitions would be specifically related to, and predictive of, depressive (but not anxiety) symptoms in a depressed sample. Conversely, it was predicted that anxiety cognitions would be specifically related to, and predictive of, anxiety (but not depressive) symptoms in a depressed sample. Results revealed that the ATQ was the sole predictor of the BDI and similarly, the ASSQ was the sole predictor of the BAI. These findings support the CCSH in depression and provide an integrative framework for a greater understanding of the relationship between anxiety and depression.

Testing the Cognitive Content-Specificity Hypothesis of Social Anxiety and Depression: An Application of Structural Equation Modeling

The present research examined three key issues of the cognitive content-specificity hypothesis of social anxiety and depression using structural equation modeling (SEM) approach. First, using confirmatory factor analyses on data from a sample of 507 undergraduate students, we found that both positive and negative self-statements factors of the modified Social Interaction Self-Statement Test were empirically differentiated from those of the Automatic Thoughts Questionnaire-Positive and the Automatic Thoughts Questionnaire. Next, SEM was used to analyze data from a subsample of 489 students to identify unique and common cognitive contents that contribute to social anxiety or depressive symptoms and then to evaluate their magnitudes simultaneously. Both positive and negative social interaction self-statements were unique to social anxiety symptoms. However, negative depressive self-statement was specific to depressive symptoms, whereas positive affect self-statement was common to the symptoms of social anxiety and depression. Furthermore, the effects of unique components of self-statements seemed stronger than that of common component on the symptoms of social anxiety and depression. In conclusion, these findings provide general support for the cognitive content-specificity hypothesis of social anxiety and depression.

Self-Talk and Affective Problems in College Students: Valence of Thinking and Cognitive Content Specificity

The aim of this study was to develop a Self-Talk Inventory for young adults. This inventory consisted of two scales. The Negative Self-Talk Scale included three categories of self-talk (depressive, anxious, and angry thoughts) and the Positive Self-Talk Scale, three categories (minimization, positive orientation, and coping self-instructions). Participants were 982 undergraduate students (Mean age = 20.35 years, SD = 2.16). They completed the self-talk scales together with the following scales to measure symptoms of affective disorders: the Center for Epidemiological Studies Depression Scale (CES-D), the State-Trait Anxiety Inventory (STAI), and the State-Trait Anger Expression Inventory (STAXI-T). Factor analyses confirmed the hypothesized structure for the Self-Talk Inventory. The relations between self-talk and symptoms of affective disorders (depression, anxiety, and anger) were also evaluated. In general, states-of-mind -SOM- ratios and negative cognitions showed a greater association with psychological symptoms than did positive cognitions. Results concerning the cognitive characteristics of depression, anxiety, and anger were mixed and partially supported the cognitive content specificity theory.

Automatic Thoughts and Psychological Symptoms: A Cross-Cultural Comparison of American and Spanish Students

This study examined the structure of automatic thoughts and relations between automatic thoughts and psychological symptoms from a cross-cultural perspective. Spanish university students (N = 437) and American university students (N = 349) completed the Automatic Thoughts Questionnaire-Revised (ATQ-R) and the Young Adult Self-Report. Results supported a hierarchical arrangement of cognitions in which four first-order categories of self-talk (Dissatisfaction, Negative Self-Concept, Inability to Cope, and Positive Thoughts) were encompassed by two broad factors of Positive and Negative Self-Talk. The pattern of associations between automatic thoughts and symptoms of anxiety, depression, and externalizing problems supported both the cognitive content-specificity theory and the tripartite model of anxiety and depression. Multiple group covariance structure analysis showed that the structure of the ATQ-R and relations between the ATQ-R and symptoms were comparable in both groups, suggesting that the nature of automatic thoughts is similar across Western cultures.

The relationship between automatic thoughts and negative emotions in children and adolescents: a test of the cognitive content-specificity hypothesis.

The aim of this study was to test the cognitive content-specificity hypothesis in children and adolescents aged 7-16 years. Participants consisted of a community sample of 200 youth and a clinical sample of 160 youth with anxiety, depressive, or disruptive behavior disorders. Participants completed several self-report measures assessing a wide range of negative beliefs and symptoms of internalizing and externalizing problems. Multivariate analyses examining the interrelationships between beliefs and noncognitive symptoms revealed that thoughts on loss or personal failure were the strongest predictors of depressive symptoms, thoughts on social threat were the strongest predictors of anxiety symptoms, and thoughts on hostility or revenge were the strongest predictors of aggression. Results showed clear evidence of cognitive-affective specificity across both internalizing and externalizing problems in youth.