Cognitive Mediation Hypothesis Research Articles

Psychosocial Group Intervention Among War-Affected Children: An Analysis of Changes in Posttraumatic Cognitions.

Cognitive theories point to reduction in dysfunctional posttraumatic cognitions (PTCs) as one mechanism involved in recovery from posttraumatic stress symptoms (PTSS), yet research findings have shown individual differences in the recovery process. We tested the cognitive mediation hypothesis above in a previously published psychosocial group intervention among war-affected children. We also examined heterogeneity in children's PTCs during the intervention. We used a cluster randomized trial of Smith et al.'s (2002) teaching recovery techniques (TRT) intervention among 482 Palestinians 10-13 years of age (n = 242 for intervention group, n = 240 for control group). Children reported PTSS, PTCs, and depressive symptoms at baseline, midpoint, postintervention, and at 6-month follow-up. Path analysis results showed that TRT was not effective in reducing dysfunctional PTCs, and the reductions did not mediate intervention effects on PTSS. Using latent class growth analysis, we chose the model with 3 differing trajectories in the intervention group: high, decreasing, moderate, downward trending, and severe, stable levels of PTCs. Higher PTSS and depressive symptoms at baseline were associated with membership in the severe, stable trajectory. The intervention did not produce the kind of beneficial cognitive change needed in the cognitive mediation conceptualization. Nevertheless, cognitive changes differed substantially across children during the intervention, and were associated with their preintervention mental health status. These findings call for more detailed examination of the process of cognitive mediation.

Understanding Pain and Depression in Back Pain: the Role of Catastrophizing, Help-/Hopelessness, and Thought Suppression as Potential Mediators.

The cognitive mediation hypothesis describes the influence of psychological factors on the relationship between pain and depression such as cognitions of catastrophizing and help-/hopelessness. More recent research also emphasizes the role of suppression of negative thoughts and experiences such as pain. However, there is little research investigating direct and indirect effects of these contrasting cognitions. A total of 164 acute and sub-acute non-specific back pain patients participated in this study. Pain intensity, depression, and pain-related cognitions were measured using questionnaires, such as the Beck Depression Inventory and the Kiel Pain Inventory. Data were analyzed using structural equation modeling. The results of the path analysis support the hypothesis that cognitive coping strategies have a mediating effect on pain and depression. Consistent with previous research, we found that pain had no direct relation with depression. Help-/hopelessness had a direct path to depression, whereas catastrophizing had an indirect effect via increased help-/hopelessness. The current results also indicate that thought suppression mediated the relationship between pain and depression via both direct and indirect effects. Cognitive mediators, such as help-/hopelessness, catastrophizing, and thought suppression, have a significant impact on depression in patients with acute and sub-acute back pain. The current results may aid in the optimization of treatments for these patients by focusing attention toward the modification of dysfunctional cognitive pain-coping strategies.

Childhood familial environment, maltreatment and borderline personality disorder symptoms in a non-clinical sample: A cognitive behavioural perspective

The present study sought to determine if cognitive beliefs and schemas mediated the relationship between retrospectively reported childhood events and adult borderline personality disorder (BPD) symptoms in a non-clinical sample. One hundred and seventy-eight non-clinical participants completed questionnaires measuring BPD symptoms, core beliefs, and retrospective reports of childhood family functioning and childhood maltreatment. Results of a series of multiple regressions showed that core beliefs hypothesised to be related to BPD mediated the relationship between BPD symptoms and retrospective reports of childhood emotional abuse. Hence, the current study adds further support to the cognitive mediation hypothesis in BPD and provides theoretical support for cognitive behavioural formulations and treatments for BPD.

Treatment of depression and mechanisms of change: Strengthening the links among theory, research, and practice.

Greater knowledge of the mechanisms underlying cognitive change in the context of depression is an important goal of current clinical research. The thoughtful review by Garratt, Ingram, Rand, and Sawalani (2007) highlights the wealth of research that has been conducted in this area, while also drawing attention to the many complexities inherent in studying the cognitive mediation hypothesis in cognitive therapy. In this commentary, we use the review by Garratt et al. as a starting point from which to highlight some of the issues that we believe to be imperative to the advancement of knowledge in this field of research. These issues include the need for strong connections between theories of cognitive mediation and depression, the deployment of appropriate research paradigms and methods to advance the field, and the conduct of research in contexts that are relevant to clinical practice.

Do changes in dysfunctional attitudes mediate changes in depression and anxiety in cognitive behavioral therapy?

Using structural equation modeling (SEM), four hypotheses about the causal linkages between dysfunctional attitudes (DAs), anxiety, and depression were tested in a group of 521 outpatients treated with cognitive behavioral therapy (CBT) over a 12-week period. The four hypotheses were as follows: (1) changes in DAs lead to changes in depression and anxiety during treatment (the cognitive mediation hypothesis); (2) changes in depression and/or anxiety lead to changes in DAs (the mood activation hypothesis); (3) DAs and negative emotions have reciprocal causal effects on each other (the circular causality hypothesis); and (4) there are no causal links between DAs and emotions—instead, a third variable simultaneously activates DAs, depression and anxiety (the “common cause” hypothesis). Consistent with previous reports, DAs were significantly correlated with levels of depression and anxiety at intake and at 12 weeks; in addition, changes in DAs were significantly correlated with changes in depression and anxiety during treatment. However, the results were inconsistent with the first three hypotheses. There did not appear to be any causal effects linking the DAs with depression or anxiety at intake or at 12 weeks. Instead, the analyses suggested the existence of an unknown variable with simultaneous causal effects on dysfunctional attitudes, depression, and anxiety. This common cause accounted for all the correlations between the attitude and mood variables, and also appeared to mediate the effects of psychotherapy and medication on dysfunctional attitudes, depression, and anxiety.

The expression of cognitive vulnerabilities for depression in daily life: a French-American study

This prospective study provided a direct comparison of French and American samples concerning a cognitive diathesis for depression. Using the Experience Sampling Method and identical measures across sites, subjects were signaled five times daily by electronic devices to provide in vivo reports of negative events, attributions, and depressed moods. After controlling for effects associating clinical and demographic variables, and despite differences attributable to national origin, attributional style emerged as a highly significant predictor of the numerous specific attributions made to negative events within the course of daily life. However, consistent with the cognitive mediation hypothesis, attributional style did not directly explain depression levels. The results are discussed in terms of the predictive power of cognitive and personality assessments in understanding the day-to-day experience of depression.

The Cognitive Mediation Hypothesis Revisited: An Empirical Response to Methodological and Theoretical Criticism

The cognitive mediation hypothesis has become a well-established assumption in persuasion theory. However, several theoretical and methodological criticisms have been raised to call this assumption into question. Three experiments that address these criticisms were conducted to provide a more direct test of the cognitive mediation hypothesis. Using the forewarning effect as a testing arena, Experiment I demonstrated that interference with either motivation or ability to counterargue reduced fore-warning-induced resistance to persuasion. Experiment 2 demonstrated that exposure to counterarguments generated by others and self-generated counterarguments were functionally equivalent and redundant. Experiment 3 used a path-analytic approach to demonstrate that the persuasion differences produced by forewarning were eliminated by covarying the effect of cognitive responses generated between forewarning and message exposure. Taken together, the three experiments provide converging support for the cognitive mediation hypothesis, reconfirming the central role of cognition in the persuasion process.

Cognitive mediation of panic attacks induced by biological challenge tests

A variety of pharmacological and physiological procedures reliably induce panic attacks in panic disorder patients but rarely do so in controls. Some biologically orientated researchers have described these procedures as biological challenge tests and have assumed that pharmacological and physiological manipulations have a direct panic-inducing effect and that individuals who are susceptible to these manipulations have a neurochemical disorder. An alternative explanation is provided by the cognitive theory of panic which proposes that the challenge tests induce panic because they produce bodily sensations that panic patients are prone to misinterpret and that it is the misinterpretation which is responsible for the induced attack. Experiments that have attempted to test the cognitive mediation account of biological challenge induced panic are reviewed. Overall, the results of these experiments provide strong support for the cognitive mediation hypothesis. In addition, it is suggested that the crucial cognitive variable is likely to be interpretation of challenge induced sensations, not expected affect or perceived control of the sensations.

Amnesic Patients Can Benefit from Instructions to Use Imagery: Evidence Against the Cognitive Mediation Hypothesis

Six bi-temporal amnesics and seven Korsakoff patients were compared on paired associate learning under four different conditions, rote learning, images provided, images self generated, verbal mediation. Both imagery manipulations produced better learning than either rote learning or verbal mediation but the latter two conditions did not differ. The data are interpreted as arguing against an interpretation of amnesia in terms of cognitive mediation. The two patient groups behaved similarly in the experiment, thus suggesting that immediate recall of paired-associates learning does not differentiate different forms of organic amnesia.