Maladaptive Thinking Patterns Research Articles

Negative cognitive-affective involvement as a mechanism linking job demands to occupational well-being: The moderating role of maladaptive thinking patterns.

Negative cognitions and emotions about work during off-job time (e.g., worry about work tasks) can hinder the necessary recovery from work and lead to impaired occupational well-being. To better understand when this negative cognitive-affective involvement arises, we considered simultaneous and interactive effects of external and individual factors. Specifically, we investigated whether job demands (i.e., time pressure, cognitive demands, emotional demands) and maladaptive thinking patterns are independently and jointly related to negative cognitive-affective involvement and whether this is in turn associated with impaired occupational well-being (i.e., emotional exhaustion, cynicism). Using a diary study, we collected daily data from 109 employees twice a day over two working weeks (N = 667 day-level observations). Multilevel analyses showed that negative cognitive-affective involvement mediates the relationship between job demands (i.e., cognitive demands, emotional demands) and the two occupational well-being indicators. The relationship between cognitive and emotional demands, respectively, and negative cognitive-affective involvement is moderated by work-related maladaptive thinking patterns, with stronger relationships for employees reporting more frequent maladaptive thinking patterns. Moreover, work-related maladaptive thinking patterns moderate the indirect effects of job demands on occupational well-being via negative cognitive-affective involvement. Overall, we expanded the research on negative cognitive-affective involvement by providing a more comprehensive picture of its antecedents and outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Feasibility and acceptability of an mHealth app integrating pain-cognitive behavioral therapy and pharmacologic support for patients with advanced cancer.

275 Background: Up to 60% of patients with advanced cancer and chronic pain experience inadequate relief from analgesics. We developed an mHealth app that augments pharmacologic therapy by integrating CBT-based psychological support for patients with cancer pain, and evaluated its feasibility and acceptability. Methods: Patients were recruited from the Dana-Farber Cancer Institute (Boston, MA) and Stephenson Cancer Center (Oklahoma City, OK). Patients were ≥21 years old, diagnosed with an advanced solid tumor or hematologic malignancy, had moderate-to-severe pain (4 or greater on 0-10 scale) that was related to cancer or their cancer treatment, and were using opioids. Exclusion criteria were cognitive impairment, history of opioid use disorder, enrollment in hospice, and acute pain from a recent surgery. App content integrated pain-CBT treatment with pain education and opioid support, and utilized just-in-time adaptive interventions (e.g. algorithm-based advice for pain, stress, and sleep) in response to once daily symptom surveys, including once daily psychoeducational content to support pain self-management. Patients used the app for 2-4 weeks, after which they completed the E-Acceptability scale and semi-structured debriefing interview. Results: Fifteen patients (female=9, mean age=50.3) enrolled on the study and 93% opted to test the app for 28 days (1 patient chose to test the app for 14 days). Patients who tested the app for 28 days completed a median of 18 of the 28 daily surveys (54% total surveys completed). Within patients who tested the app, 11 patients (73%) completed ≥50% of their daily surveys, with 4 (27%) completing ≥75%, and 4 (27%) completing ≤25% of surveys. Overall satisfaction with the app was high (4.43/5-pt Likert scale). Patients also rated the app as understandable (4.93/5) and easy to use (4.57/5-pt Likert scale). In study interviews, many patients reported that the app improved their ability to self-manage their cancer-related pain by facilitating the creation of more intentional pain management routines, and by helping to modify maladaptive thinking patterns allowing them to better cope with their pain. Patients emphasized how salient, clear, and succinct the information was, particularly in the context of coping with stress and pain. Conclusions: The STAMP+CBT app was an acceptable and feasible method to integrate and deliver psychological/behavioral treatment with opioid support to support cancer pain management. Compliance may have been influenced by the app’s notification structure limiting survey engagement to a 45-minute period each day. A future, larger pilot study will further evaluate feasibility and acceptability in patients with advanced cancer. In addition to additional content, the updated version of the app retains notifications but allows patients to return to missed content for 24 hours.

SPECIAL ISSUE: Do Biofeedback, Neurofeedback, and Neuromeditation Have a Role in Psychedelic-Assisted Therapies?

SPECIAL ISSUE: Do Biofeedback, Neurofeedback, and Neuromeditation Have a Role in Psychedelic-Assisted Therapies?

Taking Work Home: A Diary Study on Negative Cognitive-Affective Involvement During Off-job Time

Negative cognitions and emotions about work during off-job time (e.g., worry about work tasks) can hinder the necessary recovery from work and lead to impaired well-being. To better understand when this so-called negative cognitive-affective involvement arises, we considered simultaneous and interactive effects of external and individual factors. Specifically, we investigated whether job demands (i.e., time pressure, cognitive demands, emotional demands) and maladaptive thinking patterns are independently and jointly related to negative cognitive-affective involvement and whether this is in turn associated with work-related well-being (i.e., emotional exhaustion, cynicism). Using a diary study, we collected daily data from employees (N = 109) twice a day over two working weeks. Multilevel analyses showed that negative cognitive-affective involvement mediates the relationship between job demands (i.e., cognitive demands, emotional demands) and the two work-related well-being indicators. The relationship between cognitive and emotional demands, respectively, and negative cognitive-affective involvement is moderated by work-related maladaptive thinking patterns, with stronger relationships for employees reporting more frequent maladaptive thinking patterns. Moreover, work-related maladaptive thinking patterns moderate the indirect effects of job demands on work-related well-being via negative cognitive-affective involvement. Overall, we expanded the research on negative cognitive-affective involvement by providing a more comprehensive picture of its antecedents and outcomes.

Psychological Dimensions Relevant to Motivation and Pleasure in Schizophrenia.

Motivation and pleasure deficits are common in schizophrenia, strongly linked with poorer functioning, and may reflect underlying alterations in brain functions governing reward processing and goal pursuit. While there is extensive research examining cognitive and reward mechanisms related to these deficits in schizophrenia, less attention has been paid to psychological characteristics that contribute to resilience against, or risk for, motivation and pleasure impairment. For example, psychological tendencies involving positive future expectancies (e.g., optimism) and effective affect management (e.g., reappraisal, mindfulness) are associated with aspects of reward anticipation and evaluation that optimally guide goal-directed behavior. Conversely, maladaptive thinking patterns (e.g., defeatist performance beliefs, asocial beliefs) and tendencies that amplify negative cognitions (e.g., rumination), may divert cognitive resources away from goal pursuit or reduce willingness to exert effort. Additionally, aspects of sociality, including the propensity to experience social connection as positive reinforcement may be particularly relevant for pursuing social goals. In the current review, we discuss the roles of several psychological characteristics with respect to motivation and pleasure in schizophrenia. We argue that individual variation in these psychological dimensions is relevant to the study of motivation and reward processing in schizophrenia, including interactions between these psychological dimensions and more well-characterized cognitive and reward processing contributors to motivation. We close by emphasizing the value of considering a broad set of modulating factors when studying motivation and pleasure functions in schizophrenia.

Understanding intergenerational transmission of early maladaptive schemas from a memory perspective: Moderating role of overgeneral memory on adverse experiences

BackgroundPrevious studies demonstrated that early maladaptive schemas (EMSs) are transmitted from mothers to children through adverse childhood experiences, such as maltreatment and unfulfilled core needs. The traumatic memory literature demonstrated that people with a history of trauma recall their traumatic and/or other negative experiences as categories of events—a phenomenon called overgeneral autobiographical memory (OGM)—to avoid the accompanying intense negative feelings. In the long run, OGM originating from an affect-regulation process after childhood traumatic experiences can facilitate the development of EMSs in children. ObjectiveThis study expands the previous literature by studying whether OGM facilitates the transmission of EMSs by strengthening maladaptive thinking patterns after traumatic experiences. Participants and settingsA total of 120 mothers and late adolescents participated in this study. The mothers filled out the forms online through a link sent to their e-mail addresses, and the adolescents completed the forms online through a link posted on social media. MethodLate adolescents completed the Autobiographical Memory Recall Task, Young Schema Questionnaire-Short Form-3 (YSQ-SF3), Childhood Trauma Questionnaire, and Beck Depression Inventory (BDI). Mothers filled out the YSQ-SF3 and BDI. ResultsThe results confirmed that adverse childhood experiences significantly mediated the relationship between mothers' and children's disconnection and rejection schemas. Furthermore, this relationship was stronger, especially for children with a higher tendency of overgeneral retrieval of negative experience (β = 0.26 (0.10), 95% CI [0.09, 0.49]). ConclusionsThe present study provides evidence that OGM facilitates the transmission of early maladaptive schemas.

A randomized controlled trial to improve psychological detachment from work and well-being among employees: a study protocol comparing online CBT-based and mindfulness interventions

BackgroundThe changing landscape of the work environment, which often encompasses expectations of employees being continuously available, makes it difficult to disengage from work and recover. This can have a negative impact on employees’ well-being, resulting in burnout, depression and anxiety, among other difficulties. The current study will test the effectiveness of two different online interventions (i.e., cognitive behavioral therapy; CBT and mindfulness-based stress reduction; MBSR) on employees’ psychological detachment, burnout and other variables related to general (e.g., life satisfaction) and work-specific (e.g., work engagement) well-being.Methods/designThe study is designed as a randomized control trial with two intervention groups (i.e., CBT, MBSR) and a waitlist control group. Participants will be full-time employees from a wide range of organizations from Slovenia, who report moderate difficulties with psychological detachment from work and burnout and are not receiving any other form of treatment. The online interventions will encompass 12 sessions over 6 weeks (2 sessions per week); each session will include 1) an active audio-guided session and 2) home assignments, accompanied by handouts and worksheets. The study outcomes (i.e., psychological detachment, burnout, general and work-specific well-being), potential mechanisms (i.e., work-related maladaptive thinking patterns, mindfulness) and moderators (e.g., supervisor support for recovery) will be assessed immediately before and after the interventions (pre and post measurement) and 3 months after intervention completion (follow-up). Additionally, participants will fill out questionnaires for the assessment of the central mechanisms and study outcomes each week.DiscussionWe expect that the CBT-based intervention will lead to greater improvements in psychological detachment from work and burnout compared to the MBSR and the waitlist control group. Additionally, we expect that the CBT-based intervention will also lead to greater enhancement of both general and work-related well-being.Trial registrationhttps://doi.org/10.1186/ISRCTN98347361 [May 19, 2020].

Worthy and able: How helping relationships alter the trajectories of young people who face severe and multiple disadvantages.

Relationships with professional helpers, partly resembling family relationships, have the potential to help young people facing severe and multiple disadvantages. The aim of this study was to document how relationships alter the trajectories of young people in these circumstances. Young people (n = 30) and support workers (n = 35) were identified by the leaders of 11 UK and 5 US not-for-profit organisations providing support for this population. Thematic analysis of the semi-structured interviews revealed that relationships helped young people feel positive about themselves, disrupted their maladaptive patterns of thinking, and fostered a sense of agency in themselves. The result was a self that was worthy and able. Findings provided an in-depth exploration of the notion of support in the context of adversity.

Maladaptive Cognitions and Attributional Styles Among Youth with Pediatric Bipolar Disorder

Although studies have examined cognitive styles among adults with bipolar disorder (BD), less is known about this issue in pediatric samples. Therefore, we investigated negative cognitions and attributional styles in pediatric patients with BD and healthy controls (HC). Participants completed measures about their views of themselves, the world, and the future and causal attributions for positive and negative events. Compared to HCs, youth with BD displayed greater negative thoughts about others and the future, but not about themselves. They were also more likely to report dysfunctional attributional styles for negative events. When including depressive and manic symptoms in the analyses, both were significant covariates and accounted for the group differences in negative cognitions. Findings point to the importance of manic and depressive symptoms in the occurrence of maladaptive thinking patterns among pediatric patients with BD and highlight the unique cognitive styles specific to this group.

Cognitive Behavioural Chairwork

Recent years have seen increased interest in the use of experiential techniques within cognitive behavioural therapy (CBT). Chairwork techniques such as empty-chair and two-chair interventions are popular therapeutic tools which originate from the psychodrama and gestalt schools of psychotherapy. Despite a growing body of evidence, however, such techniques are often neglected in CBT. This article provides an overview of key cognitive behavioural chairwork (CBC) techniques used for addressing maladaptive patterns of thinking, feeling and behaving. Chair-based methods for restructuring distressing cognitions, resolving ambivalence, generating metacognitive awareness, bolstering self-compassion and improving emotional regulation are outlined. Evidence for the clinical effectiveness of CBC is then reviewed, and possible mechanisms of action are discussed with reference to theories of cognitive science. The paper concludes by discussing the limitations associated with chairwork and provides guidelines for introducing, conducting and consolidating CBC.

Motivation-Matched Approach to the Treatment of Problem Gambling: A Case Series Pilot Study

The aim of the present case series was to provide a preliminary assessment of the utility of a motivation-matched treatment for problem gamblers. On the basis of their primary underlying motivations for gambling, 6 problem gamblers received either action-motivated (n = 4) or escape-motivated (n = 2) treatment. Drawing upon a cognitive-behavioural framework, this 6-session motivation-matched treatment was designed to address gamblers' maladaptive motivations for gambling (i.e., the need or desire for "escape" or "action"), as well as the effects of conditioning and maladaptive thinking patterns unique to each gambling motive subtype. Assessments were conducted at pre-treatment, post-treatment, and 3- and 6-month follow-up. Primary outcome measures included gambling behaviour (i.e., gambling frequency, time, and money spent gambling), severity of gambling problems, and gambling-related impairment or disability; secondary outcome measures included gambling-related craving, gambling abstinence self-efficacy, positively and negatively reinforcing gambling situations, and gambling outcome expectancies. Overall, participants showed pre- to post-treatment improvements on the majority of these measures, with relatively less immediate post-treatment treatment gains observed on measures that assessed positively and negatively reinforcing gambling situations and gambling-related impairment or disability. However, treatment gains at the 3- and 6-month follow-up were shown for most participants on these latter measures as well. Findings suggest promise for this novel treatment approach. The next step in this line of research is to conduct a randomized, controlled trial to compare the efficacy of this motivation-matched treatment for disordered gambling with treatment as usual.

Role of behavioral techniques in patients with insomnia and headache

Behavioral treatments focus exclusively on modifying environmental contexts/contingencies and patterns of behavior that presumably exacerbate symptoms and functional impairment. Cognitive-behavioral treatments (CBTs), by comparison, include a focus on behavior modification and an emphasis on modifying maladaptive patterns of thinking. There are central elements of CBT and self-management, which cut across treatment for specific psychiatric disorders and headache disorders. In many cases, insomnia occurs when there is another problem, such as stress, pain, or a medical condition. In these cases, treatment of the underlying problem may help to improve sleep. In other cases, the causative factor of insomnia is unclear or the insomnia does not improveeven after the treatment of the coexisting problem. Hence, the insomnia itself requires to be particularlytreated.

Maladaptive cognitions and physical health of the caregivers of dementia: An interpretative phenomenological analysis

The aim of the study was to conduct in-depth analyses of the lived experiences of the caregivers of dementia and their maladaptive thinking patterns and how their physical health was influenced and compromised. The main method used was interpretative phenomenological analysis and involved in-depth analysis of eight participants screened through homogenous purposive sampling. After taking written consent from the participants, semi-structured interviews were conducted to gather the data that were transcribed later on to carry out free textual analysis. The themes were generated from the transcripts through the funneling approach in order to arrive at the themes that were common, frequent, and reflected the experiences shared by the participants. The verification was done through peer review and rich thick description. The most significant themes regarding maladaptive cognitions were catastrophizing, overgeneralizing, and blaming, whereas fatigue and sleep disturbances were the most significant themes regarding physical health. The emergent themes point towards a need to devise indigenous therapeutic intervention for the caregivers of dementia in the Pakistani sociocultural context as the literature available on caregiving is quite scanty in our culture.

Individual risk factors for physician boundary violations: the role of attachment style, childhood trauma and maladaptive beliefs

ObjectiveThe assessment and remediation of boundary-challenged health care professionals is enhanced through examination of individual risk factors. We assessed three such factors — attachment style, childhood trauma and maladaptive beliefs — in 100 attendees (mostly physicians) of a continuing medical education (CME) professional boundaries course. We propose a theoretical model that draws a causal arc from childhood maltreatment through insecure attachment and maladaptive beliefs to elevated risk for boundary violations. MethodsWe administered the Experiences in Close Relationships Questionnaire Revised (ECR-R), Childhood Trauma Questionnaire (CTQ) and Young Schema Questionnaire (YSQ) to 100 health care professionals attending a CME course on professional boundaries. Experts rated participant autobiographies to determine attachment style and early adversities. Correlations and relationships between self-ratings and expert ratings and among different risk factors were examined. ResultsOne fifth of participants reported moderate to severe childhood abuse; sixty percent reported moderate to severe emotional neglect. Despite this, average attachment anxiety and attachment avoidance were low, and more than half of participants were rated “secure” by experts. Childhood maltreatment was correlated with attachment anxiety and avoidance and predicted expert-rated insecure attachment and maladaptive beliefs. ConclusionsOur findings support a potential link between childhood adversity and boundary difficulties, partly mediated by insecure attachment and early maladaptive beliefs. Furthermore, these results suggest that boundary education programs and professional wellness programs may be enhanced with a focus on sequelae of childhood maltreatment, attachment and common maladaptive thinking patterns.

Mechanisms to medicines: elucidating neural and molecular substrates of fear extinction to identify novel treatments for anxiety disorders.

The burden of anxiety disorders is growing, but the efficacy of available anxiolytic treatments remains inadequate. Cognitive behavioural therapy for anxiety disorders focuses on identifying and modifying maladaptive patterns of thinking and behaving, and has a testable analogue in rodents in the form of fear extinction. A large preclinical literature has amassed in recent years describing the neural and molecular basis of fear extinction in rodents. In this review, we discuss how this work is being harnessed to foster translational research on anxiety disorders and facilitate the search for new anxiolytic treatments. We begin by summarizing the anatomical and functional connectivity of a medial prefrontal cortex (mPFC)-amygdala circuit that subserves fear extinction, including new insights from optogenetics. We then cover some of the approaches that have been taken to model impaired fear extinction and associated impairments with mPFC-amygdala dysfunction. The principal goal of the review is to evaluate evidence that various neurotransmitter and neuromodulator systems mediate fear extinction by modulating the mPFC-amygdala circuitry. To that end, we describe studies that have tested how fear extinction is impaired or facilitated by pharmacological manipulations of dopamine, noradrenaline, 5-HT, GABA, glutamate, neuropeptides, endocannabinoids and various other systems, which either directly target the mPFC-amygdala circuit, or produce behavioural effects that are coincident with functional changes in the circuit. We conclude that there are good grounds to be optimistic that the progress in defining the molecular substrates of mPFC-amygdala circuit function can be effectively leveraged to identify plausible candidates for extinction-promoting therapies for anxiety disorders.

Practical Tools for Engaging "The 6th A: Awareness"

Physicians and allied health care professionals must engage skillful ‘Awareness’ of the complex range of factors causing and maintaining obesity so as to effectively ‘Assess’ and ‘Advise’. It is also essential for patients to be aware of the relevant root causes of their weight status in order for them to make and sustain behaviour change. Evidence consistently identifies a complex range of factors contributing directly to obesity, including emotional regulation, stimulus control, maladaptive thinking patterns, learned associations, social-cultural factors, sleep, stress management and mental health.

Facebook and the Cognitive Model: A Tool for Promoting Adolescent Self-Awareness

A homework activity incorporating the social networking site Facebook is presented as a tool for teaching adolescent clients about the cognitive model and increasing their ability to identify and modify problematic thinking. The authors describe how a worksheet developed to help clients examine information presented on their Facebook profile can increase self-awareness and reflection of maladaptive patterns of thinking. The process is explained and the authors provide a case illustration of how the worksheet was used with an adolescent client who was experiencing school and relational difficulties.

Professional Nursing Burnout and Irrational Thinking

This expanded (n = 648) replication study examines job-related burnout in practicing nurses in relation to five maladaptive thinking patterns at eight northeast Florida hospitals. Data supported the hypothesis that maladaptive thinking patterns may be related to nurses' burnout thoughts and behaviors. The focus of this research spotlights the individual nurse's thoughts, emotions, and actions and suggests that these burnout tendencies can be mitigated if not changed.

Differences in early maladaptive schemas of men and women

This study investigated the differences between men and women in the Young Schema Questionnaire reduced form (YSQ-S2) responses. This was a quantitative, cross-sectional comparison between groups. The sample consisted of 236 participants and divided into two groups, one group of 114 male participants and another group of 122 female participants. For inclusion the subjects should have minimum age of 18 years and maximum of 59 years and have studied up to the fifth grade. The participants answered the YSQ-S2 and data sheet socio-demographic factors. The results indicated significant differences between groups of males and females in early maladaptive schemas (EMSs) of Failure, Vulnerability to Disease and Pain, Self-Sacrifice and Emotional Inhibition, as well as in the domain of Autonomy and Impaired Performance, and, Orientation to the Other. Women had higher scores than men in all the mentioned areas, except in the EMSs Emotional Inhibition, where men had higher scores. These results may contribute to the development of knowledge about differences in maladaptive thinking patterns between men and women.

Treatments for Later-Life Depressive Conditions: A Meta-Analytic Comparison of Pharmacotherapy and Psychotherapy

To improve interventions for depressed older adults, data are needed on the comparative effects of pharmacotherapy versus psychotherapy. Given that most older adults with clinically significant depressive symptoms do not have major depression, data on treatments for minor depression and dysthymia are especially needed. Meta-analysis was used to integrate the results of 89 controlled studies of treatments focused on acute major depression (37 studies) and other depressive disorders (52 studies conducted with mixed diagnostic groups, including patients with major depression, minor depression, and dysthymia). A total of 5,328 older adults received pharmacotherapy or psychotherapy in these studies. Clinician-rated depression scores improved, on average, by 0.80 standard deviation (SD) units; self-rated depression scores improved by 0.76 SD units. Clinician-rated depression improved by 0.69 SD units in pharmacotherapeutic studies and by 1.09 SD units in psychotherapeutic studies. Self-rated depression improved by 0.62 SD units and 0.83 SD units, respectively. An interesting finding was the stronger improvements in clinician-rated depression among control subjects participating in medication studies, compared to those in psychotherapeutic studies. Available treatments for depression work, with effect sizes that are moderate to large. Comparisons of psychotherapy and pharmacotherapy must be interpreted with caution, in part because medication studies are more likely to use a credible active placebo, which may lead to smaller adjusted effect sizes in medication studies. Given that psychotherapy and pharmacotherapy did not show strong differences in effect sizes, treatment choice should be based on other criteria, such as contraindications, treatment access, or patient preferences.