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Santos B, Pinho L, Nogueira MJ, Pires R, Sequeira C, Montesó-Curto P. Cognitive Restructuring during Depressive Symptoms: A Scoping Review. Healthcare (Basel) 2024; 12:1292. [PMID: 38998827 PMCID: PMC11241739 DOI: 10.3390/healthcare12131292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 06/20/2024] [Accepted: 06/25/2024] [Indexed: 07/14/2024] Open
Abstract
Cognitive restructuring (CR) aims to get people to challenge and modify their cognitive distortions, generating alternative, more adaptive thoughts. Behavioral, emotional, and physiological responses are modified by analyzing and changing dysfunctional thoughts. The person must have the cognitive capacity to participate in the analysis of their thoughts. CR for people with depression has positive effects, although there is little research on how it should be structured and applied. CR is a thought modification technique presented in the Nursing Interventions Classification (NIC), but is not organized in a sequential approach, and there is no procedure for applying it in practice. This scoping review aims to identify the structure, contents and assessment instruments used in CR for people with depressive symptoms and to analyze the health outcomes of applying the CR technique in this population. Out of 515 articles, seven studies were included in the review, up to 2021 and without any time limitation. The studies were not guided by a consistent and sound framework of the CR technique and each study used its own framework, although they used similar techniques. We grouped CR into six steps. No specific studies were found regarding intervention by nurses. CR is effective in reducing depressive symptoms, so it is an important therapeutic tool that should be used on people with depression. With this scoping review, mental health nurses will have a more comprehensive idea of the techniques that can be used in the application of CR to patients with depressive symptoms.
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Affiliation(s)
- Bruno Santos
- Department of Nursing, ESSCVP Alto Tâmega, 5400-673 Chaves, Portugal
- Department of Nursing, University of Rovira i Virgili, 43003 Tarragona, Spain
| | - Lara Pinho
- Department of Nursing, University of Évora, 7000-811 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-811 Évora, Portugal
| | | | - Regina Pires
- Nursing School of Porto, CINTESIS of University of Porto, 4200-072 Porto, Portugal
| | - Carlos Sequeira
- Nursing School of Porto, CINTESIS of University of Porto, 4200-072 Porto, Portugal
| | - Pilar Montesó-Curto
- Department of Nursing, University of Rovira i Virgili, 43003 Tarragona, Spain
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Brinkhof LP, de Wit S, Murre JMJ, Ridderinkhof KR. Mitigating the Harmful Impact of Ageism among Older Individuals: The Buffering Role of Resilience Factors. Geriatrics (Basel) 2023; 9:1. [PMID: 38392100 PMCID: PMC10888260 DOI: 10.3390/geriatrics9010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/05/2023] [Accepted: 12/12/2023] [Indexed: 02/24/2024] Open
Abstract
Frequent exposure to ageism has significant repercussions on the quality of life and mental well-being/health of older adults. Resilience may play a crucial role in mitigating these effects. The current study aimed to investigate the potential buffering roles of two types of coping variables-behavioral coping and a positive appraisal style-in older adults (N = 2000, aged 55-93). Confirming previous findings, higher levels of perceived negative ageism (PNA) were associated with diminished quality of life and mental well-being, increased depression and loneliness. However, individuals that tend to employ behavioral coping strategies when confronted with challenging/stressful situations showed a weaker relationship between PNA and quality of life, mental well-being, and depression. Embracing a positive appraisal style attenuated the negative impact of PNA on feelings of depression and loneliness. Interestingly, younger older adults appeared to benefit the most from these resilience factors. Despite considerable inter-individual variability, encouraging the utilization of behavioral coping strategies and nurturing a positive appraisal style could serve as effective approaches to mitigate the detrimental effects of PNA.
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Affiliation(s)
- Lotte P Brinkhof
- Department of Psychology, Faculty of Behavioural and Social Sciences, University of Amsterdam, 1018 WS Amsterdam, The Netherlands
- Centre for Urban Mental Health, University of Amsterdam, 1018 WS Amsterdam, The Netherlands
- Amsterdam Brain & Cognition (ABC), University of Amsterdam, 1018 WS Amsterdam, The Netherlands
| | - Sanne de Wit
- Department of Psychology, Faculty of Behavioural and Social Sciences, University of Amsterdam, 1018 WS Amsterdam, The Netherlands
- Centre for Urban Mental Health, University of Amsterdam, 1018 WS Amsterdam, The Netherlands
- Amsterdam Brain & Cognition (ABC), University of Amsterdam, 1018 WS Amsterdam, The Netherlands
| | - Jaap M J Murre
- Department of Psychology, Faculty of Behavioural and Social Sciences, University of Amsterdam, 1018 WS Amsterdam, The Netherlands
- Centre for Urban Mental Health, University of Amsterdam, 1018 WS Amsterdam, The Netherlands
- Amsterdam Brain & Cognition (ABC), University of Amsterdam, 1018 WS Amsterdam, The Netherlands
| | - K Richard Ridderinkhof
- Department of Psychology, Faculty of Behavioural and Social Sciences, University of Amsterdam, 1018 WS Amsterdam, The Netherlands
- Centre for Urban Mental Health, University of Amsterdam, 1018 WS Amsterdam, The Netherlands
- Amsterdam Brain & Cognition (ABC), University of Amsterdam, 1018 WS Amsterdam, The Netherlands
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Bokoch R, Hass-Cohen N, Fowler G, Liu L. Obesity prevention: a pilot study on community workshops delivered by art therapists. INTERNATIONAL JOURNAL OF ART THERAPY 2022. [DOI: 10.1080/17454832.2022.2123010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Rebecca Bokoch
- California School of Professional Psychology, Alliant International University, Alhambra, CA, USA
| | - Noah Hass-Cohen
- California School of Professional Psychology, Alliant International University, Alhambra, CA, USA
| | - Grace Fowler
- California School of Professional Psychology, Alliant International University, Alhambra, CA, USA
| | - Lisa Liu
- California School of Professional Psychology, Alliant International University, Alhambra, CA, USA
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Sardella A, Lenzo V, Basile G, Martino G, Quattropani MC. Emotion regulation strategies and difficulties in older adults: A systematic review. Clin Gerontol 2022; 46:280-301. [PMID: 36163629 DOI: 10.1080/07317115.2022.2128706] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The purpose of this systematic review was to assess the types of emotion regulation (ER) strategies used and difficulties in emotion regulation experienced by older adults, within the theoretical frameworks proposed by Gross, and by Gratz and Roemer, respectively. METHODS A systematic search was conducted using principal electronic scientific databases (PubMed, Scopus, and Web of Science). The systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines. RESULTS The final number of articles included was 44. Older adults reported a higher use of adaptive ER strategies, as well as fewer difficulties in ER, compared with younger adults. Findings from this review also suggest that the use of maladaptive ER strategies can also expose older adults to psychological distress, and may affect their adaptation to negative disease-related outcomes more common in later life. CONCLUSIONS Older adults generally showed a greater emotional control compared with younger subjects. Adaptive control strategies, rather than maladaptive control strategies, were correlated with more positive outcomes for psychological distress and adaptation to chronic diseases. CLINICAL IMPLICATIONS Understanding the nature of ER processes in older adults may contribute to implement tailored interventions aimed at reinforcing adaptive ER processes.
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Affiliation(s)
- Alberto Sardella
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Vittorio Lenzo
- Department of Social and Educational Sciences of the Mediterranean Area, University for Foreigners "Dante Alighieri" of Reggio Calabria, Reggio, Italy
| | - Giorgio Basile
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Brothers SL, Gereau MM, DesRuisseaux LA, Suchy Y. Reappraising cognitive reappraisal: The taxing impact of emotion regulation on executive functioning in older adults. J Clin Exp Neuropsychol 2022; 44:1-14. [PMID: 36094061 DOI: 10.1080/13803395.2022.2113765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 08/12/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVE Cognitive reappraisal (CR) and expressive suppression (ES) are two common emotion regulation strategies that share similar cognitive and neural underpinnings. Prior research has consistently shown that recent engagement in ES (both self-reported and experimentally manipulated) is associated with subsequent temporary decrements in executive functioning (EF). Thus far, only one study has examined the association between CR and EF, with null results. However, that study was limited by examining only zero-order correlations and by assessing only the speed, not accuracy, of EF performance. The present study examined multivariate relationships among recent CR, recent ES, and EF (both speed and accuracy), as well as the potential impacts of more chronic engagements in, and trait-level preferences between, the two emotion regulation strategies. METHOD Participants were 201 community-dwelling older adults aged 60 to 93 who had participated in three separate studies examining the relationship between self-reported emotion regulation and EF. RESULTS Recent CR was associated with EF performance accuracy above and beyond chronic CR. Both recent CR and ES contributed to EF performance accuracy uniquely beyond each other and beyond chronic and preferred emotion regulation. CONCLUSIONS Both recent ES and CR appear to have a deleterious impact on EF performance accuracy, potentially due to utilization of similar resources; both should be accounted for when assessing emotion regulation and its impacts on EF.
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Affiliation(s)
- Stacey L Brothers
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Michelle M Gereau
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | | | - Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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Dol A, Bode C, Velthuijsen H, van Strien T, van Gemert-Pijnen L. Application of three different coaching strategies through a virtual coach for people with emotional eating: a vignette study. J Eat Disord 2021; 9:13. [PMID: 33446275 PMCID: PMC7809774 DOI: 10.1186/s40337-020-00367-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 12/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Around 13% of the world's population suffers from obesity. More than 40% of people with obesity display emotional eating behaviour (eating in response to negative emotions or distress). It is an alternate to more effective coping strategies for negative emotions. Our study explored the opportunities for helping adults with emotional overeating using a virtual coach, aiming to identify preferences for tailored coaching strategies applicable in a personal virtual coach environment. Three different coaching strategies were tested: a validating, a focus-on-change, and a dialectical one - the latter being a synthesis of the first two strategies. METHODS A qualitative study used vignettes reflecting the two most relevant situations for people with emotional eating: 1. experiencing negative emotions, with ensuing food cravings; and 2. after losing control to emotional eating, with ensuing feelings of low self-esteem. Applied design: 2 situations × 3 coaching strategies. PARTICIPANTS 71 adult women (Mage 44.4/years, range 19-70, SD = 12.86) with high scores on the DEBQ-emotional eating scale (Memo 3.65, range 1.69-4.92, SD = .69) with mean BMI 30.1 (range 18-46, SD = 6.53). They were recruited via dieticians' practices, were randomly assigned to the conditions and asked how they would face and react to the presented coaching strategies. Data were transcribed and a thematic analysis was conducted. RESULTS Qualitative results showed that participants valued both the validating coaching strategy and the focus-on-change strategy, but indicated that a combination of validation and focus-on-change provides both mental support and practical advice. Data showed that participants differed in their level of awareness of the role that emotions play in their overeating and the need for emotion-regulation skills. CONCLUSION The design of the virtual coach should be based on dialectical coaching strategies as preferred by participants with emotional eating behaviour. It should be tailored to the different stages of awareness of their emotions and individual emotion-regulation skills.
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Affiliation(s)
- Aranka Dol
- Department of Psychology, Health and Technology, Faculty of Behavioural, Management and Social Sciences (BMS), University of Twente, De Zul 10, 7522 NJ Enschede, The Netherlands
| | - Christina Bode
- Department of Psychology, Health and Technology, Faculty of Behavioural, Management and Social Sciences (BMS), University of Twente, De Zul 10, 7522 NJ Enschede, The Netherlands
| | - Hugo Velthuijsen
- Institute for Communication, Media & IT, Hanze University, Groningen, The Netherlands
| | - Tatjana van Strien
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Lisette van Gemert-Pijnen
- Department of Psychology, Health and Technology, Faculty of Behavioural, Management and Social Sciences (BMS), University of Twente, De Zul 10, 7522 NJ Enschede, The Netherlands
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Tan WH, Sheffield J, Khoo SK, Byrne G, Pachana NA. Influences on Psychological Well‐Being and Ill‐Being in Older Women. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Aafjes-van Doorn K, Sweeney K. The effectiveness of initial therapy contact: A systematic review. Clin Psychol Rev 2019; 74:101786. [PMID: 31733564 DOI: 10.1016/j.cpr.2019.101786] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 07/17/2019] [Accepted: 09/25/2019] [Indexed: 10/25/2022]
Abstract
'Initial therapy contacts', defined as (the first) 3 h or less of face-to-face psychological treatment, encompassing both the early phase of a longer therapy and one-off single session therapies, are seen as a critical phase of treatment. However, little is known about the direct effect of initial therapy contacts on change in common symptoms typically presented by patients in psychological therapy services. Our systematic literature search resulted in 35 identified empirical studies on the effect of initial therapy contacts. These studies were analyzed in three stages: 1) A systematic comparison of study characteristics using the preferred reporting items for systematic reviews and meta-analyses; 2) A domain-based evaluation of methodological rigor of the studies, in line with Cochrane's guidelines on assessing risk of bias; 3) A narrative synthesis of reported findings. The considerable variability in therapy format (a stand-alone single session, 2 + 1 format, or initial session of multisession therapy) and study design (post/pre-post measurement, with/without control) limited comparability of studies. The quality assessment indicated that the majority of studies had relatively weak methodologies overall. Qualitative synthesis of the effectiveness results suggests that a significant proportion of patients reported benefits, including symptom change. This positive effect is especially clear when compared to no-treatment controls, and appears to be maintained at follow-up. The findings suggest that a broad range of initial therapy formats, could in itself be beneficial to patients in primary care treatment settings, and that further research is warranted.
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Massey CN, Feig EH, Duque-Serrano L, Wexler D, Moskowitz JT, Huffman JC. Well-being interventions for individuals with diabetes: A systematic review. Diabetes Res Clin Pract 2019; 147:118-133. [PMID: 30500545 PMCID: PMC6370485 DOI: 10.1016/j.diabres.2018.11.014] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/19/2018] [Accepted: 11/21/2018] [Indexed: 12/25/2022]
Abstract
In patients with diabetes, psychological well-being constructs (e.g., optimism, positive affect) have been associated with superior medical outcomes, including better glucose control and lower mortality rates. Well-being interventions may be well-suited to individuals with diabetes, as they are simple to deliver, broadly applicable across a range of psychological distress, and may help increase self-efficacy and motivation for diabetes self-care. This systematic review, completed using PRISMA guidelines, examined peer-reviewed studies indexed in PubMed, PsycINFO, and/or Scopus between database inception and October 2017 that investigated the effects of well-being interventions (e.g., positive psychology interventions, mindfulness-based interventions, resilience-based interventions) on psychological and physical health outcomes in individuals with Type 1 or Type 2 diabetes. The search yielded 34 articles (N = 1635 participants), with substantial variability in intervention type, measures used, and outcomes studied; the majority found the intervention to provide benefit. Overall, results indicate that a range of well-being interventions appear to have promise in improving health outcomes in this population, but the literature does not yet provide definitive data about which specific interventions are most effective. The variability in interventions and outcomes points to a need for further rigorous, controlled, and well-powered studies of specific interventions, with well-accepted, clinically relevant outcome measures.
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Affiliation(s)
- Christina N Massey
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
| | - Emily H Feig
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Laura Duque-Serrano
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Deborah Wexler
- Harvard Medical School, Boston, MA, USA; Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Judith Tedlie Moskowitz
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Jeff C Huffman
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
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Dryman MT, Heimberg RG. Emotion regulation in social anxiety and depression: a systematic review of expressive suppression and cognitive reappraisal. Clin Psychol Rev 2018; 65:17-42. [DOI: 10.1016/j.cpr.2018.07.004] [Citation(s) in RCA: 123] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 07/20/2018] [Accepted: 07/21/2018] [Indexed: 10/28/2022]
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Abstract
It is well-established that as people age, deterioration in cognitive abilities including processing speed, memory, and cognitive flexibility occurs, although vast individual differences occur in the rate and consequences of this decline (Christensen, 2001). Anxiety and depression in late life are also associated with specific cognitive deficits in memory and executive functioning that may impact on new learning (Yochim et al., 2013). Therefore, it is possible that cognitive changes make it more difficult for older adults to learn how to change their thinking particularly in the context of psychological therapy.
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Abstract
This article discusses potential adaptations to cognitive behavioral therapy (CBT) needed when working with older adults. Although CBT has been demonstrated to be efficacious in older anxious populations in meta-analyses, more research is needed to better understand the efficacy of CBT for the individual anxiety disorders, for older adults aged 80 years and older, and the efficacy of individual CBT elements. Despite normal age-related reductions in cognitive and physical abilities, most research suggests that only minor adaptations to CBT, if any, are needed for older adults. More significant adaptations relate to therapist attitudes and beliefs rather than the pragmatic CBT delivery, for example, negative attitudes related to aging and the likely benefit of CBT. Despite normal age-related declines in some cognitive domains, research to date suggests that normal cognitive changes do not significantly impact on treatment outcomes over the course of CBT; a case example is presented.
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Appraisal assessment in patient-reported outcome research: methods for uncovering the personal context and meaning of quality of life. Qual Life Res 2016; 26:545-554. [PMID: 27988907 DOI: 10.1007/s11136-016-1476-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Recent work on patient-reported outcomes (PROs) focuses on precise, brief measures, which generally convey little about what an individual's rating actually means. Individual differences in appraisal are important and relevant to PRO research. This paper highlights the advantages of integrating appraisal assessment into clinical research. METHODS The most comprehensive method for assessing appraisal, the quality of life (QOL) Appraisal Profile, includes open-ended and multiple choice questions to assess four appraisal parameters: frame of reference, sampling of experience, standards of comparison, and combinatory algorithm. We illustrate with empirical findings four classes of investigation that would benefit from appraisal assessment: methodological, interpretation of change, the backstory of resilience, and clinical applications. RESULTS A methodological investigation of HIV/AIDS patients revealed a range of cognitive schemas induced by the then-test response shift detection method, only 15% of which reflected the presumed process invoked. In this same study and in a study of people with multiple sclerosis (MS), interpretation of change in positive versus negative mental-health response shifts was characterized by different appraisal processes. In studying resilience in MS patients, patients with more reserve-building activities were more likely to use appraisals that emphasized the positive and more controllable aspects of their illness experience, as compared to lower-reserve patients. In underserved cancer patients, the QOL Appraisal Profile was used as a clinical interview to articulate current concerns and for personalized treatment decision-making to reduce burden and promote adherence. CONCLUSIONS Integrating appraisal assessment can provide a more textured, person-centered understanding of person-factors not captured by standard PROs.
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Anxiety-Linked Differences in Older Adults’ Interpretation of Ambiguous Information. COGNITIVE THERAPY AND RESEARCH 2016. [DOI: 10.1007/s10608-016-9824-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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