1
|
Özdemir İ, Kuru E. Investigation of Cognitive Distortions in Panic Disorder, Generalized Anxiety Disorder and Social Anxiety Disorder. J Clin Med 2023; 12:6351. [PMID: 37834995 PMCID: PMC10573573 DOI: 10.3390/jcm12196351] [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: 08/05/2023] [Revised: 09/25/2023] [Accepted: 10/01/2023] [Indexed: 10/15/2023] Open
Abstract
The aim of this study was to determine the main cognitive distortions observed in panic disorder (PD), generalized anxiety disorder (GAD) and social anxiety disorder (SAD) and to investigate the impact of cognitive distortions on diagnoses, depression levels, disorder type and severity of anxiety. This study consisted of 150 clinical (50 PD, 50 GAD, 50 SAD) and 91 healthy control participants. A sociodemographic data form, the Beck Depression Inventory (BDI), the Dysfunctional Attitudes Scale (DAS), the Cognitive Distortions Scale (CDS) and the State-Trait Anxiety Inventory (STAI) scales were administered to all participants. It was found that cognitive distortions were higher in individuals with PD, GAD and SAD. The PD, SAD and GAD groups were similar for "catastrophizing", "mindreading", "all or nothing thinking", "overgeneralization", "should statements" and "emotional reasoning". "Personalization", "labeling" and "minimizing or disqualifying the positive" were observed at a higher severity in the SAD group compared to the PD group, and "mental filter" was observed at a higher severity in the GAD group compared to the PD group. Our findings emphasize the need to address cognitive distortions in PD, GAD and SAD treatment. The evaluation of cognitive distortions specific to anxiety disorders is significant in guiding therapy goals and pioneering new research.
Collapse
Affiliation(s)
- İlker Özdemir
- Department of Psychiatry, Faculty of Medicine, Giresun University, Giresun 28200, Turkey
| | - Erkan Kuru
- Private Practice, Psychiatry, Ankara 06510, Turkey;
| |
Collapse
|
2
|
Morrison AS, Ustun B, Horenstein A, Kaplan SC, de Oliveira IR, Batmaz S, Gross JJ, Sadikova E, Hemanny C, Pires PP, Goldin PR, Kessler RC, Heimberg RG. Optimized short-forms of the Cognitive Distortions Questionnaire. J Anxiety Disord 2022; 92:102624. [PMID: 36087565 DOI: 10.1016/j.janxdis.2022.102624] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/13/2022] [Accepted: 08/17/2022] [Indexed: 10/15/2022]
Abstract
INTRODUCTION The Cognitive Distortions Questionnaire (CD-Quest) is a self-report questionnaire that assesses common cognitive distortions. Although the CD-Quest has excellent psychometric properties, its length may limit its use. METHODS We attempted to develop short-forms of the CD-Quest using RiskSLIM - a machine learning method to build short-form scales that can be scored by hand. Each short-form was fit to maximize concordance with the total CD-Quest score for a specified number of items based on an objective function, in this case R2, by selecting an optimal subset of items and an optimal set of small integer weights. The models were trained in a sample of US undergraduate students (N = 906). We then validated each short-form on five independent samples: two samples of undergraduate students in Brazil (Ns = 182, 183); patients with depression in Brazil (N = 62); patients with social anxiety disorder in the US (N = 198); and psychiatric outpatients in Turkey (N = 269). RESULTS A 9-item short-form with integer scoring was created that reproduced the total 15-item CD-Quest score in all validation samples with excellent accuracy (R2 = 90.4-93.6%). A 5-item ultra-short-form had good accuracy (R2 = 78.2-85.5%). DISCUSSION A 9-item short-form and a 5-item ultra-short-form of the CD-Quest both reproduced full CD-Quest scores with excellent to good accuracy. These shorter versions of the full CD-Quest could facilitate measurement of cognitive distortions for users with limited time and resources.
Collapse
Affiliation(s)
- Amanda S Morrison
- Department of Psychology, California State University, East Bay, Hayward, CA, USA.
| | - Berk Ustun
- Halıcıoğlu Data Science Institute, UC San Diego, La Jolla, CA, USA
| | - Arielle Horenstein
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Simona C Kaplan
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | | | - Sedat Batmaz
- Department of Psychology, Faculty of Social Sciences and Humanities, Social Sciences University of Ankara, Ankara, Turkey
| | - James J Gross
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Ekaterina Sadikova
- Department of Epidemiology, Harvard Chan School of Public Health, Boston, MA, USA; Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Curt Hemanny
- Postgraduate Program of Interactive Processes of Organs and Systems, Health Sciences Institute, Federal University of Bahia, Bahia, Brazil
| | - Pedro P Pires
- Department of Psychometrics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Philippe R Goldin
- Betty Irene Moore School of Nursing, University of California, Davis, Davis, CA, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Richard G Heimberg
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| |
Collapse
|
3
|
Lieberman R, Dick GL. Interdisciplinary healing power of words. JOURNAL OF POETRY THERAPY 2022. [DOI: 10.1080/08893675.2022.2089689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
| | - Gary L. Dick
- School of Social Work, College of Allied Health Sciences, University of Cincinnati, Cincinnati, Ohio, USA
| |
Collapse
|
4
|
Fernández-Tobar B, González-Moreno J, Cantero-García M. Propiedades psicométricas del Children's Negative Cognitive Error Questionnaire en población española adolescente y joven. REVISTA DE ESTUDIOS E INVESTIGACIÓN EN PSICOLOGÍA Y EDUCACIÓN 2022. [DOI: 10.17979/reipe.2022.9.1.8999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
El objetivo de este estudio era analizar las propiedades psicométricas de la versión española del Children’s Negative Cognitive Errors Questionnaire (CNCEQ) en una muestra de población joven. El CNCEQ es uno de los procedimientos de autoinforme más utilizados para medir cuatro tipos de distorsión cognitiva (pensamiento catastrófico, sobregeneralización, personalización y abstracción selectiva) en tres áreas de contenido (social, académica y deportiva). A pesar de ello, no existen estudios que analicen las propiedades del instrumento entre los jóvenes. El estudio utilizó una amplia muestra (N = 2040; entre 12 y 22 años; 50,7% hombres y 47,3% mujeres) de diferentes centros educativos. La validez de constructo se evaluó mediante un análisis factorial exploratorio, y la consistencia interna mediante el coeficiente alfa de Cronbach. También se realizaron contrastes de medias para evaluar la validez discriminante y se llevó a cabo un análisis de correlación y regresión para explorar la validez de criterio. Los resultados indican que el CNCEQ permite evaluar las distorsiones cognitivas autodegradantes entre los jóvenes con suficientes garantías psicométricas. Su uso por parte de los profesores les permitirá adaptar sus actividades para tener en cuenta la presencia de distorsiones cognitivas entre sus estudiantes.
Collapse
|
5
|
Vieira RVDA, Peterlin BL, Kowacs F, Londero RG, Barea LM, Grassi V, Gomes WB, Gauer G. Headache-related cognitive distortions questionnaire. HEADACHE MEDICINE 2022. [DOI: 10.48208/headachemed.2021.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Background. - Cognitive distortions are systematic errors in thinking and can be observed in the relationship of headache patients with their own disease and treatment.
Objective. - To construct and validate an instrument to evaluate headache-related cognitive distortions in those with primary headache disorders; and to investigate the psychometric properties of this new instrument. Methods. - One hundred thirty-six (136) migraine outpatients from three Brazilian specialized headache hospital services completed the Headache-related Cognitive Distortions Inventory (HCDQ) and validated measures of psychological symptoms, pain catastrophizing, mood disorders, quality of life and headache-related disability. Results. - All hypothesized study measures’ correlations were statistically significant, supporting construct validity. HCDQ scores were positively correlated with headache frequency, headache intensity, psychological symptoms, depression, anxiety, and pain catastrophizing; and negatively correlated with 7 of 8 quality of life domains and time the patient was in treatment. Cronbach’s alpha demonstrated excellent internal consistency for the 17-item total scale (alpha=.92). Along with headache intensity and depression, HCDQ Pain subscale accounted for 46% of variance in the prediction of headache-related disability. Conclusions. - HCDQ is a valid and reliable measure of migraine patients´ cognitive distortions about their headaches and headache treatment.
Collapse
|
6
|
Création de l’Échelle de Distorsions Cognitives pour adultes (EDC-A) : étude des propriétés psychométriques en population générale et association avec l’anxiété et la dépression. PSYCHOLOGIE FRANCAISE 2021. [DOI: 10.1016/j.psfr.2021.04.003] [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: 11/23/2022]
|
7
|
Mercan N, Bulut M, Yüksel Ç. Investigation of the relatedness of cognitive distortions with emotional expression, anxiety, and depression. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02251-z] [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]
|
8
|
Butler RM, O'Day EB, Swee MB, Horenstein A, Heimberg RG. Cognitive Behavioral Therapy for Social Anxiety Disorder: Predictors of Treatment Outcome in a Quasi-Naturalistic Setting. Behav Ther 2021; 52:465-477. [PMID: 33622514 DOI: 10.1016/j.beth.2020.06.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 05/26/2020] [Accepted: 06/08/2020] [Indexed: 10/24/2022]
Abstract
We examined the outcomes of individual cognitive behavioral therapy (CBT) for social anxiety disorder (SAD) in a sample of 93 adults seeking treatment in a university outpatient clinic specializing in CBT for SAD. Treatment followed the structure of a manual, but number of sessions varied according to client needs. After approximately 20 weeks of therapy, patients' social anxiety had decreased and their quality of life had increased. Patients with more severe SAD or comorbid major depressive disorder (MDD) at pretreatment demonstrated higher levels of social anxiety averaged across pre- and posttreatment. However, clinician-rated severity of SAD, comorbid MDD, or comorbid generalized anxiety disorder did not predict treatment outcome. Higher pretreatment scores on measures of safety behaviors and cognitive distortions were associated with higher social anxiety averaged across pre- and posttreatment and predicted greater decreases from pre- to posttreatment on multiple social anxiety outcome measures. We found no predictors of change in quality of life. Those with high levels of safety behaviors and distorted cognitions may benefit more from CBT, perhaps due to its emphasis on targeting avoidance through exposure and changing distorted thinking patterns through cognitive restructuring methods. Our study lends support to the body of research suggesting that manualized CBT interventions can be applied flexibly in clinical settings with promising outcomes for patients over a relatively short course of therapy.
Collapse
|
9
|
Pike AC, Serfaty JR, Robinson OJ. The development and psychometric properties of a self-report Catastrophizing Questionnaire. ROYAL SOCIETY OPEN SCIENCE 2021; 8:201362. [PMID: 33614077 PMCID: PMC7890513 DOI: 10.1098/rsos.201362] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 12/11/2020] [Indexed: 06/12/2023]
Abstract
Catastrophizing is a cognitive process that can be defined as predicting the worst possible outcome. It has been shown to be related to psychiatric diagnoses such as depression and anxiety, yet there are no self-report questionnaires specifically measuring it outside the context of pain research. Here, we therefore develop a novel, comprehensive self-report measure of general catastrophizing. We performed five online studies (total n = 734), in which we created and refined a Catastrophizing Questionnaire, and used a factor analytic approach to understand its underlying structure. We also assessed convergent and discriminant validity, and analysed test-retest reliability. Furthermore, we tested the ability of Catastrophizing Questionnaire scores to predict relevant clinical variables over and above other questionnaires. Finally, we also developed a four-item short version of this questionnaire. We found that our questionnaire is best fit by a single underlying factor, and shows convergent and discriminant validity. Exploratory factor analyses indicated that catastrophizing is independent from other related constructs, including anxiety and worry. Moreover, we demonstrate incremental validity for this questionnaire in predicting diagnostic and medication status. Finally, we demonstrate that our Catastrophizing Questionnaire has good test-retest reliability (intraclass correlation coefficient = 0.77, p < 0.001). Critically, we can now, for the first time, obtain detailed self-report data on catastrophizing.
Collapse
|
10
|
Qian L, Liu L, Chen M, Wang S, Cao Z, Zhang N. Reliability and Validity of the Chinese Version of the Cognitive Distortions Questionnaire (CD-Quest) in College Students. Med Sci Monit 2020; 26:e926786. [PMID: 33253139 PMCID: PMC7716620 DOI: 10.12659/msm.926786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 09/15/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the reliability and validity of the Chinese version of the Cognitive Distortions Questionnaire (CD-Quest) among Chinese college students. MATERIAL AND METHODS A total of 460 college students from Jining were recruited in the study. Sample 1, including 239 college students, was tested for item analysis and exploratory factor analysis. Sample 2, including 221 college students, was tested for confirmatory factor analysis and criterion validity. The criterion validity was tested using the Negative Automatic Thoughts questionnaire (ATQ) and Dysfunctional Attitudes Scale (DAS). Test-retest reliability was evaluated in 40 college students from sample 1 with 4 weeks interval. RESULTS The corrected item-total correction (ITC) ranged from 0.675 (emotional reasoning) to 0.829 (unfair comparison). Exploratory factor analysis revealed the variance of the CD-Quest items was unidimensional, and it explained 55.261% of the data variance. Confirmatory factor analysis indicated all regression coefficients were higher than 0.4. The criterion validity was excellent, as shown by the relationships among CD-Quest, DAS, and ATQ (r=0.447, 0.566, respectively). Cronbach's alpha coefficient was 0.941 and the test-retest reliability was 0.928. CONCLUSIONS The Chinese version of CD-Quest had good reliability and validity, suggesting it is a reliable tool to evaluate cognitive distortion of Chinese college students.
Collapse
Affiliation(s)
- Liju Qian
- Department of Psychiatry, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, P.R. China
- Department of Psychiatry, Jining Neuro-Psychiatric Hospital, Jining, Shandong, P.R. China
| | - Li Liu
- Department of Psychiatry, Jining Neuro-Psychiatric Hospital, Jining, Shandong, P.R. China
| | - Min Chen
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, Shandong, P.R. China
| | - Shanmei Wang
- Department of Psychiatry, Jining Neuro-Psychiatric Hospital, Jining, Shandong, P.R. China
| | - Zhongchang Cao
- Department of Psychiatry, Jining Neuro-Psychiatric Hospital, Jining, Shandong, P.R. China
| | - Ning Zhang
- Department of Psychiatry, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, P.R. China
| |
Collapse
|
11
|
Efficacy of trial-based cognitive therapy, behavioral activation and treatment as usual in the treatment of major depressive disorder: preliminary findings from a randomized clinical trial. CNS Spectr 2020; 25:535-544. [PMID: 31769377 DOI: 10.1017/s1092852919001457] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Major depressive disorder (MDD) is a prevalent, debilitating and disabling disorder, and its prevalence is increasing. Antidepressants (AD), cognitive-behavioral therapy (CBT) and behavioral activation (BA) are the main treatments for MDD. Trial-based cognitive therapy (TBCT) addresses and restructures dysfunctional negative core beliefs (CBs) and is a novel and promising approach. OBJECTIVE The aim of this study was to compare the efficacy of TBCT, BA and treatment as usual (TAU) in the treatment of MDD. METHODS A total of 76 patients with MDD were randomized into 1 of 3 groups and evaluated at baseline, after 6 weeks and at week 12 (final evaluation). The primary outcome was changing in HAM-D scores, and the secondary outcomes included scores on the BDI, CD-Quest, Sheehan Disability Scale (SDS) and WHOQOL. RESULTS Both TBCT and BA (which also included AD) were different from TAU (which included antidepressants alone) in reducing the HAM-D and BDI scores and other measures. TBCT and BA were different from TAU in the reduction of disability in SDS and WHOQOL physical domain scores. Besides limited by a small sample size, the dropout rate in the TAU arm was higher, and only 10 patients completed the 3 evaluations. CONCLUSION This trial provides evidence that TBCT and BA combined with antidepressants were more efficacious than the TAU (drug alone) in reducing the severity of depressive symptoms and disability, showing that this combination can be useful for clinical practice.
Collapse
|
12
|
DiGiuseppe R, Gorman B, Raptis J. The Factor Structure of the Attitudes and Beliefs Scale 2: Implications for Rational Emotive Behavior Therapy. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2020. [DOI: 10.1007/s10942-020-00349-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
13
|
Yesilyaprak N, Batmaz S, Yildiz M, Songur E, Akpinar Aslan E. Automatic thoughts, cognitive distortions, dysfunctional attitudes, core beliefs, and ruminative response styles in unipolar major depressive disorder and bipolar disorder: a comparative study. PSYCHIAT CLIN PSYCH 2019. [DOI: 10.1080/24750573.2019.1690815] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
| | - Sedat Batmaz
- Department of Psychiatry, School of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Mesut Yildiz
- Department of Psychiatry, School of Medicine, Marmara University, Istanbul, Turkey
| | - Emrah Songur
- Psychiatry Clinic, Kecioren Training and Research Hospital, Health Sciences University, Ankara, Turkey
| | - Esma Akpinar Aslan
- Department of Psychiatry, School of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey
| |
Collapse
|
14
|
Do sudden gains predict treatment outcome in social anxiety disorder? Findings from two randomized controlled trials. Behav Res Ther 2019; 121:103453. [PMID: 31430688 DOI: 10.1016/j.brat.2019.103453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 06/22/2019] [Accepted: 08/09/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Sudden gains (SGs) have been found to occur during randomized controlled trials (RCTs) for social anxiety disorder (SAD). Evidence is mixed whether SGs relate to treatment outcome in SAD. We examined SGs in two RCTs for SAD. METHOD Study 1 (N = 68) examined SGs in individual cognitive-behavioral therapy (CBT), and Study 2 (N = 100) compared SGs in group CBT and Mindfulness-Based Stress Reduction (MBSR). Weekly ratings of social anxiety were used to calculate SGs. The Liebowitz Social Anxiety Scale-Self-Report and the Social Interaction Anxiety Scale were completed at pretreatment, posttreatment, and follow-up to assess outcome. RESULTS In Study 1, 17.6% of participants experienced a SG. Participants with SGs started and ended treatment with lower social anxiety. SGs were not associated with greater decreases in social anxiety from pre-to posttreatment or 12-month follow-up. In Study 2, SGs occurred in 27% of participants and at comparable rates in MBSR and group CBT. SGs were not associated with changes in social anxiety during treatment in either condition. CONCLUSION SGs occurred during treatment for SAD. In both RCTs, participants improved regardless of experiencing a SG, suggesting that SGs are not predictive of greater improvement during treatment for SAD.
Collapse
|