The Factor Structure of the Attitudes and Beliefs Scale 2: Implications for Rational Emotive Behavior Therapy

Mapping the Path to Cognitive Balance: Applying the States of Mind Model and Network Analysis to Eating Disorder Patients

Background: In eating disorders (EDs), cognitive-behavioral therapy (CBT) represents one of the first-line treatment options albeit with sub-optimal results. The assessment of cognitive balance through an index measuring increased adaptive thinking and reduced maladaptive thinking, the desired outcomes, and the ultimate goal of CBT treatments warrants attention. The states of mind model (SOM) provides a framework through which a cognitive balance index can be defined. The current cross-sectional controlled study tested the clinical utility of the SOM model in a sample of ED outpatients. Methods: ED outpatients (n = 199) were assessed at baseline with the attitudes and beliefs scale-2 (ABS-2) for rational beliefs (RBs) and irrational beliefs (IBs), from which a SOM ratio score index (RBs/(RBs + IBs)) was calculated, the eating disorder inventory-3 (EDI-3) for ED symptoms and ED-related psychopathological features, the psychological well-being scales (PWB) for positive psychological functioning. A matched control sample (n = 95) was also assessed with the ABS-2. Results: ED patients exhibited significantly lower SOM and RB scores compared to controls. Network analysis results highlighted the centrality of the SOM-cognitive balance index, PWB-self-acceptance, and EDI-3-general psychological maladjustment, as well as the importance of the influence that cognitive balance and general psychological maladjustment exert on each other. Conclusions: The findings support the clinical utility of the SOM ratio applied to cognitions in EDs. This demonstrates its ability to differentiate such patients from controls and in capturing worse ED-related general psychopathology as well as compromised aspects of psychological well-being, in particular self-acceptance and environmental mastery. It thus might be considered in CBT treatment of EDs a potential cognitive clinimetric and clinical index of ED severity indicating key difficulties in counteracting maladaptive thinking with adaptive thinking.

The COVID-19 Pandemic-Related Irrational and Rational Beliefs Scale. An Investigation of the REBT Theoretical Model

The present study proposes a contextual specific, short measure of irrational and rational beliefs in order to provide a methodologically rigorous investigation of the REBT theoretical model. The COVID-19 Pandemic- Related Irrational and Rational Beliefs Scale was developed according with the REBT theory including rationally and irrationally worded items for each of the four cognitive processes. The data were collected online via google forms between March and June 2020, the sample comprised 798 individuals. A series of confirmatory factor analysis was conducted to investigate the factor structure of the scale. A total of seven measurement models representing different hypotheses about the structural relationship between the 32 items were estimated. Among the seven competing models, the eight-factor bifactor model comprising eight cognitive processes of irrational and rational beliefs factors and a general factor showed the best trade-of between model fit and complexity among all models. This model is congruent with the current theoretical formulation of REBT. The irrational cognitive processes themselves were highly correlated and the rational cognitive processes were moderately to highly correlate with each other. The concurrent validity was investigated and the results supported the validity of the instrument. Implications for research and clinical practice are discussed.

Positive irrational beliefs are associated with hypomanic personality

Primary irrational beliefs, such as demanding about attaining personal goals, are a common trans-diagnostic factor involved in many emotional disorders. Although Bipolar Disorder (BPD) is a severe emotional disorder, little is known about the role of primary irrational beliefs in the risk of BPD. Given that the risk for mania is related to responses to positive rather than adverse events, we developed a measure of irrational beliefs in response to cues of positive events. This is the first study that examines the relationship between positive primary irrational beliefs and the risk of BPD. 119 participants completed an online survey including measures for the risk of BPD, irrational beliefs, positive irrational beliefs, mania-related cognitions, and mood measures (depressive and manic mood). Results revealed significant associations between the risk of BPD and positive primary irrational beliefs, irrational beliefs, positive generalization, and mood. Regression analyses revealed that positive primary irrational beliefs, such as demanding to attain significant goals in response to cues for positive events, uniquely predict the risk for BPD independently of mood, mania-related cognitions and irrational beliefs. These findings encourage the treatment approaches focused on restructuring primary irrational beliefs in response to positive situations to reduce the risk of BPD.

The role of women's traditional gender beliefs in depression, intimate partner violence and stress: insights from a Spanish abbreviated multicultural measure

BACKGROUND

Research on traditional gender beliefs has highlighted their psychological impact and social implications for women. The purpose of this study was twofold. First, we aimed to adapt and validate the Spanish version of the Multicultural O'Kelly Women's Beliefs Scale. Next, we explored its sources of validity evidence in relation to intimate partner violence, stress, and depression. Based on the Rational Emotive Behavior Therapy framework, traditional gender beliefs were expected to be associated with higher levels of intimate partner violence, stress and depression. We also expected to obtain a psychometrically-sound factor structure of the Multicultural O'Kelly Women's Beliefs Scale.

METHODS

A sample of Spanish women (N = 322) completed the Multicultural O'Kelly Women's Beliefs Scale, the Beck's Depression Inventory II, the Modified Conflict Tactics Scale, and the Stress Perceived Scale. To test the psychometric properties of the Multicultural O'Kelly Women's Beliefs Scale we implemented exploratory and confirmatory factor analyses and an analysis of the area under the curve.

RESULTS

Regarding the psychometric properties of the scale, statistical analysis revealed a one-factor dimensionality (Global traditionalism) and supported a reduction of items in the original instrument. The abbreviated version (eight items) obtained the best fit indices. Considering the association between traditional gender beliefs and psychological outcomes, we found that traditional gender beliefs were associated with increased severity of stress, depressive symptoms and reciprocal verbal aggression.

CONCLUSION

The Spanish adaptation of the Multicultural O'Kelly Women's Beliefs Scale provided a very short, psychometrically robust and clinically relevant measure of traditional gender beliefs. In addition to the association between traditional gender beliefs and mental health outcomes, an important finding was the relationship between traditional gender beliefs and intimate partner violence. Our scale might be used in clinical settings by helping women to identify their traditional gender beliefs and replace them by healthy and goal-oriented beliefs, which would also contribute in achieving a more egalitarian society.

Do metacognitions mediate the relationship between irrational beliefs, eating disorder symptoms and cognitive reappraisal?

Objective: Cognitively oriented therapies, first-line treatment for eating disorders (EDs), still show room for improvement in treatment retention and outcomes. Despite the development of additional cognitive models and therapies, few studies examine the relationship between traditional and third-wave cognitive targets in EDs. The study explores the relationship between irrational beliefs (IBs) and metacognitions and their relationship with ED psychopathology and cognitive reappraisal in ED outpatients. Method: Seventy-seven patients (mean age 27.49 ± 12.28 years) were assessed with The Attitudes and Beliefs Scale-ABS-2, Meta-cognitions Questionnaire-MCQ-65, Eating Disorder Inventory 3-EDI-3, Eating Attitudes Test-EAT-40, Emotion Regulation Questionnaire-ERQ. Results: Correlational analyses showed that IBs and metacognitions significantly correlated with each other. Metacognitions partially mediated the relationship between IBs and ED-related general psychological maladjustment and completely mediated the relationship between IBs and ED symptom severity. Cognitive reappraisal was predicted only by IBs and metacognitions were not significant mediators. Conclusions: While IBs are sufficient in explaining ED-related psychopathology and reduced use of cognitive reappraisal, a potential integration of metacognitions about need to control thoughts in CBT models for EDs may offer incremental validity given their contribution to ED severity. Treatment implications include targeting metacognitions concerning need to control thoughts, as a potential maintenance mechanism of ED symptomatology through cognitive restructuring.