Differentiating Anxiety and Depression: A Test of the Cognitive Content-Specificity Hypothesis
|
|
- Harvey Collins
- 6 years ago
- Views:
Transcription
1 Journal of Abnormal Psychology 987, Vol. 96, No.,79-8 Copyright 987 by the American Psychological Association, Inc. 00-8X/87/S00.7 Differentiating and : A Test of the Cognitive Content-Specificity Hypothesis Aaron T. Beck and Gary Brown Center for Cognitive Therapy Department of Psychiatry University of Pennsylvania Medical School Judy I. Eidelson Philadelphia, Pennsylvania Robert A. Steer Department of Psychiatry University of Medicine and Dentistry of New Jersey- School of Osteopathic Medicine John H. Riskind George Mason University The development and initial psychometric properties of the Cognition Checklist (CCL), a scale to measure the frequency of automatic thoughts relevant to anxiety and depression, are described in this article. Item analyses of the responses of 68 psychiatric outpatients identified a -item depression and a -item anxiety subscale that were significantly related, respectively, to the revised Hamilton Rating Scales for and. Patients diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III; American Psychiatric Association, 980) with anxiety disorders had higher mean CCL anxiety scores than patients with DSM-III depression disorders who, in turn, had higher mean CCL depression scores. The validity of the CCL supports the content-specificity hypothesis of the cognitive model of psychopathology (Beck, 976). The cognitive model of psychopathology stipulates that each neurotic disorder can be characterized by a cognitive content specific to that disorder (Beck, 976). Thus the transient automatic thoughts, interpretations, and imagery of the depressed patient center around the theme of self-depreciation and negative attitudes toward the past and future. disorders, on the other hand, are characterized by the theme of danger; anxious patients tend to misread their experiences as constituting either a physical or psychosocial threat and to overestimate both the probability and intensity of anticipated harm in future situations (Beck & Emery, 98). Automatic thoughts are denned as nonvolitional, stream-of-consciousness cognitions (Beck, 976). This study describes the development and psychometric properties of the Cognition Checklist (CCL), which was designed to measure the frequency of automatic thoughts. Previous scales of this type, such as the Automatic Thoughts Questionnaire (Hollon & Kendall, 980) and the Crandell Cognitions Inventory (Crandell & Chambless, 98), have concentrated exclusively on the loss and failure cognitions characteristic of depression. In contrast, the CCL includes cognitions related to danger, which are said to be characteristic of anxiety disorders (Beck & Emery, 98), in addition to cognitions related to depression. Consequently, the CCL can be used to test explicitly the content-specificity hypothesis of the cognitive model (Beck, 967,976). This study was supported by National Institute of Mental Health Grant MH88 to Aaron T. Beck. We gratefully acknowledge the contributions of Paul McDermott and Auke Tellegen. Correspondence concerning this article should be addressed to Aaron T. Beck, Center for Cognitive Therapy, Room 60, South 6th Street, Philadelphia, Pennsylvania Patients Method A total of 68 consecutive outpatients received the CCL prior to admission to the Center for Cognitive Therapy, Philadelphia, as part of a standard pretreatment evaluation. A subsample of 0 patients was set aside for cross-validation analyses, leaving 08 patients in the index sample. The overall sample consisted of 78 (%) men and 0 (%) women. The mean age was 6.0 years (SD =.6 years). Instruments Diagnostic interview. A clinician diagnosed each patient according to the Diagnostic and Statistical Manual of Mental Disorders (DSM- III; American Psychiatric Association, 980). For a significant portion of these patients (approximately, or 68%) the Structured Clinical Interview for DSM-III (SCID; Spitzer & Williams, 98) was used. All of the patients in the cross-validation sample were diagnosed with the SCID. The SCID provides a standardized format for questioning patients about their symptoms, and the sequence of questions approximates the DSM-III decision rules. DSM-III criteria are embedded directly in the SCID interview, thus ensuring adequate coverage of the relevant criteria. Evidence for the reliability of SCID-based diagnoses on a portion of the present sample is provided by Riskind, Beck, Berchick, Brown, and Steer (in press) who found kappa coefficients of.7 for major depression and.79 for generalized anxiety disorder. In the index sample (N = 08), 99 patients (%) were given a primary diagnosis of a DSM-III anxiety disorder, 07 patients (%) were given a primary diagnosis of a depression disorder, and 0 (%) were not given a depression or an anxiety disorder as a diagnosis. In the crossvalidation sample (N = 0), 7 (.7%) of the patients were given primary anxiety diagnoses, 96 (.7%) were given primary depression diagnoses, and the remaining 9 patients (8.6%) received diagnoses other than anxiety or depression. Hamilton psychiatric rating scales for depression and anxiety. The clinician also rated each patient on the Hamilton Psychiatric Rating Scales for (Hamilton, 99) and (Hamilton, 960). Because the standard Hamilton scales overlap substantially in content,
2 80 BECK, BROWN, STEER, EIDELSON, RISKIND they were rescored as suggested by Riskind, Beck, Brown, and Steer (in press) to enhance discrimination of anxious and depressive disorders. Cognition checklist. The initial pool of items for the CCL was compiled from the verbatim reports of automatic thoughts provided by patients during the course of treatment with cognitive therapy. These cognitions are routinely recorded by cognitive therapy patients on the Daily Record of Dysfunctional Thoughts (Beck, Rush, Shaw, & Emery, 979). A preliminary -item version of the scale was extracted from a pool of nearly 00 potential items by including only cognitions that were judged to be most typical of those encountered either in anxious or depressed patients. In addition, cognitions that were confounded with symptomatology (e.g., "I have become unable to manage on my own") or that reflected a disability typical of a variety of disorders (e.g., "I can't cope") were excluded, as were redundant and overlapping cognitions. Respondents rated how often each thought typically occurred to them on a - point scale ranging from 0 (never) to (always) in the context of one of four specific situations (attending a social occasion, with a friend, working on a project, and experiencing pain or physical discomfort) and regardless of the situation. In addition to rating the frequency of each cognition, the first patients were asked to label the predominant affect they experienced while thinking each of the thoughts contained in the CCL. Results Cognition-Affect Consistency Analysis Labelings of predominant affect supplied by the respondent that were associated with nonzero ratings were categorized as depressed ("depressed," "sad," etc.), anxious ("anxious," "nervous," etc.), angry ("angry," "mad," etc.), or other. Thirty-five of the items were labeled as expected: Items reflecting themes of hopelessness and loss were most often labeled as depressed, whereas items describing themes of danger and threat of loss were most often labeled as anxious. Only two items were not labeled as expected, and six items were labeled as neither anxious nor depressed (see Table ). Item Selection For the following item-selection analyses, the anxious group was denned as those patients with revised Hamilton Rating Scale (HARS-R) scores greater than or equal to 0. standard deviations above their revised Hamilton Rating Scale for (HRSD-R) scores. Similarly, the depressed group was defined as those patients with HRSD-R scores greater than or equal to 0. standard deviations above their HARS-R scores. The total number of patients meeting either of the aforementioned criteria in the index sample was 0, 06 (.%) in the anxious group and 96 (7.%) in the depressed group; 06 met neither of the criteria and so were not included in the initial set of item-selection analyses. The initial CCL items were entered into the SPSS" Discriminant program (SPSS, 98). The classification variable was coded for anxiety and for depression. The resulting discriminant function loadings are shown in Table. Sixteen (76.%) of the highest loading positive items had depressed content and (9.%) of the items with negative loadings had anxious content. Items were next assigned tentatively to anxiety and depression subscales if the direction of the discriminant loading was Table Cognition Checklist (CCL) Items by Discriminant Function Loading and Labeling of Affect CCL item Loading Labeling Situation There's no one left to help me. I'm worse off than they are. I'll never be as good as other people are. I'm falling behind. Life isn't worth living. There's no point in trying, I'm sure to fail. I don't deserve to be loved. He(she) won't want to see me again. Nothing ever works out for me anymore. I won't know what to say. People don't respect me anymore. I'll never be as capable as I should be. I'm not worthy of other people's attention or affection. I will never overcome my problems. I won't have enough time to do a good job. I have become physically unattractive. I'm worthless. I'm a social failure. I've lost the only friends I've had. Other things might get in the way. No one cares whether I live or die. I will hurt someone I care about. What if I fail? He(she) will reject me. People will keep me from getting what I want. He(she) will be irritated with me. I'm losing my mind. They won't be there when I need them. I might make a mistake. I will make a fool out of myself. I am a defective human being. People will laugh at me. Something might happen that will ruin my appearance. There's something very wrong with me. I'm going to have an accident. Something awful is going to happen. I am going to be injured. Something will happen to someone I care about. I might be trapped. I am not a healthy person. What if no one reaches me in time to help? What if I get sick and become an invalid? I am going to have a heart attack Depressed Depressed * Note. For situations; = feeling pain or physical discomfort; = regardless of the situation; = attending a social occasion; = working on a project; = with a friend. TV = 0 for discriminant analysis; N = for labeling of affect. Values have been rounded to the nearest hundredth. " Included on tentative scale. " Included on tentative scale.
3 Table Varimax- Rotated Principal-Factor Loadings for Cognition Checklist (CCL) Items DIFFERENTIATING 8 CCL item Communality Situation I'm worthless. I'm not worthy of other people's attention or affection. I'll never be as good as other people are. I'm a social failure. I don't deserve to be loved. People don't respect me anymore. I will never overcome my problems. I've lost the only friends I've had. Life isn't worth living. I'm worse off than they are. There's no one left to help me. No one cares whether I live or die. Nothing ever works out for me anymore. I have become physically unattractive. What if I get sick and become an invalid? I am going to be injured. What if no one reaches me in time to help? I might be trapped. I am not a healthy person. I'm going to have an accident. There's something very wrong with me. Something might happen that will ruin my appearance. I am going to have a heart attack. Something awful is going to happen. Something will happen to someone I care about. I'm losing my mind. % total variance % common variance Note. For situations, = regardless of the situation; = with a friend; = attending a social occasion; = feeling pain or physical discomfort. N = 08. Values have been rounded to the nearest hundredth. Loadings less than.0 are not shown consistent with the labeling of affect. The disposition of each item is shown in Table. Treatment of Marginal Items We constructed tentative subscales by summing the unitweighted depression and anxiety items that met both the labeling-of-affect and discriminant-loading criteria. Partial correlations were calculated between each of the unassigned items that had an absolute discriminant function loading less than.0 and each subscale controlling for the correlation of the remaining subscale. One item, "I'm losing my mind," which loaded in the depressed direction on the discriminant function but was labeled as anxious in the cognition-affect consistency analysis, had a higher partial correlation with the tentative anxiety scale than with the depression scale; it was therefore added to the anxiety scale. To confirm that dimensions of anxious and depressed cognition were underlying the anxiety and depression items, we conducted a principal-factor analysis with iterations to establish communalities on the entire index sample (N = 08), and two factors were retained for rotation. After a varimax rotation, one item ("People will laugh at me") that had been assigned to the anxiety subscale now loaded on the depression factor and was therefore removed from the anxiety scale. The analysis was repeated without this item. The resulting factor pattern of the final anxiety subscale (CCL-A) and depression subscale (CCL-D) items is shown in Table. Reliability Cronbach coefficient alphas were calculated in the cross-validation sample for both CCL subscales to estimate their internal consistency. The alpha coefficient for CCL-A () was.90, and the average corrected item-total correlation was.6. The overall alpha coefficient for CCL-D () was.9, and the average corrected item-total correlation was.6. To estimate test-retest reliability, the CCL was readministered to a subsample of 66 patients during their sixth week of treatment. The correlation between intake and 6-week CCL-A scores was.79 (p<.00); the correlation between intake and 6- week CCL-D scores was.76 (p <.00). The test-retest reliabilities of the subscales did not differ. Discriminant Validity We calculated simple and partial correlations between each CCL subscale and each revised Hamilton scale, controlling, respectively, for the correlation with the remaining Hamilton scale. Because we had used the Hamilton scales in the itemselection process, this analysis was cross-validated in a separate sample (N= 0). The intercorrelation of the CCL subscales was.8 in the index sample and.7 in the cross-validation sample. Although both the CCL-D and the CCL-A correlated significantly with both revised Hamilton scales, the relationship was stronger between the CCL subscale and the same-affect Hamilton scale
4 8 BECK, BROWN, STEER, EIDELSON, RISKIND Table Simple and Partial Correlations of Cognition Checklist (CCL) Subscales With Revised Hamilton Scales Index sample (JV= 08) CCL scale HRSD-R HARS-R t r Partial r r Partial r.6**.**.**.6*.8**.**.**.79**.0* Cross-validation sample (N =0) HRSD-R HARS-R t.6**.**.6*.7**.0.**.** 6.89**.9** Note. HRSD-R = Hamilton Scale-Revised. HARS-R = Hamilton Scale-Revised. *p<.0. **/><.00. (Table ). The differences in magnitude of the correlations between same- and different-affect scales were all significant beyond the.0 level using Hotelling's t test. When partial correlations were calculated between each CCL and each revised Hamilton scale controlling, in turn, for the remaining revised Hamilton scale, all of the correlations between each CCL subscale and the same-affect Hamilton scale in both samples remained significant. All opposite-affect correlations were not significant, with the exception of the partial correlation of the CCL-A with the HRSD-R in the index sample, controlling for HARS-R (partial r =. 6, p<.0). Next, each sample was regrouped according to both DSM- III diagnosis and salience of affect. Patients were included in the second anxiety grouping if they had a primary diagnosis of a DSM-III anxiety disorder (generalized anxiety disorder, panic disorder, social phobia, etc.) and their HARS-R standard score (z score) was at least 0. standard deviations higher than their HR- SD-R standard score. Likewise, patients were included in the depression grouping if they had a primary diagnosis of a DSM- III depression disorder (major depression, dysthymic disorder, etc.) and their HRSD-R standard score (z score) was at least 0. higher than their HARS-R standard score. The mean CCL subscale scores for the criterion groups are shown in Table. rtests indicated that the CCL subscale scores differentiated the groups in both the index and the cross-validation studies (all one-tailed ps <.0). Thus anxious patients had higher mean CCL-A scores than did depressed patients in both the index study and cross-validation study, whereas depressed patients had higher mean CCL-D scores than did anxious patients. To determine the accuracy with which patients could be assigned to their correct diagnostic group on the basis of CCL subscale scores, we performed a discriminant classification analysis. By applying the discriminant function derived on the index sample to the cross-validation sample, 0 of 8 (79%, or 9% above chance) anxious patients and of (8%, or 6% above chance) depressed patients were correctly classified. Discussion The present set of results supports the content-specificity hypothesis of the cognitive model that anxious and depressed groups could be distinguished by the types of cognitive content intrinsic to the two conditions. It is clear that the items retained on the anxiety and depression subscales of the CCL are consistent in content with the cognitive themes ascribed to them by the cognitive model of psychopathology (Beck, 976). The content of the subscales also conforms to a broader framework of affective thought processes recently proposed by Tellegen (98). Tellegen proposed that depressive states are characterized by affective disengagement and that the associated cognitions are indicative of an "oriented" or "knowing" mode; in contrast, affectively engaged states such as anxiety reflect an "orienting" or "asking" mode. Thus the anxiety cognitions on the CCL embody a greater degree of uncertainty and an orientation toward the future, whereas depressive cognitions are either oriented toward the past or reflect a more absolute negative attitude toward the future. The CCL items were subjected to a variety of statistical procedures. Multivariate analyses using both internal and external criteria yielded a -item subscale of anxious cognitions and a -item subscale of depressed cognitions. Evidence for the discriminant and convergent validity of the two measures was demonstrated by (a) correlations with a set of independent ratings of anxiety (the HARS-R) and depression (HRSD-R); (b) the mean scores of the two scales, which differentiated samples of patients diagnosed with anxious and depressed DSM-III disorders; and (c) a good classification rate of patients into their correct DSM-III diagnostic category on the basis of their CCL subscale scores. Table Means of Cognition Checklist (CCL) Subscales for DSM-III and Diagnostic Groups CCL- CCL- Group N M SD / M SD t Index sample Cross-validation sample ,»..0 ^ **.0*** Note. Scores have been converted to /"scores [(z score X 0) + 0]. *p<.0. **p<.00. ***/><.00.
5 DIFFERENTIATING 8 Although the correlation between the subscales was substantial, they afforded moderate discrimination between the criterion groups on the basis of mean scores and good above-chance classification rates. The discrimination achieved with the CCL is comparable to the best results that have been obtained with symptom-based psychometric measures of anxiety and depression, in which a high degree of overlap is commonly found (see Dobson, 98, for a review). It is hoped that the CCL will be used in conjunction with symptom-based measures of psychopathology to afford enhanced discrimination of the two syndromes. In addition, the CCL would have utility in a variety of studies relating cognitive factors to diagnostic groups as well as in process studies of psychotherapy. References American Psychiatric Association. (980). Diagnostic and statistical manual of mental disorders (rd ed.). Washington, DC: Author. Beck, A. T. (967). : Clinical, experimental, and theoretical aspects. New 'York: Hoeber. Beck, A. T. (976). Cognitive therapy and the emotional disorders. New York: International Universities Press. Beck, A. T, & Emery, G. (98). disorders and phobias: A cognitive perspective. New York: Basic Books. Beck, A. T, Rush, A. J., Shaw, B. E, & Emery, G. (979). Cognitive therapy of depression. New \brk: Guilford Press. Crandell, C. J., & Chambless, D. L. (98, November). The validation of an inventory for measuring depressive thoughts: The Crandell Cognitions Inventory. Paper presented at the meeting of the Association for Advancement of Behavioral Therapy, Toronto, Ontario, Canada. Dobson, K. S. (98). Relationship between anxiety and depression. Clinical Psychology Review,, 07-. Hamilton, M. (99). The assessment of anxiety states by rating. British Journal of Medical Psychology,, 0-. Hamilton, M. (960). A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry,, 6-6. Hollon, S. D., & Kendall, P. C. (980). Cognitive self-statements in depression: Development of an automatic thoughts questionnaire. Cognitive Therapy and Research,, 8-9. Riskind, J. H., Beck, A. T., Berchick, R. J., Brown, G., & Steer, R. A. (in press). Interrater reliability of the Structured Clinical Interview for DSM-III (SCID) for major depression and generalized anxiety disorder. Archives of General Psychiatry. Riskind, J. H,, Beck, A. T, Brown, G., & Steer, R. A. (in press). Taking the measure of anxiety and depression: Validity of reconstructed Hamilton Scales. Journal of Nervous and Mental Disease. Spitzer, R. L., & Williams, J. B. W. (98). Instruction manual for the Structured Clinical Interview for DSM-III (SCID). New York: Biometrics Research Department, New \fork State Psychiatric Institute. SPSS, Inc. (98). SPSS* user's guide. New York: McGraw-Hill. Tellegen, A. (98). Structures of mood and personality and their relevance to assessing anxiety, with an emphasis on self-report. In A. H. Tuma & J. D. Maser, (Eds.), and the anxiety disorders (pp ). Hillsdale, NJ: Erlbaum. Received August 8,986 Revision received February 6,987 Accepted February 7,987
Cognitive-Behavioral Assessment of Depression: Clinical Validation of the Automatic Thoughts Questionnaire
Journal of Consulting and Clinical Psychology 1983, Vol. 51, No. 5, 721-725 Copyright 1983 by the American Psychological Association, Inc. Cognitive-Behavioral Assessment of Depression: Clinical Validation
More informationAffective Control Scale
K. Elaine Williams and Dianne L. Chambless Bibliography Berg, C.Z., Shapiro, N., Chambless, D. L., Ahrens, A. H. (1998). Are emotions frightening? II: An analogue study of fear of emotion, interpersonal
More informationTable S1: Perceived Devaluation Discrimination Scale: Item Wording, Frequency Distributions, Item and Scale Statistics 1. Strongly Agree (3) % (N) (7)
Table S1: Perceived Devaluation Discrimination Scale: Wording, Frequency Distributions, and Scale Statistics 1 Scale: Perceived Devaluation Discrimination Scale Mean 1.4, Scale Deviation., 4 Alpha.7 Mean
More informationHubley Depression Scale for Older Adults (HDS-OA): Reliability, Validity, and a Comparison to the Geriatric Depression Scale
The University of British Columbia Hubley Depression Scale for Older Adults (HDS-OA): Reliability, Validity, and a Comparison to the Geriatric Depression Scale Sherrie L. Myers & Anita M. Hubley University
More information10/9/2018. Ways to Measure Variables. Three Common Types of Measures. Scales of Measurement
Ways to Measure Variables Three Common Types of Measures 1. Self-report measure 2. Observational measure 3. Physiological measure Which operationalization is best? Scales of Measurement Categorical vs.
More informationMetacognitive therapy for generalized anxiety disorder: An open trial
Journal of Behavior Therapy and Experimental Psychiatry 37 (2006) 206 212 www.elsevier.com/locate/jbtep Metacognitive therapy for generalized anxiety disorder: An open trial Adrian Wells a,, Paul King
More informationDescription and Psychometrics
APPENDIX 6.3: Revised Memory and Behavior Problem Checklist Description and Psychometrics Brief Descriptive Information The Revised Memory and Behavior Problems Checklist (RMBPC; Teri et al., 1992) is
More informationII3B GD2 Depression and Suicidality in Human Research
Office of Human Research Protection University of Nevada, Reno II3B GD2 Depression and Suicidality in Human Research Overview Research studies that include measures for depression and suicidality should
More informationLOCUS OF CONTROL AND REACTION TO ILLNESS: A STUDY OF PATIENTS WITH CHRONIC RENAL FAILURE
Med. J. Malaysia VoI. 39 No. 4 December 1984 LOCUS OF CONTROL AND REACTION TO ILLNESS: A STUDY OF PATIENTS WITH CHRONIC RENAL FAILURE BOEY KAM WENG SUMMARY The relationship between locus of control and
More informationFurther validation of the IDAS: Evidence of Convergent, Discriminant, Criterion, and Incremental Validity
Department of Psychological & Brain Sciences Publications 9-1-2008 Further validation of the IDAS: Evidence of Convergent, Discriminant, Criterion, and Incremental Validity David Watson University of Iowa
More informationCoping with Depression
Coping with Depression What s inside: Page: What is depression and what does it look like? 2 Do I have depression? A checklist for seeking help 4 How is depression treated? 5 Some self-help skills for
More informationStatistical Significance, Effect Size, and Practical Significance Eva Lawrence Guilford College October, 2017
Statistical Significance, Effect Size, and Practical Significance Eva Lawrence Guilford College October, 2017 Definitions Descriptive statistics: Statistical analyses used to describe characteristics of
More informationCONVERGENT VALIDITY OF THE MMPI A AND MACI SCALES OF DEPRESSION 1
Psychological Reports, 2009, 105, 605-609. Psychological Reports 2009 CONVERGENT VALIDITY OF THE MMPI A AND MACI SCALES OF DEPRESSION 1 ERIN K. MERYDITH AND LeADELLE PHELPS University at Buffalo, SUNY
More informationCognitive Behaviour Therapy Resources
Cognitive Behaviour Therapy Resources FIVE STEP THINKING DIARY From www.livingcbt.com Instructions How to complete this Diary: Keep a diary of any problem times or when you experienced any of the following
More informationTheory and Practice of Cognitive Behavioral Therapy
Theory and Practice of Cognitive Behavioral Therapy Shona N. Vas, Ph.D. Department of Psychiatry & Behavioral Neuroscience Cognitive-Behavior Therapy Program MS-3 Clerkship 2008-2009 Outline n What is
More informationalternate-form reliability The degree to which two or more versions of the same test correlate with one another. In clinical studies in which a given function is going to be tested more than once over
More informationMichael Armey David M. Fresco. Jon Rottenberg. James J. Gross Ian H. Gotlib. Kent State University. Stanford University. University of South Florida
Further psychometric refinement of depressive rumination: Support for the Brooding and Pondering factor solution in a diverse community sample with clinician-assessed psychopathology Michael Armey David
More informationUSF Mood & Anxiety Disorders Program
QUICK INVENTORY OF DEPRESSIVE SYMPTOMATOLOGY (SELF-REPORT)(QIDS-SR16) Please circle the one response to each item that best describes you for the past seven days. 1. Falling Asleep: 0 I never take longer
More informationAn adult version of the Screen for Child Anxiety Related Emotional Disorders (SCARED-A)
Netherlands Journal of Psychology / SCARED adult version 81 An adult version of the Screen for Child Anxiety Related Emotional Disorders (SCARED-A) Many questionnaires exist for measuring anxiety; however,
More informationNational Institute on Drug Abuse (NIDA) What is Addiction?
National Institute on Drug Abuse (NIDA) What is Addiction? https://www.drugabuse.gov 1 Table of Contents What is Addiction? Do You or a Loved One Have a Drug Abuse Problem? Signs of Drug Abuse and Addiction
More informationTHE LONG TERM PSYCHOLOGICAL EFFECTS OF DAILY SEDATIVE INTERRUPTION IN CRITICALLY ILL PATIENTS
THE LONG TERM PSYCHOLOGICAL EFFECTS OF DAILY SEDATIVE INTERRUPTION IN CRITICALLY ILL PATIENTS John P. Kress, MD, Brian Gehlbach, MD, Maureen Lacy, PhD, Neil Pliskin, PhD, Anne S. Pohlman, RN, MSN, and
More informationAcute Stabilization In A Trauma Program: A Pilot Study. Colin A. Ross, MD. Sean Burns, MA, LLP
In Press, Psychological Trauma Acute Stabilization In A Trauma Program: A Pilot Study Colin A. Ross, MD Sean Burns, MA, LLP Address correspondence to: Colin A. Ross, MD, 1701 Gateway, Suite 349, Richardson,
More informationinterpretation Beck anxiety inventory score interpretation
Beck anxiety inventory score interpretation The Borg System is 100 % Beck anxiety inventory score interpretation Test-retest reliability (1 week) for the BAI = 0.75 (Beck, Epstein, Brown, & Steer, 1988)
More informationThe Wellbeing Course. Resource: Mental Skills. The Wellbeing Course was written by Professor Nick Titov and Dr Blake Dear
The Wellbeing Course Resource: Mental Skills The Wellbeing Course was written by Professor Nick Titov and Dr Blake Dear About Mental Skills This resource introduces three mental skills which people find
More informationSection 4 - Dealing with Anxious Thinking
Section 4 - Dealing with Anxious Thinking How do we challenge our unhelpful thoughts? Anxiety may decrease if we closely examine how realistic and true our unhelpful/negative thoughts are. We may find
More informationAn International Study of the Reliability and Validity of Leadership/Impact (L/I)
An International Study of the Reliability and Validity of Leadership/Impact (L/I) Janet L. Szumal, Ph.D. Human Synergistics/Center for Applied Research, Inc. Contents Introduction...3 Overview of L/I...5
More informationBergen County Response to the Tragic Events at the Paramus Mall
Traumatic Loss Coalitions for Youth Behavioral Research and Training Institute 151 Centennial Avenue Piscataway, New Jersey 08854 732-235-2800 Bergen County Response to the Tragic Events at the Paramus
More informationTHE MEASUREMENT OF PESSIMISM: THE HOPELESSNESS SCALE 1
Journal ol Consulting and Clinical Psychology 1974, Vol. 42, No. 6, 861-865 THE MEASUREMENT OF PESSIMISM: THE HOPELESSNESS SCALE 1 DAVID LESTER Philadelphia General Hospital AARON T. BECK 2 AND ARLENE
More informationChapter 3. Psychometric Properties
Chapter 3 Psychometric Properties Reliability The reliability of an assessment tool like the DECA-C is defined as, the consistency of scores obtained by the same person when reexamined with the same test
More informationTESTING AND MEASUREMENT. MERVE DENİZCİ NAZLIGÜL, M.S. Çankaya University
TESTING AND MEASUREMENT MERVE DENİZCİ NAZLIGÜL, M.S. Çankaya University RELIABILITY ANALYSIS Reliability can take on values of 0 to 1.0, inclusive. There are various ways of testing reliability: 1. test-retest
More informationDepressive Disorder in Children and Adolescents: Dysthymic Disorder and the Use of Self-Rating Scales in Assessment
Depressive Disorder in Children and Adolescents: Dysthymic Disorder and the Use of Self-Rating Scales in Assessment Stuart Fine, MB, FRCP (C), Marlene Moretti, MA, Glenn Haley, MA, Simon Fraser University.
More informationEmotional Changes After a Traumatic Brain Injury
Emotional Changes After a Traumatic Brain Injury EMOTIONAL LABILITY Emotional lability can be caused by damage to the parts of the brain that control emotion. Some people with Traumatic Brain Injury or
More informationCoping with Advanced Stage Heart Failure and LVAD/Transplant. Kristin Kuntz, Ph.D. Department of Psychiatry and Behavioral Health
Coping with Advanced Stage Heart Failure and LVAD/Transplant Kristin Kuntz, Ph.D. Department of Psychiatry and Behavioral Health What is Health Psychology? Health psychology focuses on how biology, psychology,
More informationEstimates of the Reliability and Criterion Validity of the Adolescent SASSI-A2
Estimates of the Reliability and Criterion Validity of the Adolescent SASSI-A 01 Camelot Lane Springville, IN 4746 800-76-056 www.sassi.com In 013, the SASSI Profile Sheets were updated to reflect changes
More informationBest Practices for Anxious Children and Teens. Christina Kirsch, MS Sharon Shorak, LSW
Best Practices for Anxious Children and Teens Christina Kirsch, MS Sharon Shorak, LSW The Anxious Child What we see Behavioral changes Emotional dysregulation Changes in academic performance Peer and social
More informationDR. GATCHEL HAS NO CONFLICTS OF INTEREST TO DISCLOSE. Gatchel
Robert J. Gatchel, Ph.D., ABPP Nancy P. and John G. Penson Endowed Professor of Clinical Health Psychology Distinguished Professor of Psychology, College of Science Director, Center of Excellence for the
More informationCorrespondence of Pediatric Inpatient Behavior Scale (PIBS) Scores with DSM Diagnosis and Problem Severity Ratings in a Referred Pediatric Sample
1 1999 Florida Conference on Child Health Psychology Gainesville, FL Correspondence of Pediatric Inpatient Behavior Scale (PIBS) Scores with DSM Diagnosis and Problem Severity Ratings in a Referred Pediatric
More informationBook review. Conners Adult ADHD Rating Scales (CAARS). By C.K. Conners, D. Erhardt, M.A. Sparrow. New York: Multihealth Systems, Inc.
Archives of Clinical Neuropsychology 18 (2003) 431 437 Book review Conners Adult ADHD Rating Scales (CAARS). By C.K. Conners, D. Erhardt, M.A. Sparrow. New York: Multihealth Systems, Inc., 1999 1. Test
More informationRunning Head: COGNITIVE VULNERABILITY AND ATTACHMENT. Cognitive Vulnerability and Attachment. Nathan L. Williams University of Arkansas
Running Head: COGNITIVE VULNERABILITY AND ATTACHMENT Cognitive Vulnerability and Attachment Nathan L. Williams University of Arkansas & John H. Riskind George Mason University Williams, N. L. & Riskind,
More informationBehavioural and Cognitive Psychotherapy, 1998, 26, Cambridge University Press. Printed in the United Kingdom
Behavioural and Cognitive Psychotherapy, 1998, 26, 87 91 Cambridge University Press. Printed in the United Kingdom Brief Clinical Reports TRAIT ANXIETY AS A PREDICTOR OF BEHAVIOUR THERAPY OUTCOME IN SPIDER
More informationThe Wellness Assessment: Global Distress and Indicators of Clinical Severity May 2010
The Wellness Assessment: Global Distress and Indicators of Clinical Severity May 2010 Background Research has shown that the integration of outcomes measurement into clinical practice is associated with
More informationUniversity Staff Counselling Service
University Staff Counselling Service Anxiety and Panic What is anxiety? Anxiety is a normal emotional and physiological response to feeling threatened, ranging from mild uneasiness and worry to severe
More informationCareer Counseling and Services: A Cognitive Information Processing Approach
Career Counseling and Services: A Cognitive Information Processing Approach James P. Sampson, Jr., Robert C. Reardon, Gary W. Peterson, and Janet G. Lenz Florida State University Copyright 2003 by James
More informationNCFE Level 2 Certificate in Awareness of Mental Health Problems SAMPLE. Part A
NCFE Level 2 Certificate in Awareness of Mental Health Problems Part A Certificate in Awareness of Mental Health Problems Welcome to this Level 2 Certificate in Awareness of Mental Health Problems. We
More informationWorkbook 3 Being assertive Dr. Chris Williams
Workbook 3 Being assertive Dr. Chris Williams From: Overcoming Depression: A Five Areas Approach. Chris Williams, Arnold Publishers (2002) 2 Section 1: Introduction. In this workbook you will: Find out
More informationWelcome to NHS Highland Pain Management Service
Welcome to NHS Highland Pain Management Service Information from this questionnaire helps us to understand your pain problem better. It is important that you read each question carefully and answer as
More informationPsychodynamic Therapy 101 An interview with Dr. Jonathan Shedler Post published by Jonathan Shedler PhD on Nov 22, 2013 i
Psychodynamic Therapy 101 An interview with Dr. Jonathan Shedler Post published by Jonathan Shedler PhD on Nov 22, 2013 i In this interview with Dr. Daniel Carlat (DC) for The Carlat Psychiatry Report
More informationSuicide.. Bad Boy Turned Good
Suicide.. Bad Boy Turned Good Ross B Over the last number of years we have had a few of the youth who joined our programme talk about suicide. So why with all the services we have in place is suicide still
More informationDepression. Most of the time, people manage to deal with these feelings and get past them with a little time and care.
Page 1 of 5 TeensHealth.org A safe, private place to get doctor-approved information on health, emotions, and life. Depression Lately Lindsay hasn't felt like herself. Her friends have noticed it. Kia
More informationA scale to measure locus of control of behaviour
British Journal of Medical Psychology (1984), 57, 173-180 01984 The British Psychological Society Printed in Great Britain 173 A scale to measure locus of control of behaviour A. R. Craig, J. A. Franklin
More informationEffects of Traumatic Experiences
Effects of Traumatic Experiences A National Center for PTSD Fact Sheet By Eve B. Carlson, Ph.D. and Josef Ruzek, Ph.D When people find themselves suddenly in danger, sometimes they are overcome with feelings
More informationOverview of cognitive work in CBT
Overview of cognitive work in CBT Underlying assumptions: Cognitive Behavioral Therapy How an individual interprets life events plays a role in determining how he or she responds to those events (Beck,
More informationFunctional Assessment of Depression and Anxiety Disorders Relevant to Work Requirements
Functional Assessment of Depression and Anxiety Disorders Relevant to Work Requirements Paul S. Appelbaum, MD Dollard Professor of Psychiatry, Medicine & Law Columbia University Overview Depression and
More information#1. What is SAD and how will we resolve it?
SCS Workbook I highly recommend using this workbook and writing everything down as it will deepen your results. The act of writing it down (typing is fine too) makes everything go into your subconscious
More informationApplying Behavioral Theories of Choice to Substance Use in a Sample of Psychiatric Outpatients
Psychology of Addictive Behaviors 1999, Vol. 13, No. 3,207-212 Copyright 1999 by the Educational Publishing Foundation 0893-164X/99/S3.00 Applying Behavioral Theories of Choice to Substance Use in a Sample
More informationSudden Gains in Cognitive Therapy of Depression and Depression Relapse/Recurrence
Journal of Consulting and Clinical Psychology Copyright 2007 by the American Psychological Association 2007, Vol. 75, No. 3, 404 408 0022-006X/07/$12.00 DOI: 10.1037/0022-006X.75.3.404 Sudden Gains in
More informationINTERPERSONAL REACTIVITY INDEX (IRI)
INTERPERSONAL REACTIVITY INDEX (IRI) Reference: Davis, M. H. (1980). A multidimensional approach to individual differences in empathy. JSAS Catalog of Selected Documents in Psychology, 10, 85. Description
More informationImportance of Good Measurement
Importance of Good Measurement Technical Adequacy of Assessments: Validity and Reliability Dr. K. A. Korb University of Jos The conclusions in a study are only as good as the data that is collected. The
More informationFIGURE 1-The Cognitive Model. Core belief. I m incompetent. Intermediate belief. If I don t understand something perfectly, then I m dumb
FIGURE 1-The Cognitive Model Core belief I m incompetent Intermediate belief If I don t understand something perfectly, then I m dumb Situation Automatic thoughts Reactions Reading this book This is too
More informationInternal Consistency and Reliability of the Networked Minds Measure of Social Presence
Internal Consistency and Reliability of the Networked Minds Measure of Social Presence Chad Harms Iowa State University Frank Biocca Michigan State University Abstract This study sought to develop and
More informationID: Test Date: 05/14/2018 Name: Sample N. Student Rater Name: Self. Birth Date: 05/18/1999 Age: 18:11 Year in. Enrollment: Full-Time
Behavior Assessment System for Children, Third Edition (BASC -3) BASC-3 Self-Report of Personality - College Interpretive Summary Report Cecil R. Reynolds, PhD, & Randy W. Kamphaus, PhD Child Information
More informationMaking a psychometric. Dr Benjamin Cowan- Lecture 9
Making a psychometric Dr Benjamin Cowan- Lecture 9 What this lecture will cover What is a questionnaire? Development of questionnaires Item development Scale options Scale reliability & validity Factor
More informationINVENTORY OF POSITIVE PSYCHOLOGICAL ATTITUDES (IPPA-32R) Self-Test Version
==RESOURCES FOR RESILIENCE== BUILDING A RESILIENT WORLDVIEW INVENTORY OF POSITIVE PSYCHOLOGICAL ATTITUDES (IPPA-32R) Self-Test Version Jared D. Kass, Ph.D., LMHC, Director Lynn Kass, M.A., M.A.T., LMHC,
More informationPerceived Stress, Life Events, Dysfunctional Attitudes, and Depression in Adolescent Psychiatric Inpatients
Journal of Psychopathology and Behavioral Assessment, Vol. 17, No. 1, 1995 Perceived Stress, Life Events, Dysfunctional Attitudes, and Depression in Adolescent Psychiatric Inpatients Rod A. Martin, 1 Shahe
More informationMastering Emotions. 1. Physiology
Mastering Emotions Emotional mastery is the key to living a life that you direct. The ability to have absolute direct power over what you feel in every single moment no matter what happens around you is
More informationMMPI-2 short form proposal: CAUTION
Archives of Clinical Neuropsychology 18 (2003) 521 527 Abstract MMPI-2 short form proposal: CAUTION Carlton S. Gass, Camille Gonzalez Neuropsychology Division, Psychology Service (116-B), Veterans Affairs
More informationUsing the STIC to Measure Progress in Therapy and Supervision
Using the STIC to Measure Progress in Therapy and Supervision William Pinsof As well as providing a system for the conduct of empirically informed and multisystemic psychotherapy, the Systemic Therapy
More informationA1a. Have you ever had a time in your life when you felt sad, blue, or depressed for two weeks or more in a row?
PhenX Measure: General Psychiatric Assessment (#120100) PhenX Protocol: General Psychiatric Assessment - Adult (#120101) Date of Interview/Examination (MM/DD/YYYY): SECTION A: [Major Depressive Episode]
More informationTable S1. Search terms applied to electronic databases. The African Journal Archive African Journals Online. depression OR distress
Supplemental Digital Content to accompany: [authors]. Reliability and validity of depression assessment among persons with HIV in sub-saharan Africa: systematic review and metaanalysis. J Acquir Immune
More informationA 15-Minute Psychiatric Assessment
A 15-Minute Psychiatric Assessment The following questions have been adapted from several sources (see references) and are intended to screen for the following psychiatric conditions: MDE Alcohol Misuse
More informationLina M. Aldana, Psy.D.
to reduce violence and impulsivity, improve coping strategies, and increase activities of daily living. Assisted other treatment teams in managing difficult or violent patients. Faculty Member for APA-
More informationThese questionnaires are used by psychology services to help us understand how people feel. One questionnaire measures how sad people feel.
ADAPTED PHQ-9 & GAD-7 QUESTIONNAIRES How to fill in these questionnaires: These questionnaires are used by psychology services to help us understand how people feel. One questionnaire measures how sad
More informationSex Differences in Depression in Patients with Multiple Sclerosis
171 Sex Differences in Depression in Patients with Multiple Sclerosis Andrae J. Laws, McNair Scholar, Penn State University Faculty Research Advisor Dr. Peter A. Arnett, Associate Professor of Psychology
More informationTreatment Advice for Dissociative Attacks (non-epileptic attacks) from
Treatment Advice for Dissociative Attacks (non-epileptic attacks) from www.neurosymptoms.org 1 Treatment advice for Dissociative Attacks (Non-epileptic attacks/seizures) This document is reproduced from
More informationSHARED EXPERIENCES. Suggestions for living well with Alzheimer s disease
SHARED EXPERIENCES Suggestions for living well with Alzheimer s disease The Alzheimer Society would like to thank all the people with Alzheimer s disease whose photos and comments appear in this booklet.
More informationTeen depression: Large study finds girls have the highest risk
Teen depression: Large study finds girls have the highest risk June 6, 2017 12:00 AM By Jill Daly / Pittsburgh Post-Gazette Reaching teenagers with depression and offering them help in a crisis is not
More informationThe Panic Attack: syndrome and symbol (A Psychosynthesis approach)
The 2 nd International Conference on Psychophysiology of Panic Attacks 'Diversity of Theories & Treatments - How Far Have We Come?' London, UK, 1-4 October 2004 Organized by PsyEdu.com, University of Westminster
More informationPatterns and Predictors of Subjective Units of Distress in Anxious Youth
Behavioural and Cognitive Psychotherapy, 2010, 38, 497 504 First published online 28 May 2010 doi:10.1017/s1352465810000287 Patterns and Predictors of Subjective Units of Distress in Anxious Youth Courtney
More informationNonjudgmentally and Cognitive Therapy
Nonjudgmentally and Cognitive Therapy See, but don t evaluate. Take a nonjudgmental stance. Just the facts. Focus on the what, not the good or bad, the terrible or wonderful, the should or should not.
More informationthreats, losses, or injustices and the associated feelings of anxiety, depression, or anger.
Can t Quit Thinking About AIDS: Ruminations, Depression & HIV A General Form of Rumination proposed by Trapnell & Campbell (1999) Patti O Kane, NP Yep, board certified Brookdale Hosp. Medical Ctr. Brooklyn,
More informationThe Cognitive Model Adapted from Cognitive Therapy by Judith S. Beck
The Cognitive Model Adapted from Cognitive Therapy by Judith S. Beck Automatic Thoughts The Cognitive Model is based on the idea that our emotions and behaviors are influenced by our perceptions of events.
More informationHow to stop Someone who is ADDICTED ENABLING
stop ENABLING Table of Contents 2 Are You an Enabler? What if the steps you were taking to help a friend or family member through a problem or crisis were actually the very things hurting them most? And,
More informationMichael Norman International &
FOUNDATION SERIES Episode #3 of 4 THE PANIC PARADOX The White Bear Effect Ironically, the very act of trying to suppress a thought makes it much more likely that we ll have it. Trying to suppress a thought
More informationWORD WALL. Write 3-5 sentences using as many words as you can from the list below.
WORD WALL Write 3-5 sentences using as many words as you can from the list below. Suicide Phobia Bipolar Obsessive compulsive disorder(ocd) Anxiety Depression Mood Post traumatic stress disorder (PTSD)
More informationDeployment Stressors, Coping, and. Psychological Well-Being Among Peacekeepers. Luigi Pastò, Ph.D., Don McCreary, Ph.D., Megan Thompson, Ph.D.
Deployment Stressors, Coping, and Psychological Well-Being Among Peacekeepers Luigi Pastò, Ph.D., Don McCreary, Ph.D., Megan Thompson, Ph.D. Defence Research and Development Toronto 1133 Sheppard Avenue
More informationCounseling and Psychotherapy Theory. Week 4. Psychodynamic Approach II : Object Relations/Attachment Theory
Counseling and Psychotherapy Theory Week 4. Psychodynamic Approach II : Object Relations/Attachment Theory Contents 1 Major Concepts and Propositions 1 2 3 4 Relationship Needs Objects and Object Relations
More informationSeek, Test, Treat and Retain for Vulnerable Populations: Data Harmonization Measure
Seek, Test, Treat and Retain for Vulnerable Populations: Measure MENTAL HEALTH Center for Epidemiologic Studies Depression Scale (CES-D) Reference: Radloff, L.S. (1977). The CES-D Scale: a self-report
More informationSection 4 Decision-making
Decision-making : Decision-making Summary Conversations about treatments Participants were asked to describe the conversation that they had with the clinician about treatment at diagnosis. The most common
More informationWarning Signs of Mental Illness in Children/Adolescents. Beth Confer, MA, LPC Director, Community Relations Clarity Child Guidance Center
Warning Signs of Mental Illness in Children/Adolescents Beth Confer, MA, LPC Director, Community Relations Clarity Child Guidance Center Identify At least 5 warning signs of mental illness in children
More informationAssessment in Integrated Care. J. Patrick Mooney, Ph.D.
Assessment in Integrated Care J. Patrick Mooney, Ph.D. Purpose of assessment in integrated care: Assessment provides feedback to promote individual and group learning and change. Physicians Mental health
More informationChapter 3 Self-Esteem and Mental Health
Self-Esteem and Mental Health How frequently do you engage in the following behaviors? SCORING: 1 = never 2 = occasionally 3 = most of the time 4 = all of the time 1. I praise myself when I do a good job.
More informationStep 2 Challenging negative thoughts "Weeding"
Managing Automatic Negative Thoughts (ANTs) Step 1 Identifying negative thoughts "ANTs" Step 2 Challenging negative thoughts "Weeding" Step 3 Planting positive thoughts 'Potting" Step1 Identifying Your
More informationObsessive Compulsive Disorder. David Knight
Obsessive Compulsive Disorder David Knight OCD is a serious anxiety-related condition a person experiences frequent intrusive and unwelcome obsessional thoughts followed by repetitive compulsions, impulses
More informationTeacher stress: A comparison between casual and permanent primary school teachers with a special focus on coping
Teacher stress: A comparison between casual and permanent primary school teachers with a special focus on coping Amanda Palmer, Ken Sinclair and Michael Bailey University of Sydney Paper prepared for presentation
More informationCLASSIFICATION AND TREATMENT PLANS
CLASSIFICATION AND TREATMENT PLANS C H A P T E R 2 EXPERIENCES OF CLIENT AND CLINICIAN PSYCHOLOGICAL DISORDER: EXPERIENCES OF CLIENT AND CLINICIAN Psychologist: Healthcare professional offering psychological
More informationPsychological wellbeing in heart failure
Patient information Struggling to cope? Can trelax? Psychological wellbeing in heart failure Stressedout? Trouble sleeping? Feelinglow? i Living with heart failure can be challenging mentally as well as
More informationPrinciples of Treatment
Principles of Treatment John R. Cook, Ph.D. Registered Psychologist The good news for people with social phobia who are able to seek help for their problem is that there are a myriad of treatment options
More informationSUPPORTING COLLABORATIVE CARE THROUGH MENTAL HEALTH GROUPS IN PRIMARY CARE Hamilton Family Health Team
SUPPORTING COLLABORATIVE CARE THROUGH MENTAL HEALTH GROUPS IN PRIMARY CARE Hamilton Family Health Team Jackie Bootsma, MSW, RSW Marian Schorr, MSW, RSW About Family Health Teams Family Health Teams are
More informationThe Youth Experience Survey 2.0: Instrument Revisions and Validity Testing* David M. Hansen 1 University of Illinois, Urbana-Champaign
The Youth Experience Survey 2.0: Instrument Revisions and Validity Testing* David M. Hansen 1 University of Illinois, Urbana-Champaign Reed Larson 2 University of Illinois, Urbana-Champaign February 28,
More information