Summary for interim exam 1 of Mood, Anxiety & Psychotic Disorders
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Module
Mood, Anxiety & Psychotic Disorders (7202BK02XY)
Institution
Universiteit Van Amsterdam (UvA)
This is a long, extensive summary of the reading material and lectures for interim exam 1 of the course Mood, Anxiety & Psychotic Disorders at the Universiteit van Amsterdam. It includes summaries of all the reading materials for interim exam 1 in the academic year 2023/2024, and includes notes and...
Power & Dalgleish (2015) Ch. 4: Cognitive
theories of emotional disorder
Introduction
Models of emotional disorder usually focus on a single disorder, such as anxiety. However, emotions
are still connected as shown by the models mentioned earlier.
Some models on emotional disorder still cross into other disorders (e.g. Beck’s model also
being used for schizophrenia, anxiety, personality disorders);
Cross-fertilization of clinical and cognitive psychology may also lead to more general theories
on emotional disorders.
Sometimes different psychological approaches integrate to form a more complex model (e.g.
psychodynamic + cognitive). However, theories on emotional disorders do not always have the
capacity to account for normal emotions.
Seligman’s learned helplessness theory
Seligman dog experiment:
Dogs were put in a box that they could not escape from;
The dogs experienced multiple shocks;
On subsequent trials escape was made possible, but the dogs did not try to escape.
Learned helplessness = People may start viewing certain reinforcing events as uncontrollable
and react passively and helplessly even though they may have control over them.
o Was initially badly replicated and did not account for some parts of depression, such
as low self-esteem.
Non-contingent positive reinforcement as may occur from parents and subsequent removal of this
was also proposed as an explanatory mechanism but it has also been disputed.
The reformulated learned helplessness theory added Weiner’s attribution theory to Seligman’s
original idea. Thus, both the type of event and the importance of the experienced event were added
into the model.
Locus: internal or external attribution;
Stable – unstable: likelihood of recurrence for similar events was added;
Global – specific: whether a lot of areas of a person’s life or very few would affected was
added.
Negative attributions that are internal, stable, and global serve as a vulnerability factor, as
well as positive attributions that are external, unstable, and specific.
Low self-esteem may result from the internal attribution of a negative event.
Research shows that people prone to depression may not have a pre-existing negative
attributional style.
,Problems with this theory:
People may possess dual attributions: explicit attributions made visible by questionnaires but
also implicit attributions that should be measured indirectly.
There has been little evidence for the idea on how positive events are evaluated.
The theory seems to ignore the consequences of events which may affect secondary
appraisal (see the Lazarus model) and be either evaluated as fine or overwhelming.
There are questionable correlations between the attributions one makes and the emotions
one experiences.
Alternative second reformulation is hopelessness
theory which was placed within Beck’s cognitive
therapy framework.
Key differences:
o Requires only the occurrence of
negative events, not uncontrollable
ones;
o Main outcome of negative events is
hopelessness, not helplessness;
o Low self-esteem comes from
internal-stable-global attribution;
o Combining stability and globality leads to generality and chronicity of depressive
effects.
,Beck’s cognitive therapy
Beck et al. first developed cognitive therapy to treat only depression, today it is also used for many
other syndromes. His initial idea was that cognition caused emotions, however today he sees
cognition as one element of a biopsychosocial interactive model causing disorders in the end.
In Beck’s model of depression, the main components are:
Cognitive structures underlying the disordered state;
o Knowledge representation through schemas, which are different units that allow for
the organization of cognition. Schemas are not passive and activation of one part of a
schema can lead to the activation of the whole schema.
Beck proposed the cognitive triad (negative views of the self, world, and
future) as the dysfunctional schema present in depression, but these are still
all related to the self so not all of it is required for the presence of
depression.
Possible explanations of regular periods between disordered states in the
schema framework:
1) Dysfunctional schemas are inactive and are only activated if the
matching stressors are present;
2) The individual may be able to inhibit some of the negative
outcomes of dysfunctional schemas;
3) Dysfunctionality may not be global and some specific
dysfunctional schemas may remain active;
4) Traditional schema theory may be too simplistic and have to be
adjusted to account for regular states – hybrid representation of
cognition and emotion in schematic models might be more accurate.
o Another idea is distinction between sociotropic (people whose dysfunctional beliefs
are based on dependency on others) and autonomous (socially distanced, highly
goal-oriented people) individuals, with mixed evidence for this distinction.
Cognitive processes that initiate and maintain this state.
o The results of the dysfunctional schemas is that the person starts having negative
automatic thoughts and believing them. The distorted ways of thinking include:
Magnification of negative materials in relation to the self;
Minimization of positive materials in relation to the self;
Personalization of anything negative (taking the blame).
o Assumes both that normal thinking is logical and rational, and that the depressed
self-concept is monolithic and negative.
o Instead of illogical thinking, it may be better to distinguish between positively-biased
and negatively-biased thinking processes.
, Depressive realism may involve depressed individuals seeming more realistic
because of more readiness to accept negative conclusions as they are similar
to the current model of the self.
Additionally, some positive schemas may still be active in the active phase of
depression and thus, depressed individuals may be more ambivalent in their
views on themselves.
Clark’s adaptation of cognitive therapy for panic
Clark adapted Beck’s model to panic disorder.
Key theme in both Beck’s and Clark’s approaches: the individual is considered to be prone to the
detection of threat or danger in both the external and internal environment.
In panic disorder, the focus is primarily on bodily sensations. The individual interprets normal anxiety
symptoms (e.g. breathlessness, increased heartbeat, dizziness) in a catastrophic way (e.g. heartbeat
is sign of heart attack, dizziness of stroke).
Maintains high level of distress.
Individual becomes hypervigilant for particular bodily sensations.
Individual starts avoiding situations or activities that produce similar sensations.
Cognitive therapy must focus on not only truth value of propositions (e.g. disputing “I am a failure”),
but also on higher-order meanings of such a process (e.g. feelings of worthlessness/inferiority).
Strength of Clark’s approach is that it takes the individual’s model of the problem as the starting
point, and then offers a new model for the understanding of panic and anxiety.
The questions of whether catastrophic misinterpretations are automatic or not and why one person
interprets something as catastrophic or not are still not answered.
Williams, Watts, MacLeod and Mathews
Williams et al. proposed specific cognitive biases present in specific emotional disorders.
Use the distinction between priming (automatic, stimulus linked to long-term memory
representation – not always automatic however) and elaboration (strategic process).
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