Clinical Psychology Lecture 8: Cognitive Models

Lecture 8: Basic Theoretical Models of Human Functioning in Clinical Psychology (Part III)

• Lecture covers cognitive and cognitive-behavioral models in clinical psychology.
• Cognitive models are based on the information processing viewpoint.
• Cognition involves mental processes like perceiving, recognizing, judging, and reasoning.
• Schemas are sets of underlying assumptions, beliefs, attributions, and expectancies, rooted in experience.
• Irrational and maladaptive assumptions and thoughts are core to some psychological disturbances.
• Beck's cognitive therapy targets distortions of thought processes, particularly in depression.
• Ellis's Rational Emotive Therapy emphasizes irrational beliefs as contributors to psychological distress.
• Modern cognitive behavior therapy (CBT) is more generalized than earlier models.

Ellis's Irrational Beliefs

• Ellis proposed that thoughts can be rational or irrational.
• Rational thoughts lead to rational actions and positive feelings.
• Irrational thoughts can lead to negative or disturbed thinking patterns.
• These patterns can lead to mental disorders like depression and anxiety.

Cognitive Model - Ellis

• Dysfunctional thought patterns can lead to psychological problems.
• Illogical thinking in response to life situations can cause psychological distress.
• The model outlines the sequence of activating events, beliefs, and resulting consequences.

Automatic Thoughts

• Automatic thoughts occur spontaneously in response to situations.
• These thoughts are often shorthand—in words or images.
• They are not based on reasoning and lack a logical sequence.
• Automatic thoughts can be difficult to articulate and stop.
• Stressful situations often trigger automatic thoughts that lead to negative emotions.

Core Beliefs

• Core beliefs underlie and generate automatic thoughts.
• They influence information processing and shape understanding of oneself, others, and the future.
• Core beliefs remain dormant until activated by stress or negative life events.
• Categories of core beliefs include helplessness, worthlessness, and unlovability.

Examples of Core Beliefs

• Helpless: Inadequate, ineffective, out of control, can't cope.
• Unlovable: Unlikeable, unwanted, rejected, abandoned.
• Worthless: Worthless, unacceptable, bad, crazy, broken.

Beck's Cognitive Distortions

• Patients with psychiatric disorders often display consistent negative thinking errors.
• Includes arbitrary inference, selective abstraction, overgeneralization, magnification/minimization, dichotomous/polarized thinking.
• Beck's cognitive triad (negative views of self, others, and the future) is often observed in depression.
• There is an important connection between sensing risk as dangerously high and emotional experiences.
• Emotional reasoning involves regarding feelings as facts.

Beck's Cognitive Triad

• Three forms of negative thinking typical of people with depression:
  • Negative views about the future.
  • Negative views about themselves.
  • Negative views about the world.

Cognitive Specificity Hypothesis

• Psychological disorders are characterized by different psychological profiles.
• Examples:
  • Depression: negative views of self, others, and future. Core beliefs include helplessness, failure, incompetence, and unlovability.
  • Anxiety: exaggerating physical/psychological threats. Core beliefs reflect risk, dangerousness, uncontrollability.

Cognitive Specificity - Negative Triad

• Negative views associated with depression includes: self (incompetent/unlovable), others (people don't care about me), Future (the future is bleak).
• Negative views associated with anxiety include: self (unable to protect myself), others (people will humiliate me), future (it's a matter of time before I'm embarrassed).

Cognitive Conceptualization

• A model illustrating the interplay between current situations, thoughts, feelings, behaviors, and underlying core beliefs and assumptions.
• The diagram shows a cyclical interplay between current situations and automatic thoughts about oneself, the world, and others, feeding back into physiological responses, feelings, behaviors, and underlying assumptions or core beliefs. Childhood and early life events can impact this structure.
• Helps identify how dysfunctional core beliefs and early life experiences may contribute to a person's current thoughts, emotions, and actions.

Cognitive Behavioral Paradigm

• Subsequent research in behavioral approaches highlighted the role of cognitive processes in learning.
• Cognitive behavior therapists often focus on treatment, rather than etiology of a condition.
• Learned behavior can be both "normal" and "abnormal" and are important facets of the model.

Working Model of CBT

• Illustrates the flow of a triggering event and cognitive processes that lead a person to act in a certain way.
• The model emphasizes appraisal, behavioral inclination, and bodily sensations as links between the event and behavior.

Cognitive Behavioral Therapy (CBT)

• Goal-oriented and problem-focused therapy.
• Initially emphasizes the present.
• Educational approach, teaching the client to be their own therapist.
• Identifies, evaluates, and addresses dysfunctional thoughts and beliefs.
• Uses various techniques to alter thinking, mood, and behavior.

Etiology of Depressive and Bipolar Disorders

• Genetic vulnerability plays a role in mood disorders, evidenced by concordance rates.
• Neurochemicals like norepinephrine and serotonin are potentially involved.
• Neuroanatomy, inflammation, cognitive factors (like learned helplessness, rumination), interpersonal relationships, and precipitating stress all influence the onset and development of mood disorders.

Interpreting Correlation Between Negative Thinking and Depression

• Explains the connection between negative thinking (e.g., attributions) and depression.
• Neurochemical changes are involved as a possible mechanism between cognitive processes and observed mood disorders.

Modern CBT

• Includes specific forms of CBT, such as dialectical behavior therapy (DBT), acceptance and commitment training (ACT), mindfulness-based cognitive therapy (MBCT), metacognitive therapy (MCT), schema therapy, and panic control treatments (PCT).