Advances in Cognitive–Behavioral Research and Therapy. Volume 5

285 Pages·1986·3.688 MB·English

by  Philip C. Kendall (Eds.)

Advances in
Cognitive - Behavioral
Research and Therapy
Volume 5
Edited by
PHILIP C. KENDALL
Department of Psychology
Temple University
Philadelphia, Pennsylvania
1986
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Preface
Cognitive-behavioral approaches to assessment and intervention
with adults and children have received widespread acceptance. In ad-
dition to this expanding acceptance, there continue to be increases in
the quality and quantity of research and applications pertinent to the
integration of such topics as cognition and behavior, affect, social sys-
tems, and development. The size of the field requires an outlet for
authoritative reviews, critical commentaries, and theoretical trea-
tises, as well as more speculative analysis.
Advances in Cognitive - Behavioral Research and Therapy is broadly
conceived to include a diversity of topics. For example, systematic ex-
ploration of assessment issues, theoretical analyses, treatment strategies
for distinct clinical disorders, basic studies in psychology and psycho-
pathology, and advanced research methodologies are a few of the topics
appropriate for inclusion. Drawing on the developments in the study of
cognition, behavior therapy, development, learning, personality, and
social interaction, and occasionally including dialogues on pertinent
issues, this serial publication draws together the advances in diverse
areas related to cognitive-behavioral research and application. All
contributions are prepared with the academic researcher and practicing
clinician in mind. Advances in Cognitive -Behavioral Research and
Therapy, a serial publication, is not intended to be only a collection of
literature reviews, nor is it designed to serve solely as a display of treat-
ment successes. Rather, each volume contains a collection of articles
that deal with a sample of the numerous content areas that are of inter-
est to researchers and clinicians struggling with the interplay of cogni-
tion and behavior. There is not a single theme or mold to each volume.
Rather, each contribution stands by itself. Most important, perhaps,
contributors are encouraged to develop their thinking and present these
advances in their contributions.
The contributions of research and applied psychologists contained in
Volume 5 include assessment, treatment, and theoretical papers.
ix
χ Preface
Schwartz and Garamoni provide an integrative and stimulating analysis
and review of the internal dialogue. In addition, they offer a model for
the understanding of the balance between positive and negative think-
ing and adjustment. In the next chapters, by Smith-Allred and Marzil-
lier, respectively, two of the seminal approaches within cognitive -
behavioral therapy are examined. Ellis' rational emotive model is
considered by Smith and Allred, with a special focus on empirical evalu-
ations and the methods for assessment of rationality. With a greater
focus on treatment, Marzillier addresses Beck's cognitive-behavioral
methods for depression that are receiving wide application and evalua-
tion. In each chapter, the author(s) provide(s) a current consideration of
the seminal contributions. The topic of depression is also addressed by
Kuiper and Olinger as they examine the notion of self-schema, the
interactive role of dysfunctional cognitions and negative life events, and
the self-worth contingency model for understanding the development
of depressive disorders. Safran and Greenberg then provide an informa-
tive analysis of psychotherapy from both a cognitive and affective view-
point. Models of information processing are examined as they relate to
the process of change, and the roles of emotions within this change
process are considered. The role of causal attributions, their antecedent
and consequents, their role in health and illness behaviors, and related
implications for research and treatment are then provided in a theoreti-
cally rich and detailed review by Michela and Wood. In the final chap-
ter, by Azar and Twentyman, the important topic of child abuse is
examined from a cognitive-behavioral perspective. Issues of maltreat-
ment and stress and procedures for assessment and treatment are con-
sidered. The negative effects of inordinate expectations is highlighted.
I am grateful to each of the authors for being a part of this venture and
to the staff of Academic Press for their expertise and support. I also wish
to recognize the competent aid of the staff of my home institution,
Temple University, especially Elaine Gatsoulas, and the highly valued
support of my wife, Sue.
Philip C. Kendall
A Structural Model of Positive and
Negative States of Mind: Asymmetry
in the Internal Dialogue
ROBERT M. SCHWARTZ
Department of Behavioral Science and
Western Psychiatric institute and CJinic
University of Pittsburgh
Pittsburgh, Pennsylvania 15261
GREGORY L. GARAMONI
Department of Psychology
University of Pittsburgh
Pittsburgh, Pennsylvania 15260
I. Introduction 2
II. Conceptions of Polarity 4
A. From Yang and Yin to the Semantic Differential. . . 5
B. Polarity in the Internal Dialogue 6
C. Conceptual and Definitional Issues 7
D. Bidimensional Assessment 10
III. The Golden Section Hypothesis 11
A. The Golden Section 11
B. Theoretical Explanations 13
IV. States of Mind Model 15
A. Self-Statements and the Internal Dialogue 15
B. Overview of States of Mind Model 16
C. States of Mind Defined 21
V. Empirical Evaluation of the Model 30
A. Set Points and Ranges 40
B. Validity Issues 43
VI. Directions for Clinical Research and Practice 45
A. Implications for Assessment 45
B. Research and Clinical Issues 47
VII. Conclusion 54
References 55
1
ADVANCES IN COGNITIVE-BEHAVIORAL RESEARCH Copyright ©1986 by Academic Press. Inc.
AND THERAPY, VOLUME 5 All rights of reproduction in any form reserved.
2 Robert M. Schwartz and Gregory L. Garamoni
The equal part may be described as a mean between too much and too little. By the
mean of the thing I understand a point equidistant from the extremes. . . . The man
who knows his business avoids both too much and too little. It is the mean he seeks
and adopts. (Aristotle)
Life is asymmetric. (Guidano & Liotti, 1983)
I. INTRODUCTION
Philosophers, artists, and scientists throughout history have adopted
the ancient Greek idea of symmetry to "comprehend and create order,
beauty, and perfection" (Weyl, 1952, p. 5). In contrast to this veneration
of symmetry, asymmetry was typically viewed as secondary and even
disturbing: A striking example is the perturbing asymmetry or irrever-
sibility of time ("time's arrow") that underlies the inexorable move-
ment of the universe toward entropy (Bochner, 1973). Yet modern scien-
tific research has revealed benign and intriguing asymmetries in
cerebral hemispheric specialization (Kinsbourne, 1978), facial expres-
sion (Rinn, 1984), and neurochemical function (Tucker & Williamson,
1984). It is therefore less surprising that functional asymmetries have
been discovered in recent cognitive-behavioral research (Kendall &
Hollon, 1981; Safran, 1982; Schwartz, 1986; Schwartz & Gottman, 1976).
Studies that include a bidimensional assessment of cognition consist-
ently reveal an asymmetry between positive and negative thoughts,
whereby the negative dimension has greater functional impact than the
positive on psychological adjustment, coping, and the process of thera-
peutic change. For example, Schwartz and Gottman (1976) found that
although functionally positive and negative self-statements both related
to assertiveness, the effect was stronger for the negative dimension. In a
study of coping with medical stress, Kendall, Williams, Pechacek, Gra-
ham, Shisslak, and Herzoff (1979) reported that only negative cognitions
differentiated the effective from the ineffective coper. Finally, several
psychotherapy outcome studies indicated that successful treatment re-
sulted in a decrease in negative thoughts without a corresponding in-
crease in positive thoughts (Derry & Stone, 1979; Mavissakalian, Mi-
chelson, Greenwald, Kornblith, & Greenwald, 1983). The discovery of
this functional asymmetry in cognition led Kendall (Kendall, 1982; Ken-
dall & Hollon, 1981) to aptly observe that the "power of nonnegative
thinking" may be more accurate than the familiar, popularized phrase.
Although this asymmetrical pattern is new to cognitive-behavioral
researchers, a related phenomenon called the negativity bias has been
investigated by social psychologists. Considerable evidence supports
the facts that negative information carries more weight than positive in
States of Mind Model 3
impression formation and evaluation of others (Kanouse & Hanson,
1972), that the response to losses is more extreme than the response to
gains (Tversky & Kahneman, 1981), and that negative life events have
greater impact than positive ones (Zautra & Reich, 1983). Thus, the
asymmetry between positive and negative thoughts appears to be a
fundamental and pervasive aspect of human information processing.
How is this phenomenon, which can be called the negative striking-
ness asymmetry, to be understood? Ironically, it may be the result of a
complementary positivity bias that characterizes human cognition (cf.
Kanouse & Hanson, 1972). Many aspects of information processing are
permeated by a tendency for humans to view things positively. This
positivity bias or "Pollyanna principle" has been documented by over
1000 studies covering areas such as language, expectations, memory,
self-perception, evaluation of others, and thinking (Matlin & Stang,
1978). As Kanouse and Hanson explain, the "negativity biases occur
against a backdrop of perceived bliss — indeed because of it" (p. 56).
Since people view themselves and the world as generally positive, the
less frequent negative cognitions and events have greater information
value and are therefore weighted more heavily: Against a positive back-
ground, negative cognitions become more striking figures.
The negative strikingness asymmetry focuses exclusively on the sa-
lience of the negative dimension, whereas the Pollyanna principle deals
only with the complementary positive dimension. A more dialectical
formulation that integrates both the positive and negative dimensions
would represent an important conceptual advance. Fortunately, an ele-
gant and quantitatively precise theory and line of experimental re-
search exists that focuses on the balance or harmony between positive
and negative thoughts. This formulation, known as the golden section
hypothesis, holds that "while we construe most events positively, we
attempt to create a harmony between positive and negative events such
that the latter make a maximal contribution to the whole" (Benjafield &
Adams-Webber, 1976, p. 14). This hypothesis — derived from ancient
mathematical calculations traced to Pythagoras and supported by con-
temporary information-processing theory — holds that there is an opti-
mal balance of positive and negative cognitions that can be quantified
and is presumed to relate to effective psychological functioning. As is
evident, this formulation incorporates the fact that people tend to view
things positively (Pollyanna principle) as well as the consistent finding
that the negative dimension has a greater impact or makes a maximal
contribution to the whole (negative strikingness asymmetry). Beyond
that, the golden section hypothesis maintains that this relationship
holds only when a specific and optimal harmony between positive and
negative cognitions is achieved.
4 Robert M. Schwartz and Gregory L. Garamoni
Incorporating the golden section hypothesis, we have developed a
structural model of positive and negative states of mind (Garamoni &
Schwartz, 1986; Schwartz & Garamoni, 1984, 1986a) that draws upon
principles of information processing, cybernetic self-regulation, and in-
trapersonal communication (Garner, 1962, 1974; Carver & Scheier,
1981,1983; Meichenbaum, 1977). Specifically, the model proposes that
functionally optimal states of mind consist of a precise balance of posi-
tive and negative cognitions and/or affects, closely approximating the
golden section proportion. Such asymmetrically balanced cognitive/af-
fective structures proportioned according to the golden section render
negative events and cognitions maximally striking and are therefore
optimally suited for coping with stress (Adams-Webber, 1982; Berlyne,
1971; Rigdon & Epting, 1982; Shalit, 1980). Consequently, any substan-
tial and lasting deviations (in either direction) from the golden section
represent distinct states of mind that are hypothesized to be associated
with various forms of psychopathology. In agreement with Aristotle, the
person who knows his business does avoid both too much and too little.
According to the present model, he accomplishes this by adopting not
the point equidistant between the extremes, but rather the asymmetri-
cal "golden mean."
In sum, the purpose of this article is to (1) demonstrate the heuristic
value of conceptualizing the "internal dialogue" as a dialectical process
based on the fundamental polarity of positive and negative cognitions
(Section II); (2) review the golden section hypothesis and its associated
information-processing properties (Section III); (3) present a rationally
derived and empirically grounded model of states of mind that draws
upon the concept of positive-negative polarity, the golden section hy-
pothesis, information-processing principles, intrapersonal communica-
tion concepts, and cybernetic theory (Section IV); (4) evaluate the
extent to which the model fits existing data (Section V); and (5) explore a
number of related research and clinical issues (Section VI).
II. CONCEPTIONS OF POLARITY
Cognitive - behavioral researchers have only recently begun to inves-
tigate polarity in the internal dialogue by assessing the positive-
negative dimension of thought. Yet the idea of polarity — a structured
balance or organization of two opposing attributes, clashing tendencies,
or contradictory principles — is as old as human thinking about think-
ing and feeling itself (Meerlo, 1954). Contemporary conceptions of polar-
ity have a rich intellectual heritage, originating in diverse ancient cul-
tures and influencing subsequent developments in philosophy, art, and
science, including psychology.
States of Mind Model 5
A. From Yang and Yin to the Semantic Differential
Eastern and Western cultures have, since their earliest origins, em-
braced the idea of polarity to comprehend the universe in general and
human nature in particular. The ancient Chinese understood harmony
or discord in their world in terms of balance or imbalance in life's
opposing forces, Yang and Yin. The ancient Greeks, particularly the
Pythagoreans, similarly held that the universe was designed according
to specific harmonious proportions. Such philosophical conceptions of
polarity have had a ubiquitous influence on the history of ideas, reach-
ing a zenith during the nineteenth century in the formulations of dia-
lectical idealism and materialism.
In science, the idea of polarity has yielded theoretical and empirical
advances in various disciplines, including mathematics (positive and
negative numbers), physics (positive and negative poles), chemistry
(positive and negative ions), and biology (positive and negative neuro-
transmission). In medicine specifically, the notion of health as a proper
balance of opposites influenced Galen, who formulated the classic
theory of body humors, which was based on the blending of four basic
qualities (hot, cold, dry, moist) in binary combinations. Manifestations
of this view remained dominant until the seventeenth century (Temkin,
1973). In general, health was viewed as balance, harmony, or symmetry
and disease as their disturbance. These ideas presaged contemporary
concepts of homeostasis (Cannon, 1932) and "eustress" (Selye, 1974),
both of which imply that some optimal balance — typically unspecified
— is a necessary condition for physical health.
Psychologists have also conceptualized mental health and other basic
psychological phenomena in terms of a polarity of opposites. Wil-
liam James (1890/1950) — anticipating current cognitive-behavioral
theories — held that human action could be understood as a joint func-
tion of "favorable" and "antagonistic" ideas struggling for dominance
within the mind. Psychodynamic theorists conceptualized normal and
pathological behavior in terms of an interaction and balance between
conflicting polarities (Bleuler, 1914; Erikson, 1950/1963; Freud,
1920/1955; Jung, 1964; Lewin, 1935; see also Werner, 1957). Biological
psychologists have conducted research on the pathophysiology of var-
ious disorders based on presumed functional imbalances in the polari-
ties of neurotransmission (e.g., Klein, 1974).
Basic psychological research closely tied to cognitive-behavioral
theory has successfully employed the positive - negative dimension as
well. Experimental studies on approach-avoidance operationalized
conflicting polarities at the behavioral level (Miller, 1944). Principles of
positive and negative reinforcement have generated an unprecedented
6 Robert M. Schwartz and Gregory L. Garamoni
volume of research on operant learning (Skinner, 1953; Honig, 1966).
Cognitive theories of emotion (Arnold, 1960; Lazarus, 1966) advanced
the hypothesis that positive and negative appraisals are causally related
to affect. And lastly, in psycholinguistics, the positive-negative dimen-
sion has been found to explain up to 75% of the variance in semantic
differential studies (Osgood, Suci, & Tannenbaum, 1957).
Β. Polarity in the Internal Dialogue
Given this rich heritage, it follows that the concept of polarity should
play an important role in advancing our understanding of the pathologi-
cal and therapeutic implications of the internal dialogue. In fact,
cognitive-behavioral theorists have employed a wide array of con-
structs of polarity to conceptualize cognitive factors in anxiety, stress,
and depression (Abramson, Seligman, & Teasdale, 1978; Beck, 1976;
Ellis, 1962; Kelly, 1955; Meichenbaum, 1977).
These constructs of positive and negative thinking have inspired re-
cent advances in assessment and a growing body of research (Kendall &
Hollon, 1979; Merluzzi, Glass, & Genest, 1981). Measures of "positive
and negative self-statements" have been employed in studies of unas-
sertiveness (e.g., Schwartz & Gottman, 1976), social anxiety (e.g., Glass,
Merluzzi, Biever, & Larson, 1982), and coping with an invasive medical
procedure (Kendall et αϊ., 1979). In a study of test anxiety, Hollands-
worth, Glazeski, Kirkland, Jones, and Van Norman (1979) assessed "on-
task" and "off-task" self-statements and "positive and negative self-
evaluations." In a psychotherapy outcome study, Mavissakalian et αϊ.
(1983) assessed agoraphobics' pre- and posttreatment "coping thoughts"
and "fearful thoughts" during the course of treatment. Stress re-
searchers have investigated the role of "positive and negative ap-
praisals" in mediating affective-physiological responses to stressors
(Lazarus, 1966) and the effects of "desirable" and "undesirable" life
events (Johnson & Sarason, 1979; Kanner, Coyne, Schaefer, & Lazarus,
1981). Depression research has also measured positive and negative
dimensions of self-verbalization (Missel & Sommer, 1983), attributional
style (Abramson et ah, 1978), memory (Clark & Teasdale, 1982), self-re-
inforcement (Rehm, 1977), and self-schema (Derry & Kuiper, 1981).
The empirical yield from these and other studies demonstrates the
heuristic value of conceptualizing polarity as a fundamental, clinically
relevant aspect of the internal dialogue. Recognizing the fertility of this
construct, Kendall and Hollon (1981) recommended that "the assess-
ment of self-statements should always attempt to include an examina-
tion of the valence dimension by providing both positive and negative
items on measures using the endorsement method or coding the re-