Cognitive vulnerability to emotional disorders PDF
Preview Cognitive vulnerability to emotional disorders
COGNITIVE VULNERABILITY TO EMOTIONAL DISORDERS This page intentionally left blank COGNITIVE VULNERABILITY TO EMOTIONAL DISORDERS Edited by Lauren B. Alloy Temple University John H. Riskind George Mason University LAWRENCE ERLBAUM ASSOCIATES, PUBLISHERS 2006 Mahwah, New Jersey London Copyright(cid:1)2006byLawrenceErlbaumAssociates,Inc. Allrightsreserved.Nopartofthisbookmaybereproducedin anyform,byphotostat,microform,retrievalsystem,oranyother means,withoutthepriorwrittenpermissionofthepublisher. LawrenceErlbaumAssociates,Inc.,Publishers 10IndustrialAvenue Mahwah,NewJersey07430 www.erlbaum.com CoverdesignbyKathrynHoughtalingLacey Sculpture:“MedusaintheNewAge”byAdrienneL.Romer LibraryofCongressCataloging-in-PublicationData Cognitivevulnerabilitytoemotionaldisorders/editedbyLaurenB.Alloy,JohnH.Riskind. p. cm. Includesbibliographicalreferencesandindex. ISBN0-8058-3828-7(cloth:alk.paper) ISBN0-8058-5774-5(pbk.:alk.paper) 1.Affectivedisorders—Riskfactors. 2.Anxiety—Riskfactors. 3.Eatingdisorders— Riskfactors. 4.Emotionsandcognition. 5.Cognitivestyles. I.Alloy,LaurenB. II.Riskind,JohnH. RC537.C6324 2005 616.85(cid:2)2—dc22 2005047279 CIP BookspublishedbyLawrenceErlbaumAssociatesareprintedonacid-freepaper, andtheirbindingsarechosenforstrengthanddurability. PrintedintheUnitedStatesofAmerica 10 9 8 7 6 5 4 3 2 1 Contents Preface vii 1 Cognitive Vulnerability to Emotional Disorders: TheoryandResearchDesign/Methodology 1 John H. Riskind and Lauren B. Alloy PART I: MOOD DISORDERS 2 The Cognitive Vulnerability to Depression (CVD) Project:CurrentFindingsandFutureDirections 33 Lauren B. Alloy, Lyn Y. Abramson, Scott M. Safford, and Brandon E. Gibb 3 CognitiveVulnerabilitytoDepression 63 Rick E. Ingram, Jeanne Miranda, and Zindel Segal 4 CognitiveVulnerabilitytoBipolarSpectrumDisorders 93 Lauren B. Alloy, Noreen A. Reilly-Harrington, David M. Fresco, and Ellen Flannery-Schroeder 5 CognitiveVulnerabilitytoSuicide 125 Jeremy W. Pettit and Thomas E. Joiner, Jr. v vi CONTENTS 6 CognitiveVulnerabilitytoMoodDisorders:AnIntegration 155 Saskia K. Traill and Ian H. Gotlib PART II: ANXIETY DISORDERS 7 A Unique Vulnerability Common to All Anxiety Disorders:TheLoomingMaladaptiveStyle 175 John H. Riskind and Nathan L. Williams 8 CognitiveVulnerabilitytoPanicDisorder 207 Norman B. Schmidt and Kelly Woolaway-Bickel 9 Cognitive Vulnerability to Obsessive-Compulsive Disorders 235 Stanley J. Rachman, Roselyn Shafran, and John H. Riskind 10 CognitiveVulnerabilitytoSocialAnxietyDisorder 251 Deborah Roth Ledley, David M. Fresco, and Richard G. Heimberg 11 CognitiveVulnerabilitytoPTSD 285 Norah C. Feeny and Edna B. Foa 12 Cognitive Vulnerability to Anxiety Disorders: AnIntegration 303 Adrian Wells and Gerald Matthews PART III: EATING DISORDERS 13 CognitiveVulnerabilitytoBulimia 329 Lyn Y. Abramson, Anna M. Bardone-Cone, Kathleen D. Vohs, Thomas E. Joiner, Jr., and Todd F. Heatherton 14 CognitiveVulnerabilitytoAnorexiaNervosa 365 David M. Garner and Cristina Magana 15 Cognitive Vulnerability to Eating Disorders: AnIntegration 405 Pamela K. Keel AuthorIndex 419 SubjectIndex 443 Preface In modern life, anxiety disorders, together with depressive disorders, rankatthetopofthemostdevastatingformsofmentalillnessinWestern society. These disorders affect as many as 46 million individuals in the United States alone (Kessler et al., 1994). In response, there is a rapidly proliferating literature on these emotional disorders, as well as on the group of closely related eating disorders. Cognitivemodelsofpsychopathologyhavebecomeprominentincon- temporaryattemptstounderstandthecauses,mechanisms,andeffective treatments for psychological problems. In these models, factors such as appraisals,attributions,andcognitivestylesareimportant.Cognitivethe- ories assume that mental processes—such as interpretation, attention, or memory—areintermediaryeventsthatintercedebetweenenvironmental stimuli and emotional responses. Cognitive theories have received in- creasing attention not only in the clinical and psychiatric literatures, but also in the social and personality, experimental, cognitive, and develop- mental ones. If emotional disorders such as anxiety and depression are, indeed, in- fluencedbycognitivefactors,itisimportanttounderstandthewaysthat thesefactorsmaycontributetocognitivevulnerability.Someindividuals are clearly more susceptible than others to developing emotional disor- ders, and to experiencing chronic problems or recurrences. What, then, makes them susceptible? This is, in essence, a question about cognitive vulnerability, and one of the most vibrant research efforts in psycho- vii viii PREFACE pathology is now devoted to exploring it. The literature is rapidly bur- geoning on cognitive vulnerability to not only depression but emotional disorders such as bipolar, panic, OCD, and eating disorders; new devel- opments are constantly being reported. Thus,wefeltthelackof,andneedfor,abookthatwouldpresentand synthesizethelatestknowledgeaboutcognitivefactorsinvulnerabilityto emotional disorders. Mostworkoncognitionaddressesconcurrentcognitionsorbiases(about whichthereisahugeliterature).Workonvulnerabilityisdifferent.Itcon- cernsthecognitiveantecedentsofthese,andthedisordersinwhichtheyare implicated. Understanding cognitive vulnerabilities is important for un- derstanding how disorders develop, how they are maintained, and how they can be prevented and treated. Cognitivevulnerabilitiesarefaultybeliefs,long-previouslydeveloped cognitivepatterns,orstructuresthatarehypothesizedtosetthestagefor later psychological problems. They are in place long before the earliest signsorsymptomsofdisorderfirstappear.Thesevulnerabilitiesaregen- erally purported to create specific liabilities to particular psychological disordersafterindividualsencounterstressfulevents,andtomaintainthe problems after their onset. Only by addressing these vulnerabilities can long-termtherapeuticimprovementsbemaintained,andtheriskofrecur- rences or relapse be reduced. We have structured this book to make it easy for readers to focus on particular interests. They can read about specific disorders (e.g., depres- sionorbipolardisorder,suicide,obsessive-compulsiveorpanicdisorder), read about groups of disorders (e.g., mood disorders or anxiety disor- ders),orreadaboutemotionaldisordersingeneral.Thebookisorganized inwhatwehopeisahighlyaccessiblewaywithinacommonoverarching conceptualframework.Allthechaptersbuildonamodelofcognitivevul- nerabilitythatisdescribedinthefirstchapter.Thismodelexplainsthere- lationships between developmental factors, cognitive vulnerabilities as riskfactorsforlaterdisorder,thenatureofspecificvulnerabilitiesforspe- cificdisorders,andthedifferencebetweendistalantecedentsofdisorders (e.g., depressive inferential styles, dysfunctional attitudes) and proximal cognitivefactors(e.g.,schemaactivation,orinferences).Itsynthesizesthe commonalities evidenced by a number of different cognitive clinical ap- proachestoemotionaldisorders.Thefirstchapteralsoprovidesanover- viewofthemajorissuesbearingondesignandmethods,andhowthese must be guided by theory. Theremainderofthebookisdividedintothreesections,onmooddis- orders,anxietydisorders,andeatingdisorders,respectively.Eachsection contains a series of chapters summarizing the latest formulation of the role of cognitive vulnerabilities in a particular disorder, by a leading ex- PREFACE ix pertwhodescribesemergingtheoryandresearch,andalsoidentifiesar- eas where work remains to be done, since cognitive vulnerability is still less studied than other aspects of cognitive function in emotional disor- der.Eachsectionconcludeswithanintegrativechapter,alsobyaleading expert, which offers incisive commentary, theoretical synthesis, and in- sightful suggestions for further systematic research. Part I concentrates on mood disorders, both depressive and bipolar. Chapters by Alloy, Abramson, Safford, and Gibb, and Ingram, Miranda, andSegal,describemajorrecentfindingsandtheoreticalissuesconcern- ing cognitive vulnerability to depression; chapters by Alloy, Reilly-Har- rington, Fresco, and Flannery-Schroeder, and Pettit and Joiner, describe recentdevelopmentsonresearchoncognitivevulnerabilitytobipolardis- order and suicide, respectively. A chapter by Traill and Gotlib sums up andsynthesizes.PartIIfocusesonthemajoranxietydisorders.Achapter byRiskindandWilliamsdescribesworkonacommoncognitivevulnera- bilitytoanxietydisordersthatdifferentiatesthemfromdepression.Other chapters by Schmidt and Woolaway-Bickel on panic disorder, Rachman, Shafran, and Riskind on OCD, Ledley, Fresco, and Heimberg on social anxiety, and Feeny and Foa on PTSD, describe recent findings and theo- retical issues concerning specific anxiety disorders. Wells and Matthews sum up and synthesize. Part III is devoted to bulimia and anorexia nervosa, which are closely related to anxiety and depression and may sharesomeofthesameunderlyingcausalprocesses.ChaptersbyAbram- son,Bardone-Cone,Vohs,Joiner,andHeathertononbulimia,andbyGar- nerandMaganaonanorexianervosadiscusscurrentwork;achapterby Keel sums up and synthesizes. We are excited about this book and hope that it will be helpful to all whoseektounderstandthecognitive-behavioralbasisofmood,anxiety, andeatingdisordersintheserviceofmoreeffectivepreventionandtreat- ment.Ourfieldofinquiryhasexpandedrapidlyandwitnessedmuchre- centprogress;wehopealsothatthebookwillstimulatefurtherresearch. REFERENCE Kessler, R. C., McGonagle, K. A., Zhao, S., Nelson, C. G., Hughes, C. R., Eshleman, S., Witchen,H.U.,&Kendler,K.S.(1994).Lifetimeand12-monthprevalenceofDSM-III-R psychiatricdisordersintheUnitedStates:ResultsfromtheNationalComorbiditySur- vey.ArchivesofGeneralPsychiatry,51,8–49.
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