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Cognitive Therapy and Research

, Volume 41, Issue 4, pp 519–529 | Cite as

Change in Explanatory Flexibility and Explanatory Style in Cognitive Therapy and its Components

  • Michael T. Moore
  • David M. Fresco
  • Jeremiah A. Schumm
  • Keith S. Dobson
Original Article

Abstract

The current study represents a secondary analysis of the dismantling study of cognitive therapy of depression originally conducted by Jacobson et al. (J Consult Clin Psychol 64:295–304, 1996). New analyses examined the role of explanatory flexibility and explanatory style in the recovery from depression. Results indicated that BA treatment responders, but not AT or CT participants evidenced significant improvement in explanatory flexibility, whereas patients from all three study arms, irrespective of responder status demonstrated improvements in explanatory style. Improvement in explanatory flexibility was associated with decreases in symptoms of depression for CT, but not BA or AT, participants. Further, the combination of high explanatory flexibility and low explanatory style conferred maximal protection over relapse. These results suggest that explanatory flexibility is a viable candidate as a process associated with treatment gains in CT. In addition, the results suggest that important cognitive change is possible without an explicit, deliberate focus on the part of the therapist.

Keywords

Cognitive therapy Depression Explanatory flexibility Explanatory style 

Notes

Compliance with Ethical Standards

Conflict of Interest

Michael T. Moore, David M. Fresco, Jeremiah A. Schumm, Keith S. Dobson declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Animal Rights

This article does not contain any studies with animals performed by any of the authors.

References

  1. Abramson, L., Metalsky, G. I., & Alloy, L. B. (1989). Hopelessness depression: A theory-based subtype of depression. Psychological Review, 96, 358–372.CrossRefGoogle Scholar
  2. Abramson, L., Seligman, M., & Teasdale, J. (1978). Learned helplessness in humans: Critique and reformulation. Journal of Abnormal Psychology, 87, 102–109.CrossRefPubMedGoogle Scholar
  3. Allison, P. D. (1984). Event History Analysis: Regression for Longitudinal Event Data. Newbury Park, CA: Sage Publications.CrossRefGoogle Scholar
  4. American Psychiatric Association (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: American Psychiatric Association.Google Scholar
  5. Barber, J. P., & DeRubeis, R. J. (1989). On second thought: Where the action is in cognitive therapy for depression. Cognitive Therapy and Research, 13, 441–457.CrossRefGoogle Scholar
  6. Beck, A. T. (1967). Depression: Causes and treatment. Philadelphia: University of Pennsylvania Press.Google Scholar
  7. Beck, A. T. (1976). Cognitive therapy and the emotional disorders. New York: International Universities Press.Google Scholar
  8. Beck, A. T. (1984). Cognition and therapy. Archives of General Psychiatry, 41, 1112–1114.CrossRefPubMedGoogle Scholar
  9. Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford.Google Scholar
  10. Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77–100.CrossRefGoogle Scholar
  11. Bernstein, A., Hadash, Y., Lichtash, Y., Tanay, G., Shepherd, K., & Fresco, D. M. (2015). Decentering and Related Constructs: A Critical Review and Metacognitive Processes Model. Perspectives on Psychological Science, 10(5), 599–617. http://doi.org/10.1177/1745691615594577.
  12. Brosschot, J. F., & Thayer, J. F. (2004). Worry, preservative thinking, and health. In I. Nyklicek, L. Temoshok & A. Vingerhoets (Eds.), Emotional expression and health: Advances in theory, assessment, and clinical application (pp. 99–114). New York: Brunner and Rutledge.Google Scholar
  13. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd edn.). San Diego: Academic Press.Google Scholar
  14. DeRubeis, R. J., Evans, M. D., Hollon, S. D., Garvey, M. D., Grove, W. M., & Tuason, V. B. (1990). How does cognitive therapy work? Cognitive change and symptom change in cognitive therapy and pharmacotherapy for depression. Journal of Consulting and Clinical Psychology, 58, 862–869.CrossRefPubMedGoogle Scholar
  15. Elkin, I., Shea, M. T., Watkins, J. T., Imber, S. D., Sotsky, S. M., Collin, J. F., Glass, D. R., Pilkonis, P. A., Leber, W. R., Fiester, S. J., Docherty, J., & Parloff, M. B. (1989). National Institute of Mental Health Treatment of Depression Collaborative Research Program: General effectiveness of treatments. Archives of General Psychiatry, 46, 971–982.CrossRefPubMedGoogle Scholar
  16. Evans, M. D., Hollon, S. D., DeRubeis, R. J., Piasecki, J., Grove, W. M., Garvey, M. J., & Tuason, V. B. (1992). Differential relapse following cognitive therapy and pharmacotherapy for depression. Archives of General Psychiatry, 49, 802–808.CrossRefPubMedGoogle Scholar
  17. Ferster, C. B. (1973). A functional analysis of depression. American Psychologist, 28, 857–870.CrossRefPubMedGoogle Scholar
  18. Frank, E., Prien, R. F., Jarrett, R. B., Keller, M. B., Kupfer, D. J., Lavori, P. W., Rush, A. J., & Weissman, M. M (1991). Conceptualization and rationale for consensus definitions of terms in major depressive disorder: Remission, recovery, relapse, and recurrence. Archives of General Psychiatry, 48, 851–855.CrossRefPubMedGoogle Scholar
  19. Fresco, D. M., Heimberg, R. G., Abramowitz, A., & Bertram, T. L. (2006). The effect of a negative mood priming challenge on dysfunctional attitudes, explanatory style, and explanatory flexibility. British Journal of Clinical Psychology, 45, 167–183.CrossRefPubMedGoogle Scholar
  20. Fresco, D. M., Mennin, D.S., Hambrick, J. & Heimberg, R.G. (2009). The effect of a negative mood priming challenge on explanatory flexibility and state emotional intelligence in individuals with and without generalized anxiety disorder. Manuscript under review.Google Scholar
  21. Fresco, D. M., Moore, M. T., van Dulmen, M., Segal, Z. V., Teasdale, J. D., Ma, H., & Williams, J. M. G. (2007a). Initial psychometric properties of the Wider Experiences Questionnaire: A self-report survey of decentering. Behavior Therapy, 38, 234–246.CrossRefGoogle Scholar
  22. Fresco, D. M., Rytwinski, N. K., & Craighead, L. W. (2007b). Explanatory flexibility and negative life events interact to predict depression symptoms. Journal of Social and Clinical Psychology, 26, 595–608.Google Scholar
  23. Fresco, D. M., Williams, N. L., & Nugent, N. R. (2006). Association of explanatory flexibility and coping flexibility to each other and to depression and anxiety. Cognitive Therapy and Research, 30, 201–210.CrossRefGoogle Scholar
  24. Fresco, D. M., Moore, M. T., Mennin, D. S., Heimberg, R. G., & Hambrick, J. (2014). Changes in explanatory flexibility among individuals with generalized anxiety disorder in an emotion evocation challenge. Cognitive Therapy and Research, 38, 416–427.CrossRefGoogle Scholar
  25. Gortner, E. T., Gollan, J. K., Dobson, K. S., & Jacobson, N. S. (1998). Cognitive-behavioral treatment for depression: Relapse prevention. Journal of Consulting and Clinical Psychology, 66, 377–384.CrossRefPubMedGoogle Scholar
  26. Hamilton, M. (1967). Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 276–296.CrossRefGoogle Scholar
  27. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guilford.Google Scholar
  28. Hollon, S. D., & Garber, J. (1988). Cognitive therapy. In L. Y. Abramson (Ed.), Social cognition and clinical psychology (pp. 204–253). New York: Guilford.Google Scholar
  29. Hollon, S. D., Kendall, P. C., & Lumry, A. (1986). Specificity of depressotypic cognitions in clinical depression. Journal of Abnormal Psychology, 95, 52–59.CrossRefPubMedGoogle Scholar
  30. Hollon, S. D., & Kriss, M. R. (1984). Cognitive factors in clinical research and practice. Clinical Psychology Review, 4, 35–76.CrossRefGoogle Scholar
  31. Ingram, R. E., & Hollon, S. D. (1986). Cognitive therapy for depression from an information processing perspective. In R. E. Ingram (Ed.), Information processing approaches to clinical psychology (pp. 259–281). San Diego: Academic Press.Google Scholar
  32. Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K., Gortner, E., & Prince, S. E. (1996). A component analysis of cognitive-behavioral treatment for depression. Journal of Consulting and Clinical Psychology, 64, 295–304.CrossRefPubMedGoogle Scholar
  33. Jacobson, N. S., Martell, C.R., & Dimidjian, S. (2001). Behavioral activation treatment for depression: Returning to contextual roots. Clinical Psychology, 8, 255–270.Google Scholar
  34. Kashdan, T. B., & Rottenberg, J. (2010). Psychological flexibility as a fundamental aspect of health. Clinical Psychology Review, 30, 865–878.CrossRefPubMedPubMedCentralGoogle Scholar
  35. Keller, M. B., Lavori, P. W., Friedman, B., Nielsen, E., Endicott, J., McDonald-Scott, P., & Andreason, N. C. (1987). The longitudinal interval follow-up evaluation: A comprehensive method for assessing outcome in prospective longitudinal studies. Archives of General Psychiatry, 44, 540–548.CrossRefPubMedGoogle Scholar
  36. Kendall, P. C., & Ingram, R. E. (1989). Cognitive behavioral perspectives: Theory and research on depression and anxiety. In P. C. Kendall & D. Watson (Eds.), Anxiety and depression: Distinctive and overlapping features (pp. 27–53). San Diego: Academic Press.Google Scholar
  37. Lackner, R. J., Moore, M. T., Minerovic, J., & Fresco, D. M. (2015). Explanatory flexibility and explanatory style in treatment-seeking clients with Axis I psychopathology. Cognitive Therapy and Research, 39, 736–743.CrossRefPubMedPubMedCentralGoogle Scholar
  38. Lewinsohn, P. M. (1974). A behavioral approach to depression. In R. J. Friedman & M. M. Katz (Eds.), The psychology of depression: Contemporary theory and research. Oxford: John Wiley & Sons.Google Scholar
  39. Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.Google Scholar
  40. Martell, C. R., Addis, M. E., & Jacobson, N. S. (2001). Depression in context: Strategies for guided action. New York: Norton & Co.Google Scholar
  41. Moore, M. T., & Fresco, D. M. (2007). Depressive realism and attributional style: Implications for individuals at risk for depression. Behavior Therapy, 38, 144–154.CrossRefPubMedGoogle Scholar
  42. Peterson, C., Semmel, A., von Baeyer, C., Abramson, L. Y., Metalsky, G. I., & Seligman, M. E. P. (1982). The Attributional Style Questionnaire. Cognitive Therapy and Research, 6, 287–300.CrossRefGoogle Scholar
  43. Peterson, C., & Villanova, P. (1988). An expanded attributional style questionnaire. Journal of Abnormal Psychology, 97, 87–89.CrossRefPubMedGoogle Scholar
  44. Rush, A., Beck, A., Kovacs, M., & Hollon, S. (1977). Comparative efficacy of cognitive therapy and pharmacotherapy in the treatment of depressed outpatients. Cognitive Therapy and Research, 1, 17–37.CrossRefGoogle Scholar
  45. Safran, J. D., & Segal, Z. V. (1990). Interpersonal process in cognitive therapy. New York: Basic Books.Google Scholar
  46. Safran, J. D., Vallis, T. M., Segal, Z. V., & Shaw, B. F. (1986). Assessment of core cognitive processes in cognitive therapy. Cognitive Therapy and Research, 10, 509–526.CrossRefGoogle Scholar
  47. Segal, Z. V., Gemar, M., & Williams, S. (1999). Differential cognitive response to a mood challenge following successful cognitive therapy or pharmacotherapy for unipolar depression. Journal of Abnormal Psychology, 108, 3–10.CrossRefPubMedGoogle Scholar
  48. Seligman, M.E.P. (1980). A learned helplessness point of view. In L. Rehm (Ed.), Behavior therapy for depression (pp. 123–142). New York: Academic Press.Google Scholar
  49. Seligman, M. E., Castellon, C., Cacciola, J., Schulman, P., Luborsky, L., Ollove, M., & Downing, R. (1988). Explanatory style change during cognitive therapy for unipolar depression. Journal of Abnormal Psychology, 97(1), 13.CrossRefPubMedGoogle Scholar
  50. Spitzer, R. L., Williams, J. B. & Gibbon, M. (1987). Instruction manual for the Structured Clinical Interview for DSM—III—R. (Available from the Biometrics Research Department, New York, NY: New York State Psychiatric Institute.Google Scholar
  51. Tabachnik, B. G., & Fidell, L. S. (2013). Using multivariate statistics (6th edn.). Boston: Pearson.Google Scholar
  52. Thayer, J. F., & Lane, R. D. (2002). Perseverative thinking and health: neurovisceral concomitants. Psychology and Health, 17, 685–695.CrossRefGoogle Scholar
  53. Wilson, K. G., & Murrell, A. R. (2004). Values work in acceptance and commitment therapy: Setting a course for behavioral treatment. In S. C. Hayes, V. M. Follette & M. M. Linehan (Eds.), Mindfulness and acceptance: Expanding the cognitive-behavioral tradition (pp. 120–151). New York: Guilford.Google Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Gordon F. Derner Institute of Advanced Psychological StudiesAdelphi UniversityGarden CityUSA
  2. 2.Department of PsychologyKent State UniversityKentUSA
  3. 3.School of Professional PsychologyWright State UniversityDaytonUSA
  4. 4.Department of PsychologyUniversity of CalgaryCalgaryCanada

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