Interpretational Processing Biases in Emotional Psychopathology: From Experimental Investigation to Clinical Practice

Description

The primary aim of this book is to bridge the gap between lab-based and clinical research by disseminating the latest interdisciplinary scientific findings on interpretational processing biases in the context of emotional psychopathology. It is designed to help the practitioner by drawing explicit links between the basic science and implications for clinical practice. This enables an enhanced interaction between science and practice, strengthening bi-directional translational links, and the potential to produce more meaningful and significant advances in the treatment of emotional psychopathology. This in turn will facilitate an innovative step-change in the area of both research and clinical practice. The book focuses on cognitive processing biases that are common across a wide range of psychological disorders, meaning that the conclusions drawn have relevance across the whole spectrum of psychopathology and will stimulate and inspire a broad range of discussions and future work.  From the foreword by Nikolaos Kazantzis: "The practice of CBT is complex and requires a tailored approach. Every technique has a specific target but may be used for multiple purposes simultaneously in support of the client’s therapeutic goals. The purpose of Dr. Woud’s book is to elucidate the ways in which interpretational biases can be a focus of intervention for CBT therapists at all stages of professional development, from those undertaking training to master clinicians. Dr. Woud has succeeded admirably in this regard." Foreword Preface Contents Contributors Chapter 1: Introduction: Imagining Science Reaching Practice and Moving Forward – Transforming Psychological Treatments via Mental Health Science 1.1 Up for Interpretation 1.2 There Are Many Ways to Crack a Nut 1.3 What and Why Is Mental Health Science? 1.4 Taking a Line for a Walk 1.5 Imagining Science Reaching Practice—It Can References Part I: Scientific Innovations on Mechanisms of Psychopathology Chapter 2: The Challenge of Translational Research: How Do We Get from Basic Research Findings to Evidence-Based Interventions? 2.1 Introduction 2.2 A Conceptual Framework of Translational Research in Clinical Psychology 2.2.1 Step 1. Identification of Processes 2.2.2 Step 2. Establishing Causality of the Process 2.2.3 Step 3. Developing/Refining Intervention Strategies to Modify the Process 2.2.4 Step 4. Clinical Trials 2.2.5 Step 5. Implementation and Dissemination 2.3 Doing Translational Research: Challenges, Recommendations, and Perspectives 2.3.1 Issues Related to Basic Research (Steps 1 and 2) 2.3.1.1 Focus on Theory 2.3.1.2 Focus on Stable and Replicable Effects 2.3.1.3 Statistical Power 2.3.1.4 Reliability of the Task 2.3.1.5 Focus on Transdiagnostic Processes and Clinical Areas with Need for Improvement 2.3.2 Issues Related to Experimental Psychopathology Research (EPP; Step 2) and the Development and Refinement of Intervention Strategies (Step 3) 2.3.2.1 Steps 2 and 3 Should Not Be Skipped 2.3.2.2 Choosing the Right Sample in Experimental Psychopathology Research 2.3.2.3 External Validity in Step 2 and Step 3 Research 2.3.3 Considerations Related to Clinical Trials (Step 4) 2.3.3.1 Bridging Designs 2.3.3.2 Research Assessing Mediators and Mechanisms of Change 2.3.3.3 Back Translation 2.3.3.4 Studying Personalized Treatments and Focusing on Add-On Interventions 2.4 Conclusion References Chapter 3: Assessing Interpretation Biases in Emotional Psychopathology: An Overview 3.1 Offline Interpretation Bias Assessments 3.1.1 The Starting Point: The Cognitive Bias Questionnaire 3.1.2 Rank-Order Questionnaires 3.1.3 Imagery-Based Assessments: The Ambiguous Scenarios Test 3.1.4 Generation of Multiple Interpretations: The Interpretation Bias Questionnaire 3.1.5 Questionnaires Prompting the Completion of Open-Ended Sentences 3.2 Online Interpretation Bias Assessments 3.2.1 Making Sense of Scrambled Information: The Scrambled Sentences Task 3.2.2 Word or Non-Word?: Lexical Decision Tasks 3.2.3 Related or Unrelated?: The Word-Sentence Association Paradigm (WSAP) 3.3 Here and Back Again, Basic Research, and Clinical Application 3.4 Summary and Outlook References Chapter 4: Moderators and Mediators of the Interpretation Bias–Emotional Disorders Link 4.1 Interpretation Bias as a Predictor, Mediator, and Outcome of Emotional Disorders 4.2 Significance of Mediators and Moderators 4.3 Mediators of the Relationship Between Interpretation Bias and Emotional Disorders 4.3.1 Positive Reappraisal 4.3.2 Rumination 4.3.3 Dampening 4.3.4 Irritable Mood 4.4 Moderators of the Interpretation Bias and Emotional Disorders’ Relationship 4.4.1 Population Characteristics 4.4.1.1 Age 4.4.1.2 Interpersonal Context 4.4.1.3 Gender 4.4.1.4 Psychopathology Type 4.4.1.5 Psychopathology Severity 4.4.2 Methodological Factors 4.4.2.1 Stimuli 4.4.2.2 Self-Relevance of the Stimuli 4.4.2.3 Content Specificity of the Stimuli 4.4.2.4 Stimuli Modality 4.4.2.5 Measurement Method 4.5 Summary and Outlook References Chapter 5: Biased Interpretation of Ambiguity in Depression and Anxiety: Interactions with Attention, Memory, and Cognitive Control Processes 5.1 Introduction 5.2 Theoretical Frameworks on Interactions Between Cognitive Biases 5.3 Empirical Research Examining Interactions Between Interpretation Bias and Basic Cognitive Processes 5.3.1 Attention Bias and Interpreting Ambiguity 5.3.2 Cognitive Control Difficulties and Interpreting Ambiguity 5.3.3 Memory Bias and Interpreting Ambiguity 5.4 Future Research Directions 5.5 Conclusion References Chapter 6: Mental Imagery and Interpretational Processing Biases 6.1 Introduction 6.2 The Relationship Between Mental Imagery and Interpretation Biases 6.3 Using Mental Imagery to Change Interpretation Biases 6.3.1 Using Mental Imagery in CBT 6.3.2 Mental Imagery and Cognitive Training 6.4 Conclusions and Future Directions References Chapter 7: Fear Conditioning Biases in Anxiety Disorders: A Matter of Interpretation? 7.1 Biases of Anxiety Patients in the Context of Fear Conditioning and Links to Interpretational Processing 7.2 Defining Biases: Bias as (Observable) Behavior and Bias as a (Cognitive) Deficit 7.2.1 Bias as (Observable) Behavior 7.2.2 The Etiology of (Fear Conditioning) Biases 7.2.2.1 Temperamental and Genetic Factors 7.2.2.2 Environmental Factors and Learning History 7.2.3 Bias as a Latent Mental Process 7.3 The Role of (Fear Conditioning) Biases in Reducing Anxiety 7.4 Conclusion References Chapter 8: Interpretational Bias in Psychopathology and Psychological Well-Being: What Role Does Genetics Play? 8.1 The Aetiology of Interpretational Processing Biases 8.2 Twin Studies 8.3 Molecular Genetic Studies 8.4 The Importance of Genome-Wide Approaches 8.5 Polygenic Approaches 8.6 The CogBIAS Hypothesis: An Integrated Model for Well-Being and Emotional Disorders 8.7 Implications 8.8 Future Directions 8.9 Conclusion References Chapter 9: Neural Correlates of Interpretation Processing Biases 9.1 Language-Related ERPs 9.2 Applying ERPs to Understand Interpretations in Relation to Psychopathology 9.3 Methodological Issues 9.3.1 Issues in Developing Materials for Assessing Online Interpretation Biases 9.3.1.1 Levels of Constraint and Cloze Probability 9.3.1.2 Content Specificity and Relevance 9.3.1.3 Self-Referent 9.3.2 Issues Relevant to EEG Testing and Measurement 9.3.3 Guidelines for Material Development Procedures for Assessing Online Interpretation Biases 9.4 Other Potential Neural and Biological Correlates for Interpretation Biases 9.5 Conclusion References Chapter 10: Pharmacological Manipulations of Emotional Processing Biases: From Bench to Bedside 10.1 Introduction 10.2 How Do Antidepressants Affect Emotional Processing and Interpretation Bias? 10.3 Evaluation of the Cognitive Neuropsychological Model 10.3.1 Antidepressants and Emotional Processing Bias: Evidence from Behavioural Studies 10.3.2 How Do We Measure the Neural Correlates of Depression and the Effects of Antidepressants on the Brain? 10.3.3 What Are the Neural Correlates of Negative Emotional Processing Bias? 10.3.4 Antidepressants and Emotional Processing Bias: Neural Mechanisms 10.3.5 Do These Neural Findings Concur with the ‘Top-Down’ and ‘Bottom-Up’ Hypothesis of Psychological Treatment Versus Antidepressant Action? 10.3.6 Interaction with the Environment 10.4 Can Measuring Emotional Processing Biases Help the Future Treatment of MDD? 10.4.1 Providing an Early Marker of Treatment Response to Antidepressants 10.4.2 Providing an Experimental Medicine Model for Treatment Development 10.5 Overall Perspective References Chapter 11: Cognitive Bias Modification Training to Change Interpretation Biases 11.1 Cognitive Bias Modification – Interpretation (CBM-I) Training 11.2 Overview CBM-I Training Paradigms 11.2.1 Scenario-Based CBM-I 11.2.2 Homograph CBM-I Training 11.2.3 Interpretation Modification Program (IMP): Word Sentence Association Paradigm (WSAP) 11.2.4 CBM-I Training Paradigms with Images or Imagery 11.2.5 Assessing Effects on Interpretation Bias 11.3 Overview Empirical Findings CBM-I Effects 11.4 Mediators and Moderators of CBM-I Training Effects 11.4.1 Mediators of CBM-I Training Effects 11.4.1.1 Moderators of CBM-I Training Effects 11.5 Concluding Comments and Avenues for Future Directions References Part II: Clinical Guidance for Interpretational Bias Modification Across Different Emotional Disorders Chapter 12: Changing Biased Interpretations in CBT: A Brief History and Overview 12.1 A Brief Historical Background 12.2 CBT – The Basic Principles in a Nutshell 12.3 Techniques 12.4 Cognitive Restructuring 12.5 Behavioral Experiments 12.6 Exposure 12.7 Mental Imagery-Based Techniques 12.8 Behavioral Activation and Activity Scheduling 12.9 Cognitive Training Approaches 12.10 “Third Wave” Approaches 12.11 Summary and Outlook References Chapter 13: “If Only I Was a Doctor! The Burger Bite” – A Case Study in Posttraumatic Stress Disorder 13.1 The Case 13.1.1 Assessment 13.2 Main Cognitions Targeted 13.3 Treatment 13.3.1 Introduction to Trauma-Focused Treatment and Crisis Intervention 13.3.2 Trauma-Focused CBT 13.3.3 Cognitive Work: Socratic Dialogue and Cognitive Restructuring 13.3.4 Exposure 13.3.5 Follow-Up Sessions 13.4 Special Challenges and Problems 13.5 Summary, Conclusions, and Learning Points References Chapter 14: “I am Incompetent – I Just Can’t Cope”  – A Case Study in Depression 14.1 The Case 14.1.1 Assessment 14.2 Main Cognitions Targeted 14.3 Treatment 14.3.1 Introduction of the Cognitive Model and Monitoring 14.3.2 Challenging Cognitive Distortions and Thinking Errors 14.3.3 Targeting the Ruminative Spiral 14.3.4 Behavioural Experiment to Test the Benefit of Thinking About ‘Why’ 14.4 Special Challenges and Problems 14.5 Summary, Conclusions and Learning Points References Chapter 15: “It Is Dangerous to Ignore This Thought” – A Case Study in Obsessive Compulsive Disorder 15.1 The Case 15.1.1 Background and Problem History 15.1.2 Relevant Family History 15.1.3 Assessment Results 15.2 Main Cognitions Targeted 15.2.1 Core Beliefs, Assumptions, and Rules for Living 15.2.2 Appraisal of Obsessions 15.2.3 Appraisal of Compulsions 15.2.4 Compulsions and Values 15.3 Treatment 15.3.1 Psychoeducation and Case Formulation 15.3.2 Initial Sessions of Treatment 15.3.3 Initial Sessions of CBT 15.3.4 Sessions 4–8 of CBT 15.3.5 Sessions 8–12 15.4 Special Challenges and Problems 15.5 Summary, Conclusions, and Learning Points References Chapter 16: “I Don’t Want to Bother You” – A Case Study in Social Anxiety Disorder 16.1 The Case 16.1.1 Presenting Problem 16.1.2 History 16.1.3 Chief Symptoms 16.2 Main Cognitions Targeted 16.3 Treatment 16.3.1 Phase 1 (Sessions 1–6) 16.3.2 Phase 2 (Sessions 7–12) 16.3.3 Phase 3 (Sessions 13–15) 16.3.4 Termination and Booster Sessions 16.4 Special Challenges and Problems 16.4.1 Difficulties Associated with the COVID-19 Pandemic 16.4.2 Difficulties Associated with Inhibitory Learning 16.4.3 Difficulties Associated with Overly Positive Self-Talk 16.5 Summary, Conclusions, and Learning Points References Chapter 17: “There Is This Strange Feeling: Oh no, Another Panic Attack!” – A Case Study in Panic Disorder 17.1 The Case 17.2 Main Cognitions Targeted 17.3 Treatment 17.3.1 Diagnostics 17.3.2 Psychoeducation and the Treatment Rationale 17.3.2.1 Panic Disorder 17.3.2.2 Agoraphobia 17.3.3 Exposure 17.3.3.1 Exposure of Internal Cues: Panic 17.3.3.2 Exposure In Vivo: Agoraphobia 17.3.4 Relapse Prevention 17.3.5 Outcome 17.4 Special Challenges and Problems 17.5 Summary and Conclusions References Index