Cognitive Behavioural Processes across Psychological Disorders: A Transdiagnostic Approach to Research and Treatment

376 Pages·2004·1.86 MB·English

by  Allison Harvey

Cognitive behavioural
processes across
psychological disorders:
A transdiagnostic approach
to research and treatment
Allison G. Harvey, et al.
OXFORD UNIVERSITY PRESS
Cognitive Behavioural
Processes Across
Psychological Disorders:
A transdiagnostic approach to
research and treatment
This page intentionally left blank
Cognitive
behavioural
processes across
psychological
disorders:
A transdiagnostic
approach to research
and treatment
Allison G. Harvey
Department of Experimental Psychology, University of
Oxford, Oxford, UK
Edward Watkins
School of Psychology, University of Exeter, Exeter, UK
Warren Mansell
Department of Psychological Medicine, Institute of Psychiatry,
London, UK
and
Roz Shafran
Department of Psychiatry, University of Oxford, Oxford, UK
1
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1
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© Allison G.Harvey,Edward Watkins,Warren Mansell,and Roz Shafran 2004
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For our loved ones
(they know who they are!)
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Preface
Three ofus (Roz,Warren,and Allison) began our work as clinical psychologists
and researchers specializing in anxiety disorders and one ofus (Ed) worked
mainly with patients diagnosed with depression.As time went on our interests
diverged.Roz to eating disorders.Warren and Ed to bipolar disorder.Allison to
insomnia.We were all struck by the similarities between the disorders in which
we first specialized and our new interests.At the annual conference of the
British Association for Behavioural and Cognitive Psychotherapy (BABCP),
held in London in 2000,Warren organized a symposium entitled ‘Cognitive
processes across disorders’.Again,we were struck by the similarities in the
processes that maintained different psychological disorders.Since then we have
organized,presented in,and attended several ‘across disorder’symposia in
which clinical researchers working on the same cognitive or behavioural
process,across a range ofdifferent psychological disorders,presented their
research.The similarities across the disorders were confirmed,again and again.
Hence,in the Spring of2003 we decided to attempt to systematically determine
the utility ofan ‘across disorder’,or ‘transdiagnostic’approach,to understand-
ing cognitive behavioural processes in psychological disorders.This book is the
output ofour efforts.
Before sharing with you where we have got to in our thinking on this issue,
we would like to acknowledge that we have all been very fortunate to have had
the opportunity to interact with,and be influenced by,many distinguished
clinical researchers who have taught us so much.We are grateful to them all
but would particularly like to thank our close supervisors and mentors as they
have carefully and thoughtfully tutored and nurtured us.They are Chris
Brewin,Richard Bryant,David M.Clark,Padmal de Silva,Anke Ehlers,
Christopher Fairburn,Paul Salkovskis,S.Rachman,and John Teasdale.
We would like to extend a special thanks to Philip Tata who,in his capacity
as Chair of the Scientific Committee of the BABCP,granted us the freedom
to organize discussions and presentations on transdiagnostic issues at
each annual conference.We would also like to acknowledge the influence
on our thinking of the groundbreaking work of Christopher Fairburn,
Zafra Cooper,and Roz Shafran who outlined a transdiagnostic approach to
eating disorders as published in Behaviour Research and Therapy (Fairburn
et al.2003).
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viii PREFACE
Finally,there are several other people we wish to thank for their patience
and support while we have been writing this book and/or for their willingness
to brainstorm ideas.Thanks to Alison Bugg,John Campbell,Padmal de Silva,
David and Matthew Gittleson,Emily Holmes,Melissa Ree,and Mark Williams.
Contents
1 Introduction 1
Classification 3
Advantages ofa transdiagnostic perspective 6
Disadvantages ofa transdiagnostic perspective 13
How will the transdiagnostic process perspective be evaluated 14
Aims and summary 23
2 Attention 25
What is selective attention? 26
Self-focused attention 27
How is selective attention measured? 27
To what kind ofstimuli do people selectively attend? 34
Selective attention 36
Discussion 54
Theoretical issues 60
Clinical implications 63
Future research 69
Key points 70
3 Memory 73
What is memory? 74
What kind ofstimuli do people selectively remember? 79
Selective memory 82
Overgeneral memory 96
Avoidant encoding and retrieval 101
Recurrent memories 107
Working memory 112
Memory distrust 113
Discussion 113
Clinical implications 124
Future research 129
Key points 133
4 Reasoning 135
Interpreting ambiguous stimuli 137
Attributions 145
Expectancies and heuristics 153
Detecting covariation and illusory correlation 163
Hypothesis testing and data gathering 166