Cognitive vulnerability to emotional disorders

462 Pages·2006·3.815 MB·English

by  Lauren B Alloy, John H Riskind

COGNITIVE VULNERABILITY
TO EMOTIONAL DISORDERS
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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
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CoverdesignbyKathrynHoughtalingLacey
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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.
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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.