The relationship between dysfunctional schemata and outcomes from a pain management programme

Psychologists involved in the treatment of chronic pain have increasingly emphasised the importance of cognitive factors in the development and maintenance of chronic pain (Turk and Rudy, 1992). Most pain management programmes (PMP's) incorporate a cognitive-behavioural component that, for example, teaches patients to identify thoughts the might lower mood, exacerbate their pain or interfere with their ability to engage in rehabilitative behaviours. These treatment elements are derived from the cognitive model of depression (Beck, 1967), which states that depressed mood is maintained by negative automatic thoughts that arise out of the patient's dysfunctional schemata. Schemata are cognitive structures that organise our beliefs, attitudes and assumptions, and help the individual to construe themselves and their world. Whilst there has been some research suggesting that dysfunctional schemata (those thought to be associated with poor psychological adjustment) can interfere with outcome in cognitive-behavioural therapy for depression (Jarrett, Eaves, Granneman and Rush, 1991) no similar research has been conducted examining their influence on outcome from a PMP.In this study, 66 patients, who were attending six consecutive pain management groups, were asked to complete two measures of dysfunctional schemata (the Dysfunctional Attitudes Scale, Weissman, 1979 and the Young Schema Questionnaire - Short Form, Young and Brown, 1999). These measures were supplemented by two sets of informant ratings (provided by a close friend or relative and by the psychologist leading the PMP) of the patient's schemata. Outcome measures used to assess the effectiveness of the PMP included current pain intensity, iv self-reported mood disturbance, self-efficacy, readiness to engage in pain management, disability, and physiotherapist ratings of functional ability. These were collected at the beginning and at the end of treatment. The number of significant associations between the measures of dysfunctional schemata and patient outcomes (the difference between pre and post-treatment scores) were few and were often in the direction opposite to that predicted. Various substantive and methodological reasons were examined in an attempt to explain why the study hypothesis was not upheld

Framing-effects approach: A theoretical and methodological critique

The article deals with research on framing effects. First, I will start with classifying different approaches on framing. Subsequently, I will provide a definition of the concepts of frame, schema and framing, expand on framing research conducted so far - both theoretically and operationally. Having this equipment at hand, I will initiate a discussion on studies of framing-effects in terms of theory, methods and empirical results. This discussion leads to the conclusion that studies on framing effects are insufficiently concerned with the more recent psychological constructs and theories. In merely focusing on the activation of schemata, most studies ignore the more elaborate types of framing-effects. Therefore, several empirical questions remain unanswered and some methodical chances seem to be wasted

Convergence and Divergence of Themes in Successful Psychotherapy: An Assimilation Analysis

Theme convergence is the linking of seemingly unrelated problem domains as they advance through assimilation stages-a developmental sequence of cognitive and affective changes through which problematic content is hypothesized to pass during successful psychotherapy. Theme divergence is the contradiction or conflict of solutions to different problems, so that progress in one domain leads to stagnation or regression in another domain. An intensive qualitative method called assimilation analysis was used to examine theme convergence and divergence in a successful psychodynamic psychotherapy with a 20–yr–old female patient. Because specific problems often fail to progress monotonically, even in successful psychotherapy cases, it is suggested that clients\u27 problems cannot be resolved in isolation; instead, they may influence each other toward resolution or stagnation in complex and unpredictable ways

Understanding creativity

We have never seen creativity. More precisely, we have never seen the creative process; what we have seen is the creative individual (ex ante) and the outcome of creativity (ex post). Therefore we try to understand creativity by examining creative individuals and their creations. In this paper we only consider the creation of new knowledge. We draw on a wide variety of backgrounds. We wander into the area of cognitive psychology to investigate who is talented for creativity. We also draw on arts, history and philosophy of science, stories of mystics, some great novels and essays we have read as well as our experience in both working with creatives and creating new knowledge. Based on this shaky foundation we will describe creativity as illumination, through jokes, as a quest for harmony, as being kissed by the muse

Schemata

No abstract available

Spontaneous thought and vulnerability to mood disorders : the dark side of the wandering mind

There is increasing interest in spontaneous thought, namely task-unrelated or rest-related mental activity. Spontaneous thought is an umbrella term for processes like mind-wandering, involuntary autobiographical memory, and daydreaming, with evidence elucidating adaptive and maladaptive consequences. In this theoretical framework, we propose that, apart from its positive functions, spontaneous thought is a precursor for cognitive vulnerability in individuals who are at risk for mood disorders. It is important that spontaneous thought mostly focuses on unattained goals and evaluates the discrepancy between current and desired status. In individuals who stably (i.e., trait negative affectivity) or transitorily (i.e., stress) experience negative emotions in reaction to goal-discrepancy, spontaneous thought fosters major cognitive vulnerabilities (e.g., rumination, hopelessness, low self-esteem, and cognitive reactivity), which, in turn, enhance depression. Furthermore, we also highlight preliminary links between spontaneous thought and bipolar disorder. The evidence for this framework is reviewed, and we discuss theoretical and clinical implications of our proposal

Short papers and letters on the 'linear micro-element' theory of mental mechanism; and related questions of scientific method

Seven papers/letters further developing the ideas raised in Monographs #12 and #15 (q.v.), and in two papers published in Kybernetes (vols 5 and 7) -- later incorporated into the Thesis (q.v.) as "Part A". In particular: *Chapters I & VI: apply the postulated 'linear elements' to explain Piaget's notion of how the mental concept of 'object' is developed. *Chapter II: extends this to account for the rudiments of 'personal identity'. *Chapter III: answers criticisms and queries raised by Dr N.E.Wetherick, mainly on the plausibility of RNA and infra-red as a Second (multiplexed) Neurotransmitting System. *Other chapters offer critiques of some accepted views on scientific method