The perseveration of checking thoughts and mood–as–input hypothesis

This paper describes two experiments designed to investigate how a current model of task perseveration, the mood-as-input hypothesis, might be applied to activities relevant to compulsive checking. The mood-as-input hypothesis predicts that perseveration at an open-ended task will be determined by a combination of the “stop rules” adopted for the task, and the valency of the mood state in which the task is conducted. Experiment 1 required participants to generate items that should be checked for safety/security if they were leaving their home unattended. Experiment 2 used an analogue recall task, in which participants were asked to recall items from a comprehensive list of items that should be checked if they were to leave their home safe/secure. Both experiments found that perseveration at the tasks was determined by particular configurations of mood and stop rules for the task. Of most relevance to compulsive checking was the fact that facilitated perseveration occurred when participants were asked to undertake the tasks in a negative mood using “as many as can” stop rules. Implications for the factors that develop and maintain compulsive checking are discussed

Mood as input and catastrophic worrying

The authors describe 3 experiments investigating a "mood-as-input" approach to understanding catastrophic worrying. Experiment 1 found that induced negative mood increased the number of steps emitted in both a catastrophizing interview procedure and a positive iteration task. Experiment 2 found that the number of items that worriers emitted in an iterative item generation task was dependent on the stop rules specified by the procedure. Experiment 3 found that manipulating the stop rules for catastrophizing had differential effects on worriers and non-=worriers, depending on the nature of the stop rules specified. These results suggest that mood provides information about continuing or terminating the catastrophizing process that is interpreted in the context of the stop rules for the task. It is argued that the mood-as-input hypothesis accounts for the facts of exacerbated catastrophizing in worriers better than explanations couched in terms of either mood congruency effects or worriers possessing a generalized perseverative iterative style

Repetitive and iterative thinking in psychopathology: anxiety-inducing consequences and a mood-as-input mechanism

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The use of "as many as can" versus "feel like continuing" stop rules during worrying

Two studies are reported that investigated the processes involved in stopping worry. Study 1 found that the use of "as many as can" stop rules was significantly related to measures of trait worry and beliefs about the positive and negative consequences of worrying, and Study 2 demonstrated that the reported use of "as many as can" stop rules significantly predicted perseveration on behavioral measures of catastrophic worrying. Reported use of "feel like continuing" stop rules was unrelated to any measures of worry in both studies. These results indicate that the use of "as many as can" stop rules is a highly significant predictor of worry frequency and perseveration, and that beliefs about the positive and negative consequences of worry also independently predict the use of "as many as can" stop rules. These findings are consistent with (1) the view that the stop rules used by worriers are closely associated with, or directly derived from, the more stable, global beliefs that worriers hold about the utility of the worry process, and (2) predictions from the mood-as-input model of catastrophic worryin

Perseveration of checking thoughts and mood-as-input hypothesis

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Correction to: Design of an international multicentre RCT on group schema therapy for borderline personality disorder

Correction to: BMC Psychiatry 14, 319 (2014)..

Persecutory delusions and psychological well-being.

PURPOSE: Persecutory delusions are one of the key problems seen in psychotic conditions. The aim of the study was to assess for the first time the levels of psychological well-being specifically in patients with current persecutory delusions. METHOD: One hundred and fifty patients with persecutory delusions in the context of a diagnosis of non-affective psychosis, and 346 non-clinical individuals, completed the Warwick-Edinburgh Mental Well-Being Scale and symptom assessments. RESULTS: Well-being scores were much lower in the persecutory delusions group compared with the non-clinical control group. 47 % of the persecutory delusions group scored lower than two standard deviations below the control group mean score. Within the patient group, psychological well-being was negatively associated with depression, anxiety, and hallucinations. In both groups, lower levels of well-being were associated with more severe paranoia. CONCLUSIONS: Levels of psychological well-being in patients with current persecutory delusions are strikingly low. This is likely to arise from the presence of affective symptoms and psychotic experiences. Measurement of treatment change in positive mental health for patients with psychosis is recommended

Design of an international multicentre RCT on group schema therapy for borderline personality disorder

Background Borderline personality disorder (BPD) is a severe and highly prevalent mental disorder. Schema therapy (ST) has been found effective in the treatment of BPD and is commonly delivered through an individual format. A group format (group schema therapy, GST) has also been developed. GST has been found to speed up and amplify the treatment effects found for individual ST. Delivery in a group format may lead to improved cost-effectiveness. An important question is how GST compares to treatment as usual (TAU) and what format for delivery of schema therapy (format A; intensive group therapy only, or format B; a combination of group and individual therapy) produces the best outcomes. Methods/Design An international, multicentre randomized controlled trial (RCT) will be conducted with a minimum of fourteen participating centres. Each centre will recruit multiple cohorts of at least sixteen patients. GST formats as well as the orders in which they are delivered to successive cohorts will be balanced. Within countries that contribute an uneven number of sites, the orders of GST formats will be balanced within a difference of one. The RCT is designed to include a minimum of 448 patients with BPD. The primary clinical outcome measure will be BPD severity. Secondary clinical outcome measures will include measures of BPD and general psychiatric symptoms, schemas and schema modes, social functioning and quality of life. Furthermore, an economic evaluation that consists of cost-effectiveness and cost-utility analyses will be performed using a societal perspective. Lastly, additional investigations will be carried out that include an assessment of the integrity of GST, a qualitative study on patients’ and therapists’ experiences with GST, and studies on variables that might influence the effectiveness of GST. Discussion This trial will compare GST to TAU for patients with BPD as well as two different formats for the delivery of GST. By combining an evaluation of clinical effectiveness, an economic evaluation and additional investigations, it will contribute to an evidence-based understanding of which treatment should be offered to patients with BPD from clinical, economic, and stakeholders’ perspectives