1 / 14

THE BIDIRECTIONALITY HYPOTHESIS: ARE CLINICAL CONSTRUCTS BOTH CAUSES AND EFFECTS OF SYMPTOMS?

THE BIDIRECTIONALITY HYPOTHESIS: ARE CLINICAL CONSTRUCTS BOTH CAUSES AND EFFECTS OF SYMPTOMS?. Graham C L Davey, Gary Britton, Frances Meeten & Georgina Barnes UNIVERSITY OF SUSSEX. What are Clinical Constructs?.

dinh
Download Presentation

THE BIDIRECTIONALITY HYPOTHESIS: ARE CLINICAL CONSTRUCTS BOTH CAUSES AND EFFECTS OF SYMPTOMS?

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. THE BIDIRECTIONALITY HYPOTHESIS: ARE CLINICAL CONSTRUCTS BOTH CAUSES AND EFFECTS OF SYMPTOMS? Graham C L Davey, Gary Britton, Frances Meeten & Georgina Barnes UNIVERSITY OF SUSSEX

  2. What are Clinical Constructs? • “Inferred states or processes derived most often from the clinical experiences of researchers or clinicians in their interactions with patients” (Davey, 2003) • Clinical Constructs have various functions: • To help understand psychopathology symptoms • To provide a basis for developing interventions • To link thoughts, beliefs and cognitive processes to subsequent symptoms (often in an implied causal manner)

  3. Examples of Clinical Constructs • Inflated Responsibility (Salkovskis, 1985) • Intolerance of Uncertainty (Dugas et al., 1998) • Thought-Action Fusion (Shafran & Rachman, 2002)

  4. The Development of Clinical Constructs • Describing the defining features of the construct • Developing an instrument to measure the construct • Validation of the measurement instrument against symptoms • Experimental manipulation of the construct and its effects on symptoms • Development of causal models of symptoms

  5. The Bidirectionality Hypothesis • ‘Doubting’ and Checking Behaviour • Tallis (1995) • Van den Hout & Kindt (2003) • Radomsky& Alcolado (2010) • Negative Mood and Pathological Worrying • Buhr & Dugas (2009) • Johnston & Davey (1997) • McLaughlin, Borkovec & Sibrava (2007)

  6. Experiments 1 & 2 – Inflated Responsibility & Negative Mood • Experiment 1 – The effect of manipulating Inflated Responsibility (using a vignette-based responsibility manipulation) on Negative Mood • Experiment 2 – The effect of manipulating Mood Valency (positive or negative) on self-reported measures of Inflated Responsibility

  7. Results – Experiment 1

  8. Results – Experiment 2

  9. Experiment 3 • Exposure to Obsessive Aversive Thoughts (28 obsessive statements vs 4 obsessive/24 neutral statements) • Self-relevant vs Non-self-relevant • Effects on measures of: • Inflated Responsibility (Responsibility Attitude Scale) • Intolerance of Uncertainty (Intolerance of Uncertainty Scale) • Thought-Action Fusion (Thought Fusion Instrument, TFI)

  10. Obsessive Statements • Statements largely taken from a study of abnormal and normal obsessional thoughts by Rachman & de Silva (1978) • Examples of obsessive statements: • “I will harm someone I love” • “I will push someone under a train” • Examples of neutral statements: • “I will have my usual breakfast” • “I will meet someone I know”

  11. Results – Inflated Responsibility

  12. Results – Intolerance of Uncertainty

  13. Results – Thought-Action Fusion

  14. Conclusions • Are Clinical Constructs merely Re-descriptions of Symptoms? • “..when we describe people as exercising qualities of mind, we are not referring to occult episodes of which their overt acts and utterances are effects; we are referring to those utterances themselves” (Ryle, 1949, p26) • Is Anxious Psychopathology an Integrated Holistic Experience not easily Described in Box-and-Arrow Models? • Are Some Features of the Psychopathology Experience Mediators of Cognitive, Behavioural & Physiological Factors (e.g. Experienced Negative Mood)? • Should Clinical Psychology Researchers Re-Consider the Usefulness of Some Contemporary Explanatory Paradigms?

More Related