Journal articles: 'Beck's Cognitive Therapy'

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Sloan, Graham. "Beck's cognitive therapy: a critical analysis." British Journal of Community Health Nursing 2, no. 10 (October 1997): 460–65. http://dx.doi.org/10.12968/bjch.1997.2.10.460.

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Bowers, Wayne A. "Beck's Cognitive Therapy: An Overview for Rehabilitation Counselors." Journal of Applied Rehabilitation Counseling 19, no. 1 (March 1, 1988): 43–46. http://dx.doi.org/10.1891/0047-2220.19.1.43.

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This article introduces Beck's Cognitive Therapy as a counseling model for rehabilitation counselors. The structured approach and success in treating anxiety and depression contribute to its validity as a tool in rehabilitation.

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Stewart, Jay R. "Applying Beck's Cognitive Therapy to Livneh's Model of Adaptation to Disability." Journal of Applied Rehabilitation Counseling 27, no. 2 (June 1, 1996): 40–45. http://dx.doi.org/10.1891/0047-2220.27.2.40.

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Rehabilitation Counselors frequently work with individuals who have recently experienced severe traumatic physical injuries. Beck originated cognitive therapy, a comprehensive approach to dealing with dysfunctional cognition and behavior. Livneh has proposed a model of adaptation to traumatic physical injuries with five phases. Each phase contains different cognitive, defensive, behavioral, and emotional reactions to the resulting disabilities. In this article, Beck's cognitive therapy and Livneh's model are combined to produce a comprehensive approach to help individuals in the five phases of reaction to physical trauma. Specific interventions are suggested for dealing with the cognitive, defense mechanisms, and emotional aspects in each phase.

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McMinn, Mark R., and Cathie J. Lebold. "Collaborative Efforts in Cognitive Therapy with Religious Clients." Journal of Psychology and Theology 17, no. 2 (June 1989): 101–9. http://dx.doi.org/10.1177/009164718901700202.

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Cognitive therapy requires an understanding of and tolerance for the religious views of clients. Collaborative techniques in cognitive therapy are described and ideological obstacles in doing cognitive therapy with religious clients are considered. It is suggested that confronting clients’ religious beliefs as pathological or absolutistic is clinically inappropriate. Beck's and Meichenbaum's collaborative techniques are endorsed as important clinical strategies in working with religious clients.

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Paykel, E. S. "Cognitive therapy and the emotional disorders: A. T. Beck." British Journal of Psychiatry 150, no. 6 (June 1987): 870–71. http://dx.doi.org/10.1192/s0007125000214918.

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Beck's original book on cognitive therapy was published in the USA in 1976 but not reviewed in the Journal until December 1979 (139, 582–583). The review was favourable. A second book (Beck et al, 1979) was not reviewed, although by then there was a substantial and growing literature on cognitive approaches to treatment.

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Bishay, Nagy Riad, Neil Petersen, and N. Tarrier. "An Uncontrolled Study of Cognitive Therapy for Morbid Jealousy." British Journal of Psychiatry 154, no. 3 (March 1989): 386–89. http://dx.doi.org/10.1192/bjp.154.3.386.

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Thirteen patients presenting with morbid jealousy were treated using a cognitive approach adapted from Beck's cognitive therapy for depression. Cognitions in morbid jealousy showed the characteristics of automatic thoughts as described by Beck, and were based on faulty assumptions derived from interpretations of past experiences. The cognitive treatment directed mainly at the faulty assumptions resulted in improvements in ten patients and no change in one; two patients dropped out of treatment. The results are considered encouraging.

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Moss, Donald P. "Cognitive Therapy, Phenomenology, and the Struggle for Meaning." Journal of Phenomenological Psychology 23, no. 1 (1992): 87–102. http://dx.doi.org/10.1163/156916292x00054.

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AbstractThis article critiques the inadequate attention given to the question of meaning in mainstream clinical psychiatry and psychology. The author reviews the history of phenomenological and existential psychiatry, especially the work of Erwin Straus, and highlights the emphasis on the personal world of experience and on such existential dimensions as time and ethical experience. Aaron Beck's school of cognitive therapy appropriates many themes and concepts from phenomenology, including the central concept of meaning, and turns them into a systematic technology for personal change. The author contrasts the phenomenological and cognitive approaches to meaning. The relationship between the cognitive and existential therapies is described by analogy to William James's healthy-minded and morbid-minded religion.

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Moorey, S., and S. Greer. "Adjuvant Psychological Therapy: A Cognitive Behavioural Treatment for Patients with Cancer." Behavioural Psychotherapy 17, no. 2 (April 1989): 177–90. http://dx.doi.org/10.1017/s0141347300016141.

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Cancer and its treatment are known to have a substantial psychological morbidity, but relatively little work has been done to investigate the effectiveness of psychotherapy with this group of patients. This paper outlines a newly developed cognitive behavioural approach for distressed cancer patients based on Beck's cognitive therapy. In addition to using cognitive and behavioural techniques to relieve depression and anxiety Adjuvant Psychological Therapy seeks to help patients develop a fighting spirit towards their illness. The application of the treatment is illustrated with the use of two case reports.

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Gipps, Richard G. T. "Does the cognitive therapy of depression rest on a mistake?" BJPsych Bulletin 41, no. 5 (October 2017): 267–71. http://dx.doi.org/10.1192/pb.bp.115.052936.

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SummaryCognitive therapy for depression is common practice in today's National Health Service, yet it does not work well. Aaron Beck developed it after becoming disillusioned with the psychoanalytic theory and therapy he espoused and practised. But Beck's understanding of psychoanalysis appears to have been seriously flawed. Understood rightly, the psychoanalytic approach offers a cogent theory and therapy for depression which, unlike the cognitive approach, takes us to its emotional-motivational roots. A clinically successful therapy can afford to eschew theory and rest on its pragmatic laurels. This is not the case for cognitive therapy. The time is right to re-examine the psychoanalytic theory and treatment of depression.

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Fennell, Melanie J. V. "Low Self-Esteem: A Cognitive Perspective." Behavioural and Cognitive Psychotherapy 25, no. 1 (January 1997): 1–26. http://dx.doi.org/10.1017/s1352465800015368.

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Although low self-esteem is common in clinical populations, a cognitive conceptualization of the problem and an integrated treatment programme deriving from that conceptualization are as yet lacking. The paper proposes a cognitive model for low self-esteem, deriving from Beck's model of emotional disorder. It outlines a treatment programme which integrates ideas and methods from cognitive therapy for depression, anxiety and more recent work on schemas or core beliefs. The model and treatment are illustrated with an extended case example.

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Fennell, Melanie J. V. "Cognitive therapy in the treatment of low self-esteem." Advances in Psychiatric Treatment 4, no. 5 (September 1998): 296–304. http://dx.doi.org/10.1192/apt.4.5.296.

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Beck's cognitive therapy originally developed as a short-term treatment for depression (Beck et al, 1979). It has been shown to be effective with a range of other disorders including panic disorder, generalised anxiety disorder, social phobia, eating disorders and sexual dysfunction (Roth et al, 1996). It is promising in the treatment of yet more disorders, many of which have traditionally been thought relatively impervious to psychotherapy, for example, bipolar disorder, chronic fatigue and psychosis (Clark & Fairburn, 1997). However, not everyone responds well to short-term cognitive therapy. In particular, it has been proposed that people with multiple, chronic problems that are apparently expressions of personality, rather than temporary responses to adverse life experiences, require more extended therapy (Beck et al, 1990).

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Rosner, Rachael I. "Aaron T. Beck's drawings and the psychoanalytic origin story of cognitive therapy." History of Psychology 15, no. 1 (2012): 1–18. http://dx.doi.org/10.1037/a0023892.

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Salkovskis, Paul M., and Hilary M. C. Warwick. "Cognitive Therapy of Obsessive – compulsive Disorder: Treating Treatment Failures." Behavioural and Cognitive Psychotherapy 13, no. 3 (July 1985): 243–55. http://dx.doi.org/10.1017/s0141347300011095.

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Foa (1979) has identified two groups of obsessional patients for whom behaviour therapy is ineffective; those with severe concurrent depression and those with “overvalued ideation”. She has also highlighted the need for the development of new treatment strategies for these individuals. A case history illustrating the development of overvalued ideation in a previously typical obsessional patient is described, together with an account of a successful treatment based on Beck's cognitive therapy combined with exposure. The implications of this report for views on the development of overvalued ideation in obsessionals are discussed. It is argued that cognitive–behavioural interventions such as the one described here may be useful as an adjunct to more traditional behavioural treatments for obsessional disorders as well as in the treatment of patients with overvalued ideation.

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Moorey, Stirling, Ruth Williams, and John Cobb. "The Institute of Psychiatry cognitive behaviour therapy course." Psychiatric Bulletin 14, no. 4 (April 1990): 219–21. http://dx.doi.org/10.1192/pb.14.4.219.

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Cognitive behaviour therapy is now widely accepted clinically as a treatment for depression and anxiety, and there is increasing research evidence to confirm its efficacy (Rush et al, 1977; Blackburn et al, 1981; Murphy et al, 1984; Butler et al, 1987; Beck, 1988). Of the various short term psychotherapies currently available, it is probably the most widely known and best researched. Despite this, and the recommendation of the Royal College of Psychiatrists (1986) that trainees receive training in cognitive therapy, there is little opportunity to gain a formal training in this psychotherapy. Short workshops are often available through the British Association for Behavioural Psychotherapy and from other sources, and ad hoc supervision from interested psychologists and psychiatrists may be available in some centres. Scott et al (1985) described a workshop and peer supervision training scheme in Newcastle. Macaskill (1986) reported a course for psychiatrists in training in Sheffield which extended over 20 weeks and combined Beck's cognitive therapy and Ellis' Rational Emotive Therapy.

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Ozga, Wioletta Karina. "The socio-cognitive theory of personality and its clinical applications." Humanities & Social Sciences Reviews 9, no. 5 (September 4, 2021): 01–07. http://dx.doi.org/10.18510/hssr.2021.951.

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Personality is a cognitive-affective processing system, which, according to the socio-cognitive theory, creates four dimensions. They are reflected in the skills, beliefs, standards and goals of the individual, which are consistent and consistent patterns of behaviour. Self-efficacy judgments and self-patterns determine the choice of goals and persistence in achieving them. On the other hand, the emotions preceding and accompanying the achievement of goals affect coping with stress and problems. The review of the clinical and therapeutic applications of this theory included stress inoculation training, REBT rational emotive therapy, Beck's cognitive depression therapy, schema therapy and modelling methods. The great advantage of this theory is the possibility of verifying its theoretical assumptions and confirming their huge amount of research. Besides, it has a practical application as many types of cognitive-behavioural therapies have been developed on its basis.

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Moorey, Stirling. "The cognitive therapy of depression rests on substantial theoretical, empirical and clinical foundations: a reply to Dr Gipps." BJPsych Bulletin 41, no. 5 (October 2017): 272–75. http://dx.doi.org/10.1192/pb.bp.116.055616.

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SummaryDr Gipps claims that the cognitive therapy for depression rests on a mistake. But his anachronistic analysis of Beck's early research from the perspective of current psychoanalytic theory misses the point. The value of the research was not that it disproved psychoanalytic theory, but that it generated a model of depression that has revolutionised psychotherapy research. Psychoanalysts are belatedly adopting research methods that Beck pioneered half a century ago. The cognitive model of depression has explanatory power for both maintenance and vulnerability and has substantial research underpinning it. Cognitive therapy for depression has a larger body of evidence for its efficacy and relapse prevention effect than any other psychotherapy. Transference-focused approaches to depression have yet to establish themselves in the same way.

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Kramer, Ueli, Guy Bodenmann, and Martin Drapeau. "Cognitive errors assessed by observer ratings in bipolar affective disorder: relationship with symptoms and therapeutic alliance." Cognitive Behaviour Therapist 2, no. 2 (June 2009): 92–105. http://dx.doi.org/10.1017/s1754470x09990043.

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AbstractThe construct of cognitive errors is clinically relevant for cognitive therapy of mood disorders. Beck's universality hypothesis postulates the relevance of negative cognitions in all subtypes of mood disorders, as well as positive cognitions for manic states. This hypothesis has rarely been empirically addressed for patients presenting bipolar affective disorder (BD). In-patients (n= 30) presenting with BD were interviewed, as were 30 participants of a matched control group. Valid and reliable observer-rater methodology for cognitive errors was applied to the session transcripts. Overall, patients make more cognitive errors than controls. When manic and depressive patients were compared, parts of the universality hypothesis were confirmed. Manic symptoms are related to positive and negative cognitive errors. These results are discussed with regard to the main assumptions of the cognitive model for depression; thus adding an argument for extending it to the BD diagnostic group, taking into consideration specificities in terms of cognitive errors. Clinical implications for cognitive therapy of BD are suggested.

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Ghahari, Shahrbanoo, Nooshin Khademolreza, Fatemeh Sadeghi Poya, Siamak Ghasemnejad, Bahram Gheitarani, and Mohammad Reza Pirmoradi. "Effectiveness of Mindfulness Techniques in Decreasing Anxiety and Depression in Women Victims of Spouse Abuse." Asian Journal of Pharmaceutical Research and Health Care 9, no. 1 (December 16, 2016): 28. http://dx.doi.org/10.18311/ajprhc/0/7644.

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Psychiatric disorders such as depression and anxiety are outputs of domestic violence and victims should be treated using medical and nonmedical treatment. The main purpose of this study is to investigate the effectiveness of mindfulness-based cognitive therapy in reducing anxiety and depression of women victims of domestic violence in Tehran. The study is an empirical research in kind of pretest-posttest plan with a control group. Statistical population consists of women victims of domestic violence in Tehran referred to several psychiatric clinics in Tehran for treatment by 2015. The statistical sample consists of 30 women selected randomly, who were placed into two groups, each group with 15 members. The experimental group was under the intervention of mindfulness-based cognitive therapy for 8 sessions and control group was in waiting list. Both groups, fulfilled Beck's Depression Inventory (BDI) and Spielberger's State-Trait Anxiety Inventory (STAI) in final step and end of treatment. Obtained data was analyzed using ANOVA and using SPSS22 software. The obtained results from the study show that there is a significant difference between two experimental and control groups in terms of depression and anxiety after mindfulness-based cognitive therapy intervention (p<001). The obtained results from the study show that mindfulness-based cognitive therapy can affect the reduction of anxiety and depression of women victims of domestic violence.

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Ghahari, Shahrbanoo, Nooshin Khademolreza, Fatemeh Sadeghi Poya, Siamak Ghasemnejad, Bahram Gheitarani, and Mohammad Reza Pirmoradi. "Effectiveness of Mindfulness Techniques in Decreasing Anxiety and Depression in Women Victims of Spouse Abuse." Asian Journal of Pharmaceutical Research and Health Care 9, no. 1 (December 16, 2016): 28. http://dx.doi.org/10.18311/ajprhc/2017/7644.

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Psychiatric disorders such as depression and anxiety are outputs of domestic violence and victims should be treated using medical and nonmedical treatment. The main purpose of this study is to investigate the effectiveness of mindfulness-based cognitive therapy in reducing anxiety and depression of women victims of domestic violence in Tehran. The study is an empirical research in kind of pretest-posttest plan with a control group. Statistical population consists of women victims of domestic violence in Tehran referred to several psychiatric clinics in Tehran for treatment by 2015. The statistical sample consists of 30 women selected randomly, who were placed into two groups, each group with 15 members. The experimental group was under the intervention of mindfulness-based cognitive therapy for 8 sessions and control group was in waiting list. Both groups, fulfilled Beck's Depression Inventory (BDI) and Spielberger's State-Trait Anxiety Inventory (STAI) in final step and end of treatment. Obtained data was analyzed using ANOVA and using SPSS22 software. The obtained results from the study show that there is a significant difference between two experimental and control groups in terms of depression and anxiety after mindfulness-based cognitive therapy intervention (p<001). The obtained results from the study show that mindfulness-based cognitive therapy can affect the reduction of anxiety and depression of women victims of domestic violence.

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Tecuta, Lucia, Elena Tomba, Ambra Lupetti, and Raymond DiGiuseppe. "Irrational Beliefs, Cognitive Distortions, and Depressive Symptomatology in a College-Age Sample: A Mediational Analysis." Journal of Cognitive Psychotherapy 33, no. 2 (April 24, 2019): 116–27. http://dx.doi.org/10.1891/0889-8391.33.2.116.

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Dysfunctional cognitions such as irrational beliefs (IBs) of Ellis' rational emotive behavior therapy (REBT) model and cognitive distortions (CDs) or cognitive errors from Beck's cognitive behavioral therapy (CBT) model are known to correlate with depressive symptomatology. However, most studies focus on one cognitive theoretical model in predicting psychopathology. The current study examined the relationship between both IBs and CDs in predicting depression. A college-age sample of 507 participants completed the Attitudes and Beliefs Scale-2, the Cognitive Distortions Scale, and the Beck Depression Inventory-II. Half of the sample showed minimal depression, while the remaining sample exhibited mild-moderate (37.4%) to severe (11.1%) depression symptomatology. Through regression analyses, the study aimed to examine whether IBs accounted for more of the variance in depression symptomatology after the effects of CDs were considered. Moreover, it tested whether CDs served as a moderator or mediator between IBs and depression. Each of Ellis' IBs (demandingness, awfulizing, self-downing, and low frustration tolerance) accounted for significantly more variance in depression after the variance of CDs was entered with the IB of self-downing explaining the most variance in depression severity. Moreover, while no moderation effect was found, CDs partially mediated the effect of IBs on depression. Both IBs and CDs contributed unique variance in predicting depression. Findings support the clinical notion that IBs and CDs are associated as well as highlight the clinical utility of both conceptualizations of dysfunctional cognitions in explaining depressive symptomatology. Clinicians might consider that each dysfunctional cognition might not be subject to change if not directly targeted. Rather than choosing to focus exclusively on IBs or CDs underlying negative automatic thoughts, psychotherapeutic efforts might benefit from identifying and challenging both types of dysfunctional cognitions.

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Moorey, Stirling. "The Six Cycles Maintenance Model: Growing a “Vicious Flower” for Depression." Behavioural and Cognitive Psychotherapy 38, no. 2 (November 20, 2009): 173–84. http://dx.doi.org/10.1017/s1352465809990580.

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Background:Cognitive behavioural models of anxiety disorders often include visual representations of feedback loops that maintain the disorder. Cognitive therapy for depression is the prototype for therapy for many other disorders, and there is now good evidence for factors that maintain depression, yet there is still no accepted diagrammatic form of the maintenance model.Aims:To develop a simple, clinically acceptable and empirically based version of the “vicious flower” for depression.Method:Current theoretical developments in depression (Differential activation and Beck's concept of modes) and empirical findings on maintenance factors were reviewed. A model was developed based on clinical utility and current knowledge of the processes and maintenance factors in depression. This model was tested for its usefulness with a small sample of IAPT trainees.Results:The model contained 6 cycles comprising 2 cognitive cycles (automatic negative thinking and rumination/self-attacking), 2 behavioural cycles (withdrawal/avoidance and unhelpful behaviour), a mood/emotion cycle, and a motivation/physical symptoms cycle. Students found it a very useful tool for understanding maintenance factors.Conclusions:This diagrammatic maintenance model of depression, like similar “vicious flowers” for anxiety, may be helpful in conceptualization, socialization and treatment planning as well as teaching CBT.

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Moorey, Stirling, and Herbert Steiner. "Do Depressive Symptoms Differ Between Medically Ill and Non-Medically Ill Patients Referred for Psychological Therapy? Comparing Negative Thoughts about the Self in Cancer and Non-Cancer Patients." Behavioural and Cognitive Psychotherapy 35, no. 3 (February 21, 2007): 283–91. http://dx.doi.org/10.1017/s1352465807003578.

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Negative thoughts about the self are a core component of Beck's cognitive triad of depression, and are seen by some as the central cognitive symptom of the disorder. The role of negative thoughts about the self in secondary depression associated with medical illness is less clear: thoughts relating to hopelessness and helplessness rather than guilt, self blame and failure may be more prominent. This study tested the hypothesis that the cognitive symptoms of depression in cancer patients would be less negatively self-referent than a psychiatric control group. Forty patients with cancer referred to a psychological medicine department were matched for age, sex and BDI score with 40 patients referred to a psychological therapies department for CBT. The cognitive-affective section of the BDI (items 1–14) was divided into a negative self-referent cognitions subscale (items 3, 5, 7, 8) and a mood-motivation subscale. These two subscales were then compared with the somatic-performance subscale (items 15–21). As a percentage of the total matched BDI score, the cancer patients had more somatic symptoms (42.7 v 34.8%), equivalent mood/motivation symptoms (44.5 v 45.6%) and less negative self-referent symptoms (12.8 v 19.5%). This difference may apply more to mild symptoms than moderate-severe symptoms. Some preliminary support for the hypothesis is therefore available.

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Bond, Frank W., and Windy Dryden. "HOW RATIONAL BELIEFS AND IRRATIONAL BELIEFS AFFECT PEOPLE'S INFERENCES: AN EXPERIMENTAL INVESTIGATION." Behavioural and Cognitive Psychotherapy 28, no. 1 (January 2000): 33–43. http://dx.doi.org/10.1017/s1352465800000047.

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Rational Emotive Behaviour Therapy (REBT) hypothesizes that the functionality of inferences is primarily affected by the preferential and demanding nature of rational and irrational beliefs, respectively. It is then, secondarily, influenced by the functional and dysfunctional contents to which rational and irrational beliefs, respectively, refer. This hypothesis was tested by asking 96 participants to imagine themselves holding one of four specific beliefs: a rational belief with a preference and a functional content, an irrational belief with a demand and a dysfunctional content, a rational belief with a functional content and no preference, and an irrational belief with a dysfunctional content and no demand. Participants imagined themselves holding their belief in an imaginary context, whilst rating the extent of their agreement to 14 functional and dysfunctional inferences. Contrary to REBT theory, results indicated that rational and irrational beliefs had the same magnitude of effect on the functionality of inferences, whether they referred to a preference/demand+contents, or only contents. The discussion maintains that preferences and demands may not constitute the principal mechanism through which rational and irrational beliefs affect the functionality of inferences. Instead, consistent with Beck's cognitive therapy, belief contents may constitute this primary mechanism.

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Davidson, Joyce. "Beckʼs Cognitive Therapy: Distinctive Features." Journal of Psychiatric Practice 16, no. 4 (July 2010): 277–78. http://dx.doi.org/10.1097/01.pra.0000386916.69935.f8.

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Leahy, Robert L. "Cognitive Development and Cognitive Therapy." Journal of Cognitive Psychotherapy 9, no. 3 (January 1995): 173–84. http://dx.doi.org/10.1891/0889-8391.9.3.173.

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Beck’s cognitive theory of psychopathology is integrated with Piaget’s and Bowlby’s structural cognitive-developmental theories. Automatic thought distortions, maladaptive assumptions, and early maladaptive schemas are formed at the preoperational level of intelligence and are marked by structural limitations of moral realism, imminent justice, dichotomous and intuitive thinking, and magical causality. The specific negative content of self-other schemas is based on early object representations reflecting pathology in the attachment process. Personality disorders are described as the persistence of preoperational structure and early object representations which are submitted to compensation and avoidance through maladaptive life-scripts. A case formulation based on this model is described.

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Rosen, Hugh. "The Creative Evolution of the Theoretical Foundations for Cognitive Therapy." Journal of Cognitive Psychotherapy 14, no. 2 (January 2000): 123–34. http://dx.doi.org/10.1891/0889-8391.14.2.123.

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The theoretical underpinnings of Beck’s model of cognitive therapy are examined from a developmental perspective with emphasis upon their creative nature. This is preceded by a general discussion of what constitutes creativity. The application of the discussion to Beck’s developing theory primarily emphasizes the “case study” and “evolving systems” approaches. Major attributes and dimensions of creativity are also defined and their presence in Beck’s evolving theory for cognitive therapy identified. The basic premise of this article is that Beck’s developing theory reflects a creative process and product.

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Rosner, Rachael I. "Aaron T. Beck’s Dream Theory in Context: An Introduction to His 1971 Article on Cognitive Patterns in Dreams and Daydreams." Journal of Cognitive Psychotherapy 16, no. 1 (March 2002): 7–21. http://dx.doi.org/10.1891/jcop.16.1.7.63702.

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Aaron T. Beck developed a rudimentary theory of dreams in the early years of cognitive therapy (1969-1971) that he presented to both psychoanalysts and behavior therapists. This article will examine the historical conditions that fostered Beck’s cognitive dream theory. Beck’s early psychoanalytic dream research taught him the virtues of social science research and catalyzed his shift towards the cognitive model. Once the cognitive model was in place he returned to dreams to help position himself politically in the national therapeutic scene. The 1971 article reprinted in this special issue is evidence of his effort to reach out to psychoanalysts with his new cognitive model. Beck’s dream work, once he allied with behavior therapists, fell out of public view, but the current interest in psychotherapy integration has brought renewed attention to dreams in cognitive therapy.

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Clark, David A. "Perceived Limitations of Standard Cognitive Therapy: A Consideration of Efforts to Revise Beck’s Theory and Therapy." Journal of Cognitive Psychotherapy 9, no. 3 (January 1995): 153–72. http://dx.doi.org/10.1891/0889-8391.9.3.153.

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In this paper I discuss five basic principles that make Beck’s cognitive therapy (CT) a distinctive school of psychotherapy. In light of these principles, four major criticisms of Beck’s standard cognitive theory and practice are considered. These include: (a) standard CT has a limited view of emotion; (b) CT has an inadequate view of interpersonal factors; (c) CT ignores the therapeutic alliance; and (d) CT overemphasizes conscious controlled processing. Each of these criticisms are evaluated on whether they can be accommodated within the standard CT approach advocated by Beck thereby leading to refinement of his theory and therapy, or whether efforts at revision and/or integration with other schools of psychotherapy result in a transformation so radical as to threaten the distinctiveness of Beck’s therapy.

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Padesky, Christine A., and Aaron T. Beck. "Science and Philosophy: Comparison of Cognitive Therapy and Rational Emotive Behavior Therapy." Journal of Cognitive Psychotherapy 17, no. 3 (July 2003): 211–24. http://dx.doi.org/10.1891/jcop.17.3.211.52536.

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Aaron T. Beck’s Cognitive Therapy (CT) and Albert Ellis’ Rational Emotive Behavior Therapy (REBT) are compared. A major difference between these therapies is that CT is an empirically based therapy and REBT is philosophically based. The origins and subsequent development of the therapies are reviewed with this difference highlighted. Comparisons between CT and REBT practice are made regarding attitudes toward client beliefs, use of guided discovery, types of cognition addressed, and the nature of the client-therapist relationship. The scientific foundations of CT are summarized in terms of the specificity of its conceptual models, the construction of targeted treatment protocols, and empirical findings that support both CT conceptualizations and treatments.

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Kuehlwein, Kevin T. "Enhancing Creativity in Cognitive Therapy." Journal of Cognitive Psychotherapy 14, no. 2 (January 2000): 175–87. http://dx.doi.org/10.1891/0889-8391.14.2.175.

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This article explores the nature of creativity in psychotherapy and offers several methods and frameworks with which to enhance creativity as a cognitive therapist. It reviews the methodologically permissive parameters of Beck’s model, while providing a framework for enfolding methods from other models so as to retain the cognitive character of these interventions when used within the cognitive therapy session. It also extrapolates from Edward deBono’s model of how to improve the quality of thinking to suggest specific interventions as well as general principles that can be used or adapted in cognitive therapy treatment. Numerous case examples are given and further resources for nurturing and generating creativity are provided.

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Ellis, Albert. "Discussion of Christine A. Padesky and Aaron T. Beck, “Science and Philosophy: Comparison of Cognitive Therapy and Rational Emotive Behavior Therapy”." Journal of Cognitive Psychotherapy 19, no. 2 (June 2005): 181–85. http://dx.doi.org/10.1891/jcop.19.2.181.66789.

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The author largely agrees with Christine A. Padesky and Aaron T. Beck’s (2003) article, “Science and Philosophy: Comparison of Cognitive Therapy and Rational Emotive Behavior Therapy,” disagrees with several of its statements about REBT, and particularly objects to Padesky and Beck’s view that the fundamental difference between CT and REBT is that the former therapy is empirically based and the latter is philosophically based.

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Strunk, Daniel R., and Robert J. DeRubeis. "Cognitive Therapy for Depression: A Review of Its Efficacy." Journal of Cognitive Psychotherapy 15, no. 4 (January 2001): 289–97. http://dx.doi.org/10.1891/0889-8391.15.4.289.

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The empirical status of cognitive therapy for depression, based on Aaron T. Beck’s model, is reviewed. Available evidence suggests that cognitive therapy is at least as effective in the short run as other psychotherapies, as well as pharmacotherapy. Patients in cognitive therapy experience a large reduction in depressive symptoms and a substantial portion meet recovery criteria at the end of a 12- or 16-week acute treatment period. Moreover, there is evidence that cognitive therapy produces a prophylactic effect. Thus, we conclude that cognitive therapy works well and should be strongly considered as a first-line treatment for depressed people.

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Liese, Bruce S., and Mark W. Larson. "Coping With Life-Threatening Illness: A Cognitive Therapy Perspective." Journal of Cognitive Psychotherapy 9, no. 1 (January 1995): 19–34. http://dx.doi.org/10.1891/0889-8391.9.1.19.

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For years, behavioral scientists have been examining the process of coping with life-threatening illnesses. In fact, much of the work in this area has been influenced by cognitive-behavioral theories (e.g., Lazarus & Folkman, 1984). The purpose of this article is to apply Beck’s model of cognitive therapy to coping, to discuss specific cognitive processes related to life-threatening illnesses, and to suggest specific interventions appropriate for individuals diagnosed with life-threatening illnesses. AIDS, cancer, and myocardial infarction are discussed in terms of the emotional reactions they may produce (e.g., anxiety, depression, and anger). Cognitive processes related to these emotions are examined and cognitive therapy techniques are suggested for helping individuals with maladaptive emotional and behavioral coping responses.

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Piasecki, Bartosz, and Karolina Kabzińska. "Neuropsychological deficits in depression – a challenge for cognitive-behavioral therapies." Journal of Medical Science 88, no. 4 (December 23, 2019): 227–34. http://dx.doi.org/10.20883/medical.318.

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Neuropsychological deficits in depression are a significant therapeutic challenge. Their occurrence means poor therapeutic prospects, worse social and professional functioning after therapy, as well as a higher risk of relapse. Despite clinical improvement, they often remain even in a state of complete remission. Beck’s model of depression does not include interventions directed at neuropsychological processes leading to neurocognitive mechanisms responsible for the development and maintenance of depression. More recent trends in cognitive-behavioral therapy seem to involve neuropsychological processes to a greater extent. This applies to Well’s metacognitive model, which focuses on the meta-level of thinking. Therapeutic process involves various aspects of attention, as well as detached mindfulness. Available empirical studies indicate that this therapy model is more effective in reducing neuropsychological deficits than Beck’s model. Acceptance and commitment therapy as well as mindfulness-based cognitivetherapy both focus on the development of skills that are related to the efficiency of executive functions and flexibility of attention, i.e. the cognitive processes whose deficits are characteristic of depression. However, research is needed to confirm their effectiveness in reducing neuropsychological deficiencies compared to other therapeutic models. Interventions in the field of cognitive remediationcan be used to enrich cognitive-behavioral therapies and increase their effectiveness. Until now, they have been used as a separate form of therapy, for example in anorexia.

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Romanowska, Monika, and Bartłomiej Dobroczyński. "Unconscious processes in Aaron Beck’s cognitive theory: Reconstruction and discussion." Theory & Psychology 30, no. 2 (January 29, 2020): 223–42. http://dx.doi.org/10.1177/0959354320901796.

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The concept of the unconscious has always provoked controversy. While some psychologists treated it as a relic of metaphysics or a manifestation of psychoanalytic mysticism, others saw it as an important explanatory construct. At the heart of this conflict, there is the theory proposed by Aaron Beck, the originator of cognitive therapy. According to the founding myth, he rejected the concept of the dynamic unconscious to develop an evidence-based approach. The aim of this article is to reconstruct and analyze Beck’s understanding of the unconscious based on his published works and archival materials and to identify the values that guided his theoretical choices. We argue that Beck’s conceptualization of the unconscious ignores contradictory conscious and unconscious representations and attitudes and offers no systematic model of basic needs and the conflicts between them. We conclude that this stems from Beck’s attachment to the phenomenological understanding of the psyche, emphasis on humanism in the therapeutic relationship, fear of cognitive theory losing its distinctness, and caution in formulating theories.

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Leonardi, Angela. "Depression on a Screen. “The Love Song of J. Alfred Prufrock” in the Light of Cognitive Theories of Depression." Le Simplegadi 18, no. 20 (November 2020): 35–43. http://dx.doi.org/10.17456/simple-154.

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This article analyses “The Love Song of J. Alfred Prufrock” in the light of the American psychiatrist A. T. Beck’s diagnostic criteria and cognitive theories for interpreting and evaluating symptoms and levels of depression. This study aims to show that many symptoms listed in Beck’s Inventory for Measuring Depression (sixteen out of twenty-one) are recognizable – at different levels of signifier and signified – in both the poetical structure and the imagery of the poem, whereas specific aspects included in Cognitive Therapy of Depression (for instance, the cognitive process defined by Beck as “Faulty Information Processing” and two crucial points of this process, “Selective abstraction” and “Arbitrary inference”) are identifiable in some of the most relevant figurative isotopies of the poem.

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Dahlen, Eric R., and Jerry L. Deffenbacher. "A Partial Component Analysis of Beck’s Cognitive Therapy for the Treatment of General Anger." Journal of Cognitive Psychotherapy 14, no. 1 (January 2000): 77–95. http://dx.doi.org/10.1891/0889-8391.14.1.77.

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Eighty-six high-anger undergraduates were assigned to eight group sessions of Beck’s full cognitive therapy (FCT) focusing on both cognitive and behavioral change, cognitive restructuring only (CRO) focusing only on cognitive change, or a no-treatment control. Analyses suggested treatments were delivered in an equivalent, high-quality manner and that therapists adhered to treatment protocols. By 5-week follow-up, treatment groups, while not differing from each other, showed reductions in trait anger, cognitive, emotional, and behavioral components of anger, the individual’s greatest ongoing source of anger, and anger-related physiological arousal. Treatments lowered anger suppression and outward negative expression and enhanced controlled expression. Compared to controls, CRO also reduced trait anxiety and depression. Treatment effect sizes were medium (η2 = .06 to .13) to large (η2 > .13), and more treatment participants met a clinically reliable change index on trait anger. Findings support FCT and CRO for general anger reduction.

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Cordes, Joachim, Maya Woite, Christina Engelke, Gunnar Regenbrecht, Kai G. Kahl, Christian Schmidt-Kraepelin, Uwe Henning, Daniel Kamp, and Ansgar Klimke. "Hormone replacement therapy with L-thyroxine promotes working memory and concentration in thyroidectomized female patients after differentiated thyroid carcinoma." International Journal of Psychiatry in Medicine 55, no. 2 (November 5, 2019): 114–22. http://dx.doi.org/10.1177/0091217419885751.

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Objective It is well established that long-term hypothyroidism is associated with cognitive deficits. Based on recent literature, we hypothesized that pharmacologically induced euthyroidism would lead to improved cognitive performance compared to a hypothyroid state. Methods We analyzed data from 14 nondepressed thyroidectomized female patients after differentiated thyroid carcinoma during hypothyroidism (due to a four-week withdrawal of thyroid hormone, T1) and euthyroidism brought about by substitution with L-thyroxine (T2). At both measurement points, patients completed a cognitive test battery as our dependent measure and Beck’s Depression Inventory to control depressive states. Results A Wilcoxon signed-rank tests revealed a significant improvement in the Rey–Osterrieth complex figure test (cognitive reproduction), Z = −3.183, p = 0.001, and the D2 concentration score, Z = −1.992, p = 0.046 in euthyroidism compared to hypothyroidism. Conclusions Our results confirm that hormone replacement therapy with L-thyroxine promotes cognitive reproduction and concentration in thyroidectomized female patients after differentiated thyroid carcinoma.

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Ruizq, Francisco J., and Paula Odriozola-González. "The role of psychological inflexibility in Beck’s cognitive model of depression." Anales de Psicología 32, no. 2 (April 3, 2016): 441. http://dx.doi.org/10.6018/analesps.32.2.214551.

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Beck’s cognitive model of depression proposes that depressogenic schemas have an effect on depressive symptoms by increasing the frequency of negative automatic thoughts in response to negative life events. We aimed to test a moderated, serial mediation model where psychological inflexibility, a core concept of the Acceptance and Commitment Therapy (ACT) model of psychopathology, both mediates and moderates the relationship between depressogenic schemas and the frequency of negative automatic thoughts. A cross-sectional design was used in which 210 undergraduates responded to questionnaires assessing the constructs of interest. Results supported the proposed moderated mediation model. Both psychological inflexibility and negative automatic thoughts were significant mediators of the relationship between depressogenic schemas and depressive symptoms, and psychological inflexibility also moderated the effect of depressogenic schemas on negative automatic thoughts. We conclude that the role of psychological inflexibility in the cognitive model of depression deserves more attention.

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Hamblet, Charles. "Using Husserl’s Natural Attitude to Understand the Change Process within Cognitive Therapy." Journal of Phenomenological Psychology 50, no. 2 (November 26, 2019): 189–224. http://dx.doi.org/10.1163/15691624-12341362.

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Abstract The following paper argues that Husserl’s description of the natural attitude can be used as an alternative to Beck’s cognitive therapy’s understanding of the change process and the perpetuation of an emotional disorder. Conversely this also provides further insight into the natural attitude. Specifically the works of Sebastian Luft and Alfred Schutz are referred to as a means of developing what is termed by the paper as the universalising attitude. The paper extrapolates the incidental, yet significant, phenomenological structures within CBT’s process of guided discovery to support its hypothesis that the change process can be understood as the patient undertaking at various times in therapy, a series of differing epoché. It is argued that CBT ultimately ‘works’ by the patient learning to achieve a rudimentary phenomenological attitude. The patient acquires insight by ‘standing back’ from their factual understanding of self, others and the world.

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Rutberg, Eric. "Beyond Words: Learning to Use Role-Play to Treat Posttraumatic Stress Disorder." Journal of Psychodrama, Sociometry, and Group Psychotherapy 64, no. 1 (May 1, 2016): 25–39. http://dx.doi.org/10.12926/0731-1273-64.1.25.

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Scholarly research conducted by former National Institute of Mental Health Director Frank Ochberg (2006), the American Psychological Association (2003), and Rosenberg et al. (2001) show that cognitive-behavioral therapy (CBT), especially exposure therapy, is effective in treating posttraumatic stress disorder (PTSD) on a psychobiological level. Yet according to studies by Becker, Zayfert, and Anderson (2003) and Cahill, Foa, Hembree, Marshall, and Nacash (2006), many psychologists and master's-level clinicians do not include an exposure therapy component in their treatment of PTSD.

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Berg, Selina K., Trine B. Rasmussen, Margrethe Herning, Jesper H. Svendsen, Anne V. Christensen, and Lau C. Thygesen. "Cognitive behavioural therapy significantly reduces anxiety in patients with implanted cardioverter defibrillator compared with usual care: Findings from the Screen-ICD randomised controlled trial." European Journal of Preventive Cardiology 27, no. 3 (October 2, 2019): 258–68. http://dx.doi.org/10.1177/2047487319874147.

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Aim The aim of this study was to investigate the effect of a cognitive behavioural therapy intervention provided by trained cardiac nurses plus usual care compared with usual care alone in patients with an implanted cardioverter defibrillator who, prior to randomization, had presented with symptoms of anxiety measured by the Hospital Anxiety and Depression Scale. Background Around 20–25% of all patients with an implanted cardioverter defibrillator experience anxiety. Among these patients anxiety is associated with mortality, presumably explained by risk behaviour and activation of the autonomic nervous system. We hypothesised that cognitive behavioural therapy provided by cardiac nurses in an out-patient setting would be an effective treatment of anxiety. Methods This was an investigator-initiated randomised clinical superiority trial with blinded outcome assessment, with 1:1 randomisation to cognitive behavioural therapy plus usual care or to usual care. The primary outcome was Hospital Anxiety and Depression Scale-Anxiety mean score at 16 weeks. Secondary outcomes included Hospital Anxiety and Depression Scale-Depression, Becks Anxiety Inventory, HeartQoL and Hamilton Anxiety Scale. Primary outcome analysis was based on the intention-to-treat principle. Results A total of 88 participants were included, 66% men, mean age 64.3 years and 61% had primary indication implantable cardioverter defibrillator. A significant difference after 16 weeks was found between groups: intervention group (Hospital Anxiety and Depression Scale-A mean (standard deviation) 4.95 points (3.30) versus usual care group 8.98 points (4.03) ( p < 0.0001)). Cohen's d was –0.86, indicating a strong clinical effect. The effect was supported by secondary outcomes. Conclusion Cognitive behavioural therapy provided by cardiac nurses to patients with a positive screening for anxiety had a statistically and clinically significant effect on anxiety compared with patients not receiving cognitive behavioural therapy.

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Westra, Henny A., David J. A. Dozois, and Christine Boardman. "Predictors of Treatment Change and Engagement in Cognitive-Behavioral Group Therapy for Depression." Journal of Cognitive Psychotherapy 16, no. 2 (June 2002): 227–41. http://dx.doi.org/10.1891/jcop.16.2.227.63996.

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This study examined predictors of treatment response in 48 individuals who presented for participation in a 10-session cognitive-behavioral group therapy (CBGT) program for depression. The majority of participants carried a diagnosis of major depression and all were concurrently on at least 1 antidepressant medication. The therapeutic approach involved an integration of 2 empirically supported therapies: Beck’s cognitive therapy (Beck, Rush, Shaw, & Emery, 1979) and Lewinsohn’s Coping With Depression course (Lewinsohn, Antonuccio, Breckenridge, & Teri, 1984). Participants completed the Burns Depression Checklist, the Dysfunctional Attitudes Scale (DAS), and the Burns Hopelessness Scale, a 5-item questionnaire which assesses the degree of optimism/pessimism an individual has regarding mood and symptom control. No significant differences were found on pre-treatment dysfunctional attitudes or depressive symptomatology between individuals who dropped out of treatment (n = 9) and treatment completers (n = 39). However, pre-treatment hopelessness scores were significantly higher in dropouts than in individuals who completed treatment. Increased pessimism about symptom control was also related to fewer reductions in DAS scores throughout treatment among completers and to poorer overall treatment response. These findings suggest that negative expectations about treatment outcome may be associated with reduced treatment benefit in CBGT, and may place individuals at significantly greater risk of premature treatment termination. The theoretical and clinical significance of these findings are discussed and suggestions for future research and practice are detailed.

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Butler, Robert W. "Claudia Zayfert and Carolyn Black Becker, Cognitive-Behavioral Therapy for PTSD: A Case Formulation Approach." Journal of Contemporary Psychotherapy 37, no. 4 (August 3, 2007): 241. http://dx.doi.org/10.1007/s10879-007-9062-0.

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Cheavens, Jennifer S., David B. Feldman, Julia T. Woodward, and C. R. Snyder. "Hope in Cognitive Psychotherapies: On Working With Client Strengths." Journal of Cognitive Psychotherapy 20, no. 2 (June 2006): 135–45. http://dx.doi.org/10.1891/jcop.20.2.135.

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The field of psychology, which is traditionally rooted in the study and treatment of psychological disorders and pathology, recently has begun to embrace an examination of individual, as well as societal, strengths and virtues. This subspecialty within psychology, known as positive psychology, can be defined as the attempt to understand the characteristics and processes that contribute to optimal functioning, flourishing, and resiliency. The purpose of the present article is to draw a link between traditional psychology and positive psychology using the example of the positive psychological construct of hope. Specifically, we explore the ways in which hope theory can be incorporated into traditional forms of cognitive therapy for symptom reduction and elimination. First, the theory of hope (Snyder, 1994) is introduced and the concept of hopeful thought is defined. Next, we explore the distinction between Snyder’s definition of hope and Beck’s definition of hopelessness (Beck, Weissman, Lester, & Trexler, 1974). Finally, we present possible strategies for utilizing hope concepts in cognitive therapies. Studying individuals with high levels of hope has resulted in a wealth of information about the ways these individuals overcome obstacles and find multiple ways to the goals that they have set for themselves. Integrating these lessons into empirically based treatments for symptom reduction is likely to result in a synergy that utilizes the most sound aspects of both traditional psychology and positive psychology.

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Chand, Bibin, Madhavi Sharma, and Narendra S. Thagunna. "Efficacy of Integrated Intervention Program on Mental Health of Cancer Patients." Journal of Institute of Medicine Nepal 42, no. 1 (April 30, 2020): 77. http://dx.doi.org/10.3126/jiom.v42i1.37456.

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Introduction Copious researchers have made notable findings on the mental health of cancer patients and effect of various discrete therapies, but still there exist a significant paucity on integrated therapeutic interventions over their mental health. The objectives of this study were to find the prevalence of mental health morbidity and the efficacy of an integrated intervention program comprised of Aaron Beck’s Cognitive Behavior Therapy (CBT), Jacobson Progressive Muscle Relaxation Therapy (JPMRT) and self- imagery training on the mental health of cancer patients. MethodsIn this cross-sectional study, data was collected from 20 patients diagnosed with cancer aged between 40-55 years from an outpatient department of Cancer Institute, India. General Health Questionnaire by Goldberg & Hiller, 1979 (GHQ-28) was administrated to assess the mental health in four domains viz: somatic complaints, anxiety and insomnia, social dysfunction and severe depression. Integrated intervention program was conducted for four days per week for one month. Data was analyzed statistically by using normal probability curve (NPC) and paired t-test. ResultsAn overall prevalence of negative mental health and significant positive effect by the integrated intervention on the mental health among cancer patients have been statistically corroborated in this pre-post research. ConclusionIntegrated intervention program is efficacious in improving mental health in cancer patients.

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Wilcox, James A. "A Review of: Cognitive-Behavioral Therapy for PTSD, a Case Formulation Approach. By Claudia Zayfert and Caroline Black Becker." Annals of Clinical Psychiatry 19, no. 4 (October 2007): 322–23. http://dx.doi.org/10.1080/10401230701613231.

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Linton, Steven J. "Applying dialectical behavior therapy to chronic pain: A case study." Scandinavian Journal of Pain 1, no. 1 (January 1, 2010): 50–54. http://dx.doi.org/10.1016/j.sjpain.2009.09.005.

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AbstractBackground and aimsChronic pain patients often present with a host of psychological and somatic problems and are unable to work despite receiving traditional pain management. For example, it is common that patients with persistent pain also suffer from a variety of anxiety and depressive symptoms. Indeed, the regulation of emotions may be one important factor that is associated with the development of persistent pain. Dialectical behavior therapy, a form of cognitive-behavioral therapy, focuses on emotion regulation and has successfully addressed other complex problems. The objective of this case study was to test the feasibility of developing and applying a dialectical behavior therapy approach to chronic pain.MethodsFeasibility study of n = 1: A 52-year-old adult suffering musculoskeletal pain, work disability, depression, and mood swings was offered therapy. She had not worked at her occupation for 10 years. An intervention was developed based on dialectical behavior therapy that included goal setting, validation, behavioral experiments and interoceptive exposure. Goals were developed with the client, based on her own values, and these were to: increase participation in previously enjoyable activities, not only reduce but also accept that some pain may remain, and, express and regulate emotions. Validation (understanding the patient’s situation) and psychoeducation were used to analyze the problem with the patient in focus. Function was approached by monitoring activities and conducting dialectical behavioral experiments where the patient systematically approached activities she no longer participated in (exposure). Emotional regulation followed a training program developed in dialectical behavior therapy designed to have people experience, express, and manage a variety of positive and negative emotions. In order to address the patient’s complaint that she avoided her own feelings as well as the pain, interoceptive exposure was introduced. After establishing calm breathing, the client was asked to focus attention on the negative feelings or pain as a way of de-conditioning the psychological responses to them. Therapy was conducted during 16 sessions over a six-month period.ResultsImprovements were seen on the main outcome variables. Pain intensity ratings dropped from 4.3 during the baseline to almost 0 at the end of treatment. Function increased as the patient participated in goal activities. Depression scores were decreased from 26 (Beck’s Depression Inventory) at pre treatment to 5 at follow-up, which falls within the normal range. Similarly, catastrophizing and fear decreased on standardized scales and fell within the range of a nonclinical population. Ratings indicated that acceptance of the pain increased over the course of therapy. Sleep improved and was also within the normal range according to scores on the Insomnia Severity Index. The patient reported seeking and obtaining employment as well. At the three-month follow-up improvements were maintainedConclusionsThis case shows that dialectical behavior therapy may be feasible for people suffering persistent pain with multiple problems such as pain, depression, and emotion regulation. However, since this is a case study, the validity of the findings has not yet been established. The positive results, however, warrant the further investigation of the application of these techniques to complex chronic pain cases.

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Chambers, Ron. "Cognitive Behavioural Therapy for PTSD: A Case Formulation Approach Claudia Zayfert and Carolyn Black Becker New York: Guilford Press, 2008. pp. 252. £21.95 (pb). ISBN: 978-1-60623-031-2." Behavioural and Cognitive Psychotherapy 38, no. 3 (March 22, 2010): 375–76. http://dx.doi.org/10.1017/s1352465810000135.

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Sousa, K. M., R. D. Piovezan, L. e Silva, C. De melo, D. Poyares, and S. Tufik. "0635 Effects of Donepezil in Patients with Residual Excessive Sleepiness of Obstructive Sleep Apnea: A Double Blind; Randomized Placebo; Controlled Study." Sleep 43, Supplement_1 (April 2020): A242. http://dx.doi.org/10.1093/sleep/zsaa056.631.

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Abstract Introduction Residual excessive sleepiness (RES) is presented by 6% of obstructive sleep apnea patients despite effective CPAP therapy. Few interventions have been tested for this condition and are focused on daytime stimulants. Recently, cholinergic activity decline was suggested as a potential mechanism in the pathophysiology of RES. This study aimed to investigate the effects of donepezil, an anticholinesterase inhibitor, in patients with RES. Methods This double-blind, randomized, placebo-controlled crossover study included participants with RES (35-65 years). Neuropsychiatric disorders, alcoholism, smoking, shiftwork, psychoactive drugs, other sleep disorders were exclusion criteria. Participants were assigned to one intervention arm (donepezil 5 mg for 15 days followed by donepezil 10mg for 15 days or placebo in the morning). After a 20-day wash-out, the same procedure was repeated following the crossover design. Somnolence measured by the Epworth sleepiness scale (ESS) and Maintenance of Wakefulness Test (MWT) were the primary endpoints. PSG, cognitive (trail test, continuous performance test) and Beck’s depression scale parameters were secondary endpoints. General Linear Models for repeated measures compared interventions responses. Cohen’s d measured effect sizes. Adverse events (AEs) were assessed by questionnaire. Results The study enrolled eight individuals. ESS was lower in the donepezil arm than in the placebo arm (8.9±4.4 vs 15.7±4.1, p<0.05). Effect size for ESS was high (d 1.61). Other endpoints were not different among study arms. Randomization order didn’t affect the results. No AEs were reported. Conclusion Donepezil improved subjective sleepiness in individuals with RES. To our knowledge, this is the first study to report the effects of a cholinergic intervention in patients with RES. Effect size was high for self-reported sleepiness, which may impact on quality of life and risk of disability in people with RES. Agents acting on the cholinergic system are potential targets for treating RES. Support Acknowledgements Brazilian National Council for Scientific and Technological Development (CNPq) This study is supported by AFIP (Associacao Fundo Incentivo a Pesquisa).

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Journal articles on the topic 'Beck's Cognitive Therapy'

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