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认知重构过程中担忧与放松对灵活性的影响

The Effects of Worry and Relaxation on Flexibility During Cognitive Restructuring.

作者信息

Stevens Elizabeth S, Jendrusina Alexander A, Legrand Alison C, Nahin Erica R, Kaufman Michelle Goldwin, Borkovec Thomas D, Behar Evelyn

机构信息

1 University of Illinois at Chicago, Chicago, IL, USA.

2 University of Vermont, Burlington, VT, USA.

出版信息

Behav Modif. 2018 Nov;42(6):838-863. doi: 10.1177/0145445517732272. Epub 2017 Sep 18.

Abstract

Worry is associated with inflexibility in cognitive, emotional, and physiological functioning. In addition, worry's negative valence and abstract level of construal are rigid characteristics that contribute to its nonadaptive consequences. Relaxation and cognitive therapy aim to increase flexibility in chronic worriers, and may have greater efficacy when administered in combination. We examined the extent to which relaxation enhances and/or worry inhibits cognitive flexibility during a cognitive restructuring exercise in which participants generated alternative predictions for their worries. Participants ( n = 189) were randomly assigned to engage in relaxation, worry, or neutral thinking prior to cognitive restructuring. We measured the number and perceived likelihood of alternative predictions generated by participants, and coded those alternative predictions for their degree of positive valence, negative valence, and level of construal (abstractness to concreteness). Worry and relaxation did not lead to different numbers or perceived likelihood of alternative predictions. However, compared with participants with minimal symptoms of generalized anxiety disorder (GAD), those with elevated symptoms of GAD who engaged in prior worry generated alternative predictions characterized by greater negative valence and more abstractness (i.e., less concreteness). We also found that greater negative valence of alternative predictions was associated with more abstractness, whereas greater positive valence of alternative predictions was associated with more concreteness. These findings suggest that after engaging in worry, individuals with GAD may be less able to flexibly shift from the use of nonadaptive characteristics (negative valence, abstractness) associated with feared outcomes to the use of more adaptive characteristics (positive valence, concreteness) when considering alternative predictions.

摘要

担忧与认知、情绪和生理功能的僵化有关。此外,担忧的负性效价和抽象的解释水平是导致其非适应性后果的僵化特征。放松疗法和认知疗法旨在提高慢性担忧者的灵活性,联合使用时可能具有更高的疗效。我们研究了在认知重构练习中,放松在多大程度上增强和/或担忧在多大程度上抑制认知灵活性,在该练习中参与者要对自己的担忧产生替代性预测。参与者(n = 189)被随机分配在认知重构前进行放松、担忧或中性思维。我们测量了参与者产生的替代性预测的数量和感知可能性,并对这些替代性预测的正性效价、负性效价和解释水平(从抽象到具体)进行编码。担忧和放松并没有导致替代性预测的数量或感知可能性有所不同。然而,与广泛性焦虑障碍(GAD)症状轻微的参与者相比,那些在之前进行过担忧的GAD症状较重的参与者产生的替代性预测具有更高的负性效价和更抽象(即更不具体)的特点。我们还发现,替代性预测的负性效价越高,其抽象性越强;而替代性预测的正性效价越高,其具体性越强。这些发现表明,在进行担忧之后,GAD患者在考虑替代性预测时,可能较难灵活地从使用与恐惧结果相关的非适应性特征(负性效价、抽象性)转向使用更具适应性的特征(正性效价、具体性)。

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