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Biomedical subjects

A T Beck

Publications and source records attributed to A T Beck.

At least 19 recordsLinked to original sources

Self-concept dimensions of clinically depressed and anxious outpatients.

Principal components analyses of the Beck Self-Concept Test (BST) were conducted independently for 288 women with primary mood disorders, 230 women with anxiety disorders, 236 men with mood disorders, and 161 men with anxiety disorders. Four self-concept dimensions that reflected (1) Intellectual Ability; (2) Work Efficacy; (3) Physical Attractiveness; and (4) Virtues/Vices occurred within the four samples. For 5-item subscales that represent these four dimensions, a two-way MANOVA found significant effects for sex and type of disorder. Women described themselves as having less intellectual ability than men did. Outpatients with mood disorders considered their physical appearance, work efficacy, and virtues/vices to be less acceptable than did those with anxiety disorders. Findings were discussed with respect to the cognitive content-specificity theory of psychopathology.

Adult

Prevalence of personality disorders in patients with major depression and dysthymia.

The authors administered the Structured Clinical Interview for DSM-III-R Axis I (SCID-P) and Axis II (SCID-II) Disorders to 197 patients with major depression, 63 patients with dysthymia, and 32 patients with both major depression and dysthymia ("double depression"). Fifty percent of major depressive patients, 52% of dysthymic patients, and 69% of patients with double depression were diagnosed as having at least one personality disorder. Patients with a personality disorder had higher scores on the Beck Anxiety and Depression Inventories. The most commonly diagnosed personality disorders were from the anxious/fearful cluster, most notably avoidant and dependent personality disorders.

Adult

A crossover study of focused cognitive therapy for panic disorder.

OBJECTIVE: This study sought to determine the short- and long-term effects of focused cognitive therapy for panic disorder. METHOD: Thirty-three psychiatric outpatients with the DSM-III diagnosis of panic disorder were randomly assigned to either 12 weeks of individual, focused cognitive therapy or 8 weeks of brief supportive psychotherapy based on principles of client-centered therapy. The patients who received supportive psychotherapy were subsequently given the opportunity to cross over to cognitive therapy for 12 weeks. Patients were rated for panic and depression before therapy, after 4 and 8 weeks of therapy, and at 6-month and 1-year follow-up. RESULTS: Clinician ratings and self-ratings of panic frequency and intensity indicated that the focused cognitive therapy group achieved significantly greater reductions in panic symptoms and general anxiety after 8 weeks of treatment than did the group that received brief supportive psychotherapy. At 8 weeks, 71% of the cognitive therapy group were panic free, compared to 25% of the psychotherapy group. Moreover, 94% of the psychotherapy patients elected to cross over to 12 weeks of cognitive therapy. At 1-year follow-up, 87% of the group that received cognitive therapy only and 79% of the group that crossed over into cognitive therapy remained free of panic attacks. CONCLUSIONS: Focused cognitive therapy offers a promising nonpharmacological alternative for the treatment of panic disorder.

Adolescent

Relationship of intelligence with cognitive therapy outcome.

Theorists have speculated that intelligence is positively associated with the capacity to benefit from cognitive-behavioral therapies. We evaluated this notion by relating pre-treatment measures of fluid and crystallized intelligence to self-reported symptom reduction in a naturalistic study (n = 106) of cognitive therapy for outpatients with principal diagnoses of major depression, dysthymia, or generalized anxiety disorder. Intelligence measures did not significantly predict outcome, and nonsignificant relationships were in the opposite direction from the theoretical prediction. Discussion centered on possible limitations to the generalizability of these results and on the logical interpretation of prediction studies in psychotherapy research.

Anxiety Disorders

Self-reported depression in younger and older pregnant inner-city adolescents.

Younger (14- to 17-year-old) inner-city adolescent mothers have been reported by Colletta (1983) as being more depressed than older (18- to 19-year-old) inner-city adolescent mothers. To determine whether this finding applies to pregnant adolescents, the revised Beck Depression Inventory (BDI; Beck, Rush, Shaw, & Emery, 1979; Beck & Steer, 1987) was administered to 175 (65.1%) Black, 64 (23.8%) Hispanic, and 30 (11.1%) White inner-city adolescents during their 28th week of pregnancy. The sample was divided into 129 (48.0%) younger (13- to 15-year-old) adolescents and 140 (52.0%) older (16- to 18-year-old) adolescents. The mean profiles of the 21 BDI symptoms were comparable for both age groups, and it was concluded that younger and older pregnant inner-city adolescents describe similar levels of self-reported depression.

Adolescent

Panic disorder and suicidal ideation and behavior: discrepant findings in psychiatric outpatients.

OBJECTIVE: Previous investigators found that persons who had ever met criteria for panic disorder or panic attacks reported more lifetime suicide attempts and ideation than persons who had ever met criteria for other psychiatric disorders. To determine whether outpatients with current panic disorders also report such differences, this study examined the suicide attempt rates, levels of suicidal ideation, and levels of hopelessness among four groups of psychiatric outpatients. METHOD: Structured clinical interviews were used to assign diagnoses to 900 consecutive psychiatric outpatients. These patients were administered the Scale for Suicide Ideation and the Beck Hopelessness Scale and were also questioned in detail about previous suicide attempts and past and present suicidal ideation. RESULTS: None (0.0%) of the 73 patients with primary panic disorder without agoraphobia reported having made suicide attempts during their lifetimes. One (1.3%) of the 78 patients who had panic disorder with agoraphobia, 34 (7.0%) of the 485 patients who had mood disorders, and four (1.5%) of the 264 patients who had other psychiatric disorders reported suicide attempts. The mean scores on the Scale for Suicide Ideation and the Beck Hopelessness Scale of the patients with panic disorders and other disorders were significantly lower than the mean scores of the patients with mood disorders. CONCLUSIONS: The rates of suicidal ideation and behavior for psychiatric outpatients who had panic disorders were discrepant with those reported by the earlier group of investigators for a random community sample of persons who reported ever having had panic attacks or met criteria for panic disorders.

Adult

Changes in nonverbal behavior of therapists and depressed patients during cognitive therapy.

Nonverbal behavior of 8 patients and 7 therapists during the first few minutes of 20 therapeutic sessions (either 2 or 3 per therapist-patient pair) was used as a baseline measure to assess whether there were systematic changes by the end of a single therapeutic session. The nonverbal behavior of both patients and therapists showed increases in prosocial behavior. Also, increases in signs of anxiety were noted in the nonverbal behavior of therapists. Significant correlations between nonverbal behavior of patients and therapists occurred for certain classes of behavior. It appears worthwhile to assess changes in nonverbal behavior during therapeutic sessions.

Cognitive Behavioral Therapy

A cognitive investigation of schizophrenic delusions.

Delusions have traditionally been regarded as unmodifiable false beliefs. Both Freud (1911) and Jaspers (1968) argue that there is a unidirectional relationship between a delusional belief and consensually validatable realtiy: the delusion structures reality in accordance with the delusion's demand. In contrast, we postulate that there is a bidirectional interaction between the delusion and external events. We believe that external events might modify the rigid belief when there is a dramatic incongruity between specific beliefs and selected events. The following investigation was motivated by a desire to understand more clearly how some overtly delusional patients come to lose their delusions during the course of treatment for schizophrenia. Do delusions simply melt away under the influence of major tranquilizers, or does the delusional patient play some active part in assessing the validity of this belief?

Adult

Depression in treated narcotic addicts, ex-addicts, nonaddicts, and suicide attempters: validation of a very Brief Depression Scale.

Samples of heroin-addicted veterans in treatment at a VA drug clinic, ex-addict and nonaddict Vietnam veterans followed-up after return to the United States, and male suicide attempters who were not drug abusers completed a very short (five item) form of the Beck Depression Inventory developed for screening and research purposes. Results confirmed prior findings of high rates of depression among narcotic addicts in treatment. Two samples of patients assessed at intake to treatment did not differ significantly from the suicide patients in BDI-5 scores. Methadone maintenance patients and ex-addicts scored below those groups, but higher than nonaddicts. Relief of inner tensions or worries was chosen most frequently as the reason for continuing use of narcotics by patients in treatment, suggesting that self-medication for psychiatric problems may be common. The BDI-5 proved to be an efficient method for screening for depression in these samples, and thus might be useful in clinical or research settings when a very brief method is needed.

Depression

Drug abuse, hopelessness, and suicidal behavior.

This study focused on assessing variables which may differentiate suicidal drug abusers from nonabusers. Data from a sample of drug abusing (n = 86) and nonabusing (n = 298) suicide attempters were subjected to a stepwise multiple regression analysis to identify factors related to suicidal intent. The analysis revealed that in our sample of suicide attempters, drug abuse status was not a significant contributor to the severity of suicidal intent. However, it was found that hopelessness accounted for a significant proportion of the variance of intent. The findings suggest that hopelessness among drug abusers, an important determinant of suicidal behavior, presents an important target for therapeutic intervention.

Adolescent

Cognitive aspects of suicidal behavior.

Recent efforts to quantify various aspects of suicide ideation are described. The Suicide Intent Scale, Hopelessness Scale, and the Scale for Suicide Ideation all assess components of the individual's suicidal ruminations. Hopelessness seems to account for the bulk of the relationship between depression and suicidal intent. The Scale for Suicide Ideation seems to show promise as a predictive instrument, as a dependent variable in research on treatment efficacy, and as a tool for clinical assessment of suicide potential. Implications for further research and clinical practice are discussed.

Cognition

Maladaptive cognitive structures in depression.

According to the cognitive view, the individual's negative and distorted thinking is the basic psychological problem in the depressive syndrome. The distorted cognitions are supported by maladaptive cognitive schemata, which involve immature "either-or" rules of conduct or inflexible and unattainable self-expectations. These schemata are probably acquired early in development and, if uncritically carried into adulthood, serve to predispose the individual to depression. Since these schemata are long-term identifiable psychological patterns that influence attitude and behavioral responses, they may constitute a cognitive dimension of the depression-prone individual's personality. The authors discuss the treatment implications of the cognitive approach to depression.

Attitude