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Biomedical subjects

S Rachman

Publications and source records attributed to S Rachman.

At least 37 records · Page 2Linked to original sources
PubMed1999

Multiple pathways to inflated responsibility beliefs in obsessional problems: possible origins and implications for therapy and research.

The purpose of this paper is to consider the possible origins of an inflated sense of responsibility which occupies an important place in the cognitive theory of obsessive compulsive disorder (Rachman, S. (1993). Obsessions, responsibility, and guilt. Behaviour Research and Therapy, 31, 149-154. Salkovskis, P. M. (1985). Obsessional-compulsive Problems: A cognitive-behavioural analysis. Behaviour Research and Therapy, 23 (5), 571-583). Clinical experience and consideration of current cognitive conceptualisations of obsessions and obsessive compulsive disorder suggest a number of possibilities, each of which is described after a brief introduction to the concept itself. While there are reasons to believe that some general patterns can be identified, the origins of obsessional problems are best understood in terms of complex interactions specific to each individual.

Cognitive Behavioral Therapy↗
PubMed1999

A cognitive distortion associated with eating disorders: thought-shape fusion.

OBJECTIVES: The primary objective of this study was to describe and investigate a cognitive distortion associated with eating psychopathology. This distortion, termed 'thought-shape fusion', is said to occur when merely thinking about eating a forbidden food increases the person's estimate of their shape or weight, elicits a perception of moral wrongdoing and makes the person feel fat. DESIGN: Two studies were conducted. The first was a psychometric study and the second utilized a within-participants experimental design. METHODS: In Study 1, thought-shape fusion was assessed in a sample of 119 undergraduate students using a questionnaire. In Study 2, 30 students with high thought-shape fusion scores participated in an experiment designed to elicit the distortion. RESULTS: Thought-shape fusion was found to be significantly associated with measures of eating disorder psychopathology. The questionnaire used to measure thought-shape fusion had high internal consistency, a good factor structure accounting for 46.2% of the variance and predictive validity. The results from Study 2 indicated that the distortion can be elicited under experimental conditions, produces negative emotional reactions and prompts the urge to engage in corrective behaviour (e.g. neutralizing/checking). This corrective behaviour promptly reduces the negative reactions. CONCLUSION: The results of the two studies indicate that the concept of thought-shape fusion is coherent, unifactorial and measurable. It is associated with eating disturbance and elicits negative emotional and behavioural responses.

Adult↗
PubMed1998

A cognitive theory of obsessions: elaborations.

The theory that obsessions are caused by catastrophic misinterpretations of one's intrusive thoughts/ images/impulses is elaborated in an attempt to explain the frequency of obsessions and why they persist. The internal and external provocations of obsessions are considered, and an explanatory framework for the varying contents of obsessions is set out. The role and functions of neutralization and inflated responsibility are assessed, and the treatment implications of the theory are described.

Cognition↗
PubMed1998

Claustrophobia and the magnetic resonance imaging procedure.

We examined fear induced by the magnetic resonance imaging (MRI) procedure in 80 adult patients who were undergoing the procedure for the first time. Participants completed self-report measures of claustrophobia, anxiety sensitivity, thoughts about the scan, and pain. Participants were assessed pre- and postscan, and at 1-month follow-up. Twenty-five percent of the participants experienced moderate to severe anxiety during the MRI scan. Prescan scores on the Claustrophobia Questionnaire (CLQ: Rachman and Taylor, 1993) significantly predicted participants' distress during the scan: pain and anxeity sensitivity did not. Furthermore, CLQ scores discriminated between participants who reported panic during the scan and participants who did not report panic. A brief screening instrument consisting of six items from the 29-item CLQ is suggested. This brief screening instrument administered prior to the scan may help identify in advance those people who are most likely to experience claustrophobic fear and, in particular, those who panic during the MRI procedure.

Adult↗
PubMed1997

A cognitive theory of obsessions.

It is proposed that obsessions are caused by catastrophic misinterpretations of the significance of one's thoughts (images, impulses). The obsessions persist as long as these misinterpretations continue and diminish when the misinterpretations are weakened. Evidence and arguments in support of the theory are presented, and the questions of vulnerability and the origins of the thoughts are addressed. A firmly focused treatment strategy is deduced from the theory.

Cognition↗
PubMed1995

Perceived responsibility and compulsive checking: an experimental analysis.

An experiment was carried out on 30 Ss who qualified for the DSM-IIIR diagnosis of OCD in order to test the hypothesis, derived from cognitive theory, that changes in perceived responsibility are followed by corresponding changes in the urge to check compulsively. The manipulation succeeded in increasing/decreasing perceived responsibility, as required for the experiment. Decreased responsibility was followed by significant declines in discomfort and in the urge to carry out the compulsive checking. Increased responsibility was followed by corresponding increases in discomfort and urges, but these failed to reach a statistically significant level. Additionally, two types of OCD-related cognitive biases were encountered.

Adult↗
PubMed1995

Perceived responsibility: structure and significance.

Given the postulated significance of inflated responsibility in obsessive compulsive disorder (OCD), there is a need for clarification of the concept itself and a means for measuring such responsibility. Two psychometric studies were conducted in order to develop a reliable self-report scale. In the first study 291 students completed the specially constructed Responsibility Appraisal Questionnaire (RAQ). Four factors emerged: responsibility for harm, responsibility in social contexts, a positive outlook towards responsibility, and thought-action fusion (TAF). In the second study, 234 students completed a revised RAQ. Four comparable factors emerged, and the TAF subscale correlated significantly with measures of obsessionality, guilt, and depression. The correlations between TAF and obsessionality and guilt remained significant even after BDI scores were controlled. It is concluded that the broad concept of inflated responsibility needs to be qualified; the connection between inflated responsibility and OCD appears to be situation-specific and idiosyncratic. There is more inflated responsibility than there is OCD. The measured concept of inflated responsibility is multifactorial (harm, social, positive, and TAF), not unitary. The TAF factor appears to be particularly significant in OCD.

Adult↗
PubMed1994

The overprediction of fear: a review.

There is converging evidence that many people overestimate how frightened they will be when faced by a fear-provoking situation (Arntz & van den Hout, 1988, Behaviour Research and Therapy, 26, 207-223; Rachman & Bichard, 1988, Clinical Psychology Review, 8, 303-313; Rachman, 1990, Fear and courage (2nd edn). New York: W. H. Freeman). This overprediction of fear is commonly seen in people who are troubled by excessive fear (e.g. claustrophobics, panic patients), but is not confined to them. Anecdotal, clinical, and research evidence suggests that the tendency to overestimate the subjective impact of an aversive event is a common psychological phenomenon. This review will present examples of overpredictions, put forward some explanations of why people might overpredict, consider the function that overpredicting might serve, and the possible consequences of overpredicting. The process by which overpredictions are reduced is also considered and an attempt will be made to relate this strong tendency to overpredict fear to other types of psychological overestimation.

Cognition↗
PubMed1994

Role of selective recall in the overprediction of fear.

Overprediction of fear is a bias in which phobic individuals tend to overestimate the amount of fear they will experience in a subjectively threatening situation. The selective recall model states that this bias arises because memories of highly fearful experiences are more easily retrieved than memories of nonfearful experiences. The model predicts that phobics should show a greater magnitude of overprediction if they receive fear-relevant priming compared with fear-irrelevant priming. A study of 100 spider-fearful Ss found that the magnitude of overprediction was smallest after fear-relevant priming, thus refuting the model. Alternative models are considered, and directions for further investigation are set out.

Adult↗
PubMed1993

A critique of cognitive therapy for anxiety disorders.

Progress in the cognitive-behavioral treatment of anxiety disorders is reviewed. Significant advances have been made in treating panic disorders and there are promising signs of an expansion of cognitive theory and therapy to other disorders, notably hypochondriasis, obsessional disorders and circumscribed phobias. Nevertheless, some difficult obstacles have emerged to present serious problems for the prevailing cognitive theory.

Anxiety Disorders↗
PubMed1993

The reduction of claustrophobia--II: Cognitive analyses.

A clinical experiment comparing methods of fear reduction in claustrophobia was used as the basis for analysing the relationships between a number of cognitive variables and the reduction of claustrophobia. Both the number and believability of negative cognitions present were associated with fear reduction and return of fear; this was also found when considering the number of body sensations experienced. High fear and panic were always accompanied by these phenomena whilst zero fear was never reported in the presence of believable cognitions and body sensations. An absence of believable cognitions post-test was accompanied by an absence of claustrophobia in 10/13 subjects. Specifically, removal of belief in any of the cognitions "I will be trapped", "I will suffocate" and/or "I will lose control" was associated with removal of belief in all the other cognitions and a dramatic reduction in claustrophobia. Belief in one of these central cognitions was associated with the maintenance of fear. We conclude that it is possible to conceptualize claustrophobia as comprising a number of cognitions centred on key thoughts of trappedness, suffocation and loss of control.

Adaptation, Psychological↗
PubMed1993

Obsessions, responsibility and guilt.

Introduction of the concept of "inflated responsibility" into the so-called anatomy of obsessions gives rise to an elaborated analysis of obsessions, responsibility and guilt. The analysis touches on a range of phenomena including anger and guilt, control of thoughts, the fusion of thoughts and action, resistance to additional responsibility, procrastination and unfinished tasks, hypochondriasis, brief holidays. Some clinical implications are deduced from the analysis.

Anger↗
PubMed1992

Fearful distortions.

Clinical observations suggesting that perceptual distortions can take place during episodes of fear are described, and two hypotheses are set out: (1) perceptual distortions occur during episodes of fear, and (2) such distortions decline after reduction of the pertinent fear. An experiment in which fearful subjects were asked to report their perceptions of a feared object during episodes of fear, and then again after fear-reduction, was carried out. Snake-phobic and spider-phobic subjects showed evidence of some distortions in the activity of the pertinent fear object, but no distortions of size. After the reduction of the relevant fear, the subjects reported significant declines in the activity of the pertinent animal. The two hypotheses received partial support.

Adult↗
PubMed1992

The reduction of claustrophobia--I.

The purpose of this study was to investigate the process of change during three interventions for claustrophobia, with particular reference to cognitive changes. Forty-eight participants, recruited from the community through the local media, were randomly assigned to one of four groups: pure exposure, exposure to the sensations of anxiety (interoceptive exposure), modification of negative cognitions, or a control group. All interventions were given over three sessions. The exposure group proved superior to the control on a wide range of measures. In the cognitive group, scores of reported fear and panic, declined significantly. The interoceptive group made some modest gains. An analysis of the timing of fear reduction and of treatment generalization, provides some indications of the mechanism of change.

Adult↗