Negative thoughts, experienced by 80% to 99% of the non-clinical population, have been linked to the development of psychopathology. The current study aimed to compare a cognitive restructuring and cognitive defusion technique for coping with a personally relevant negative thought. Over a 5-day period, participants used either a restructuring, defusion, or control strategy to manage a negative thought. Pre- and post-intervention participants reported (a) believability of the thought, (b) discomfort associated with the thought, (c) negativity associated with the thought, and (d) willingness to experience the thought. Daily online questionnaires assessing the total frequency of negative thought intrusions and their level of willingness to experience the negative thought were also used. Also, 10 positive and negative self-statements were rated on the same scales, and self-report measures of mood and psychological flexibility were completed. Findings indicated that defusion lowered believability, increased comfort and willingness to have the target thought, and increased positive affect significantly more than the control and cognitive restructuring. Within groups, cognitive restructuring also made significant gains in target thought discomfort, negativity, and “willingness to have” in the same direction as defusion but the no-instruction control did not. Negative thought frequency was reduced in the defusion group, maintained in the restructuring group, and increased in the no-instruction control group. Similar trends emerged from the secondary outcome measures, that is, the effects of the strategies on the positive and negative self-statements. The current findings support the efficacy of using defusion as a strategy for managing negative thoughts.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
2.
ArchJ. J.CraskeM. G. (2008). Acceptance and Commitment Therapy and Cognitive Behavioral Therapy for Anxiety Disorders: Different treatments, similar mechanisms?Clinical Psychology: Science and Practice, 15, 263-279. doi:10.1111/j.1468-2850.2008.00137.x
3.
BeckA. T. (1979). Cognitive therapy for depression. New York, NY: Guilford Press.
4.
BeckA. T.SteerR. A.BrownG. K. (1996). Beck depression inventory manual (2nd ed.). San Antonio, TX: Psychological Corporation.
5.
BeckJ. S.BeckA. T. (2011). Cognitive Behavior Therapy: Basics and beyond. New York, NY: Guilford Press.
6.
BellochA.MorilloC.LuceroM.CabedoE.CarrióC. (2004). Intrusive thoughts in non-clinical subjects: The role of frequency and unpleasantness on appraisal ratings and control strategies. Clinical Psychology & Psychotherapy, 11, 100-110. doi:10.1002/cpp.397
7.
BondF. W.HayesS. C.BaerR. A.CarpenterK. M.GuenoleN.OrcuttH. K.. . . ZettleR. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire—II: A revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy, 42, 676-688.
8.
ButlerA. C.ChapmanJ. E.FormanE. M.BeckA. T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychological Review, 26, 17-31.
9.
CiarrochiJ.RobbH.GodsellC. (2005). Letting a little nonverbal air into the room: Insights from Acceptance and Commitment Therapy Part 1: Philosophical and theoretical underpinnings. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 23, 79-106. doi:10.1007/s10942-005-0005-y
10.
ClarkD. A.BeckA. T. (2011). Cognitive Therapy of Anxiety Disorders. New York, NY: Guilford Press.
11.
ClarkD. A.CrewdsonN.PurdonC. (2000). No worries, no cares: An investigation into self-reported “nondistress” in college students. Cognitive Therapy and Research, 22, 209-224. doi:10.1002/jcp.23969
12.
ClarkD. A.RhynoS. (2005). Unwanted intrusive thoughts in nonclinical individuals. Implications for clinical disorders. In ClarkD. A. (Ed.), Intrusive thoughts in clinical disorders: Theory, research, and treatment (pp. 1-29). New York, NY: Guilford Press.
13.
CohenJ. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates.
14.
CrawfordJ.HenryJ. (2004). The Positive and Negative Affect Schedule (PANAS): Construct validity, measurement properties and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 43, 245-265.
15.
DeaconB. J.FawzyT. I.LickelJ. J.Wolitzky-TaylorK. B. (2011). Cognitive defusion versus cognitive restructuring in the treatment of negative self-referential thoughts: An investigation of process and outcome. Journal of Cognitive Psychotherapy: An International Quarterly, 25, 218-228.
16.
De YoungK. P.LavenderJ. M.WashingtonL. A.LoobyA.AndersonD. A. (2010). A controlled comparison of the word repeating technique with a word association task. Journal of Behavior Therapy and Experimental Psychiatry, 41, 426-432. doi:10.1016/j.jbtep.2010.04.006
17.
FairburnC. G.MarcusM. D.WilsonG. T. (1993). Cognitive-behavioral therapy for binge eating and bulimia nervosa: A comprehensive treatment manual. In FairburnC. G.WilsonG. T. (Eds.), Binge eating: Nature, assessment and treatment (pp. 361-404). New York, NY: Guilford Press.
18.
HayesS. C. (2015). Foreword. In HooperN.LarssonA. (Eds.), The research journey of Acceptance and Commitment Therapy (ACT) (pp. x-xvii). London, England: Palgrave Macmillan.
19.
HayesS. C.Barnes-HolmesD.RocheB. (Eds.). (2001). Relational frame theory: A post-Skinnerian account of human language and cognition. New York, NY: Plenum Press.
20.
HayesS. C.BrownsteinA. J. (1986). Mentalism, behavior-behavior relations, and a behavior-analytic view of the purposes of science. The Behavior Analyst, 9, 175-190.
21.
HayesS. C.LuomaJ.BondF.MasudaA.LillisJ. (2006). Acceptance and Commitment Therapy: Model, processes, and outcomes. Behavior Research and Therapy, 44, 1-25.
22.
HayesS. C.StrosahlK. D.WilsonK. G. (1999). Acceptance and Commitment Therapy: An experiential approach to behavior change. New York, NY: Guilford Press.
23.
HayesS. C.StrosahlK. D.WilsonK. G. (2012). Acceptance and Commitment Therapy, Second edition: The process and practice of mindful change. New York, NY: Guilford Press.
24.
HayesS. C.StrosahlK. D.WilsonK. G.BissettR. T.PistorelloJ.ToarminoD.. . . McCurryS. M. (2004). Measuring experiential avoidance: A preliminary test of a working model. The Psychological Record, 54, 553-578.
25.
HealyH.Barnes-HolmesY.Barnes-HolmesD.KeoghC.LucianoC.WilsonK. (2010). An experimental test of cognitive defusion exercise: Coping with negative and positive self-statements. The Psychological Record, 58(4), Article 8.
26.
HintonM. J.GaynorJ. T. (2010). Cognitive defusion for Psychological Distress, Dysphoria, and low self-esteem: A randomized technique evaluation trial of vocalizing strategies. International Journal of Behavioral Consultation and Therapy, 6, 164-185.
27.
HooperN.McHughL. (2013). Cognitive defusion versus thought distraction in the mitigation of learned helplessness. The Psychological Record, 63, 209-218.
28.
HooperN.SandozE.AshtonJ.ClarkeA. (2012). Comparing thought suppression and acceptance as coping techniques for food cravings. Eating Behaviors, 13, 62-64.
29.
HooperN.SaundersJ.McHughL. (2010). The derived generalization of thought suppression. Learning & Behavior, 38, 160-168.
30.
JeffcoatT.HayesS. C. (2012). A randomized trial of ACT bibliotherapy on the mental health of K-12 teachers and staff. Behavior Research and Therapy, 50, 571-579.
31.
KazdinA. E.BlaseS. L. (2011). Rebooting psychotherapy research and practice to reduce the burden of mental illness. Perspectives on Psychological Science, 6, 21-37.
32.
LuomaJ. B.HayesS. C. (2009). Cognitive defusion. In O’DonohueW. T.FisherJ. E. (Eds.), Cognitive Behavior Therapy applying empirically supported techniques in your practice (pp. 181-188). New York, NY: John Wiley.
33.
MasudaA.FeinsteinA. B.WendellJ. W.SheehanS. T. (2010). Cognitive defusion versus thought distraction: A clinical rationale, training, and experiential exercise in altering psychological impact of negative self-referential thoughts. Behavior Modification, 34, 520-538.
34.
MasudaA.HayesS. C.SackettF. C.TwohigM. P. (2004). Cognitive defusion and self-relevant negative thoughts: Examining the impact of a ninety year old technique. Behavior Research and Therapy, 42, 477-485. doi:10.1016/j.brat.2003.10.008
35.
MasudaA.PriceM.AndersonP. L.WendellJ. W. (2010). Disordered eating-related cognition and psychological flexibility as predictors of psychological health among college students. Behavior Modification, 34, 3-15. doi:10.1177/0145445509351569
36.
MasudaA.TwohigM. P.StormoA. R.FeinsteinA. B.ChouY.WendellJ. W. (2010). The effects of cognitive defusion and thought distraction on emotional discomfort and believability of negative self-referential thoughts. Journal of Behavior Therapy and Experimental Psychiatry, 44, 11-17. doi:10.1016/j.jbtep.2009.08.006
37.
O’DonohueW. T.FisherJ. E. (Eds.). (2012). Cognitive Behavior Therapy: Core principles for practice. Hoboken, NJ: John Wiley.
38.
PernegerT. V. (1998). What’s wrong with Bonferroni adjustments. The British Medical Journal, 316, 1236-1238.
39.
RuizF. J. (2010). A review of Acceptance and Commitment Therapy (ACT) empirical evidence: Correlational, experimental psychopathology, component and outcome studies. International Journal of Psychology and Psychological Therapy, 10, 125-162.
40.
SmithR. C.LayC. D. (1974). State and trait anxiety: An annotated bibliography. Psychological Reports, 34, 519-594.
41.
SpielbergerC. D.GorsuchR. L.LuscheneR.VaggP. R.JacobsG. A. (1983). State-Trait Anxiety Inventory. Menlo Park, CA: Mind Garden Inc.
42.
TitchenerE. B. (1916). A text-book of psychology. New York, NY: MacMillan.
43.
WatsonD.ClarkL. A.CareyG. (1988). positive and negative affectivity and their relation to anxiety and depressive disorders. Journal of Abnormal Psychology, 97, 346-353.
44.
WegnerD.SchneiderD.CarterS.WhiteT. (1987). Paradoxical effects of thought suppression. Journal of Personality and Social Psychology, 53, 5-13.
45.
WhismanM. A.PerezJ. E.RamelW. (2000). Factor structure of the Beck Depression Inventory—Second edition (BDI-II) in a student sample. Journal of Clinical Psychology, 56, 545-551.
