The Relation between Negative Automatic Thoughts and Psychological Inflexibility in Schizophrenia

Abstract

Background: Schizophrenia is one of the most severe disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) spectrum. Negative automatic thoughts (NAT), cognitive fusion (CF), and experiential avoidance (EA), as part of psychological inflexibility (PI), can be considered important dysfunctional cognitive processes in schizophrenia. Methods: In the present study, two samples were included: a target group consisting of 41 people with schizophrenia (23 females; aged 44.98 ± 11.74), and a control group consisting of 40 individuals with end-stage chronic kidney disease (CKD) (27 males; aged 60.38 ± 9.14). Results: Differences were found between the two groups, with patients with schizophrenia showing an increased frequency of NAT, as well as higher levels of CF and EA (psychological inflexibility), compared to the control group. NAT were the mediator in the relation between the schizophrenia diagnosis and CF, as well as EA. Conclusion: Individuals with schizophrenia present a specific dysfunctional pattern of cognitive functioning, in which negative automatic thoughts represent a distinctive pathway to cognitive fusion and experiential avoidance.

A Single-Session Process-Based Cognitive-Behavioral Intervention Combined with Multimodal Rehabilitation Treatment for Chronic Pain Associated with Emotional Disorders

“…This approach targets psychological inflexibility as a common process involved in the onset of psychological disorders associated with chronic pain, including cognitive fusion, experiential and behavioral avoidance [41][42][43]. Psychological inflexibility is defined as the excessive influence of thoughts and emotions over behavioral choices, resulting in the difficulty to adapt to different life contexts, including chronic pain [42,44].…”

Automatic Thoughts, Self-Stigma, and Resilience Among Schizophrenia Patients with Metabolic Syndrome: A Cross-Sectional Study

“… 15 These psychosocial risk factors play a pivotal role to initiate and facilitate unhealthy habits, such as poor treatment compliance, unhealthy dietary pattern, lack of physical activity, 16 excessive drinking, smoking, and sleeping problems, 17 which contribute to the generation and development of cardiovascular diseases, diabetes mellitus, and MetS. 18 Prior investigations have indicated that negative affect and internalized stigma are not only less valuable because they have a mental illness, 19 but can also be obstacles to treatment adherence and negatively influence long-term recovery. 20 However, studies on the psychosocial risk mechanisms of MetS in SCZ are limited; thus, further research would provide useful insights into this issue.…”

A Single-Session Process-Based Cognitive-Behavioural Interven-Tion for Chronic Pain Associated with Emotional Disorders

“…This approach targets psychological inflexibility as a common process involved in the onset of psychological disorders associated with chronic pain, including cognitive fusion, emotional suppression, experiential and behavioural avoidance [31][32][33]. These processes result in the patient's incapacity to adapt to various life circumstances, including the aversive experience of pain [32,34].…”

“…The healthier variant is represented by acceptance, or the willingness to fully experience emotions or sensations, whether pleasant or not, without attempts to control them, facilitating adaptation in the case of chronic pain [38,39]. From a behavioural point of view, difficulties are linked to the use of unhealthy coping strategies, inconsistent with the patient's aspirations, especially in the context of a chronic health condition [30,33]. On the other hand, increasing values-based action was associated with less disability and elevated motivation in chronic pain [40].…”