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The “Yes, but” cognitive response to partial success: an exploratory research,[object Object],Gabriele Caselli1,2, Alina Decsei-Radu3, Francesca Fiore1, Chiara Manfredi1, Sara Querci1, Sara Sgambati1, Daniela Rebecchi1, Giovanni M. Ruggiero1,[object Object],& Sandra Sassaroli1,[object Object],1StudiCognitivi, Cognitive Psychotherapy School, Italy,[object Object],2 London South Bank University, UK,[object Object],3 University of Oradea, Romania ,[object Object]
Cognitive theories of depression,[object Object],Cognitive processing biases can act as latent vulnerability factors for emotional and affective disorders (Mathews & MacLeod, 1994) ,[object Object],Anxious and depressed people prioritize the encoding and elaboration of negative information in order to prepare themselves to flee from potential harmful or dangerous situations (Beck & Clark, 1997; Eysenck, 1997),[object Object],There is a greater risk for depression for people who exhibit a dispositional negative style and a dysfunctional attitude (Abramson et al., 1989; Beck 1987),[object Object]
Three possible outcomes of this dysfunctional attitude,[object Object],Cognitive biases: the tendency to distort one’s own experience misinterpreting events in terms of personal failure and tending to exaggerate or over generalize any event that holds any semblance of negative information about oneself (Beck, 1964),[object Object],Chronic and embeddedpessimism: a generalized negative outcome expectancy (Armor & Taylor, 1998); a proximal predictor of adjustment (Scheier & Carver, 1985),[object Object],Ruminativebrooding: a mode of thinking that involves repetitive and passive focus on one’s depressive symptoms as well as their causes and consequences; a cognitive risk factor for depressive mood (Nolen-Hoeksema, 1991).,[object Object],The dysfunctional attitude that provides for cognitive biases, pessimistic forecasts and ruminative brooding has been conceptualized as a reaction to negative sensations or thoughts that acts as a trigger for ruminative process itself,[object Object]
Clinical evidence: “Yes,but”,[object Object],There is a difference between depressed and non depressed individuals in emotional response even to positive stimuli, as firstly described by clinical theories that focused on the concept of anhedonia (Klein, 1974; Meehl, 1975),[object Object],We have hypothesized an attitude towards cognitive re-coding of positive stimuli in a negative way, that should influence depressive mood and symptoms, and that we named the “Yes, but” thinking style,[object Object],This cognitive response is characterized by the re-orientation of attention and cognition towards possible negative implications of a positive situation or a proposed positive vision of facts ,[object Object]
What does “Yes, but” lead to?,[object Object],It forbids positive emotional experience,[object Object],It re-orients attention towards the negative and even less outstanding aspects of situations,[object Object],It enhances the frequency of negative triggers,[object Object],It acts as a trigger for ruminative brooding and depressive mood in front of: ,[object Object],everyday positive experiences ,[object Object],alternative interpretations emerging from cognitive restructuring techniques,[object Object]
Distinguishing “Yes, but” from other cognitive processes,[object Object]
Aims,[object Object],To investigate the outcome of engaging in the “Yes, but” thinking style on mood and negative automatic thoughts,[object Object],To investigate if the impact of this thinking style would have been stronger in depressed rather than non-depressed individuals,[object Object]
Methods,[object Object],Participants:,[object Object],Italian clinical sample: 28 outpatients (19 females) with a diagnosis of moderate depression (mean = 38.8 years; SD = 12.9; range = 18-64),[object Object],Italian non-clinical sample: 28 non-depressed subjects (19 females) recruited from general population (mean= 39.3 years; SD = 13.9; range = 21-67),[object Object],Romanian clinical sample: 30 inpatients (15 females) with a diagnosis of severe depression (mean = 40.2 years; SD = 11.8; range = 20-62) and,[object Object],Romanian non-clinical sample: 30 non-depressed subjects (14 females) recruited from general population (mean = 39.6 years; SD = 12.3; range = 20-65),[object Object],Measures: Depression (BDI), Rumination (RRS), Pessimism (LOT-R), Mood and negative thoughts (VAS), Current brooding (RRS modified) ,[object Object]
Attentional manipulation,[object Object],Tasks were adapted from Nolen-Hoeksema and Morrow’s (1993) distraction and rumination task,[object Object],Participants were asked to retrieve images of a positive life event for 3 minutes,[object Object],Participants were asked to focus on one of two lists of audio recorded items that were presented with an interval of 20 seconds, for 8 minutes,[object Object],In the experimental condition participants were asked to focus their attention on what was missing in the recalled situation to be fully happy or satisfied (e.g. “think about what missed to fully reach your goal”, “think about what you could have done better”),[object Object],In the control condition item suggested to focus attention on emotion, sensation and thoughts participants perceived in the recalled episode (e.g. “think about what made you feel satisfied”, “think about what you managed to do”),[object Object]
Procedure,[object Object],Written informed consent, SCID, BDI, RRS and LOT-R,[object Object],Current brooding, mood and negative thoughts measure (Time 1),[object Object],3 minutes of imagery retrieving and 8 minutes working through their assigned attentional task,[object Object],Current brooding, mood and negative thoughts measure (Time 2),[object Object],Open-ended questions investigating what the participants thought the study was testing ,[object Object],Debriefing,[object Object]
Results: Italian sample,[object Object],Paired t-test  for “Yes, but” condition: t(27)=-22.2; p<.05,[object Object],ANCOVA between conditions with the change score of depressed mood between Time 1 and Time 2 as dependent variable, and change in current brooding between Time 1 and Time 2 as covariate.,[object Object],The effect of the conditions remained significant [F(1) = 4.90, p=.03] but change score for current brooding appeared to have a significant effect [F(1) = 9.21, p = .004], too. ,[object Object],The increase in depressed mood following “yes-but” thinking style induction depended on both experimental condition and levels of current brooding.,[object Object]
Results: Romanian sample,[object Object],Paired t-test was for the “Yes, but” condition: t(28) = -2.70, p = .01,[object Object],ANCOVA between conditions with the change score of depressed mood between Time 1 and Time 2 as dependent variable, and change in current brooding between Time 1 and Time 2 as covariate. ,[object Object],The effect of the conditions remained significant [F(1, 54) = 19.89, p < .001], while the impact of change score for current brooding appeared not significant. ,[object Object],Thus the increase in depressed mood following ‘yes-but’ thinking induction was not purely dependent on the concurrent levels of brooding.,[object Object]
Discussion,[object Object],“Yes, but” cognitive response leads to a significant decrease in mood and to a significant increase in negative thoughts independently on the severity and presence of depressive symptoms and not purely dependently on the concurrent change in levels of brooding.,[object Object],“Yes, but” thinking style may represent a depressive response to positive stimuli that can hinder positive experiences and thoughts and lead to a decrease in mood and an increase in negative automatic thoughts.,[object Object]
Possible “Yes, but” effects ,[object Object],[object Object]
Indirect effect: following a positive stimulus, individuals may re-orientate attention on the negative part of experience as an intermediate step for the resumption of negative attitudes which, in turn, can trigger negative thoughts or depressive sensations, worsening mood’s state.
Hinderingthe degree of acceptance of alternative beliefs emerging from cognitive restructuring techniques. Functional beliefs could play the role of positive stimuli and act as a trigger for “yes, but” cognitive response. ,[object Object]
Clinical implications,[object Object],Assessing “Yes, but” cognitive response to positive stimuli may be useful to identify and socialize a potential detrimental way of thinking that could have an impact on low mood and negative automatic thoughts, even independently from the diagnosis of depression,[object Object],Address “Yes, but” thinking style may be beneficial to negative emotion reduction but also to the enhancement of the degree of acceptance of alternative beliefs emerging from cognitive restructuring techniques.,[object Object]
Future research,[object Object],Deepen investigate both the “yes, but” frequency of use in depressives and non-clinical population, and the reasons that lead people to undertake it,[object Object],Understanding these reasons, therapists will be able to call them into question and try to bring evidences of the “Yes, but” damaging nature together with the patient himself,[object Object],Patients can learn how to manage their orientation of attention and cognition in a different way, and re-learn their effectiveness in governing it, as a voluntary and not automatic process,[object Object]

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"Yes...But..." cognitive response to partial success: an exploratory research

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  • 15. Indirect effect: following a positive stimulus, individuals may re-orientate attention on the negative part of experience as an intermediate step for the resumption of negative attitudes which, in turn, can trigger negative thoughts or depressive sensations, worsening mood’s state.
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