More on cognition and affect

Today, I focus on therapy and two studies examining cognition and affect. First, Stevens (2023) published “Revisiting the Cognitive Primacy Hypothesis: Implications for psychotherapy” in Journal of Psychotherapy Integration.  Here’s the edited abstract and impact statement:

While emotions, thoughts, and behaviors are considered to each impact one another, cognitive interventions have come to dominate most forms of psychotherapy practiced today. This assumes the cognitive primacy hypothesis, which is often considered to be in opposition to the affective primacy hypothesis. These two hypotheses are examined in conjunction with recent advances in psychological research along with the neuroscience of evaluative processing models. Research is investigated to determine if cognitive models like the A–B–C model are the most applicable to psychotherapy. Research does not find support for either the cognitive or affective primacy hypotheses. Neuroscience research indicates that cognition and emotion interact dynamically, unlike previously proposed linear models of therapeutic change (A–B–C model, insight for therapeutic change). Given such, emotional interventions in psychotherapy should be applied in tandem with cognitive interventions. Emotional interventions should be considered as relevant as cognitive interventions in the practice of psychotherapy, given there is no single linear model starting with cognitive or affective primacy.

This study revisits one of the major assumptions of psychotherapy, the cognitive primacy hypothesis, questioning its relevance given the current state of research in psychology and neuroscience. This study highlights the need to use emotion-based psychotherapeutic interventions in addition to cognitive interventions. 

If you’ve read the blog for a while, you know I like to criticize narrow CBT approaches to therapy. I like the fact that Stephens emphasizes neuroscience and the inadequacy of either a cognitive of affective primacy hypothesis. This next study helps explain why. Wen, A., Fischer, E. R., Watson, D., & Yoon, K. L. (2023) published “Biased Cognitive Control of Emotional Information in Remitted Depression: A meta-analytic review” in Journal of Psychopathology and Clinical Science.  Here are the edited abstract and impact statements:

Cognitive theories of depression posit that maladaptive information processing increases the risk for depression recurrence. There is increasing theoretical and empirical support for the cognitive control of emotional information as a vulnerability factor for depression recurrence. In this investigation, findings from behavioral studies that compared the cognitive control of emotional information between participants with remitted major depressive disorder (rMDD) and healthy control (HC) participants were examined. Response times (RTs) and error rates were used as outcome variables, and aspects of clinical features, sample characteristics, and methodology and design were examined as moderating variables. The final review included 44 articles with a total of 2,081 rMDD participants and 2,285 HC participants. The two groups significantly differed in the difference score between RTs for negative and positive stimuli. Specifically, the difference in RTs between negative and positive stimuli was larger in participants with rMDD than in HC participants, indicating greater difficulty controlling irrelevant negative (vs. positive) stimuli in rMDD. Such cognitive control bias may be associated with preferential processing of negative over positive information in working memory. This imbalance may then be linked to other emotional information processing biases and emotion dysregulation, thereby increasing the risk for depression recurrence. Implications, limitations, and future directions are discussed. 

This systematic review suggests that people with a history of depression demonstrate greater difficulty in the cognitive control of negative than positive information. This imbalance in emotional information processing in working memory may increase the risk for depression recurrence.

Since Stephens simply indicates reviewing research, this study nicely illustrates the value of examining the complex interactions between cognition and affect. It may be helpful to therapists.