Aaron T. Beck's research while affiliated with University of Pennsylvania and other places

Publications (414)

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The original version of this article contained an error in the corresponding author’s first name and e-mail address. The author name should read as “Aaron T. Beck” instead of “Aron T. Beck” and the e-mail address should read as “abeck@pennmedicine.upenn.edu” instead of “abeck@penmedcine.upenu.edu.” The original article has been corrected.
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In this paper we look at the manifestation of different psychopathologies and propose that the disorders are on a continuum with normal behavior which, when exaggerated, becomes maladaptive. The basic paradigm of adaptation consists of cognition, affect, motivation, and behavior. Maladaptation occurs when there are errors in cognition involving the...
Chapter
In this chapter, Mauro Galluccio and Aaron T. Beck explain how the area of research on cognitive biases has made clear that the kinds of judgements people are likely to make may well be affected by their own baggage in the form of various biases and perceptual predispositions. Politicians and scientists, like the rest of us, may be affected by vari...
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Individual differences in intolerance of uncertainty are hypothesized to play a role in certain difficulties and distress in individuals with psychosis. However, the few studies that have directly explored this have yielded mixed results, which are difficult to interpret because measures of intolerance of uncertainty have not been formally validate...
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Individuals with multiple suicide attempts have a greater risk for eventual suicide death. We investigated clinical differences in participants with single versus multiple suicide attempts. Individuals with multiple attempts were more likely to have severe depressive symptoms, drug use disorder, and a higher wish to die. Borderline personality diso...
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Background Neurocognitive deficits are often seen as core features of schizophrenia, and as primary determinants of poor functioning. Yet, our clinical observations suggest that individuals who score within the impaired range on standardized tests can reliably perform better in complex real-world situations, especially when performance is embedded...
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A requisite step for testing cognitive theories regarding the role of self-concept in schizophrenia is the development of measures that follow a cognitive conceptualization and better capture the multifaceted nature of this construct. The purpose of this study was to examine the psychometric properties a new self-concept measure, the Beck Self-Este...
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Background: Over a number of decades, Cognitive Behavior Therapy has evolved and been modified by various theorists and researchers. Concerns regarding the integrity of cognitive and behavioral treatment in research studies, including fidelity, competence, and treatment differentiation, have been raised. Ensuring adequate treatment fidelity and com...
Chapter
This chapter analyzes the current state of the art of various psychotherapies for major depressive disorder (MDD) in adults, through the lens of David and Montgomery's psychotherapy classification system. These include evidence-based psychotherapies, intervention-driven psychotherapies, theory-driven psychotherapies and investigational psychotherap...
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Objective: Use of expert-led workshops plus consultation has been established as an effective strategy for training community mental health (CMH) clinicians in evidence-based practices (EBPs). Because of high rates of staff turnover, this strategy inadequately addresses the need to maintain capacity to deliver EBPs. This study examined knowledge,...
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Theorists, clinicians, and investigators have attempted to find a common source for the negative and positive symptoms of schizophrenia. We propose that a unified theory, based on a common cognitive structure not only has explanatory value, but can serve as a framework for a psychotherapeutic intervention. Specifically, we propose that the cognitiv...
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The present research is an investigation of prospective links between neurocognition (assessed with a well-validated, computerized battery of performance tasks) and cognitive insight (assessed with the Beck Cognitive Insight Scale), using data from two longitudinal studies of adult outpatients diagnosed with schizophrenia or schizoaffective disorde...
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Objective: The study examined six-month follow-up results and the impact of length of illness on treatment outcomes of recovery-oriented cognitive therapy (CT-R). Methods: Sixty outpatients (mean age 38.4 years, 33% female, 65% African American) with schizophrenia or schizoaffective disorder and elevated negative symptoms were randomly assigned...
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Despite the central role of training and consultation in the implementation of evidence-based psychological interventions (EBPIs), comprehensive reviews of research on training have highlighted serious gaps in knowledge regarding best practices. Consultation after initial didactic training appears to be of critical importance, but there has been ve...
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Recent innovations in behavior modification have, for the most part, detoured around the role of cognitive processes in the production and alleviation of symptomatology. Although self-reports of private experiences are not verifiable by other observers, these introspective data provide a wealth of testable hypotheses. Repeated correlations of measu...
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Since the description of catastrophizing by Ellis (Reason and emotion in psychotherapy. Lyle Stuart, Oxford, 1962) as a general factor in psychopathology, numerous studies have explored this construct and its association with many common disorders. This paper investigates the role of catastrophic thinking across psychiatric disorders. We conducted...
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Background: Disruptions in emotion regulation are a transdiagnostic risk factor for psychopathology. However, scant research has examined whether emotion regulation strategies are related to the onset of posttraumatic stress disorder (PTSD) symptoms among youths exposed to trauma. We investigated whether pretrauma emotion regulation strategies pro...
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Objective: Progress bringing evidence-based practice (EBP) to community behavioral health (CBH) has been slow. This study investigated feasibility, acceptability, and fidelity outcomes of a program to implement transdiagnostic cognitive therapy (CT) across diverse CBH settings, in response to a policy shift toward EBP. Method: Clinicians (n = 34...
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Training in evidence-based practices may better prepare providers to address the effect of behavioral health concerns on chronic homelessness. Through the Beck Initiative, a community–academic partnership, case managers (n = 19) were selected to incorporate a cognitive-behavioral therapy (CBT) framework into services for chronic homelessness at sev...
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Johnsen and Friborg (Psychological Bulletin 2015; doi:10.1037/bul0000015) report that modern cognitive behavior therapy (CBT) clinical trials yield less relief from depression compared to seminal trials, but methodological limitations may qualify the conclusions. Given the empirical support for CBT for depression, a closer look is warranted. High I...
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Given the preponderance of evidence supporting the efficacy of cognitive behavior therapy (CBT), there has been an increased emphasis on dissemination to community mental health systems (CMH). Trainers from two large-scale dissemination initiatives (n = 27) were surveyed regarding the common pitfalls and difficulties encountered by CMH clinicians l...
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We propose that depression can be viewed as an adaptation to conserve energy after the perceived loss of an investment in a vital resource such as a relationship, group identity, or personal asset. Tendencies to process information negatively and experience strong biological reactions to stress (resulting from genes, trauma, or both) can lead to de...
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This study used a mixed methods approach to examine pathways to suicidal behavior by identifying cognitive warning signs that occurred within one day of a suicide attempt. Transcripts of cognitive therapy sessions from 35 patients who attempted suicide were analyzed using a modified grounded theory approach. Cognitive themes emerging from these tra...
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Objective: The current study examines the predictive validity of the Beck Depression Inventory (BDI) suicide item for death by suicide and suicide attempts. Method: The study included 2 samples: (1) 5,200 psychiatric outpatients who were evaluated between 1975 and 1995 and followed prospectively for up to 20 years (all psychiatric diagnoses base...
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Received: March 30, 2015 Accepted: May 24, 2015 Published online: September 25, 2015 Issue release date: October 2015
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Attentional fixation is a cognitive process characterized by a narrowing of attention on and preoccupation with suicide as the only solution to one’s problems. The present study sought to investigate the experience of attentional fixation on suicide by establishing the psychometric properties of the Attentional Fixation on Suicide Experiences Quest...
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Prevention of recurrence is a challenge in the management of major depressive disorder (MDD). The long-term effects of Preventive Cognitive Therapy (PCT) in preventing recurrence in MDD are not known. A RCT comparing the addition of PCT to Treatment As Usual (TAU), versus TAU including patients with recurrent depression who were in remission at ent...
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The purpose of this study was to examine influences on the sustainability of a program to implement an evidence-based psychotherapy in a mental health system. Interviews with program administrators, training consultants, agency administrators, and supervisors (N=24), along with summaries of program evaluation data and program documentation, were an...
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Background: Internet-based cognitive therapy with monitoring via text messages (mobile CT), in addition to treatment as usual (TAU), might offer a cost-effective way to treat recurrent depression. Method: Remitted patients with at least 2 previous episodes of depression were randomized to mobile CT in addition to TAU (n = 126) or TAU only (n = 113)...
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Objective The onset of psychosis typically occurs during adolescence or early adulthood and can have a detrimental impact on social and cognitive development. Cognitive behavioural therapy (CBT) shows promise in reducing the risk of psychosis. Teaching families to apply CBT with their offspring may bolster therapeutic gains made in time-limited tre...
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Cooperation and conflict may be understood as two sides of the same coin, comprising the social, political, and international sciences on the one hand and, on the other, the murkier nature of human psychology. The authors focus on these concepts by inquiring into the mental mechanisms triggering both cooperative and conflicting approaches in human...
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Policy-makers, payers, and consumers often make decisions based on therapists' reported theoretical orientations, but little is known about whether these labels represent actual or potential skills. Prior to CBT training, therapists (n = 321) reported theoretical orientations. Experts rated CBT competency using the Cognitive Therapy Rating Scale Th...
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Although theorists have posited that suicidal individuals are more likely than non-suicidal individuals to experience cognitive distortions, little empirical work has examined whether those who recently attempted suicide are more likely to engage in cognitive distortions than those who have not recently attempted suicide. In the present study, 111...
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To determine the risk factors for suicide, 6,891 psychiatric outpatients were evaluated in a prospective study. Subsequent deaths for the sample were identified through the National Death Index. Forty-nine (l %) suicides were determined from death certificates obtained from state vital statistics offices. Specific psychological variables that could...
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For over 50 years, Beck's cognitive model has provided an evidence-based way to conceptualize and treat psychological disorders. The generic cognitive model represents a set of common principles that can be applied across the spectrum of psychological disorders. The updated theoretical model provides a framework for addressing significant questions...
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We investigated the feasibility of implementing a recovery-oriented cognitive therapy (CT-R) milieu training program in an urban acute psychiatric inpatient unit. Over a 1-month period, 29 staff members learned short-term CT-R strategies and techniques in an 8-h workshop. Trainees' perceptions of CT-R, beliefs about the therapeutic milieu, and atti...
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A growing literature supports cognitive therapy (CT) as an efficacious treatment for youth struggling with emotional or behavioral problems. Recently, work in this area has extended the dissemination of CT to school-based settings. The current study has two aims: 1) to examine the development of therapists’ knowledge and skills in CT, an evidence-b...
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Objective: This study identified modifications to an evidence-based psychosocial treatment (cognitive therapy) within a community mental health system after clinicians had received intensive training and consultation. Methods: A coding system, consisting of four types of contextual modifications, 12 types of content-related modifications, seven...
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Cognitive-Behavioral Therapy for psychosis (CBTp) is an evidence-based treatment for psychosis-related disorders. However, despite the strong evidence-base and inclusion in national treatment guidelines, CBTp remains poorly disseminated in the US. It is proposed that this state is a product of lack of CBTp knowledge among clinical training leaders...
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Individuals with severe and persistent schizophrenia can present challenges (e.g., difficulties sustaining motivation and conducting information processing tasks) to the implementation of recovery-oriented care. We present a successful application of recovery-oriented cognitive therapy (CT-R), a fusion of the spirit and principles of the recovery m...
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Cognitive therapy (CT) refers to a family of interventions and a general scientific approach to psychological disorders. This family has evolved from a specific treatment model into a scientific approach that incorporates a wide variety of disorder-specific interventions and treatment techniques. The goal of this article is to describe the scientif...
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To compare the outcomes of cognitive therapy for depression under controlled and clinically representative conditions, while holding several therapist and clinical assessment factors constant. Treatment outcomes for a sample of 23 adults with a primary diagnosis of Major Depressive Disorder who received cognitive therapy in an outpatient clinic wer...
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In replyWe welcome the opportunity to address the difference between low-functioning and negative symptoms because this appears to have not been clearly explained in the original article. Between the time we submitted the trial to the grants.gov website and starting the trial, we became more aware of the importance of functioning as emphasized by t...
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The Beck Depression Inventory (BDI-II) is a widely used instrument that provides information about the presence and severity of depressive symptoms. Although the BDI-II is a psychometrically sound instrument, relatively little is known about norm scores. This study aimed to develop reliable norms for the BDI-II in a Dutch community sample. Gender,...
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Objective: The Cognitive Biases Questionnaire for psychosis (CBQp) was developed to capture 5 cognitive distortions (jumping to conclusions, intentionalising, catastrophising, emotional reasoning, and dichotomous thinking), which are considered important for the pathogenesis of psychosis. Vignettes were adapted from the Cognitive Style Test (CST),...
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Objective: The Beck Depression Inventory (BDI) has been used more than any other self-report questionnaire in research on depression in cardiovascular disease. However, no studies have examined whether BDI scores may be influenced by somatic symptoms common after myocardial infarction (MI) that may overlap with symptoms of depression. The objectiv...
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Despite the mounting evidence of the benefits of cognitive therapy for depression and suicidal behaviors over usual care, like other evidence-based psychosocial treatments (EBTs), it has not been widely adopted in clinical practice. Studies have shown that training followed by intensive consultation is needed to prepare providers to an appropriate...
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The Beck Depression Inventory (BDI) is one of the most commonly used self-report depression symptom questionnaires in medical settings. The revised BDI-II was developed in 1996, partially due to concerns about the influence of somatic symptoms from medical illness on BDI scores. The BDI, however, continues to be frequently used in medical settings....
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Background: Clinical research is required to develop and evaluate suicide prevention interventions in the elderly. However, there is insufficient information available about how to best recruit suicidal older adults for such research. This study evaluated the success and efficiency of five recruitment strategies for a clinical trial on the efficac...
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This article reviews the main issues associated with the concept and the diagnosis of generalized anxiety disorder (GAD) and examines the proposed DSM-5 diagnostic criteria for GAD. The lack of specific features, which is the primary issue for GAD, will not be addressed in DSM-5. The hallmark of the condition will remain pathological worry, althoug...
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Policymakers are investing significant resources in large-scale training and implementation programs for evidence-based psychological treatments (EBPTs) in public mental health systems. However, relatively little research has been conducted to understand factors that may influence the success of efforts to implement EBPTs for adult consumers of men...
Chapter
This chapter describes the theory, practice, and empirical status of cognitive therapy. After highlighting the main conceptual axioms of the cognitive model and its treatment techniques, the role of mindfulness- and acceptance-based strategies are discussed. Although emphasized less than direct cognitive change strategies, some notions of acceptanc...
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The concept of cognitive insight was introduced in 2004 to describe the capacity of patients with psychosis to distance themselves from their psychotic experiences, reflect on them, and respond to corrective feedback. The Beck Cognitive Insight Scale (BCIS) was developed to evaluate these aspects of cognitive flexibility and to complement scales th...
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Women have a higher prevalence of Major Depressive Disorder (MDD) and report more severe depressive symptoms than men. Several studies have suggested that gender differences in depression may occur because women report higher levels of somatic symptoms than men. Those studies, however, have not controlled or matched for non-somatic symptoms. The ob...
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Low-functioning patients with chronic schizophrenia have high direct treatment costs and indirect costs incurred due to lost employment and productivity and have a low quality of life; antipsychotic medications and psychosocial interventions have shown limited efficacy to promote improved functional outcomes. To determine the efficacy of an 18-mont...
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This article presents an overview of the Personality Beliefs Questionnaire (PBQ)--a 126-item self-report measure of beliefs associated with 10 personality disorders. It consolidates the literature on the PBQ over the last 20 years to provide a summary of the psychometric status, revisions and applications of the PBQ scales. The PBQ scales are psych...
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[Clin Psychol Sci Prac 18: 275–299, 2011] Despite decades of research on the etiology and treatment of depression, a significant proportion of the population is affected by the disorder, fails to respond to treatment, and is plagued by relapse. Six prominent scientists—Aaron Beck, Richard Davidson, Fritz Henn, Steven Maier, Helen Mayberg, and Marti...
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Cluster C personality disorders are prevalent in outpatient samples, highly comorbid with Axis I disorders, and can worsen the course of Axis I pathology and treatment outcomes. Cognitive therapy for personality disorders (CT-PD) can be a potent treatment, but establishing and navigating the therapeutic alliance can be especially difficult with thi...
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Previous research has identified only a few variables that have been associated with making an impulsive suicide attempt. The aim of the current study was to compare individuals who made an impulsive suicide attempt with those who made a premeditated attempt on both previously examined and novel characteristics. Participants were classified as maki...
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This study examines the structure of the Personality Belief Questionnaire (PBQ), a self-report instrument designed to assess dysfunctional beliefs associated with personality pathology, as proposed by the cognitive theory of personality dysfunction. The PBQ was examined using exploratory factor analysis (EFA) with responses from 438 depressed out-p...
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In the 40 years since Aaron Beck first proposed his cognitive model of depression, the elements of this model--biased attention, biased processing, biased thoughts and rumination, biased memory, and dysfunctional attitudes and schemas--have been consistently linked with the onset and maintenance of depression. Although numerous studies have examine...
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The deficit syndrome was proposed over 20 years ago as a separate negative symptom syndrome within schizophrenia with a distinct neurobiological pathophysiology and etiology. Recent research, however, has indicated that psychological factors such as negative attitudes and expectancies are significantly associated with the broad spectrum of negative...
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Although there is a large literature that prospectively examines predictors of suicide, low base rates of suicide and imprecision of measurement hinder definitive conclusions from being drawn. This study examined predictors of suicide relative to other types of death in a sample of 297 patients who had been hospitalized for suicide ideation or a su...
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Although individuals who attempt suicide have poor compliance rates with treatment recommendations, the nature and degree of participation bias in clinical treatment research among these individuals is virtually unknown. The purpose of this study was to examine participation bias by comparing the demographic and diagnostic characteristics of adult...
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Cognitive therapy is a system of psychotherapy with a powerful theoretical infrastructure, which has received extensive empirical support, and a large body of research attesting to its efficacy for a wide range of psychiatric and medical problems. This article provides a brief overview of the conceptual and practical components of cognitive therapy...