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Chapter: Essentials of Psychiatry: Cognitive Psychology: Basic Theory and Clinical Implications

Cognitive Psychology: Basic Theory and Clinical Implications

A number of factors, including the development of complex learning theories, discussions regarding language development.

Cognitive Psychology: Basic Theory and Clinical Implications


A number of factors, including the development of complex learning theories, discussions regarding language development, use of computers as a metaphor for human information process-ing and practical applications needed during World War II, all contributed to the cognitive revolution in psychological research during the 1950s and 1960s. Cognitive psychology is now one of the major areas of psychological inquiry alongside experimental, developmental, social and personality, and clinical psychologies.


The major synthesis of cognitive psychology with clinical practice has been forged by cognitive–behavior therapists. There are, however, other major applications and implications of cogni-tive psychology regarding attention, memory and higher order cognitive processes such as problem solving, schema construc-tion and modification, and automatic processing.


The purposeful allocation of one’s finite mental resources is a process known as attention (Ashcraft, 1994). Attentional pro-cesses have profound implications regarding adaptive function-ing, inasmuch as it falls to the attentional system to identify and select the most salient pieces of information in need of processing at each moment. Inefficient or erratic allocation of attention may engender maladaptive behavioral responses. Furthermore, it has been noted that a subset of cognitive processes appears to occur in the absence of attentional focus; such processes are often re-ferred to as automatic (Posner and Snyder, 1975). Dysregulations of the attentional system appear to play a central role in several clinical disorders, such as Generalized Anxiety Disorder (GAD), Major Depressive Disorder (MDD), Attention-Deficit/Hyper-activity Disorder (ADHD) and Borderline Personality Disorder (BPD). Consequently, efficacious cognitive–behavioral interven-tions for these disorders have accorded considerable attention to the development of strategies designed to facilitate more efficient and adaptive functioning of the attentional system.


Human memory is the central, essential ingredient in an in-formation-processing system. Human cognition supports operations more diverse by far than those of a computer, ranging from complex mathematical and spatial reasoning, to artistic and literary endeav-ors, to athletic prowess and interpersonal awareness. During the past century, empirical research has led to an increasingly refined under-standing of the interlocking mechanisms of human memory. This understanding has now been applied to the domain of clinical assess-ment and psychopathology. Researchers have documented the role of memory deficits and biases in several mental disorders, including (but not limited to) depression and PTSD. The results of these inves-tigations have suggested that memory, just as it plays an essential role in adaptive human functioning, may also play a central role in mal-adaptive, pathological functioning. The cognitive perspectives on psychopathology place an emphasis on the role of schematic mem-ory bias in its contribution to various forms of psychiatric disorder, and corresponding psychotherapy techniques have been developed to address bias in memory (Beck, 1976; Beck et al., 1979).

Problem solving is the complex mental process of using previously learned information to identify solutions to new prob-lems. Although specific empirical links between basic research and clinical practice have been sparse, the conceptual connections have provided several clinical procedures that are identifiable within self-control, cognitive–behavioral and interpersonal psychotherapies.

Cognitive psychologists studying memory developed the con-cept of schema, which can be understood as templates used to make sense of and draw conclusions about new sensory affective, of cog-nitive information. The schema construct was formulated to explain how memory is organized and why it produces the inaccuracies and incompleteness often observed in human recall. The incorporation and abstraction of new experiences into relevant schemata serve to influence the interpretation of future experience and thereby the en-coding and recollection of new memories. Schemata, therefore, affect all levels of human cognitive processing and may well be the most significant regarding a theoretical model contribution to date in cog-nitive psychology. The development and modification of schemata are central to Beck and others’ models of cognitive–behavioral con-ceptualizations of psychopathology and therapeutic change.


Finally, material is frequently processed automatically while conscious processing occurs on a parallel cognitive track. This raises intriguing questions regarding the similarities and differences in various conceptualizations of the unconscious. Answers to questions raised about automatic processes may well be the most significant future contributions cognitive psychology and neuroscience integration can offer clinical practice.


Piaget’s work in the mid-20th century helped delineate the subsequent areas of inquiry about human psychological functioning and adaptation, and to some extent it has influenced the mainstream of cognitive psychology; however, his greatest legacy is clearly his seminal contributions to the study of human development and developmental psychology, of which cognitive development is only a portion. The focus of Piaget’s theory was also considered cognitive when set in apposition to Freud’s fo-cus on emotion in his theory of psychosexual development.

Although the information-processing paradigm is still dominant in cognitive psychology, two new paradigms became influential during the last 10 to 15 years of the last century. The more established one is called connectionism (McClelland et al., 1986). This approach addresses an inherent limitation of the traditional computer metaphor of the mind – the fact that the brain’s infor-mation processing operations differ dramatically from those of serial symbol-processing computers, inasmuch as the former oc-cur within a distributed architecture of parallel interconnected elemental (neural) arrays. In other words, the connectionist ap-proach attempts to gain insights into human information process-ing by attending closely to the manner in which the brain’s own neurons process information. Accordingly, this approach uses neural network computational modeling techniques (simulations) as useful theoretical tools in the specification of the actual neural mechanisms and processes that underlie human cognition.


An even newer cognitive paradigm is the so-called eco-logical approach, although it is not yet as well established or as conceptually coherent as are the information-processing and connectionist paradigms. The ecological approach emphasizes that cognition does not occur in isolation from larger environ-mental (e.g., cultural) contexts, and argues that it is essential to study cognition in the natural context in which it occurs.


In the following sections, we review the general findings regarding attention, memory and higher order cognitive pro-cesses and give examples of their application to various areas of psychopathology and treatment interventions. Figure 16.1 pro-vides an overall schematic of the interactions of the cognitive processes that are discussed.


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