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

Higher Order Cognitive Processing

Newell and Simon (1972) exemplified the modern approach to the study of problem solving.

Higher Order Cognitive Processing


Problem Solving


Newell and Simon (1972) exemplified the modern approach to the study of problem solving. Their methodology involved the extensive analysis of verbal protocols, that is, subjects’ verbaliza-tions as they attempted to solve (often lengthy) mental problems. Their in-depth analyses of human mental processes ultimately led Newell and Simon to their most important conceptual contribution – the idea that human thought could be conceived of as internal symbol manipulation, or the processing of infor-mation. Their analogy to algorithmic information processing in computers proved useful; data input was similar to perception, data representation was similar to memory and data manipula-tion was similar to problem solving.


Goldfried and Davison (1994, p. 186) concluded that “much of what we view clinically as ‘abnormal behavior’…may be more usefully construed as ineffective behavior with its nega-tive consequences, such as anxiety, depression, and the creation of secondary problems”. Deficits in problem solving have been documented as nonspecific deficits associated with many psychi-atric disorders (e.g., schizophrenia). Problem-solving techniques are considered standard cognitive–behavioral interventions with applications to such diverse problems as depression, suicidal behavior, anxiety, marital problems and adolescent social prob- lems (D’Zurilla, 1986; Nezu et al., 1989; Nezu and D’Zurilla, 1980; Robin, 1981). Applications with children have focused on reducing aggressive behavior (Camp and Bash, 1985), reducing impulsive behavior (Kendall and Braswell, 1985), and teaching social competence in prevention programs (Kirschenbaum and Ordman, 1984).


In the current practice of problem-solving therapies, there is general agreement on the five steps central to most problem-solving applications. These steps may be traced to observations derived from empirical work on problem solving in cognitive psy-chology, although actual explicit empirical links have never been established. These five steps, first enumerated by D’Zurilla and Goldfried (1971), are: 1) developing a general orientation or set to recognize problems, 2) defining the specifics of the problem and what needs to be accomplished, 3) generating alternative courses of action, 4) deciding among the alternatives by evaluating their consequences, and 5) verifying the results of the decision process and determining whether the alternative selected is achieving the desired outcome. If the outcome is not satisfactory, the process is repeated. These basic steps of clinical problem solving, at times combined with components of Spivak and Shure’s (1974) program (e.g., taking the perspective of other persons), have formed the core of the empirically validated problem-solving therapies that are usually identified as a type of cognitive–behavioral therapy.


Schema Theory and Reasoning


Beck and colleagues (1979) suggested that new information about particular experiences or situations is processed through the me-dium of an established, organized, cognitive structure based on abstractions from relevant prior experience. This organized, cog-nitive structure is called a schema, and it has become one of the primary elements in the cognitive perspective on depression (as well as the cognitive perspective on other forms of psychiatric disorders). Cognitive schemata are believed to exert their influ-ence at many different levels of information processing. Schemata are hypothesized to direct the selectivity of attention, as well as the interpretation of ambiguous information, and the integration of new experiences into an existing cognitive matrix. For this rea-son, schema theory can be used as an overarching, explanatory framework for much of the clinical psychopathology research on attentional mechanisms, memory biases and reasoning processes.


The application of schema theory to the study of psychi-atric disorders represents one of the important elements in the cognitive perspective on psychopathology. Although Beck is most widely known for his theories about depression, he has also written about the cognitive bases for other emotional disorders including anxiety and anger (Beck, 1976), as well as the cogni-tive bases for personality disorders (Beck and Freeman, 1990). In all of these theories, the central credo involves the influence of schematic bias in the interpretation of new information and the encoding of new memory. Thus (for example) in depression, the overgeneralized operation of negativistic schemata is hy-pothesized to lead to faulty and depressogenic inferences about events and experiences in an individual’s life (Beck et al., 1979). Another example of the role of schemata in psychopathology is observed among personality disorders, wherein an individual is hypothesized to suffer from a self-perpetuating and treatment-resistant “early maladaptive schema”, which essentially involves a dysfunctional set of assumptions and interpretations regard-ing oneself in relation to other people and/or the environment (Young, 1990). Cognitive theory can be extended, by analogy, to many of the other forms of psychiatric disorders.

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