Cognitive Self-Statements in Depression, Dp of the ATQ, Kendall

7/29/2019 Cognitive Self-Statements in Depression, Dp of the ATQ, Kendall

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Cognitive Therapy and Research, VoL 4, No. 4, 1980, pp. 383-395

C o g n i t i v e S e l f - S t a t e m e n t s i n D e p r e s s i o n :D e v e l o p m e n t o f an A u t o m a t ic T h o u g h t sQ u e s t io n n a i r e 1S t e v e n D . H o l l o n 2 a n d P h i l i p C . K e n d a l lUniversity of Minnesota

A 30-item questionnaire was devised to measure the frequency ofoccurrence of automatic negative thoughts (negative self-statements)associated with depression. Male and female undergraduates were asked torecall dysphoric experiences and to report associated cognitions. Onehundred representative cognitions were selected and administered to asecond sample, along with the MMPI D scale and the Beck DepressionInventory. Thirty items discriminating between criterion groups o fpsychometrically depressed and nondepressed subjects were identified. Theresultant 30-item automatic thoughts questionnaire (ATQ-30) wascross-validated and found to significantly discriminate psychometricallydepressed from nondepressed criterion groups. No differences were foundbetween males and females on the measure. Factor analysts indicated afour-factor solution, with a large first factor reflecting Personal Maladjust-ment, a second factor indicative of Negative Self-Concept and NegativeExpectations, and two lesser factors. The ATQ-30 may provide a means oftesting basic theory relating cognitive content to behavioral and affectiveprocesses and assessing change in cognitions associated with experimentalmanipulation or psychotherapeutic intervention.

~ P r e p a r a ti o n o f t h i s a r ti c le w a s s u p p o r t e d i n p a r t b y t w o U n i v e r s i ty o f M i n n e s o t a G r a d u a t eS c h o o l G r a n t s in A i d o f R e s e a r c h ( 4 9 2 - 0 3 2 5 - 4 9 0 9 -0 2 ; 4 4 0- 01 6 0- 49 0 9- 02 ) t o t h e f i r s t a nds e c o n d a u t h o r s , r e sp e c ti v el y . W e w i s h t o t h a n k A u k e T e l le g e n f o r h i s in v a l u a b l e c o m m e n t sa n d s u g g e s ti o n s , a n d C l i f f J o h n s o n f o r h i s r e li a b le a s si s ta n c e .~ A dd re ss a ll c o r r e s p o n d e n c e t o S t e v e n D . H o l l o n o r P h i l i p C . K e n d a l l, C o g n i t i v e A s s e s s m e n tP r o j e c t , D e p a r t m e n t o f P s y c h o l o g y , U n i v e r s it y o f M i n n e s o t a , 7 5 E a s t R i v e r R o a d , M i n n e a -p o l is , M i n n e s o t a 5 5 45 5. A n e x p a n d e d v e r s i o n o f t h i s m a n u s c r i p t , c o m p l e t e w i th c o r r e l a t i o nm a t r i x , i s a v a i l a b l e f r o m t h e a u t h o r s .

3 8 30 1 4 7 - 5 9 1 6 / 8 0 / 1 2 0 0 - 0 3 8 3 5 0 3 . 0 0 / 0 1 9 8 0 Ple n u m P u b lis h in g Co r p o r a t i o n


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384 Hollon a n d K e n d a ll

R e c e n t t h e o r y a n d r e s e a r c h h a s f o c u s e d i n c r e a s in g l y o n t h e r o l e o f c o g n i t i o ni n t h e e ti o lo g y , m a i n t e n a n c e , a n d t r e a t m e n t o f v a r i o u s t y p e s o f p s y c h o -pa tho log y (B and ura , 1977 ; Bec k , 1976; E l li s & Gr ieger , 1977 ; Go ld f r i e d &Da vison , 1976 ; Ke nda l l & H ol lo n , 1979 ; M ah on ey , 1974 , 1977 ;M e i c h e n b a u m , 1 97 7). W i t h r e g a r d t o d e p r e s s i o n , B e c k h a s a r g u e d t h a t t h ev a r i o u s c o m p o n e n t s o f t h e c l i n i c a l s y n d r o m e a r e t h e c o n s e q u e n c e o fp e r v a s i v e , s y s t e m a t i c a l l y n e g a t i v e d i s t o r t i o n s i n b o t h c o g n i t iv e c o n t e n t a n dpro ce ss (Beck, 1963, 1964, 1967) .

E m p h a s i s o n c o g n it i v e f a c t o r s h a s l e d to t h e d e v e l o p m e n t o ft h e r a p e u t i c p r o c e d u r e s d e s i g n e d t o r e d u c e d e p r e s s i o n b y s y s t e m a t i c a l l ya l te r in g t h e s e n e g a t iv e b e l ie f s ( B e c k , R u s h , S h a w , & E m e r y , 1 97 9; H o l l o n &B e c k , 1 9 79 ). O u t c o m e s tu d i e s h a v e i n d i c a t e d t h a t s u c h p r o c e d u r e s a r es u p e r i o r t o e it h e r t ra d i t i o n a l o r s t r ic t l y b e h a v i o r a l i n t e r v e n t i o n s i n t e r m s o fs y m p t o m r e d u c t i o n ( S h a w , 1 97 7; T a y l o r & M a r s h a l l , 1 97 7) a n d s u p e r i o r t ot ri cy c li c p h a r m a c o t h e r a p y i n t e rm s o f b o t h s y m p t o m r e d u c t i o n a n dp r e v e n t i o n o f r e l a p se ( R u s h , B e c k , K o v a c s , & H o l l o n , 1 97 7).

D e s p i t e t h e c u r r e n t i n t e r e s t i n b o t h c o g n i t i v e t h e o r y a n d c o g -n i t i v e - b e h a v i o r a l t h e r a p y i n t h e a f f e c t i v e d i s o r d e r s , t h e r e a p p e a r s t oh a v e b e e n l it tl e s y s te m a t i c e f f o r t t o a s s es s c h a n g e s i n c o g n i t iv e c o n t e n t a n dp r o c e s s a s a f u n c t i o n o f t r e a t m e n t ( K e n d a l l & K o r g e s k i , 1 97 9). O n e r e a s o nf o r t hi s f a il u r e t o p r o v i d e a " c o n f i r m a t i o n o f t r e a t m e n t m e c h a n i s m s " is t h ea b s e n c e o f s u i t a b l e s p e c i f i c m e a s u r e s o f c o g n i t i o n s a s s o c i a t e d w i t hd e p r e s s i o n .

J o n e s ' s I r r a t i o n a l B e l i e f s T e s t ( I B T ) ( 1 9 6 8 ) i s o n e m e a s u r e o f t h o s eb e l ie f s p r e s u m e d t o u n d e r l y n e u r o t i c e m o t i o n a l it y . H o w e v e r , w h i le t h e I B Tp r e d i c t s a f f e c t - r e l a t e d a r o u s a l t o s p e c i f i c s i t u a t i o n a l s t i m u l i ( G o l d f r i e d &S o b o c i n s k i , 1 9 7 5 ) , i t c o r r e l a t e s o n l y m o d e r a t e l y w i t h s e l f - r e p o r t e ddep res s ion (N e lson , 1977), a s ses ses be l i e f s a s soc ia ted w i th gen era le m o t i o n a l i t y r a t h e r t h a n s p e c i fi c a f f e c t i v e st a t e s, a n d a s se s s es t h e d e g r e e t ow h i c h p e o p l e a s c r i b e t o t h e v a l i d it y o f v a r i o u s s t a t e m e n t s , n o t t h e f r e q u e n c yw i t h w h i c h t h e y e x p e r ie n c e s p e c i f ic c o g n i ti o n s . E U i s 's c o n c e p t o f " i r r a t i o n a lb e l i e f s " ( 19 6 2) m a y w e l l r e p re s e n t a c c u r a t e s u m m a r ie s o f w h a t p e o p l e ac t a si f t h e y b e li e ve , b u t m a y b e q u i t e d i s ti n c t f r o m a n y c o g n i ti o n s t h a ti n d iv i d u a ls s p o n t a n e o u s l y e x p e r i en c e . M e a s u r e s s u c h a s t h e I B T m a y r e fl e c ta t t i tu d e s t h a t p e o p l e h o l d b u t r a r e ly th i n k a b o u t , a t le a s t i n t h e f o r m a tp r e s e n t e d .T h e p r e se n t p a p e r r e p o r t s o n t h e d e v e l o p m e n t o f a n y i n v e n t o r yd e s i g n e d t o i d e n t i f y t h e c o v e r t s e l f -s t a t e m e n t s ( s e e K e n d a l l & H o l l o n , 1 98 1)r e p o r t e d b y d e p r e s s iv e s a s b e in g r e p r e s e n t a t i v e o f t h e k i n d s o f c o g n i t i o n st h e y e x p e r i e n c e . S u c h a n i n v e n t o r y s h o u l d p r o v e o f u s e b o t h i n t h e o r yt e st in g a n d a s a n i n d e p e n d e n t m e a s u r e o f c o g n i t iv e c h a n g e a s s o c i a te d w i the i t h e r l a b o r a t o r y m a n i p u l a t i o n s o r c l i n i c a l i n t e r v e n t i o n s .


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Autom atic Thoughts QuestionnaireM E T H O D

385

Item GenerationAn initial pool of items was generated by asking 788 male and femaleundergraduate students to recall an experience in their lives that they had

found to be depressing. Subjects were asked to recreate the situation inmemory as vividly as they could, as if they were reexperiencing the situationat that moment. Subjects were then instructed to record whatever thoughtshad "popped into their head" in that situation. Subjects were asked torecord their cognitions exactly the way they thought them, regardless ofgrammar or syntax.

The authors screened the pool of reported cognitions to eliminateredundant or incomprehensible responses. A total of 100 reported self-statements were selected for subsequent use, forming the initial automaticthoughts questionnaire (ATQ-100).

SubjectsA total of 348 male and female undergraduate college students were

recruited to participate in item selection and cross-validation. All subjectsreceived extra credit points toward course grades in return for participation.Protocols from 36 subjects who failed to complete the full test battery

were excluded from all further analyses, leaving a sample of 312 (167 malesand 145 females). The mean age of the full sample was 20.22 (SD = 4.34).

Subjects were randomly divided into two subsamples of 156 each. Thefirst subsample was used for item selection, while the second subsample wasused for subsequent scale cross-validation. The item selection sample wascomposed of 85 males and 71 females and the cross-validation sampleconsisted of 82 males and 74 females. These two subsamples did not differsignificantly in terms of sexual composition, X2(1) = .05, or age, t(310) =.69.

Measures of Depression and AnxietyTwo self-report inventories, recently recommended by Rehm (1976),were used to assess levels of depression. The Beck Depession Inventory(BDI) is a 21-item inventory designed to assess affective, behavioral,

cognitive, motivat ional, and vegetative aspects of depression (Beck, Ward,Mendelson, Mock, & Erbaugh, 1961; Beck, 1967). Each item consists offour statements, scored on a range from 0 to 3. Subjects are instructed to


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3 8 6 H o l l o n a n d K e n d a l l

c o m p l e t e e ac h i te m i n te r m s o f h o w t h e y f el t o v e r t h e p r e c e d i n g w e e k . At o t a l s c o re , r an g i n g f r o m 0 to 6 3 , is o b t a i n e d b y s u m m i n g o v e r t h e i t em s .T h e g r e a t e r t h e s c o re , t h e g r ea t e r t h e s e v e r it y o f s y n d r o m e d e p r e s s i o n . T h eB D I h a s s h o w n g o o d c o n c u r r e n t v a l id i t y w h e n c o m p a r e d t o p s y c h i a t ri cr a t in g s o f s e v e r it y o f d e p r e s s i o n i n b o t h c l in i c al p o p u l a t i o n s ( r = . 7 9, N =2 2 6 a n d r = . 6 7 , N = 1 8 3) ( B e c k e t a l ., 1 9 6 1 ) a n d c o l l e g e s t u d e n tp o p u l a t i o n s ( r = . 7 9, N = 5 6 ) ( B u m b e r r y , O l i v e r , & M c C l u r e , 1 9 78 ). B e c kr e c o m m e n d s a c u t t in g s c o re o f 1 0 a n d a b o v e f o r d e s i g n a t i n g a s u b j e c t a sd e p r e s s e d .

T h e M i n n e s o t a M u l t ip h a s i c P e r s o n a l i t y I n v e n t o r y D e p r e s s i o n s ca le( M M P I - D ) c o n s is t s o f 6 0 t r u e - f a l s e i t em s , 4 9 i n i t i a ll y s e l e ct e d t od i s c r i m i n a t e n o r m a l s f r o m h o s p i t a l i z e d m a n i c - d e p r e s s i v e s a n d 11 i n i t ia l l ys e le c te d to d i s t in g u i sh b e t w e e n d e p r e s se d a n d o t h e r p s y c h o p a t h o l o g i c a lc o n d i t i o n s ( H a t h a w a y & M c K i n l e y , 1 94 0). T o t a l s c o r es c a n r a n g e f r o m 0 to6 0 , w i t h h i g h s c o re s r e fl e c t in g g r e a t e r s e v e r i ty o f d e p r e s s i o n . T h e M M P I - Dh a s b e e n w i d e l y u s e d a s a s c r e e n in g i n s t r u m e n t f o r s e l e c ti n g d e p r e s s e ds a m p l e s f o r r e s e a r ch p u r p o s e s .

I t s h o u l d b e n o t e d t h a t b o t h m e a s u r e s p r o v i d e e s t im a t e s o f t h es e v er it y o f s y n d r o m e d e p r es s i o n . D e p r e s s i o n c a n b e m e a s u r e d a s a s y m p t o m( g e n er a ll y d e f i n e d a s s a dn e s s o r d y s p h o r i c m o o d ) , a s y n d r o m e ( c o n s is t in g o fc o v a r y i n g sig ns a n d s y m p t o m s ) , o r a d i s cr e te n o s o l o g i c a l c a t e g o r y ( B e c k ,1 96 7). W i t h t h e e x c e p t i o n o f s e l f - r e p o r te d a n x i e ty , n o a t t e m p t w a s m a d e t oe v a l u a te t h e p r e s e n c e o r a b s e n c e o f a s s o c ia t ed i n d i c e s o f p s y c h o p a t h o l o g yf o r t h e s a m p l e .

T h e S t a t e - T r a i t A n x i e t y I n v e n t o r y ( S T A I ) A - T r a i t s c al e ( S p i e lb e r g e r,G o r s u c h , & L u s h e n e , 1 9 70 ) is a 2 0 - i t em i n v e n t o r y a s k i n g s u b j e c t s t o r e p o r th o w f r e q u e n tl y t h e y h a d e x p e r ie n c e d v a r io u s p h e n o m e n a r e la t e d t o t ra i ta n x i e t y . T o t a l p o s s i b le s c o r es r a n g e f r o m 2 0 t o 8 0 , w i t h h i g h e r s c o r e si n d i c a t i n g g r e a t e r t r a i t a n x i e t y . A m e a s u r e o f t r a i t a n x i e t y w a s i n c l u d e d i na n e f f o r t t o c h e c k o n t h e s p e c if ic i ty o f n e g a ti v e c o g n i t i o n s t o d e p r e s si v ea f f e c t .

P r o c e d u r e

A l l 3 4 8 s u b j e c t s w e r e a d m i n i s t e r e d t h e te s ts d e s c r i b e d a b o v e a s p a r t o fa l ar g e r b a t te r y . F o r t h e A T Q , s u b j e ct s w e r e i n s t r u c t e d a s f o l l o w s .

Listed below are a variety of thou ghts that po p into people's heads. Please read eachthought and indicate how frequently, if at all, the thought occurred to you over thelast week. Please read each item carefully and flu in the appropriate circle on theanswer sheet in the following fashion (1 = "n ot at all," 2 = "sometim es," 3 ="moderate ly of ten," 4 = "o f ten ," and 5 = "a l l the t ime") .

S u b j e c t s w e r e i n s t ru c t e d t o c o m p l e t e th e o t h e r t es t s a c c o r d i n g t o s t a n d a r di n s t r u c t i o n s .


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Autom alic Though ts Questionnaire 387Method of A nalysis

Depressed and nondepressed criterion groups were formed with eachsubsample on the basis of scores on both depression measures. Subjectsscoring 1 standard deviation or more above the mean on both the BDI(score of 11 and above) and the MMPI-D (score of 26 and above) weredefined as depressed. Subjects scoring at or near the mean on both scales(BDI scores equal to 3, 4, or 5 and MMPI-D scores from 15 through 20)were defined as nondepressed.

In the item selection sample, 12 subjects (7 males and 5 females) metthe criteria for inclusion in the depressed group, while 20 subjects (9 malesand 11 females) met the criteria for inclusion in the nondepressed group. Inthe cross-validation sample, 14 subjects (5 males and 9 females) and 21subjects (12 males and 9 females) met the criteria for the depressed andnondepressed groups, respectively. There were no significant genderdifferences among the four groups, ~(2(3) = 1.97.

Independent t tests were computed on each of the ATQ-100 itemsbetween depressed and nondepressed subjects for the item selection sample.Items discriminating between the two groups were then combined into asingle scale and cross-validated on the cross-validation sample-depressedand cross-validation sample-nondepressed groups.

RESULTS

Sample Characteristics and Subsample ComparabilityOne-way analyses of variance evidenced no significant differences

between the two subsamples on the BDI, the MMPI-D, the STAI A-Trait,and the ATQ-30, all F's(1,308)< 1. Males and females did not differ onthree of the four measures: BDI, STAI A-Trait, and ATQ-30, allF's(1,308)< .05. Females did score significantly higher than males on theMMPI-D scale, F(1,308) -- 5.06, p < .05. There were also no significantSubsample X Sex interactions on all variables, all F's(1,308)< 1. It appearsthat the two subsamples were comparable.

Characteristics of Depressed and Nondepressed Criterion GroupsAs expected, depressed subjects had significantly higher mean scoresthan nondepressed subjects on both the BDI, F(1,63) = 11.00, p < .001,

and the MMPI-D, F(1,63) = 126.47, p < .001. Males did not dif fer fromfemales on either the BDI or the MMPI, all F's(1,63) < 1, nor were there anysignificant interactions between sex and criterion group on the depression


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3 9 0 H o i l o n a n d K e n d a ll

m e a s u r e s , a l l F ' s < 1 , r e s p e c ti v e ly . M e a n B D I s c o r e s f o r b o t h d e p r e s s e d c r i-t e r io n g r o u p s w e r e c o m p a r a b l e t o t h e B u m b e r r y e t a l . ( 19 7 8) m i l d ly t om o d e r a t e l y d e p r e s s e d c o l le g e s t u d e n t s . I n t h a t s t u d y , B D I s c o r e s w e r es i g n if i c an t l y c o r r e l a t e d w i th p s y c h i a t r i c r a t in g s o f d e p r e s s i o n . T h u s t h ed e p r e s s e d c r i t e r i o n g r o u p s c a n b e s a i d t o r e p r e s e n t a m i x e d s e x s a m p l e o fp s y c h o m e t r i c a l l y i d e n t if i e d m i l d l y t o m o d e r a t e l y d e p r e s s e d c o l le g e s t u d e n t s .

A TQ I t em Se lec t ionU s i n g t h e i t e m s e le c t io n s a m p l e d a t a , 3 0 o f t h e o r i g i n a l 1 00 A T Q

i t e m s w e r e f o u n d t o s i g n i f i c a n t l y d i s c r i m i n a t e b e t w e e n t h e d e p r e s s e d a n dn o n d e p r e s s e d c r i te r i o n g r o u p s a t t h e .0 1 le v e l. T h e 3 0 i t e m s , w i t h m e a n s( a n d s t a n d a r d d e v i a t i o n s ) a n d t - te s t v a l u e s a re p r e s e n t e d i n T a b l e I . O n e a c ho f th e 3 0 a u t o m a t i c t h o u g h t s , t h e d e p r e s s e d s u b j e c t s r e p o r t e d s i g n if i c a n tl ym o r e f r e q u e n t i n s ta n c e s o f t h e s p e ci fi c c o g n i t io n s . N o n e o f t h e r e m a i n in gi te m s w e r e e n d o r s e d s i g n if ic a n tl y m o r e o f t e n b y t h e n o n d e p r e s s e d g r o u pt h a n b y t h e d e p r e ss e d g r o u p .

A l t h o u g h t h e 3 0 it e m s w e r e s e l e c t e d b e c a u s e t h e y s i g n if i c a n tl yd i s c r i m i n a t e d d e p r e s s e d f r o m n o n d e p r e s s e d s u b j e c t s , t h e i t e m s w e r e n o td i f fe r e n t ia l l y e n d o r s e d b y m a l e s a n d f e m a l e s . A n a n a l y si s o f v a r i an c ei n d i c a t e d th a t , w h i le d e p r e s s e d a n d n o n d e p r e s s e d g r o u p d i d d i f f e r o n t o t a lA T Q - 3 0 s c o r e , F ( 1 , 2 7 ) = 4 3 . 4 8 , p < . 0 01 , t h e r e w a s n o s i g n i f i c a n t e f f e c t f o rs e x , F ( 1 , 2 7 ) < 1 , a n d n o s i g n if i c a n t D e p r e s s i o n X S e x i n t e r a c t i o n ,F (1 ,27 ) < 1 .

Cross- Va l idat ionT o t a l s c o r e s o n t h e A T Q - 3 0 w e r e c o m p u t e d f o r a l l s u b j e c t s i n t h e

d e p r e s s e d a n d n o n d e p r e s s e d c r i t e r i o n g r o u p f r o m t h e c r o s s - v a l i d a -t i o n s a m p l e . A n i n d e p e n d e n t t t e s t i n d i c a t e d s i g n i f i c a n t l y h i g h e r s c o r e s ,t (1 7 ) = 4 . 8 5 , p < . 00 1 , f o r t h e d e p r e s s e d s u b j e c t s. T h e m e a n A T Q - 3 0 f o rt h e d e p r e s s e d s u b j e c t s w a s 7 9 . 6 4 (S D = 2 2 . 2 9) , w h i le t h e m e a n A T Q - 3 0 f o rt h e n o n d e p e s s e d s u b j e c t s w a s 4 8 . 5 7 (S D = 1 0 .8 9 ) . T h e s e d a t a c r o s s - v a l i d a t et h e f i n d in g t h a t t h e s e 3 0 i te m s a r e e n d o r s e d m o r e f r e q u e n t l y b y d e p r e s s e dt h a n b y n o n d e p r e s s e d s u b j e c t s. D i f f e r e n c e s i n sc o r e s o n t h e A T Q - 3 0 i n t h ec r o s s - v a l i d a t io n s a m p l e a re n o t i n f la t e d b y c a p i t a li z a t i o n o n c h a n c e f a c t o r si n i t e m s e l e c ti o n . T h e m e a n s ( a n d s t a n d a r d d e v i a t i o n s ) a n d t - te s t v a l u e s f o rt h e c r o s s - v a l i d a t i o n o f e a c h i t e m a r e p r e s e n t e d i n T a b l e I .

we l l

In te r rel a ti onsh i ps A m o n g M easuresA l l c o r re l at io n s a m o n g t h e B D I , t h e M M P I - D , a n d t h e A T Q - 3 0 ( asa s t h e 1 0 0 - i t e m A T Q ) u s i n g t h e f u l l s a m p l e w e r e s t a t i s t i c a l l y


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Au tomatic Thou ghts Q uestionnaire 391s i g n i fi c a n t , p ' s < . 01 . I n t e r c o r r e l a t i o n s c a l c u l a t e d s e p a r a t e l y f r o m t h e i t e ms e l e c ti o n s a m p l e a n d c r o s s - v a l i d a t i o n s a m p l e d a t a w e r e a l s o si g n i f ic a n t . O fn o t e w e r e t h e co m p a r a b il it ie s o f A T Q - 3 0 / B D I a n d M M P I - D c o r re l a ti o n s( r ' s r a n g e f r o m . 45 t o .7 0) a c r o s s b o t h s a m p l e s ( r ' s w i t h i n . 0 2 o f e a c h o t h e r )a n d t h e r e l a t i v e l a c k o f d i f f e r e n c e s i n t h e m a g n i t u d e o f t h e c o r r e l a t i o n si n v o lv i n g t h e A T Q - 3 0 a n d t h e 1 0 0 -i te m A T Q ( la r ge s t d i f fe r e n c e b e t w e e n r ' sw a s . 0 5 ). T h e c o m p a r a b i l i t y o f th e i n t e r re l a t i o n s h i p s s p e a k s t o t h e s t a b i l i t yo f t h e e n d o r s e m e n t o f a u t o m a t i c n e g a ti v e c o g n i t io n s , w h i l e t h e s i m i la r it y o ft h e A T Q - 3 0 a n d A T Q - 1 0 0 i n d ic a t e s a r e t e n ti o n o f c o n c u r r e n t v a l id i t yd e s p i te t h e r e d u c t i o n i n th e t o t a l n u m b e r o f i te m s .

An xiety , Depression, an d the A TQ -30T h e S T A I A - T r a i t h a d b e e n a d m i n i s t e r e d t o p r o v i d e a b a s i s f o r

s e le c ti n g A T Q c o g n i ti o n s a s s o c i a t e d w i th d e p r e s s io n b u t n o t a s s o c i a t e d w i t ha n x i e ty . H o w e v e r , t h e c o r re l a t i o n b e t w e e n tr a i t a n x i e ty a n d t h e A T Q - 3 0 w a sa c t u a l l y q u i t e h i g h (r = . 7 9, f o r th e f u l l s a m p l e ) , p r e c l u d i n g a n yi n t e r p r e t a t i o n o f s p e c i f ic i t y t o d e p r e s s i o n - r e l a t e d c o g n i t i o n s . I t i s n o t c l e a r ,h o w e v e r , w h e t h e r t h i s l a c k o f s p e c i f i c i t y r e f l e c t s f l a w s i n t h e A T Q - 3 0 o ro v e r l a p in t h e m e a s u r e s o f s y n d r o m e p s y c h o p a t h o l o g y u s e d . C o r r e l a ti o n sb e t w e e n t h e e s ta b l i sh e d d e p r e s s io n m e a s u r e s a n d t h e a n x i e t y m e a s u r e w e r ea l s o h i g h ( r ' s r a n g e d f r o m . 6 0 t o . 7 8 ) , v e r s u s a n r o f . 6 3 b e t w e e n t h e t w od e p r e s s i o n m e a s u r e s , s u g g e s t i n g t h a t i t w a s n o t p o s s i b l e t o m e a n i n g f u l l yd i s c r i m i n a t e b e t w e e n se l f - r e p o r t e d d e p r e s s i o n a n d s e l f - r e p o r t e d a n x i e t y i nt h i s s a m p l e .

ReliabilityB o t h s p l i t - h a l f a n d c o e f f i c i e n t a l p h a ( K u d e r & R i c h a r d s o n , 1 93 7)

r e l i a b i l i t y c o e f f i c i e n t s w e r e u s e d t o e s t i m a t e t h e r e l i a b i l i t y o f t h e A T Q - 3 0 .T h e s p l i t - h a l f r e l i a b i l i t y c o e f f i c i e n t , c a l c u l a t e d o n o d d v e r s u s e v e n i t e m s ,w a s .9 7 , p < . 00 1 . C a l c u l a ti o n o f c o e f f i c i e n t a l p h a y i e ld e d a c o r re l a t io n o f.9 6 , p < . 00 1 . I n g e n e r al , b o t h r e l ia b i li ty e s ti m a t e s a r e q u i t e s a t i s fa c t o r y ,a n d t h e A T Q - 3 0 a p p e a r s t o p o s s e s s s u f f i c i e n t r e l i a b i l i t y t o j u s t i f y f u r t h e ru s e .

T h e r e a r e t h e o r e t i c a l g r o u n d s f o r n o t c o l le c t in g t e s t- r e t e st d a t a o n t h eA T Q - 3 0 w i t h o u t s i m u l t a n e o u s l y c o l l e c t i n g c o m p a r a b l e d a t a o n s e l f - r e -p o r t e d l ev e ls o f s y n d r o m e d e p r e s s io n . W i t h o u t s p e c if y in g t h e d i r e c t i o n o fc a u s a l it y , t h e f r e q u e n c y o f s p e c i fi c d e p r e ss i o n - re l e v a n t c o g n i t io n s w o u l d b ee x p e c t e d t o b e c l o s e ly r e l a t e d t o t h e l e v e l o f e x p e r i e n c e d d e p r e s s i o n .D e p r e s s i o n i t s e l f is a tr a n s i t o r y p h e n o m e n o n ; t h u s t e s t - r e te s t c o e f f i c i e n t s o nt h e A T Q - 3 0 s h o u l d b e e v a l u a t e d o n l y w h e n a c c o m p a n i e d b y re l ia b i li tyc o e f f ic i e n t s o n s y n d r o m e d e p r e s s i o n m e a s u r e s . S u c h d a t a a r e c u r r e n t l yb e i n g c o l l e c t e d a n d w i l l b e r e p o r t e d i n a l a t e r p a p e r .


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392 H o l l o n a n d K e n d a llTable II. ATQ-30 Scale Items with Factor Loadings Over .50 a

ATQ-30 scale Factors loadingsitem number Items I II III IVFactor I26 Something has to change. .6 4 .23 .20 .30

20 What's the matter with me? .6 3 .39 .23 .197 I wish I were a better person. .6 2 .26 .16 .13

14 Whats wrong with me? .62 .29 .31 .2910 I'm so disappointed in myself. . 5 7 .22 .24 .17

Factor II28 My future is bleak. .19 .7 0 .13 .3523 I'm a failure. .23 .6 8 .33 .2124 I'U never make it. .21 .5 7 .27 .459 My life's not going the wayI wanted it to. .49 .5 2 .27 .2821 I'm a loser. .24 .5 2 .46 .18

3 Why can't I ever succeed? .46 .5 2 .31 .222 I'm no good. .38 .5 2 .45 .03

Factor III18 I'm worthless. .10 .37 .6 6 .2317 I hate myself. .30 .14 .6 5 .06

Factor IV30 I can't finish anything. .27 .27 .11 .7329 It's just not worth it. .17 .23 .43 .5 8

aATQ-30 = Automatic Thoughts Questionnaire.

1 te rn A n a l y s i s

All ATQ-30 i tem-to-total correlat ions were signif icant at or beyondthe .001 level. Indi vidu al item -tot al correl ations ran ge from r = .47 ("I 'v elet people do wn" ) to r = .78 ("My l ife 's not going the way I wan t i t to") .These consistently moderate to strong correlat ions indicate that each i tem issignif icantly related to the to tal score.

F a c t o r A n a l y s i sA pri ncip al-c ompone nts factor analysis with Vari max rotat ions was

performed on the 312 subjects ' responses to the ATQ-30. Since males andfemales did not d iffer in terms of to tal scores in ei ther sample, data frombot h sexes were incl uded in the analysis. As shown i n Table II, four factorsemer ged with e igenva lues > 1, acc oun ti ng for a total of 58.9o7o of the


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Autom atic Thoughts Q uestionnaire 393variance. The first factor accounted for the bulk of the variance, 45.970,while factors II, III, and IV accounted for 5.2070, 4.4070, and 3.5070 of thevariance, respectively.

Items loading on the first factor appear to reflect perceptions ofPersonal Maladjustment and Desire o r Change. The second factor consistsof items reflecting Negative Self-Con cept a nd Negative Expectations. Itemson the third factor reflect L ow Self-Esteem, while items on the fourth factorreflect Giving Up/Helplessness . Items loading on Factor II seemparticularly consistent with two of the three components of Beck's negativecognitive triad (Beck, 1963): negative views of the self and negative views o fthe future. Similarly, these cognitions appear quite consistent with thetendency to attribute nonsuccess to internal, global, stable-over-timefactors, a tendency regarded by Abramson, Seligman, and Teasdale (1978)to be central to depression in their recent reformulation of the learned-helplesness model of depression.

DISCUSSIONA 30-item inventory that identifies cognitions reported as beingpresent in association with mild to moderate depression was developed and

cross-validated. The inventory appears to have sufficient internal reliabilityand concurrent validity to justify use as a general measure ofdepression-related automatic negative thoughts. Specific items, as well asthe total score on the inventory, appear to reliably separate depressed fromnondepressed criterion groups. It appears that the ATQ-30 is a relativelybrief measure of automatic thoughts (self-statements) in depression, one thatapplies to either males or females. As with research investigating the self-statements associated with assertive behavior (Schwartz & Gottman, 1976)and stressful medical procedures (Kendall, Williams, Pechacek, Graham,Shisslak, & Herzoff, 1979), the present study supports the use of self-state-ment inventories to assess certain cognitive events (see also Kendall &Hollon, 1981).

It remains to be determined whether clinically formed samples ofdepressed patients will differ in terms of reported frequency of automaticnegative thoughts on the ATQ-30. The samples utilized in the present studywere composed of subclinical volunteers likely to be somewhat lessdepressed, younger, and better educated than many populations ofpotential interest. A closely related issue concerns the ubiquitousness ofnegative cognitions across subtypes of depression. It is not unreasonable tospeculate that relationships between cognitive content and affective statesmay hold for some subtypes of depression, but not all. If so, it is possiblethat the nonbipolar rather than bipolar (Depue & Monroe, 1978) and


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3 9 4 H o l l o n a n d K e n d a l lp r i m a r y r a th e r t h a n s e c o n d a r y ( R o b i n s & G u z e , 1 9 7 2) d e p r e s s i v e s w o u l de v i d e n c e m o r e e x t r e m e l e v e l s o f n e g a t i v e c o g n i t i o n s .

F i n a l l y, t h e p r e s e n t d a t a d i d n o t s p e a k t o t h e u ti li ty o f t h e A T Q - 3 0 a sa m e a s u r e s e n s i t i v e t o c h a n g e . A s s t a t e d ea r li e r, a m a j o r r e a s o n f o rd e v e l o p i n g a m e a s u r e o f d e p r e s s i o n - r e l a t e d s e l f - s t a t e m e n t s o r n e g a t i v ea u t o m a t i c t h o u g h t s w a s t o p r o v i d e a n in d e p e n d e n t m e a n s o f a s s e ss in g t h ea d e q u a c y o f m a n i p u l a t i o n s o r th e r a p ie s ta r g et e d a t t h e c o g n i t i o n s o f d e -p r e s s i v e s . I t c u r r e n t l y r e m a i n s t o b e d e m o n s t r a t e d w h e t h e r t h e A T Q - 3 0 i ss e n s it iv e to c h a n g e s i n t h e n a t u r e a n d f r e q u e n c y o f c o g n i t i o n s t h a t r e s u ltf r o m e x p e r i m e n t a l m a n i p u l a t i o n a n d / o r p s y c h o t h e r a p e u t i c i n t e r v e n t i o n s .

A t t h i s t i m e it a p p e a r s t h a t t h e A T Q - 3 0 p o s s e s s e s g o o d c o n c u r r e n tv a l i d i t y a s a m e a s u r e o f t h e a u t o m a t i c n e g a t i v e t h o u g h t s p r e s u m e d b yc o g n i t i v e th e o r i e s t o b e r e la t ed t o t h e s ta t e o f d e p r e s s i o n . A d d i t i o n a l w o r kn e e d s t o b e d o n e a d d r e s s i n g f u r th e r i ss u e s o f r e l i a b i li ty ( e . g . , t e s t- r e te s t ),s e n s i t i v i t y t o c h a n g e , a n d a p p l i c a b i l i t y t o c l i n i c a l p o p u l a t i o n s , b u t t h eA T Q - 3 0 a p p e a r s t o b e a p r o m i s in g t o o l f o r a s s e s si n g c o g n i t i o n s a s s o c i a te dw i t h d e p r e s s i o n .

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