The moderation of cognitive defusion and disputation techniques by targeted thought domains

Abstract

Several therapeutic techniques target negative thoughts about the self, the world, and the future. These include disputation, which seeks to restructure thoughts within this negative cognitive triad into more rational ways of thinking; as well as defusion techniques, such as word repetition and thought prefacing that focus on relating to thoughts as mere psychological events rather than facts. Few previous studies have compared the relative impact of these techniques and none have directly examined whether the domain of target thoughts moderate their benefits. To address this omission, participants with subclinical levels of depression (N = 59) were randomly assigned to one of the three techniques in targeting distressing and personally relevant thoughts representing each of the three domains of the negative cognitive triad. Changes in believability of the individualized target thought along with willingness to have it were among the primary dependent variables analyzed. In addition, generalization of benefits to other thoughts within the same domain as the target thought, as well as to those within the other two domains also were evaluated. Overall, word repetition (n = 18) emerged as more efficacious than disputation (n = 20) and thought prefacing (n = 21). Word repetition of thoughts about the future (e.g., “My future is bleak”) resulted in increased willingness to also have others within that same domain, and compared even more favorably to the other two techniques when applied to self-referential thoughts (e.g., “I’m no good”). Although it was not superior to them in reducing believability, word repetition was associated with a greater willingness to have the target thought than disputation that also generalized to negative thoughts about the world (e.g., “I feel like I’m up against the world”) to a greater degree than for the other two techniques. Implications of the findings for clinical research and practice are discussed, while also recognizing the inherent limitations of analogue research as exemplified by this project.