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Chapter Summary from Current Diagnosis & Treatment

For a clinical review of the topic in Current Diagnosis & Treatment, 3e please go to Chapter 35: Psychiatric Disorders.


ALTHOUGH COGNITIVE NEUROSCIENCE emerged at the end of the 20th century as a major new discipline, a precise meaning of the term cognition remains elusive. The term is used in different ways in different contexts. At one extreme, the term cognitive in cognitive neuroscience connotes what was meant by the older term information processing. In this sense, cognition is simply what the brain does. When cognitive neuroscientists say that visual features or motor acts are represented by neural activity, they are using concepts from information processing. From this point of view, the language of cognition provides a bridge between descriptions of neural activity and behavior because the same terms can be applied in both domains.

At the other extreme, the term cognition refers to those higher-level processes fundamental to the formation of conscious experience. This is what is meant by the term cognitive therapy, an approach to treatment pioneered by Aaron Beck and Albert Ellis and developed from behavior therapy. Rather than trying to change a patient’s behavior directly, cognitive therapy has the aim of changing the patient’s attitudes and beliefs (Box 59–1).

Box 59–1 Cognitive Therapy

Dissatisfaction with psychological treatments based on Freud’s theories of unconscious motivation intensified in the middle of the 20th century. Not only did these theories have no relevance to experimental psychology, but there was no empirical evidence that psychodynamic treatments actually worked.

The first form of alternative psychological therapy to emerge from laboratory studies is known as behavior therapy. The fundamental assumption of this approach is that maladaptive behavior is learned and can therefore be eliminated by applying the Pavlovian and Skinnerian principles of stimulus-response learning. So, for example, a child who has been attacked by a dog can become fearful of all dogs, but this fearful response can be extinguished if the child learns that the conditioned stimulus (the sight of a dog) is not followed by the unconditioned stimulus (being bitten).

Behavior therapy was shown to be quick and effective for phobias, but many mental disorders are better characterized in terms of maladaptive thinking rather than maladaptive behavior. In the 1960s, Aaron Beck and Albert Ellis initiated a new kind of therapy in which the principles of learning are used to change thoughts rather than behavior. This is known as cognitive therapy or cognitive behavior therapy.

This form of therapy has been particularly successful in the treatment of depression. Depression is typically associated with negative thoughts (eg, a person remembering only the bad things that have happened to him/her) and negative attitudes (eg, a person believing that he/she will never achieve his/her goals). Cognitive therapists teach their clients methods for reducing the frequency of negative ...

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