What is the Diathesis-Stress Model?

Introduction

The diathesis-stress model, also known as the vulnerability-stress model, is a psychological theory that attempts to explain a disorder, or its trajectory, as the result of an interaction between a predispositional vulnerability, the diathesis, and a stress caused by life experiences. The term diathesis derives from the Greek term (διάθεσις) for a predisposition, or sensibility. A diathesis can take the form of genetic, psychological, biological, or situational factors. A large range of differences exists among individuals’ vulnerabilities to the development of a disorder.

The diathesis, or predisposition, interacts with the individual’s subsequent stress response. Stress is a life event or series of events that disrupts a person’s psychological equilibrium and may catalyse the development of a disorder. Thus the diathesis-stress model serves to explore how biological or genetic traits (diatheses) interact with environmental influences (stressors) to produce disorders such as depression, anxiety, or schizophrenia. The diathesis-stress model asserts that if the combination of the predisposition and the stress exceeds a threshold, the person will develop a disorder. The use of the term diathesis in medicine and in the specialty of psychiatry dates back to the 1800s; however, the diathesis-stress model was not introduced and used to describe the development of psychopathology until it was applied to explaining schizophrenia in the 1960s by Paul Meehl.

The diathesis-stress model is used in many fields of psychology, specifically for studying the development of psychopathology. It is useful for the purposes of understanding the interplay of nature and nurture in the susceptibility to psychological disorders throughout the lifespan. Diathesis-stress models can also assist in determining who will develop a disorder and who will not. For example, in the context of depression, the diathesis-stress model can help explain why Person A may become depressed while Person B does not, even when exposed to the same stressors. More recently, the diathesis-stress model has been used to explain why some individuals are more at risk for developing a disorder than others. For example, children who have a family history of depression are generally more vulnerable to developing a depressive disorder themselves. A child who has a family history of depression and who has been exposed to a particular stressor, such as exclusion or rejection by his or her peers, would be more likely to develop depression than a child with a family history of depression that has an otherwise positive social network of peers. The diathesis-stress model has also served as useful in explaining other poor (but non-clinical) developmental outcomes.

Protective factors, such as positive social networks or high self-esteem, can counteract the effects of stressors and prevent or curb the effects of disorder. Many psychological disorders have a window of vulnerability, during which time an individual is more likely to develop disorder than others. Diathesis-stress models are often conceptualised as multi-causal developmental models, which propose that multiple risk factors over the course of development interact with stressors and protective factors contributing to normal development or psychopathology. The differential susceptibility hypothesis is a recent theory that has stemmed from the diathesis-stress model.

Diathesis

The term diathesis is synonymous with vulnerability, and variants such as “vulnerability-stress” are common within psychology. A vulnerability makes it more or less likely that an individual will succumb to the development of psychopathology if a certain stress is encountered. Diatheses are considered inherent within the individual and are typically conceptualised as being stable, but not unchangeable, over the lifespan. They are also often considered latent (i.e. dormant), because they are harder to recognise unless provoked by stressors.

Diatheses are understood to include genetic, biological, physiological, cognitive, and personality-related factors. Some examples of diatheses include genetic factors, such as abnormalities in some genes or variations in multiple genes that interact to increase vulnerability. Other diatheses include early life experiences such as the loss of a parent, or high neuroticism. Diatheses can also be conceptualised as situational factors, such as low socio-economic status or having a parent with depression.

Stress

Stress can be conceptualised as a life event that disrupts the equilibrium of a person’s life. For instance, a person may be vulnerable to become depressed, but will not develop depression unless they are exposed to a specific stress, which may trigger a depressive disorder. Stressors can take the form of a discrete event, such the divorce of parents or a death in the family, or can be more chronic factors such as having a long-term illness, or ongoing marital problems. Stresses can also be related to more daily hassles such as school assignment deadlines. This also parallels the popular (and engineering) usage of stress, but note that some literature defines stress as the response to stressors, especially where usage in biology influences neuroscience.

It has been long recognised that psychological stress plays a significant role in understanding how psychopathology develops in individuals. However, psychologists have also identified that not all individuals who are stressed, or go through stressful life events, develop a psychological disorder. To understand this, theorists and researchers explored other factors that affect the development of a disorder and proposed that some individuals under stress develop a disorder and others do not. As such, some individuals are more vulnerable than others to develop a disorder once stress has been introduced. This led to the formulation of the diathesis-stress model.

Genetics

Sensory processing sensitivity (SPS) is a temperamental or personality trait involving “an increased sensitivity of the central nervous system and a deeper cognitive processing of physical, social and emotional stimuli”. The trait is characterised by “a tendency to ‘pause to check’ in novel situations, greater sensitivity to subtle stimuli, and the engagement of deeper cognitive processing strategies for employing coping actions, all of which is driven by heightened emotional reactivity, both positive and negative”.

Sensory processing sensitivity captures sensitivity to environment in a heritable, evolutionary-conserved trait, associated with increased information processing in the brain. Moderating sensitivity to environments in a for-better-and-for-worse fashion. Interaction with negative experiences increases risk for psychopathology. Whereas interaction with positive experiences (including interventions), increases positive outcomes. Mast cells are long-lived tissue-resident cells with an important role in many inflammatory settings including host defence to parasitic infection and in allergic reactions. Stress is known to be a mast cell activator.

There is evidence that children exposed to prenatal stress may experience resilience driven by epigenome-wide interactions.” Early life stress interactions with the epigenome show potential mechanisms driving vulnerability towards psychiatric illness. ancestral stress alters lifetime mental health trajectories via epigenetic regulation.

Carriers of congenital adrenal hyperplasia have a predeposition to stress, due to the unique nature of this gene. True rates of prevalence are not known but common genetic variants of the human Steroid 21-Hydroxylase Gene (CYP21A2) are related to differences in circulating hormone levels in the population.

Psychological distress is a known feature of generalised joint hypermobility (gJHM), as well as of its most common syndromic presentation, namely Ehlers-Danlos syndrome, hypermobility type (a.k.a. joint hypermobility syndrome – JHS/EDS-HT), and significantly contributes to the quality of life of affected individuals. Interestingly, in addition to the confirmation of a tight link between anxiety and gJHM, preliminary connections with depression, attention deficit (and hyperactivity) disorder, autism spectrum disorders, and obsessive-compulsive personality disorder were also found.

Protective Factors

Protective factors, while not an inherent component of the diathesis-stress model, are of importance when considering the interaction of diatheses and stress. Protective factors can mitigate or provide a buffer against the effects of major stressors by providing an individual with developmentally adaptive outlets to deal with stress. Examples of protective factors include a positive parent-child attachment relationship, a supportive peer network, and individual social and emotional competence.

Throughout the Lifespan

Many models of psychopathology generally suggest that all people have some level of vulnerability towards certain mental disorders, but posit a large range of individual differences in the point at which a person will develop a certain disorder. For example, an individual with personality traits that tend to promote relationships such as extroversion and agreeableness may engender strong social support, which may later serve as a protective factor when experiencing stressors or losses that may delay or prevent the development of depression. Conversely, an individual who finds it difficult to develop and maintain supportive relationships may be more vulnerable to developing depression following a job loss because they do not have protective social support. An individual’s threshold is determined by the interaction of diatheses and stress.

Windows of vulnerability for developing specific psychopathologies are believed to exist at different points of the lifespan. Moreover, different diatheses and stressors are implicated in different disorders. For example, breakups and other severe or traumatic life stressors are implicated in the development of depression. Stressful events can also trigger the manic phase of bipolar disorder and stressful events can then prevent recovery and trigger relapse. Having a genetic disposition for becoming addicted and later engaging in binge drinking in college are implicated in the development of alcoholism. A family history of schizophrenia combined with the stressor of being raised in a dysfunctional family raises the risk of developing schizophrenia.

Diathesis-stress models are often conceptualised as multi-causal developmental models, which propose that multiple risk factors over the course of development interact with stressors and protective factors contributing to normal development or psychopathology. For example, a child with a family history of depression likely has a genetic vulnerability to depressive disorder. This child has also been exposed to environmental factors associated with parental depression that increase their vulnerability to developing depression as well. Protective factors, such as strong peer network, involvement in extracurricular activities, and a positive relationship with the non-depressed parent, interact with the child’s vulnerabilities in determining the progression to psychopathology versus normative development.

Some theories have branched from the diathesis-stress model, such as the differential susceptibility hypothesis, which extends the model to include a vulnerability to positive environments as well as negative environments or stress. A person could have a biological vulnerability that when combined with a stressor could lead to psychopathology (diathesis-stress model); but that same person with a biological vulnerability, if exposed to a particularly positive environment, could have better outcomes than a person without the vulnerability.

What is Dependent Personality Disorder?

Introduction

Dependent personality disorder (DPD) is a personality disorder that is characterised by a pervasive psychological dependence on other people.

This personality disorder is a long-term condition in which people depend on others to meet their emotional and physical needs, with only a minority achieving normal levels of independence. Dependent personality disorder is a Cluster C personality disorder, characterised by excessive fear and anxiety. It begins by early adulthood, and it is present in a variety of contexts and is associated with inadequate functioning. Symptoms can include anything from extreme passivity, devastation or helplessness when relationships end, avoidance of responsibilities and severe submission.

Brief History

The conceptualisation of dependency, within classical psychoanalytic theory, is directly related to Freud’s oral psychosexual stage of development. Frustration or over-gratification was said to result in an oral fixation and in an oral type of character, characterised by feeling dependent on others for nurturance and by behaviours representative of the oral stage. Later psychoanalytic theories shifted the focus from a drive-based approach of dependency to the recognition of the importance of early relationships and establishing separation from these early caregivers, in which the exchanges between the caregiver and the child become internalised, and the nature of these interactions becomes part of the concepts of the self and of others.

Signs and Symptoms

People who have dependent personality disorder are overdependent on other people when it comes to making decisions. They cannot make a decision on their own as they need constant approval from other people. Consequently, individuals diagnosed with DPD tend to place needs and opinions of others above their own as they do not have the confidence to trust their decisions. This kind of behaviour can explain why people with DPD tend to show passive and clingy behaviour. These individuals display a fear of separation and cannot stand being alone. When alone, they experience feelings of isolation and loneliness due to their overwhelming dependence on other people. Generally people with DPD are also pessimistic: they expect the worst out of situations or believe that the worst will happen. They tend to be more introverted and are more sensitive to criticism and fear rejection.

Risk Factors

People with a history of neglect and an abusive upbringing are more susceptible to develop DPD, specifically those involved in long-term abusive relationships. Those with overprotective or authoritarian parents are also more at risk to develop DPD. Having a family history of anxiety disorder can play a role in the development of DPD as a 2004 twin study found a 0.81 heritability for personality disorders collectively.

Causes

The exact cause of dependent personality disorder is unknown. A study in 2012 estimated that between 55% and 72% of the risk of the condition is inherited from one’s parents. The difference between a “dependent personality” and a “dependent personality disorder” is somewhat subjective, which makes diagnosis sensitive to cultural influences such as gender role expectations.

Dependent traits in children tended to increase with parenting behaviours and attitudes characterized by overprotectiveness and authoritarianism. Thus the likelihood of developing dependent personality disorder increased, since these parenting traits can limit them from developing a sense of autonomy, rather teaching them that others are powerful and competent.

Traumatic or adverse experiences early in an individual’s life, such as neglect and abuse or serious illness, can increase the likelihood of developing personality disorders, including dependent personality disorder, later on in life. This is especially prevalent for those individuals who also experience high interpersonal stress and poor social support.

There is a higher frequency of the disorder seen in women than men, hence expectations relating to gender role may contribute to some extent.

Diagnosis

Clinicians and clinical researchers conceptualise dependent personality disorder in terms of four related components:

  • Cognitive: a perception of oneself as powerless and ineffectual, coupled with the belief that other people are comparatively powerful and potent.
  • Motivational: a desire to obtain and maintain relationships with protectors and caregivers.
  • Behavioural: a pattern of relationship-facilitating behaviour designed to strengthen interpersonal ties and minimise the possibility of abandonment and rejection.
  • Emotional: fear of abandonment, fear of rejection, and anxiety regarding evaluation by figures of authority.

American Psychiatric Association and DSM

The Diagnostic and Statistical Manual of Mental Disorders (DSM) contains a dependent personality disorder diagnosis. It refers to a pervasive and excessive need to be taken care of which leads to submissive and clinging behaviour and fears of separation. This begins by early adulthood and can be present in a variety of contexts.

In the DSM Fifth Edition (DSM-5), there is one criterion by which there are eight features of dependent personality disorder. The disorder is indicated by at least five of the following factors:

  1. Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others.
  2. Needs others to assume responsibility for most major areas of their life.
  3. Has difficulty expressing disagreement with others because of fear of loss of support or approval.
  4. Has difficulty initiating projects or doing things on their own (because of a lack of self confidence in judgement or abilities rather than a lack of motivation or energy).
  5. Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant.
  6. Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for themselves.
  7. Urgently seeks another relationship as a source of care and support when a close relationship ends.
  8. Is unrealistically preoccupied with fears of being left to take care of themselves.

The diagnosis of personality disorders in the fourth edition the DSM, including dependent personality disorder, was found to be problematic due to reasons such as excessive diagnostic comorbidity, inadequate coverage, arbitrary boundaries with normal psychological functioning, and heterogeneity among individuals within the same categorial diagnosis.

World Health Organisation

The World Health Organisation’s (WHO) ICD-10 lists dependent personality disorder as F60.7 Dependent personality disorder:

  • It is characterised by at least 4 of the following:
    1. Encouraging or allowing others to make most of one’s important life decisions;
    2. Subordination of one’s own needs to those of others on whom one is dependent, and undue compliance with their wishes;
    3. Unwillingness to make even reasonable demands on the people one depends on;
    4. Feeling uncomfortable or helpless when alone, because of exaggerated fears of inability to care for oneself;
    5. Preoccupation with fears of being abandoned by a person with whom one has a close relationship, and of being left to care for oneself;
    6. Limited capacity to make everyday decisions without an excessive amount of advice and reassurance from others.
  • Associated features may include perceiving oneself as helpless, incompetent, and lacking stamina.
  • Includes:
    • Asthenic, inadequate, passive, and self-defeating personality (disorder).

It is a requirement of ICD-10 that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria.

SWAP-200

The SWAP-200 is a diagnostic tool that was proposed with the goal of overcoming limitations, such as limited external validity for the diagnostic criteria for dependent personality disorder, to the DSM. It serves as a possible alternative nosological system that emerged from the efforts to create an empirically based approach to personality disorders – while also preserving the complexity of clinical reality. Dependent personality disorder is considered a clinical prototype in the context of the SWAP-200. Rather than discrete symptoms, it provides composite description characteristic criteria – such as personality tendencies.

Based on the Q-Sort method and prototype matching, the SWAP-200 is a personality assessment procedure relying on an external observer’s judgment. It provides:

  • A personality diagnosis expressed as the matching with ten prototypical descriptions of DSM-IV personality disorders.
  • A personality diagnosis based on the matching of the patient with 11 Q-factors of personality derived empirically.
  • A dimensional profile of healthy and adaptive functioning.

The traits that define dependent personality disorder according to SWAP-200 are:

  1. They tend to become attached quickly and/or intensely, developing feelings and expectations that are not warranted by the history or context of the relationship.
  2. Since they tend to be ingratiating and submissive, people with DPD tend to be in relationships in which they are emotionally or physically abused.
  3. They tend to feel ashamed, inadequate, and depressed.
  4. They also feel powerless and tend to be suggestible.
  5. They are often anxious and tend to feel guilty.
  6. These people have difficulty acknowledging and expressing anger and struggle to get their own needs and goals met.
  7. Unable to soothe or comfort themselves when distressed, they require involvement of another person to help regulate their emotions.

Psychodynamic Diagnostic Manual

The Psychodynamic Diagnostic Manual (PDM) approaches dependent personality disorder in a descriptive, rather than prescriptive sense and has received empirical support. The Psychodynamic Diagnostic Manual includes two different types of dependent personality disorder:

  • Passive-aggressive.
  • Counter-dependent.

The PDM-2 adopts and applies a prototypic approach, using empirical measures like the SWAP-200. It was influenced by a developmental and empirically grounded perspective, as proposed by Sidney Blatt. This model is of particular interest when focusing on dependent personality disorder, claiming that psychopathology comes from distortions of two main coordinates of psychological development:

  • The anaclitic/introjective dimension.
  • The relatedness/self-definition dimension.

The anaclitic personality organization in individuals exhibits difficulties in interpersonal relatedness, exhibiting the following behaviours:

  • Preoccupation with relationships.
  • Fear of abandonment and of rejection.
  • Seeking closeness and intimacy.
  • Difficulty managing interpersonal boundaries.
  • Tend to have an anxious-preoccupied attachment style.

Introjective personality style is associated with problems in self-definition.

Differential Diagnosis

There are similarities between individuals with dependent personality disorder and individuals with borderline personality disorder, in that they both have a fear of abandonment. Those with dependent personality disorder do not exhibit impulsive behaviour, unstable affect, and poor self-image experienced by those with borderline personality disorder, differentiating the two disorders.

The following conditions commonly coexist (comorbid) with dependent personality disorder:

Treatment

People who have DPD are generally treated with psychotherapy. The main goal of this therapy is to make the individual more independent and help them form healthy relationships with the people around them. This is done by improving their self-esteem and confidence.

Medication can be used to treat patients who suffer from depression or anxiety because of their DPD, but this does not treat the core problems caused by DPD. Individuals who take these prescription drugs are susceptible to addiction and substance abuse and therefore may require monitoring.

Epidemiology

Based on a recent survey of 43,093 Americans, 0.49% of adults meet diagnostic criteria for DPD (National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; Grant et al., 2004). Traits related to DPD, like most personality disorders emerge in childhood or early adulthood. Findings from the NESArC study found that 18 to 29 year olds have a greater chance of developing DPD. DPD is more common among women compared to men as 0.6% of women have DPD compared to 0.4% of men.

A 2004 twin study suggests a heritability of 0.81 for developing dependent personality disorder. Because of this, there is significant evidence that this disorder runs in families.

Children and adolescents with a history of anxiety disorders and physical illnesses are more susceptible to acquiring this disorder.

Book: Avoiding Anxiety in Autistic Children: A Guide for Autistic Wellbeing

Book Title:

Avoiding Anxiety in Autistic Children: A Guide for Autistic Wellbeing.

Author(s): Luke Beardon.

Year: 2020.

Edition: First (1st)

Publisher: Sheldon Press.

Type(s): Paperback and Kindle.

Synopsis:

One of the biggest challenges for the parent of any autistic child is how best to support and guide them through the situations in life which might cause them greater stress, anxiety and worry than if they were neurotypical.

Dr Luke Beardon has put together an optimistic, upbeat and readable guide that will be essential reading for any parent to an autistic child, whether they are of preschool age or teenagers. Emphasising that autism is not behaviour, but at the same time acknowledging that there are risks of increased anxiety specific to autism, this practical book gives insight into the nature of the anxiety experienced by autistic people, as well as covering every likely situation in which your child might feel anxious or worried. It will help you to prepare your child for school, to monitor their anxiety around school, and also to be informed about the educational choices available to your child. It will give you support to help make breaktimes less stressful for them and how to help them navigate things like eating at school and out of the house.

Educationally, this book will take you and your child right up to the point of taking exams and leaving school; socially and emotionally it will cover all the challenges from bullying, friendships, relationships, puberty and sex education. It will give suggestions for alternatives in the scenarios that might cause anxiety or confusion in your child; it will also give a full understanding of your child’s sensory responses and such behaviours as masking, or echopraxia.

As the parent of an autistic child, you may find their path to adulthood different to the one you had expected to take, but as this book makes clear, autism should be celebrated and affirmed. Avoiding Anxiety in Autistic Children helps you to do just that, with practical strategies that will help happiness, not anxiety, remain the over-riding emotion that colours your child’s memories of their early years.

Book: Physical Health and Schizophrenia

Book Title:

Physical Health and Schizophrenia (Oxford Psychiatry Library Series).

Author(s): David J. Castle, Peter F. Buckley, and Fiona P. Gaughran.

Year: 2017.

Edition: First (1st), Illustrated Edition.

Publisher: Oxford University Press.

Type(s): Paperback and Kindle.

Synopsis:

In comparison to the general population, people with schizophrenia and related disorders have poorer physical health and increased mortality. Whilst it is recognized that serious mental illnesses such as schizophrenia carry a reduced life expectancy, it is often assumed that suicide is the main cause of this disparity. In actuality, suicide accounts for no more than a third of the early mortality associated with schizophrenia: the vast majority is due to cardiovascular factors

Physical Health and Schizophreniaoffers a user-friendly guide to the physical health problems associated with schizophrenia and a clear overview of strategies and interventions to tackle these issues. Spanning eight chapters this resource covers the essential topics in a practical and easy-to-read format to suit the needs of busy clinicians. It also includes an appendix designed specifically for patients and carers, with practical tips on how to be actively involved in monitoring and managing physical health problems.

Part of the Oxford Psychiatry Library series, Physical Health and Schizophrenia offers readers a fully up-to-date and valuable insight into this complex issue. With helpful key points at the start of each chapter and a clear layout, this is an essential resource for busy clinicians and researchers in any mental health field as well as those working in primary care.

Book: Schizophrenia and Psychiatric Comorbidities – Recognition Management

Book Title:

Schizophrenia and Psychiatric Comorbidities – Recognition Management (Oxford Psychiatry Library Series).

Author(s): David J. Castle, Peter F. Buckley, and Rachel Upthegrove.

Year: 2021.

Edition: First (1st).

Publisher: Oxford University Press.

Type(s): Paperback and Kindle.

Synopsis:

Psychiatric comorbidities such as depression, anxiety and substance use are extremely common amongst people with schizophrenia. They add to poor clinical outcomes and disability, yet are often not at the forefront of the minds of clinicians, who tend to concentrate on assessing and treating the core symptoms of schizophrenia, notably delusions and hallucinations. There is an imperative to assess every patient with schizophrenia for psychiatric comorbidities, as they might masquerade as core psychotic symptoms and also because they warrant treatment in their own right. This volume addresses these issues using a clinical lens informed by the current literature. Published as part of the Oxford Psychiatry Library series, the book serves as a concise and practical reference for busy clinicians.

Examining the Ethnic & Migration-Related Differences in the Use of IAPT-Based Psychological Treatment

Research Paper Title

The association of migration and ethnicity with use of the Improving Access to Psychological Treatment (IAPT) programme: a general population cohort study.

Background

Common mental disorders (CMD), such as depression and anxiety, are an important cause of morbidity, economic burden and public mental health need. The UK Improving Access to Psychological Therapies (IAPT) programme is a national effort to reduce the burden and impact of CMD, available since 2008.

Therefore, the aim of this study was to examine ethnic and migration-related differences in use of IAPT-based psychological treatment using a novel epidemiological dataset with linkage to de-identified IAPT records.

Methods

Data from a psychiatric morbidity survey of two South East London boroughs (2008-2010) were individually-linked to data on IAPT services serving those boroughs. The researchers used Poisson regression to estimate association between ethnicity and migration status (including years of UK residence), with rate of subsequent use of psychological treatment.

Results

The rate of psychological treatment use was 14.4 cases per thousand person years [cases/1000 pyrs, 95% confidence intervals (95% CI) 12.4, 16.7]. There was strong statistical evidence that compared to non-migrants, migrants residing in the UK for less than 10 years were less likely to use psychological treatment after adjustment for probable sociodemographic predictors of need, life adversity, and physical/psychiatric morbidity at baseline [rate ratio (RR) 0.4 (95% CI 0.20, 0.75]. This difference was not explained by migration for asylum/political reasons, or English language proficiency, and was evident for both self- and GP referrals.

Conclusions

Lower use of IAPT among recent migrants is unexplained by sociodemographics, adversity, and baseline morbidity. Further research should focus on other individual-level and societal barriers to psychological treatment use among recent migrants to the UK, including in categories of intersecting migration and ethnicity.

Reference

Bhavsar, V., Jannesari, S., McGuire, P., MacCabe, J.H., Das-Munshi, J., Bhugra, D., Dorrington, S., Brown, J.S.L., Hotopf, M.H. & Hatch, S.L. (2021) The association of migration and ethnicity with use of the Improving Access to Psychological Treatment (IAPT) programme: a general population cohort study. Social Psychiatry and Psychiatric Epidemiology. doi: 10.1007/s00127-021-02035-7. Online ahead of print.

Book: Reverse Depression Naturally

Book Title:

Reverse Depression Naturally – Alternative Treatments for Mood Disorders, Anxiety and Stress.

Author(s): Michelle Honda (PhD).

Year: 2020.

Edition: First (1st).

Publisher: Hatherleigh Press.

Type(s): Paperback and eBook.

Synopsis:

Offering breakthrough and effective holistic methods to manage and reduce depression and anxiety naturally from a leading naturopathic doctor.

Globally, more than 300 million people of all ages suffer from depression and that number is only increasing. Reverse Depression Naturally provides a comprehensive overview of depression and anxiety and how to effectively and naturally manage them. It is a complete resource of healing remedies, dietary recommendations, mental exercises, and protocols.

Reverse Depression Naturally offers practical tips and alternative solutions to popular treatments as well as beneficial supplements and home remedies. The book also features sections on stress, mental illness, alcoholism, and post-partum depression.

Book: CBT Journal for Dummies

Book Title:

CBT Journal for Dummies.

Author(s): Rob Wilson and Rhena Branch.

Year: 2012.

Edition: First (1st).

Publisher: Wiley.

Type(s): Hardcover.

Synopsis:

Keep track of the progress you are making with Cognitive Behavioural Therapy.

Cognitive Behavioural Therapy (CBT) is a hugely popular self-help technique that teaches you how to break free from destructive or negative behaviours and make positive changes to both your thoughts and your actions. CBT Journal For Dummies offers a guided space for you to keep a record of your progress, used in conjunction with either CBT For Dummies and/or alongside consultation with a therapist.

This book features an introduction to CBT, followed by a guided 100-day journal. Each chapter focuses on a new CBT technique, with information on how to use the journal space and assessment advice. Topics covered include; establishing the link between thoughts and feelings; preventing ‘all or nothing’ thinking; turning mountains into molehills; focusing on the present; using emotional reasoning; avoiding over-generalising; thinking flexibly; keeping an open mind; assessing the positives; coping with frustration; tackling toxic thoughts; naming your emotions; comparing healthy and unhealthy emotions; working through worry; defining your core beliefs; adopting positive principles; and much more.

  • Has a removable band, leaving a discreet black journal.
  • The small trim size makes it perfect to use on the go.
  • A CBT ‘thought for the day’ appears on alternate blank pages.
  • Content is progressive, encouraging you to keep working through the following days.
  • Coverage is generalized enough to be applicable to every user of CBT.

Book: Managing Anxiety with CBT for Dummies

Book Title:

Managing Anxiety with CBT for Dummies.

Author(s): Graham C. Davey, Kate Cavanagh, Fergal Jones, Lydia Turner, and Adrian Whittington.

Year: 2012.

Edition: First (1st).

Publisher: Wiley.

Type(s): Paperback, Audiobook, and Kindle.

Synopsis:

Don’t panic! Combat your worries and minimise anxiety with CBT!
Cognitive Behavioural Therapy (CBT) is a hugely popular self-help technique, which teaches you to break free from destructive or negative behaviours and make positive changes to both your thoughts and your actions. This practical guide to managing anxiety with CBT will help you understand your anxiety, identify solutions to your problems, and maintain your gains and avoid relapse.

Managing Anxiety with CBT For Dummies is a practical guide to using CBT to face your fears and overcome anxiety and persistent, irrational worries. You’ll discover how to put extreme thinking into perspective and challenge negative, anxiety-inducing thoughts with a range of effective CBT techniques to help you enjoy a calmer, happier life.

  • Helps you understand anxiety and how CBT can help.
  • Guides you in making change and setting goals.
  • Gives you tried-and-true CBT techniques to face your fears and keep a realistic perspective.

Managing Anxiety with CBT For Dummies gives you the tools you need to overcome anxiety and expand your horizons for a healthy, balanced life.