University of Southern California Dissertations and Theses

Cognitive Assessment Of Reactance Using The Articulated Thoughts In Simulated Situations Paradigm

(USC Thesis Other)

Cognitive Assessment Of Reactance Using The Articulated Thoughts In Simulated Situations Paradigm

PDF

Download a page range

Download transcript

Copy asset link

Request this asset

Transcript (if available)

Content INFORMATION TO USERS
This manuscript has been reproduced from the microfilm master. UM I
films the text directly from the original or copy submitted. Thus, some
thesis and dissertation copies are in typewriter face, while others may be
from any type of computer printer.
The quality of this reproduction is dependent upon the quality o f the
copy submitted. Broken or indistinct print, colored or poor quality
illustrations and photographs, print bleedthrough, substandard margins,
and improper alignment can adversely afreet reproduction.
In the unlikely event that the author did not send UMI a complete
manuscript and there are missing pages, these will be noted. Also, if
unauthorized copyright material had to be removed, a note will indicate
the deletion.
Oversize materials (e.g., maps, drawings, charts) are reproduced by
sectioning the original, beginning at the upper left-hand com er and
continuing from left to right in equal sections with small overlaps. Each
original is also photographed in one exposure and is included in reduced
form at the back of the book.
Photographs included in the original manuscript have been reproduced
xerographically in this copy. Higher quality 6" x 9” black and white
photographic prints are available for any photographs or illustrations
appearing in this copy for an additional charge. Contact UMI directly to
order.
UMI
A Bell & Howell Information Company
300 North Zeeb Road, Ann Aibor MI 48106-1346 USA
313/761-4700 800/521-0600

Cognitive Assessment of Reactance
Using the Articulated Thoughts in
Simulated Situations Paradigm
By
Michael Kelly Gann
A Thesis Presented to the
FACULTY OF THE GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
in Partial Fulfillment of the
Requirements for the Degree
MASTER OF ARTS
(Psychology)
December, 1995
UMI Number: 1379583
Copyright 1996 by
Gann, Michael Kelly
All rights reserved.
UMI Microform 1379583
Copyright 1996, by UMI Company. All rights reserved.
This microform edition is protected against unauthorized
copying under Title 17, United States Code.
UMI
300 North Zeeb Rond
Ann Arbor, MI 48103
UNIVERSITY O F SOUTHERN CALIFORNIA
T H E GRADUATE SCHOO L
UNIVERSITY PARK
L O S A N G ELES, CA LIFO RN IA S 0 0 0 7
This thesis, w ritten by
...... Mi chae 1 . . K e 1 _ ly_ _ _ Gann__________
under the direction of h.3JS....Thesis C om m ittee,
and approved by all its members, has been pre
sented to and accepted by the D ean o f T h e
Graduate School, in partial fu lfillm en t o f the
requirements fo r the degree of
___ ________________________
D tan
D ate A u g u s t 8 , 1 9 9 5
THESIS COMMITTEE
ii
ACKNOWLEDGMENTS
I would like to thank W, Jake Jacobs, Mitchell Earleywine, and Janet
Metcalfe for their advice and support during the preparation of this thesis. My
thanks also to the undergraduate research assistants, Erin Dyer, Nora Osganian,
and Christine Garcia, for the many hours they contributed to the collection and
coding o f the data. Special thanks go to my advisor, Gerald Davison, for his
support and encouragement.
ABSTRACT
Psychological reactance (Brehm, 1966) and perceived self-efficacy
(Bandura, 1977) are two constructs believed to be the mechanisms underlying
paradoxical intention. To date, no study has attempted to assess a cognitive
component o f reactance to a paradoxical intervention. This study utilized the
Articulated Thoughts in Simulated Situations (ATSS; Davison, Robins, &
Johnson, 1983) paradigm to assess the cognitive aspects of psychological
reactance during a simulated group psychotherapy situation. Fifty-one
undergraduate subjects heard audiotaped simulations of both behavioral and
paradoxical interventions for anxiety. Two pretest measures, the Therapeutic
Reactance Scale (TRS; Dowd, Milne, & Wise, 1991) and the Stait-Trait Anxiety
Inventory, Trait Anxiety Scale (STAI-T: Spielberger, Gorsuch, Lushene, Vagg,
&Jacobs, 1970) were used as predictors of reactance. It was found that ATSS
reactance scores, as indicated by defiant thoughts, were significantly higher for the
paradoxical condition compared to the behavioral/control condition. No
relationship was found among the pretest measures and ATSS reactance scores.
Post hoc findings suggest a significant gender-treatment interaction as well as an
order-treatment interaction. Implications of the findings and future research are
discussed.
iv
Table of Contents
Acknowledgments ii
Abstract iii
Introduction 1
Paradoxical Intention 4
Assessment of Reactance 6
ATSS 9
Method 12
Subjects 12
Questionnaires 12
STAI-T 12
TRS 13
Design and Procedure 14
ATSS 15
Results 17
Subjects 17
Coding 17
Articulated Thoughts 18
TRS 18
STAI-T 19
Post Hoc Analyses 21
Discussion 23
Post Hoc Findings 26
References 29
Appendix A: State-Trait Anxiety Inventory - T 34
Appendix B: Therapeutic Reactance Scale 36
Appendix C: Informed Consent Form 38
Appendix D: Instructions 40
Appendix E: Paradoxical Script 42
Appendix F: Control Script 45
Appendix G: Coding Manual 48
1
Cognitive Assessment o f Reactance Using the
Articulated Thoughts in Simulated Situations Paradigm
This study assessed psychological reactance using the Articulated
Thoughts in Simulated Situations Paradigm (ATSS; Davison, et al., 1983). The
construct o f reactance has been shown to be difficult to assess for a variety of
reasons. Although multiple methods have been used to assess it, the cognitive
processes that accompany reactance have been overlooked. By accessing the
defiant thoughts of subjects exposed to a paradoxical intervention, the ATSS
paradigm allowed nearly online assessment of the cognitive processes underlying
psychological reactance.
Brehm’s theory of psychological reactance (1966) states that individuals
will experience reactance whenever their ability to choose free behaviors is
eliminated or threatened. Brehm defines psychological reactance as a
motivational state, the goal o f which is to reestablish these free behaviors. In
recent years interest in Brehm’s theory has sparked research in hopes o f
explaining various clinical phenomena. Arguably, the most important clinical
phenomenon associated with reactance is treatment noncompliance.
Paradoxically, overcoming treatment noncompliance often targets and uses this
same reactance potential through paradoxical intention.
Paradoxical intention utilizes various interventions, all aimed at creating a
“therapeutic double bind" (Watzlawick, Beavin, & Jackson, 1967). By directing
2
the client to engage in or increase the very behavior he or she wants to change,
reduced symptomatology is expected. The insomniac who has tried every method
to sleep is told to try to stay awake. If the client complies with the injunction,
there is no longer support for the theory that he or she lacks control over his or her
behavior. If the client fails to comply by falling asleep, his or her defiance o f the
intervention has successfully relieved the symptoms (Watzlawick et al., 1967).
Successful alleviation o f symptomatology results from either attempted
compliance with or defiance o f the therapeutic prescription (Rohrbaugh, Tennen,
Press, & White, 1981).
Watzlawick and his colleagues (1967) proposed a model o f paradoxical
intention involving two possible outcomes. Some clients are unable to bring
about the symptoms when directed to do so. The desired effect is achieved
through this reduction in symptomatology. Other clients are able to bring about or
increase the symptoms, complying with the therapist’s request. This compliance
is then reframed by the therapist as the client’s ability to follow directives, hence
an increase in the client’s perception o f the controllable nature o f their behavior
(Shoham-Soloman, Avner, & Neeman, 1989). The client will comply with the
directive or act to defy it (Rohrbaugh et al., 1981), and either the behavior or the
cognitive appraisal o f that behavior is changed. In either case, the client is
"changed if they do and changed if they don’t” (Watzlawick et ah, 1967).
Psychological reactance is proposed as one mechanism underlying
paradoxical intention. When a client perceives a threat to his or her freedom, he
or she wilt act in a way to regain the lost autonomy. Brehm’s theory sees
reactance as a motivational state that is defined situationally (Brehm, 1966;
Brehm & Brehm, 1981). Others have proposed that reactance may be more trait
like or dispositional in nature (Beutler, 1979; 1983; Dowd, 1989). In either case,
the client is expected to act in a defiant way to the prescription. Defiance o f the
paradoxical prescription results in reduced symptomatology.
A second proposed mechanism of paradoxical intention builds on
Bandura’s (1977) theory of perceived self-efficacy. Clients who are able to follow
the therapeutic prescription successfully enhance their efficacy expectation, A
client who can produce the symptoms at will learns that they have control over the
symptoms and the outcome. By increasing self-efficacy o f the controllability of
their symptoms, clients are then able to effect change (Shoham-Soloman et al.,
1989).
Bandura (1977) states that a person creates an “efficacy expectation” by
estimating how successfully they can execute a given behavior. These efficacy
expectations have a direct bearing on whether the behavior is attempted and how
much effort is expended to perform that behavior. Clients who are able to comply
with the paradoxical directive are reinforced by the therapist for their successes
and congratulated on their ability to comply with the directive. The client’s
successful attempts at increasing the target behavior imply the controllable nature
o f that behavior. The client’s increased perception of efficacy usually results in a
decrease in symptomatology. If the client can bring on the symptoms, they are
controllable and the client’s perception of self-efficacy increases. Self-efficacy
has not been shown to be an underlying factor with reactant clients.
Paradoxical Intention.
The directive to clinicians “if a therapist would do it, do the opposite”
(Weeks & L’Abate, 1982), exemplifies the nature of paradoxical intention. Clients
expect the therapist to facilitate change through the use o f straightforward
prescriptions specifically aimed at reducing symptoms. The paradoxical therapist
defies that expectation by prescribing the very symptoms the client presents, either
by positive reframing o f the client’s behavior or by a neutral prescription
purported to improve the client’s awareness (Lopez & Wambach, 1982). Feldman,
Strong, and Danser (1982) used positive reframing with depressed patients by
telling them they were fortunate to be in touch with their feelings. The neutral
prescription is best illustrated by the directive “be spontaneous” which places a
person in a double bind; the only way to comply with the directive is to defy it
(Watzlawick, Weakland, & Fisch, 1974). The core o f the paradox lies in the
client’s perception that the prescription is contradictory to the supposed goals of
therapy for the therapist promotes change by discouraging it (Seltzer, 1986).
Creation of this “therapeutic double bind” (Watzlawick et al., 1967)
requires the client to defy the prescription in order to comply with it, thereby
eliminating the symptoms.
Paradoxical approaches have been used by therapists from a wide range of
theoretical perspectives. Frankl’s use o f paradoxical intention in logotherapy
(1967) was designed to allow the client “to develop a sense o f detachment toward
his neurosis.” The communication theorists, Bateson, Jackson, Haley and
Weakland along with Watzlawick are prolific authors in the area o f paradox
(Seltzer, 1986). Examples o f paradoxical interventions are found also in
psychodynamic, behavioral and family therapies for a wide range o f problems
(Ascher, & Turner, 1979; Seltzer, 1986; Weeks & L’Abate, 1982),
The effectiveness o f paradoxical interventions has been shown in both
clinical and analog studies. Shoham-Soloman and Rosenthal (1987) conducted a
meta-analysis of 10 paradoxical treatments for agoraphobia, insomnia,
procrastination, stress, and depression and showed an overall significant effect of
paradoxical interventions over control conditions. A more interesting finding of
their study was that paradoxical interventions showed an increased effectiveness
over time than did other treatments. Wright and Strong (1982) found that
directives to remain the same had the same effect as directives to change in
reducing procrastination. Turner and Ascher (1979) found that paradoxical
intention was as effective as both stimulus control and progressive relaxation in
the treatment o f onset insomnia. Horvath and Goheen (1990), in a unique study
that used written therapeutic directives rather than live therapists, showed that the
success o f the paradoxical directive was not dependent on type o f administration.
They also found that reactant subjects showed greater improvement o f onset sleep
6
latencies with paradoxical interventions than they did using stimulus control
techniques.
Several studies have addressed the treatment o f anxiety using paradoxical
interventions. Agoraphobia was shown to improve more rapidly using
paradoxical interventions when compared to Self-Statement Training
(Mavissakalian, Michaelson, Greenwald, Komblith, & Greenwald, 1983).
Comparing four different paradoxical interventions for anxiety, Boettcher and
Dowd (as cited in Dowd & Milne, 1986) found significant improvement for all
conditions. When combined with in vivo exposure (Ascher, 1981), paradoxical
intent has been demonstrated to be a more effective treatment for agoraphobia
than exposure alone. More recently, Akillas and Efran (1995) found symptom
prescription with reframing was effective in reducing symptoms o f socially
anxious males.
Assessment o f Reactance
Various attempts to measure reactance have had mixed results. Reactance
has been assessed using paper and pencil measures such as the Therapeutic
Reactance Scale (TRS; Dowd et al., 1991), the Fragebogen zur Messung der
psychologischen Reactanz (Questionnaire for the Measurement of Psychological
Reactance; Merz, 1983), and the Hong Reactance Scale (Hong & Page, 1989).
All o f these measures attempt to measure reactance potential and although these
scales show strong face validity, the nature of reactance inherently complicates
accurate assessment. In order for reactance to be exhibited, one requires either a
threat or a perceived threat to freedom. It is questionable whether simple paper-
and-pencil measures present a sufficient threat to arouse reactant responses. The
following samples taken from the TRS better illustrate this point:
I f I receive a lukewarm dish at a restaurant, I make an attempt to let it be
known.
I resent authority figures who try to tell me what to do.
I find that I often have to question authority.
I enjoy seeing someone else do something that neither o f us are
supposed to do.
It is most important to me to be in a powerful position relative to others.
(Dowd et al., 1991)
Certainly, one could argue that receiving a lukewarm meal may not be as
threatening as a direct order from an authority. The TRS asks the subject to
hypothesize how they might behave in a given situation. This is, of course, no
indication as to how the person will actually behave.
Brehm (1966) also states that reactance may manifest in behaviors other
than direct opposition. He states that the behavioral manifestation of reactance
may appear in other forms. One o f these is displacement in which the person
displaces their reactance on someone or something else (i.e. kicking one’s dog
instead of opposing a police officer). In the third form, a person might manifest
reactance by complying with the original request but failing to comply with
s
something in the future. In the clinical setting this could be seen as a client
completing the homework assignment but leaving it in the car. Measures like the
TRS, while touching on the potential for reactance, fail to get to the core of this
phenomenon.
Other attempts to measure reactance, such as psychophysiological
measures of arousal (Broussard, unpublished master’s thesis), and content-filtered
speech analysis (Shoham-Soloman et al., 1989) have shown conflicting results.
Currently, Shoham and Bootzin (personal communication) arc conducting
analyses of data collected in a multimethod attempt to measure reactance. This
study included psychophysiological measures, daily reports of compliance,
content-filtered speech analysis, and ratings of nonverbal behavior occurring
during therapy sessions.
An overlooked method of assessing reactance that holds promise is
thought assessment. Cognitive therapies have long held that thoughts are the
precursors of emotions and behavior (Beck, 1963; Ellis, 1962). Given the defiant
nature of reactance, one would expect defiant thoughts to precede or underlie
defiant behaviors. To date, no empirical data exist to support the notion that
defiant thoughts are at the heart of reactance and paradoxical intention.
Furthermore, no study has attempted to assess the cognitive processes o f people
when confronted with a paradoxical directive.
9
ATSS
The Articulated Thoughts in Simulated Situations paradigm (ATSS;
Davison et al., 1983) lends itself particularly to the assessment o f thought content.
By accessing thoughts in a nearly online fashion, ATSS overcomes some o f the
drawbacks o f self-report instruments and other think-aloud techniques. Subjects
are presented with an audiotaped vignette and told to imagine that they are in the
simulated situation. By articulating their thoughts during 30-second pauses,
subjects’ recall is not adversely affected by delay. Each vignette is situation-
specific, allowing for assessment of specified target thoughts. Since subjects’ sole
task is the articulation o f thoughts, concurrent tasks commonly found in think-
aloud techniques are eliminated, reducing the effects o f competition for cognitive
resources.
The versatility o f ATSS has been demonstrated in a variety o f situations.
Stimulus tapes have been created for the assessment o f social anxiety and
irrational thoughts during stressful situations (Davison, Feldman, & Osborn,
1984; Davison & Zhigelboim, 1987). Davison, Williams, Nezami, Bice, and
DeQuattro (1991) showed that ATSS was more effective in detecting cognitive
changes following a relaxation intervention than a standard paper-and-pencil self-
report inventory. Another study (White, Davison, Haaga, & White, 1992) showed
the paradigm’s effectiveness in differentiating Beckian cognitive biases in
depressed psychiatric outpatients from nondepressed psychiatric outpatients. O f
particular interest to this proposed study is the use o f ATSS to assess self-efficacy
10
(Davison, Haaga, Rosenbaum, Dolezal, & Weinstein, 1991). The authors
determined that self-efficacy could be accurately assessed using ATSS and was
correlated with behavioral measures o f speech anxiety.
The ability to specify the content o f each ATSS stimulus tape further
facilitates the assessment o f defiant thoughts (Davison, Navarre, & Vogel, 1995).
By nature, analog studies normally do not directly address the issue at hand.
Rather, they rely on conditions close to those that might occur in real life. ATSS
stimuli create a lifelike situation, allowing the investigator to arouse a reactance
state through the observation o f threat to others’ freedom. Brehm and Brehm
(1981) state that threats to one’s freedom need not be direct to arouse reactance.
A person need only witness a threat to another’s freedom in order to induce
reactance. The ATSS stimuli created for this study capitalize on this point by
having the subject imagine him- or herself an observer in a group therapy session.
The subject hears a scenario in which a therapist severely limits the free behaviors
o f an anxious client. The observation of this intervention serves as the necessary
condition to evoke reactance.
Given these theoretical mechanisms o f paradoxical intention, this study
proposed to test the ability o f ATSS to induce a state o f reactance through
simulation. Subjects were expected to show significantly more defiant thoughts in
response to the paradoxical stimulus compared to the control stimulus. Responses
to the control stimulus were expected to be more efficacious than defiant while
responses to the paradoxical stimulus were expected to be more defiant. Evidence
11
of this nature would lend support to the dual-mechanism theory of paradoxical
intention.
The second hypothesis was that subjects’ scores on the Therapeutic
Reactance Scale (TRS; Dowd et al., 1991) would be positively correlated with
their ATSS scores o f defiant thoughts. In other words, subjects who scored higher
on the TRS would also articulate more defiant thoughts during the paradoxical
simulation than subjects who scored low on the TRS. Subjects who scored low
on reactance measures were expected to articulate more efficacious thoughts
during the paradoxical simulation than subjects who scored high on reactance
measures.
The third experimental hypothesis was that high levels o f trait anxiety
would interact with high levels o f reactance, increasing the number o f defiant
thoughts. Since both reactance and anxiety are arousal states, it was expected that
an additive effect exists when people are high in both trait anxiety and reactance.
Subjects who rated high on trait levels of anxiety using the State-Trait Anxiety
Inventory, Trait Anxiety Scale (STAI-T; Spielberger et al., Jacobs, 1970) and high
on reactance using the TRS were expected to score higher on the ATSS measure
o f defiance in the paradoxical condition.
12
METHOD
Subjects
Undergraduate students were recruited as subjects from the University of
Southern California Department o f Psychology subject pool. Volunteers were
granted extra credit for participation through their respective courses. All students
in introductory psychology were first given the opportunity to complete both the
TRS and STAI-T in order to establish baseline measures and local norms for both
reactance potential and trait anxiety. Subjects for the actual experiment
volunteered for a study labeled “Psychotherapy: What do you Think!” A total of
52 subjects were recruited for the experimental procedure, 34 female and 18 male.
Due to a technical malfunction with the recording equipment a full response
record was not obtained for one male subject, reducing the actual sample to 51.
Questionnaires
STAI-T. The State-Trait Anxiety Inventory, Trait Anxiety Scale (STAI-T)
was designed to assess levels of trait anxiety. Spielberger et al. (1970) defined
trait anxiety as relatively stable individual differences in anxiety-proneness and
the intensity with which they respond to stressful situations. Individuals who
score high in trait anxiety tend to exhibit elevations of state anxiety with greater
frequency and higher intensity than non-anxious people. The STAI-T is a self-
report inventory of trait anxiety consisting of 20 items. Subjects are asked to rate
statements such as “I feel nervous” (STAI-T) on a four-point Likert-type scale
13
ranging from “almost never” to “almost always” (see Appendix A). Spielberger
and colleagues (Spielberger et al., 1970) reported high internal consistency of the
STAI-T (a = .90) and reasonably high test-retest reliability for college students
(ranging from t = .65 to r = .75). The minimum possible score is 20; the
maximum is 80. The authors reported norms for 855 college students separated
by gender. The mean score for females is 40.40 (gd = 10.15) and for males 38.30
(ad = 9.18).
TRS. The Therapeutic Reactance Scale (TRS) was developed as a
measure of psychological reactance as defined by J. W. Brehm (Dowd et al,,
1991). Items were constructed to assess the potential for psychological reactance
to perceived threats to one’s freedom (see Appendix B). Evidence of discriminant
validity was found when the TRS was compared to the STAI-T. A negligible
correlation was found between the TRS and Trait portion of the STAI-T (r = .06;
Dowd, Hughes, Brockbank, Halpain, Seibel, & Seibel, 1988). In support of the
construct validity of the scale, Dowd and his colleagues (1988) tested client
reactance level (measured by the TRS) to compliance-based and defiance-based
paradoxical interventions. Low-reactant clients scored significantly higher than
high-reactance clients on measures of expectation to change and perceived
controllability. Additional evidence for construct validity was shown by Graybar,
Antonuccio, Boutilier, and Varble (1989). In this study the investigators found
that low-reactant clients (as measured by the TRS) significantly reduced their
cigarette consumption when given high amounts of physician advice. Morgan
(as cited in Dowd et al., 1991) found that high-reactant clients had a significantly
higher no-show rate and slower improvement rate than did low-reactant clients.
The TRS is a 28 item self-report inventory designed to measure reactance.
Subjects are asked to rate statements such as “I resent authority figures who try to
tell me what to do” on a four-point Likert-type scale ranging from “strongly
disagree” to “strongly agree.” The minimum score possible is 28 and the
maximum 112. Dowd et al. (1991) report test-retest reliability coefficients
ranging from .57 to .60 with an internal consistency ranging from .75 to .84. The
authors report a slightly positively skewed normal distribution with a mean score
of 66.68 and standard deviation of 6.59 for one college student sample (N=211).
Another study (Dowd, Trutt, & Watkins, 1989) reported a mean of 68.87 and
standard deviation of 7.19 for a sample of 150 college students.
Design and Procedure
This study utilized a within-subjects design. All subjects listened to both
the control stimulus tape and the paradoxical stimulus tape. Prior to
administration of the ATSS stimuli, experimental subjects were informed o f the
nature of the study and given general instructions on the ATSS procedure. Each
completed an informed consent form (Appendix C) which is maintained in locked
files by the experimenter. Subjects then completed a short questionnaire that
included two demographic questions and asked about prior therapy or prior
15
participation in ATSS studies. Subjects then completed an administration o f both
the STAI-T and the TRS.
AISS
Subjects were told that the purpose o f the study was to assess the thoughts
one might have regarding different types of group psychotherapy. All subjects
heard recorded ATSS instructions (Appendix D) and were given the opportunity
to ask questions regarding the procedure. Each subject participated in a practice
session o f the ATSS procedure using a standard ATSS practice tape consisting of
two segments of a simulated situation unrelated to either the control or
experimental conditions used in the current study. Subjects’ responses made
during the practice segment were not recorded or used in subsequent analyses.
Subjects then heard the ATSS stimulus tapes, alone, in a closed lab. All responses
during this phase o f the procedure were tape recorded and monitored from an
adjacent room by the experimenter. Using a within-subjects design, all subjects
heard two taped conditions: a paradoxical stimulus condition, and a behavioral,
control condition.
Presentation o f the two conditions was randomly counterbalanced. Each
condition consisted o f an audiotaped ATSS scenario containing an introductory
statement by a narrator and eight stimulus segments. Acting students were
recruited from the USC theater department to portray the various roles in the
ATSS scenarios in order to create “true-to-life” experiences. Each o f the stimulus
segments was followed by a tone to signal the beginning of the response segment.
16
A 30-second silence followed the tone, during which the subjects responded
aloud. AH subject responses were tape recorded.
The content o f the stimulus tapes presented a hypothetical psychotherapy
group for the treatment o f anxiety. The stimulus tapes were developed expressly
for use in this study. A great deal o f attention was paid to creating parallel
scenarios. Both the “Introduction by Narrator” and segment 1 o f the stimuli,
which portrays an anxious group therapy client, were identical for the control and
paradoxical conditions. The paradoxical scenario directs a client to make
themselves more anxious and observe and record their experiences. The
behavioral control script asks the client to gently approach some anxious
situations and to observe and record their experiences as a prelude to direct
attempts to reduce the anxiety. ( For transcripts see Appendices E and F.)
All subjects were closely monitored for emotional distress. Subjects were
told they could terminate the experiment at any time. Experimenters were
prepared to offer support options, but the need did not arise. Following
completion o f the second tape subjects were debriefed and questions regarding the
study were answered.
17
Results
SufejfiCtS
The mean age for the experimental subjects was 19.75. Two-thirds (N =
34) o f the participants were female and one-third (N = 17) male. Eight (16 %) of
the subjects had participated in some form o f therapy prior to hearing the ATSS
simulated therapy sessions, and only one subject (2%) had participated in an
ATSS study prior to this experiment.
Coding
Subjects’ audiotaped responses were transcribed verbatim in typewritten
form. Transcripts were randomly checked for accuracy by the experimenter. Two
undergraduate research assistants were trained as coders and checked for
reliability. A high degree o f interrater agreement (Cronbach’s a = .93) was
established prior to actual coding. Coders were informed that random reliability
checks would be performed in order to maintain the standard (Rosenthal &
Rosnow, 1991).
The schema for scoring protocols was adapted from Davison, Feldman,
and Osborn (1984). Each response segment was scored on a nine point Likert
scale. Coders were instructed to identify an overall pattern for each response
segment ranging from Efficacious (1) to Neutral (5) to Defiant (9). Scores were
then totaled and a mean reactance score (MRS) was calculated. (See Appendix G
for coding manual.)
Articulated Thoughts
The mean MRS score for the control condition was 5.07 (sd = ,89). MRS
for the control condition ranged from 2.33 to 7.56. Scores for the paradoxical
condition yielded a mean of 5.86 (si = .96) and a range o f 3.22 to 7.89. A paired
samples t-test showed these two groups to be significantly different, i (51) = -4.68,
p < .001 (two-tailed) as hypothesized. An estimate o f effect size yielded d = .66.
Cohen (as cited in Rosenthal & Rosnow, 1991) has indicated that an effect size o f
.50 is considered a “medium” effect and .80 is considered a “large" effect.
Additionally, individual subjects’ scores were compared against each other using
a nonparametric measure. Results of a Sign Test again showed significance, z - -
3.98, p < .000. These findings support the success o f the manipulation as well as
pointing to the ability o f ATSS to induce and measure reactance.
IRS
A sample o f 263 initial TRS forms were collected from introductory
psychology students. Scores for this sample ranged from a minimum o f 40 to a
maximum o f 108. The mean score was 71.33 (sd = 8.1). TRS scores for the
pretest experimental group ranged from a minimum o f 32 to a maximum o f 99
with a mean score o f 69.67 (sd = 9.8). TRS scores for men (74.35, sd = 6.37)
were significantly higher than for women (67.32, sd = 10.47; t (49) = 2.54, p =
.005). TRS scores for the experimental group showed only a slight correlation
with the initial sample o f 263 subjects (i = 12, p > .05); however, the smaller
19
subgroup (N = 15) who had taken both administrations of the TRS showed a
significant test-retest correlation (i = .80, p < .001).
Although the TRS showed strong stability in the smaller sample, it was not
associated with ATSS measures o f reactance. In fact, a slight, nonsignificant
negative association was found between pretest TRS scores and MRS for the
paradoxical group (r = -.06). These findings indicate no support for the
hypothesized association between the TRS and ATSS scores of reactance. (See
Table 1)
STA K E
A total of 260 students returned the initial STAI-T distributed to the
introductory psychology class. Scores for this preliminary sample ranged from 23
to 68 with a mean score o f 43.26 (sd = 9.9). STAI-T scores for the experimental
group ranged from a minimum o f 24 to a maximum o f 59 with a mean o f 37.96
(sd = 8.9). The mean scores for men and women were not significantly different.
Although the STAI-T scores for the initial sample of 260 students was higher than
those Spielberger et al. (1970) reported, the mean for the experimental sample
group was comparable to that obtained by Spielberger. Due to the nature o f the
subject pool sign-up process, only 29 % (N = 15) o f the experimental sample
completed both administrations o f the STAI-T. Test-retest scores for this
subgroup showed only slight association (t = .18, jj > .05). Scores for the entire
20
experimental group o f 51 subjects showed no association to the initial sample of
260 subjects (r = -.03, p > .05).
No significant association was found to exist between trait anxiety as
measured by the STAI-T and articulated thoughts. STAI-T scores were compared
to the MRS for both the paradoxical and control condition and found not to be
correlated. Comparisons were also made to the pretest scores for the TRS and
found to have only a slight, positive, nonsignificant association. (See Table 1)
These findings indicate no support for the hypothesis of the additive effect of
anxiety and reactance.
CONTROL PARADOX
STAI-T TRS
MRS MRS
STAI-T
TRS -.07
C E = .65)
CONTROL -.06 ,10
MRS
(£=.70) (£ = .46)
PARADOX .02 -.06 .15
MRS
(£=•87) (E = .6G ) (£ = .30)
TABLE 1
C orrelations of Q uestionnaires and Mean Reactance Scores (N = 51)
Post Hoc Analyses
Given that neither paper-and-pencil measure predicted reactance or
efficacy as measured by ATSS, a closer examination o f the data yielded some
interesting findings. Only eight subjects scored in the efficacious range (MRS <
5) during the paradoxical condition as compared to 23 subjects who scored in the
efficacious range during the control condition. Although the mean scores for
these subgroups were not significantly different (4.35 vs. 4.46), it is notable that
more subjects expressed efficacious thoughts to the control tape than to the
paradoxical tape. To test this hypothesis data were recoded for nonparametric
tests. The results of a sign test yielded a significant difference (p = .004, two-
tailed) between the number o f subjects with efficacious scores and the number
with defiant scores.
Although presentation o f the stimuli was counterbalanced, an interaction
was noted between order and condition. An exploratory repeated measures
analysis o f variance (RMANOVA; Condition x Order x Gender) was conducted
to examine unpredicted main effects or interactions. No main effect was found
for Order (E, (1,47) = .04, p = .84) or Gender (E (1, 47) = 3.64, p = .06). Two
significant interactions were noted.
Order and Condition interacted significantly (E (1,47) = 24.10, p < .001).
Calculations for effect size i f - .72) indicate the clear effect o f this interaction.
The results show that when the behavioral intervention (Control Condition) was
presented first, there was no difference in MRS between the two conditions.
22
When the paradoxical intervention was presented first, the MRS for the
paradoxical condition was significantly higher than for the control condition.
Gender and Condition also showed a significant interaction (E (1,47) =
4.73, n = .04). Effect size calculations yielded a medium effect ( f = .32). Males
and females showed no difference in MRS for the Control condition, but women
scored significantly higher than men for the Paradoxical condition. As an
additional test o f interaction, cell means were compared using a procedure that
controls for main effect (Rosnow & Rosenthal, 1989; Rosenthal and Rosnovv,
1991). This analysis confirmed both interactions (Order X Condition and Gender
X Condition). It is important to note that analyses indicated that subjects had
higher MRS scores overall with the paradoxical condition even though an order
effect was noted. (See Table 2)
G ender O rd er
Males Females Control First Paradox First
Control 5.03 5.09 5.44 4.68
Paradox
(sd = .87) (sd= .91) (sd = .74) (sd = .88)
5.38 6.10 5.53 6.20
(sd = .74) (sd = .97) (sd= 1.00) (sd = .80)
Table 2: M eans and S tandard Deviations for Interactions
Discussion
The goals o f this study included: 1) a test of the ability o f ATSS to induce
a state o f psychological reactance as manifested in verbalized cognition; 2)
support for the dual-mechanism theory of paradoxical intention through ATSS
measures o f reactance and efficacy; 3) demonstration o f a positive relationship
between reactance scores as measured by the TRS, and defiant thoughts, as
measured by ATSS; and 4) to provide evidence supporting the hypothesis that two
arousal states, anxiety and reactance, would have an additive effect, increasing
expressions of reactance as measured by defiant thoughts.
The results support the use o f the ATSS paradigm as a measure of
reactance. By measuring the defiant thoughts underlying reactance, ATSS was
shown to be a useful tool for assessment o f reactance. Although no support was
found for the other experimental goals, post hoc results do open up new avenues
o f research in the areas o f paradoxical intention and clinical intervention.
One of the primary problems associated with measuring reactance is that
paper-and-pencil measures address only the potential for reactance. The results of
this study support the use o f ATSS as an indicator o f actual reactance in a variety
o f simulated settings. ATSS simulations can be customized to address very
specific free behaviors rather than the more general areas addressed by the TRS.
By creating realistic scenarios using actors to enhance the believability o f the
stimuli, future research may tap the cognitive processes underlying reactance.
This study has demonstrated the potential o f ATSS as an assessment instrument to
determine how clinical patients would respond to different interventions. As
Beutler and his colleagues (Beutler, Sandowicz, Fisher, & Albanese, in press)
point out, patient resistance is the one factor common to all theories of
psychotherapy. A simple ATSS simulation could be a useful tool to clinicians
both in planning interventions and detailing clients’ dysfunctional thoughts.
Although no support was found for the dual-mechanism hypothesis, there
are two possible explanations for this failure. First, the fault may lie in the
scoring procedure. One o f the assumptions o f the author was that efficacy and
defiance were constructs that could be measured on the same continuum. This
may not be the case. It is quite possible that a subject might express very
efficacious thoughts (I’m sure I could do that...) regarding an intervention yet act
defiantly (...but why would I want to?). The data could be reanalyzed using
separate measures for efficacy and defiance.
Second, although the paradoxical manipulation was sufficient to induce
reactance, there is no evidence that the control condition “pulls” for efficacy. The
scripts created for this experiment attempted to specifically control for any
differences other than the paradoxical intention. By modifying the ATSS script
one might better elicit statements of self-efficacy through a modeling procedure,
i.e. actors could express both positive and negative efficacy statements. This
could be used in both the control and paradoxical condition, allowing a better
comparison of efficacious articulated thoughts across conditions.
Although no correlation was found between the TRS and ATSS measures,
it is possible that they address different constructs. The Therapeutic Reactance
Scale is written in such a way as to measure reactance potential. The
experimental manipulation used in this study measured actual reactance.
Furthermore, Brehm and Brehm (1981) claim that the degree of reactance
exhibited is related to the importance of the free behavior that is threatened. It is
questionable as to whether the TRS actually serves as a sufficient threat to free
behaviors. It is one thing to ask a subject if they would send a meal back at a
restaurant. It is entirely another matter to put a subject in a realistic simulation
and ask him or her to induce the very symptoms that cause distress. Reactance
potential in generic hypothetical situations may not be a useful predictor of actual
reactance. Although ATSS also utilizes hypothetical situations, it offers a strong
enough threat to free behavior so that reactance is aroused. As previously stated,
one need not feel that one’s own free behavior has been threatened in order to
experience reactance. All that is necessary is to witness the threat to another’s
free behavior. It would appear that ATSS taps the cognitive precursors to
reactance. Further investigation should be conducted to determine the utility of
ATSS as a predictor of reactance in clinical settings.
Finally, in order to test the hypothesis that anxiety and reactance would
interact, it was necessary to rely on the predictive ability of the TRS. Until such
time as a better indicator is validated, it may not be possible to test this premise.
Work is currently underway to develop an MMPI subscale measure o f reactance
26
(Beutler, personal communication), but until other more predictive measures can
be developed, this question will remain unanswered.
Post Hoc Findings
Two intriguing areas of future research were generated by the post hoc
findings of this study. The first addresses the issue of gender and reactance. The
literature on reactance shows little regarding gender differences. Three studies
conducted in Australia (Hong, 1990; Hong, Giannakopoulous, Laing, & Williams,
1994; Hong & Langovski, 1994) showed no gender difference in reactance scores
utilizing the Psychological Reactance Scale (PRS; Hong & Page, 1989). Dowd
and his colleagues (Dowd, Milne, & Wise, 1991) provided normative data for two
college student samples but did not report scores by gender. A more recent study
(Dowd, Wallbrown, Sanders, & Yesenosky, 1994) reported that men scored
significantly higher on the TRS than women. The current study also found that
men scored higher than women on the TRS, but since that scale was not
associated with ATSS reactance measures, it is unclear what these differences
mean.
A possible explanation for women scoring higher on ATSS measures of
reactance could be that because women have historically been socialized to be
more compliant to authority, they feel a double threat to their free behaviors.
First, according to reactance theory, women feel that their free behavior is
threatened by the therapeutic directive in the paradoxical intervention. Second,
27
they may feel that their ability to react against this directive is socially and/or
culturally restrained. This double-pronged attack on the free behaviors of women
may account for their higher level o f defiant thoughts.
One question that comes to mind is whether the gender o f the ATSS actors
had an effect on the subjects. AH stimuli in this study utilized a male actor in the
role o f psychotherapist and a female actor in the role o f the anxious client. One
goal espoused by the feminist theory o f psychotherapy is that o f equalizing power
in the therapeutic relationship (Hill, 1992). The present study simulated a male
therapist issuing a counterintuitive directive to a female patient. A feminist
interpretation might point to this as a power disparity, a strong and salient threat
to a woman’s free behavior. According to this theory, women might be more
reactant as a way o f correcting this disparate power relationship. In future
research the gender o f the actors should be counterbalanced in order to adequately
test the gender hypothesis. Additionally, future investigations could also use
actors o f the same sex to determine whether the gender effect is eliminated. These
situational variables are easily manipulated within the ATSS paradigm.
O f further interest is the finding that subjects displayed more reactance to
the first condition regardless o f its nature. By counterbalancing the conditions in
a random fashion, it was expected that nuisance variables would be controlled.
This leads one to speculate that this effect was not an artifact o f the methodology
but rather a potentially important clinical finding. If a new client tends to be more
reactant to the first intervention, whatever its nature, this could be a useful tool to
enhance the therapeutic relationship. Therapists might consider the first
intervention as an inoculation, designed to lower client reactance toward future
interventions. Although there appears to be no research specifically focused on
this topic, Persons and Bums (1986) found that the first dysfunctional thought
elicited from a client was more resistant to change than subsequent distorted
thoughts. In this study, no order effect was noted, but client reactance was not a
target variable. Future studies could specifically target this effect to determine
whether reactance to the first intervention is a meaningful clinical target.
In summary, the ATSS paradigm appears to be a useful technique for the
assessment of psychological reactance. Contrary to other measures o f reactance, it
taps the cognitive precursors to behavioral reactance. Although no correlation
was found between the TRS and ATSS measures, future work using ATSS may
help to validate a more useful paper-and-pencil indicator of reactance. Further
investigation is necessary to clarify the nature o f both gender and order effects
found in this study.
REFERENCES
Akillas, E., & Efran, J. S. (1995). Symptom prescription and reframing: Should
they be combined? Cognitive Therapy and Research. 19, 263-279.
Ascher, L. M. (1981) Employing paradoxical intention in the treatment of
agoraphobia. Behavior Research and Therapy. 19. 533-542.
Ascher, L. M., & Turner, R. M. (1979). Paradoxical intention and insomnia: An
experimental investigation. Behavior Research and Therapy. 12,408-411.
Bandura, A. (1977). Self-efficacy: Toward a unifying theory o f behavioral
change. Psychological Review. 84. 191-215.
Beck, A. T. (1963). Thinking and depression: 1, Idiosyncratic content and
cognitive distortions. Archives o f General Psychiatry. 2, 324-333.
Beutler, L. E. (1979). Toward specific psychological therapies for specific
conditions. Journal o f Consulting and Clinical Psychology. 42, 882-897.
Beutler, L. E. (1983). Eclectic psychotherapy: A systematic approach. Elmsford,
NY: Pergamon Press.
Beutler, L. E., Sandowicz, M., Fisher, D., & Albanese, A. L. (In press).
Resistance in psychotherapy; What conclusions are supported by research? In
Session: Psychotherapy in Practice.
Brehm, J. W. (1966) A theory o f psvcholoeicaLreactance. NY: Academic Press.
Brehm, S. S., & Brehm, J. W. (1981). PsvchologicaLreactance: A theory o f
freedom and control. New York: Academic Press.
Broussard, D. L. B. (1993). Measuring reactance in a non-reactive way.
Unpublished master’s thesis, University o f Arizona, Tucson.
Davison, G. C., Feldman, P. M., & Osborn, C. E. (1984). Articulated thoughts,
irrational beliefs, and fear o f negative evaluation. Cognitive Therapy and
Research. £, 349-362.
Davison, G. C., Haaga, D. A. F., Rosenbaum, J., Dolezal, S. L., & Weinstein, K.
A. (1991). Assessment of self-efficacy in articulated thoughts: “States o f Mind”
analysis and association with speech-anxious behavior. Journal o f Cognitive
Psychotherapy: An International Quarterly. 5, 83-92.
30
Davison, G. C., Navarre, S. G., & Vogel, R. (1995). The articulated thoughts in
simulated situations paradigm; A think-aloud approach to cognitive assessment.
Current Directions in Psychological Science. 4,29-33.
Davison, G. C., Robins, C., & Johnson, M. K. (1983). Articulated thoughts
during simulated situations: A paradigm for studying cognition in emotion and
behavior. Cognitive Therapy and Research. 7.17-40.
Davison, G. C., Williams, M. E,, Nezami, E., Bice, T. L., & DeQuattro, V. L.
(1991). Relaxation, reduction in angry articulated thoughts, and improvements in
borderline hypertension and heart rate. Journal o f Behavioral Medicine. 14,453-
468.
Davison, G. C., & Zighelboim, V. (1987). Irrational beliefs in the articulated
thoughts o f college students with social anxiety. Journal o f Rational-Emotive
Therapy. 238-254.
Dowd, E. T. (1989). Stasis and change in cognitive psychotherapy; Client
resistance and reactance as mediating variables. In W. Dryden & P. Trower (Eds.)
Cognitive Psychotherapy; Stasis and Change, (pp. 139-158) New York: Springer
Publishing Co., Inc.
Dowd, E. T., Hughes, S. L., Brockbank, L., Halpain, D., Seibel, C., & Seibel, P.
(1988). Compliance-based and defiance-based intervention strategies and
psychological reactance in the treatment of free and unfree behavior. Journal of
Counseling Psychology. 25, 370-376.
Dowd, E. T., Milne, C. R., & Wise, S. L. (1991). The Therapeutic Reactance
Scale: A measure o f psychological reactance. Journal o f Counseling and
Development, 52,541-545.
Dowd, E. T., Trutt, S. D., & Watkins, C. E. (1992). Interpretation style and
reactance in counselor’s social influence. Psychological Reports. 70 247-254.
Dowd, E. T., Wallbrown, F., Sanders, D., & Yesenosky, J. M. (1994),
Psychological reactance and its relationship to normal personality variables.
Cognitive Therapy and Research. 18,601-612.
Ellis, A. (1962). Reason and emotion in psychotherapy. New York: Lyle Stuart.
Feldman, D., Strong, S. R., & Danser, D. (1982). A comparison o f paradoxical
and non-paradoxical interpretations and directives. Journal of Counseling
Psychology, 22,572-579.
FrankI, V. (1967). Psychotherapy and existentialism. NY: Simon & Schuster.
Graybar, S. R., Antonuccio, D. O., Boutilier, L. R., & Varble, D. L. (1989).
Psychological reactance as a factor affecting patient compliance to physician
advice. Scandinavian Journal o f Behaviour Therapy. 18.43-51.
Hill, M. (1992). A feminist model for the use of paradoxical techniques in
psychotherapy. Professional Psvcholoov; Research and Practice. 22,287-292.
Hong, S. M. (1990). Effects o f sex and church attendance on psychological
reactance. Psychological Reports. 66.494.
Hong, S. M., Giannakopoulos, E., Laing, D., & Williams, N. A. (1994).
Psychological reactance: Effects o f age and gender. Journal o f Social Psychology.
134. 223-228.
Hong, S. M., & Langovski, N. (1994). Sex differences in psychological reactance
amongst Korean residents in Australia. Psvcholopical Reports. 25, 578.
Hong, S. M., & Page, S. (1989). A psychological reactance scale: Development,
factor structure and reliability. Psychological Reports. 64. 1323-1326.
Horvath, A. 0 „ & Goheen, M.D. (1990). Factors mediating the success of
defiance- and compliance-based interventions. Journal o f Counseling Psvcholopv.
22,363-371.
Lopez, F. G.*& Wambach, C. A. (1982). Effects o f paradoxical and self-control
directives in counseling. Journal o f Counseling Psychology. 22,115-124.
Mavissakalian, M., Michaelson, L., Greenwald, D., Komblith, S., & Greenwald,
M. (1983). Cognitive behavioral treatment o f agoraphobia: Paradoxical intention
vs. Self-statement training. Behaviour Research and Therapy. 21, 75-86.
Merz, J. (1983). Fragebogen zur Messung der psychologischen Reactanz
[Questionnaire for the measurement of psychological reactance]. Dinpnostica.
Band XXTX. 75-82.
Persons, J. B., & Bums, D. D. (1986). The process o f cognitive therapy: The first
dysfunctional thought changes less than the last one. Behaviour Research and
Therapy. 24,619-624.
32
Rohrbaugh, M., Tennen, H,, Press, S., & White, L. (1981). Compliance,
defiance, and therapeutic paradox: Guidelines for strategic use of paradoxical
interventions. American Journal of Orthopsychiatry. 51,454-467.
Rosenthal, R., & Rosnow, R. L. (1991). Essentials of Behavioral Research:
Methods and Data Analysis. (2nd edition). New York: McGraw-Hill, Inc.
Rosnow, R. L., & Rosenthal, R. (1989). Definition and interpretation of
interaction effects. Psychological Bulletin. 105.143-146.
Seltzer, L. F. (1986). Earadoxical strategies in psychotherapy: A comprehensive
overview and guide book. NY: John Wiley.
Shoham-Soloman, V., Avner, R., & Neeman, R. (1989). You're changed if you
do and changed if you don't: Mechanisms underlying paradoxical interventions.
Journal o f Consulting and Clinical Psychology. 52,590-598.
Shoham-Soloman, V., & Rosenthal, R. (1987). Paradoxical interventions: A
meta-analysis. Joumal.of Consulting and Clinical Psychology. 55,22-28.
Spielberger, C. D., Gorsuch, R. L., Lushene, R. E., Vagg, P. R., & Jacobs, G. A.
(1970). Manual for the State-Trait Anxiety Inventory. Palo Alto: Consulting
Psychologists Press.
Turner, R. M., & Ascher, L. M. (1979). Controlled comparison of progressive
relaxation, stimulus control, and paradoxical intervention therapies for insomnia.
Journal of Consulting and Clinical Psychology. 42,500-508.
Watzlawick, P., Weakland, J. H., & Fisch, R. (1974). Chance: Principles of
problem formation and problem resolution. NY: Norton.
Watzlawick, P., Beavin, J., & Jackson, D. D. (1967). Pragmatics of human
communication: A study of interactional patterns, pathologies and paradoxes.
New York: Norton.
Weeks, G. R., & L’Abate, L. (1982). Paradoxical psvchotheranv: Theory and
practice with individuals, couples, and families. NY: Brunner/Mazel.
White, J., Davison, G. C., Haaga, D. A. F., & White, K. (1992). Cognitive bias in
the articulated thoughts of depressed and nondepressed psychiatric patients. The
Journal ofNervous and Mental Disease. 182,77-81.
Wright, R. M., & Strong, S. R. (1982). Stimulating therapeutic change with
directives: An exploratory study. Journal of Counseling Psychology. 29. 199-
202.
34
APPENDIX A: STATE-TRAIT ANXIETY INVENTORY-T
Self-Evaluation Questionnaire
DIRECTIONS: A number of statements which people have used to describe
themselves are given below. Read each statement and then circle the appropriate
answer to the right of the statement to indicate how you generally feel. There are
no right or wrong answers. Do not spend too much time on any one statement but
give the answer which seems to describe how you generally feel.
1 = Almost Never 2 = Sometimes 3 - Often 4 = Almost Always
01. I feel pleasant. 1 2 3 4
02. I feel nervous and restless. 1 2 3 4
03. I feel satisfied with myself. 1 2 3 4
04. I wish I could be as happy as other seem to be. 1 2 3 4
05. I feel like a failure. 1 2 3 4
06. I feel rested. 1 2 3 4
07. I am “calm, cool and collected.” 1 2 3 4
08. I feel that difficulties are piling up so that I cannot
overcome them. 1 2 3 4
09. I worry too much over something that really doesn’t matter. 1 2 3 4
10. I am happy. 1 2 3 4
11. I have disturbing thoughts. 1 2 3 4
12. I lack self-confidence. 1 2 3 4
35
13. I feel secure. 1 2 3 4
14. I make decisions easily, 1 2 3 4
15. I feel inadequate. 1 2 3 4
16. I am content. 1 2 3 4
17. Some unimportant thought runs through my mind and
bothers me. 1 2 3 4
18. I take disappointments so keenly that I can’t put them out
of my mind, 1 2 3 4
19. I am a steady person. 1 2 3 4
20. I get in a state o f tension or turmoil as I think over my
recent concerns and interests. 1 2 3 4
i
36
APPENDIX B: Therapeutic Reactance Seale
Attitudes Scale
SD - Strongly disagree D = Disagree A = Agree SA = Strongly Agree
01. If I receive a lukewarm dish at a restaurant, I make an attempt to
let it be known............................................................................ . SD D A SA
02. I resent authority figures who try to tell me what to do......... SD D A SA
03. I find that I often have to question authority............................ SD D A SA
04. I enjoy seeing someone else do something that neither of us are
supposed to do.............................................................................. SD D A SA
05. I have a strong desire to maintain my personal freedom....... SD D A SA
06. I enjoy playing "Devil's Advocate" whenever I can................ SD D A SA
07. In discussions, I am easily persuaded by others...................... SD D A SA
08. Nothing turns me on as much as a good argument!,..,........... SD D A SA
09. It would be better to have more freedom to do what I
want on a job............................................................................ . SD D A SA
10. If I am told what to do, I often do the opposite....................... SD D A SA
11. I am sometimes afraid to disagree with others......................... SD D A SA
12. It really bothers me when police officers tell people
what to do...................................................................................... SD D A SA
13. It does not upset me to change my plans because
someone in the group wants to do something else.................. SD D A SA
14. I don't mind other people telling me what to do.... ................ SD D A SA
15. I enjoy debates with other people.......................................... SD D A SA
16. If someone asks a favor o f me, I will think twice
about what this person is really after..................................... SD D A SA
17. I am not very tolerant of others attempts to persuade me... SD D A SA
18. I often follow the suggestions of others............................... SD D A SA
19. I am relatively opinionated..................................................... SD D A SA
20. It is most important to me to be in a powerful
position relative to others....................................................... SD D A SA
21. I am very open to solutions to my problems from others..,. SD D A SA
22. I enjoy showing up people who think they are right........... SD D A SA
23. 1 consider myself more competitive than cooperative......... SD D A SA
24. I don't mind doing something for someone even when
I don’t know why I am doing it.............................................. SD D A SA
25. I usually go along with others' advice................................... SD D A SA
26. I feel it is better to stand up for what I believe than
to be silent............................................................................ SD D A SA
27. I am very stubborn and set in my ways................................. SD D A SA
28. It is very important for me to get along well with the
people I work with................................................................... SD D A SA
38
APPENDIX C: Inform ed Consent Form
INFORMED CONSENT FOR RESEARCH PARTICIPATION
Department of Psychology
University of Southern California
Study: Psychotherapy...What do You think?
Principal Investigator: Michael Gann (213)740-2280
This is to certify th at________________________________ agrees to participate as
a subject in a research project under the supervision o f Michael Gann. The
purpose of this study is to investigate the kinds o f thoughts people have in
different group psychotherapy situations using the Articulated Thoughts in
Simulated Situations method. Participation in the study will involve audio taping
o f your verbal responses to two audiotaped scenarios and completion o f two
questionnaires.
Anonymity is protected in that only a number will accompany any research
forms or audiotapes once your participation has ended. However, confidentiality
cannot be maintained if you report elder or child abuse, and/or intent to harm
oneself or others. You may request information from the Principal Investigator
regarding the outcome of this study.
Your participation is completely voluntary and will not affect your
relationship with the university or affiliated services. You may withdraw from
this study at any time without adverse consequences. If you have any questions
39
regarding your participation you may contact the Principal Investigator at the
number given above. USC has a standing committee known as the University
Park IRB to which complaints and problems concerning any research project may,
and should, be reported. IRB telephone: 743-6781.
The nature and purpose of this research have been defined and explained to me. I
understand that I am free to discontinue to participate at any time if I so choose,
without penalty, and that the investigator will answer any questions that arise in
the course of this research.
In addition, I am aware that if I find participation in this project at all upsetting,
and wish to talk further with a counselor about my feelings or reactions, 1 may
contact the USC Student Counseling Center at (213) 740-7979 or the USC Human
Relations Center (HRC) at (213) 740-1600.
(Name)___________________________ (Date)______________________________
I have fully explained the research to the subject explicitly pointing out the
potential risks or discomforts. I have asked whether any questions remain and
have answered these questions to the best o f my ability.
Investigator Date
APPENDIX D: T ranscript of Instructions Tape for ATSS Procedure
In this study we are interested in the kinds o f thoughts people have in
therapeutic situations. Often when people are going about their daily affairs,
interacting with others and so forth, we have a kind o f internal monologue going
through our heads, a constant stream o f thoughts or feelings that reflect our
reaction to something which is happening. What we'd like you to do is to play a
part in a make believe situation we have taped. Your part will involve listening to
a group therapy situation and tuning in to what is running through your mind, and
then saying these thoughts out loud to the tape recorder. An experimenter will be
in the control room next door operating the taping equipment. If for any reason
during the experiment you wish to end your participation, you are free to do so
without penalty. Let me mention that your name will not be connected to the
taping we do here so your thoughts will be kept confidential. Do you have any
questions at this point?
In this situation, we want you to imagine you are sitting in on a group therapy
session. What we are interested in is how you feel and what you think about what
you are hearing. How does it affect you? What do you think about yourself when
hearing it? And why do you feel that way? To help you do this, the tape is
divided into segments. At the end o f each segment there will be a tone followed
by a pause of 30 seconds, during which time we would like you to talk about the
kind o f things you are thinking. Say as much as you can until you hear another
41
tone. The microphones in this room will pick up whatever you say. O f course,
there are no right or wrong answers so please just say whatever comes to mind
without judging whether it seems appropriate or not. The more you can tell us,
the better. Now we know the situation is only make-believe, but try to really
imagine that it is you in the situation. Really get into it and take the part o f the
person hearing these words in real life. Remember, at the end o f each segment,
talk out loud as frankly and as completely as you can about what you are thinking.
Any questions?
From: Davison, G. C., Haaga, D. A. F., Rosenbaum, J., Dolezal, S. L., & W einstein, K, A. (1991).
Assessm ent o f self-cfflcacy in articulated thoughts: "States o f m ind" analysis and association with
speech-anxious behavior. Journal of Cognitive Psychotherapy: An International Q uarterly, 5,
83-92.
APPENDIX E: Paradoxical Script
Introduction by N arrator: You have been feeling very anxious over the past
year and feel the anxiety is interfering with your daily activities. Although you
have never considered therapy before, you have now agreed to attend a group
therapy session. The therapist has explained that all the group members also
experience high degrees o f anxiety. The therapist has asked you ju st to sit quietly
until you have been form ally introduced to the group. As you enter the room you
witness a woman seated among five other people in a circle, talking to the
therapist.
1) Jean: (said with tense emotion) "I have tried everything I can think o f to
control these feelings. Nothing I do works. Its getting more and more difficult to
get my work done and deal with people at school. I'm beginning to get
desperate."
2) T herapist: "Jean, everything you've told us points to one theme, control. So
far, none o f your efforts to control your anxiety have worked, and you've tried
everything from relaxation and yoga to sheer will power. Not one o f these direct
control methods has been effective. There are some cases where normally
effective methods don't work fo r certain people and I think yours is one o f them."
3) Therapist: "I'm convinced that it's time to try a completely different
approach. Although it may sound a bit unusual, I can tell you that with a few
clients I ’ ve had some success using this technique. From now on I want you to
stop all o f your efforts to control or reduce your anxiety.
4) Therapist: "First we’ ll start by collecting data, that is, you need to make
multiple observations o f your anxiety. Become more aware o f it, examine what it
feels like and when it occurs, and keep careful records o f all that you observe and
feel. Jean fo r the next week I want you to observe very carefully when you
become anxious and what it feels like."
5) Therapist: "In order to get plenty o f information about your anxiety, I want
you to make yourself more anxious than usual. Go into situations where you’ ve
experienced anxiety but this time don't try to control or escape it. This time I
want you to intensify the feelings.
6) Therapist: "Don't fight the anxiety. This will give us a better chance to
understand its nature by observing it while it happens. Every day put yourself in
as many anxious situations as possible and carefully observe and record every
aspect o f the anxiety as it intensifies."
7) Therapist: "Jean, you said you get very uptight in crowded rooms like movies
and lectures. For the next week you should go to as many large, crowded lectures
and movies as possible, at least once a day. When you begin to feel anxious don’ t
try to control or avoid it but stay with it and look closely at all you experience."
8) T herapist: "It's really important to eliminate all attempts to control your
anxiety. Just observe everything you experience
APPENDIX F: Control Script
Introduction by N arrator: You have been feeling very anxious over the past
year and feel the anxiety is interfering with your daily activities. Although you
have never considered therapy before you have now agreed to attend a group
therapy session. The therapist has explained that all the group members also
experience high degrees o f anxiety. The therapist has asked you ju st to sit quietly
until you have been form ally introduced to the group. As you enter the room you
witness a woman seated among five other people in a circle, talking to the
therapist.
1) Jean: (said with tense emotion) "I have tried everything I can think o f to
control these feelings. Nothing I do works. Its getting more and more difficult to
get my work done and deal with people at school. I'm beginning to get
desperate. "
2) Therapist: "Jean, everything you've told us is common fo r people who
experience extreme form s o f anxiety. Anxiety once was an adaptive response to
threats in our environment. Some people, however, misinterpret signals from the
environment as threats and their natural response is anxiety. The first awareness
o f the anxiety is often in the form o f muscular tensing."
3) Therapist: "When our body tenses in response to these environmental cues,
we automatically interpret that as a threat, something to worry about because o f
the danger or failure that we think is certain. In order to break this automatic
interpretation we will approach your anxiety from both the physical and the
mental with two effective techniques you can practice at home."
4) T herapist: "First, before we begin the actual anxiety-reduction training, we'll
start by collecting data. You will need to make multiple observations o f your
anxiety. By doing this you will become more aware o f the times and situations
when your anxiety occurs. By keeping records o f what you observe and feel we'll
be able to work on some o f the automatic thoughts that occur when you sense
your body beginning to tense. Jean fo r the next week I want you to observe very
carefully when you become anxious and what it feels like."
5) T herapist: "Jean I'd like you to gently approach some situations where you've
experienced m ild to moderate anxiety and note your feelings and thoughts. This
shouldn't be a situation that causes you extreme anxiety. Just note the sensations
and thoughts that occur when you feel the anxiety coming on."
6) Therapist: "As we better understand your anxiety, we will be able to improve
the effectiveness o f treatment. In treatment, we will target the physical sensations
through the use o f progressive muscle relation and you will learn methods
designed to counteract your negative automatic thoughts."
7)Therapist: "Jean, over the next week whenever you begin to feel anxious
become more aware o f both the physical sensations, thoughts, and feelings. I
want you to keep a recordfor us to review when you come back to group."
47
8)Therapist: "For the time being just observe everything you experience. Next
week you will learn progressive muscle relaxation and we will also look at some
o f the automatic thoughts you have when you feel anxious."
48
APPENDIX G: Coding M anual
Raters should consider each response segment as an independent item for
coding. Each response segment should be judged for the presence or absence of
the concepts o f defiance and efficacy (examples given below). Scoring will be
based on a nine-point scale as illustrated below. Efficacy is to be scored as 1
through 4; defiance should be scored as 6 through 9. If, in your judgment, you
believe the segment to be neutral, it should be scored as 5. Indicate the score for
that segment by circling the appropriate number on the scale.
Sample Coding sheet:
REACTANCE STUDY CODING SHEET
Coder:
Protocol if
Segm ent: Com pliant Neutral Defiant
1 1 2 3 4 5 6 7 8 9
Examples
DEFIANCE
1) Any statement that clearly reflects defiance or rebellion.
Ex: No way I’m going to do that/ He can stick it up his butt/ I wouldn't
do that in a million years/
49
2) Any statement that is an attack or threat.
Ex: The guy's a moron/ I'd bust him in the mouth/ I'll fix him/
3) Any statement indicating the person can't or won't do something.
Ex: I'm afraid I couldn't do that/ I'd die if I tried/ I don't think I could/
I'd probably not be able to/
4) Statement that indicates the person has taken offense at the speaker's words.
Ex: What does he think I am/ I must look like a chump/ how dare he
think he can trick me/ what am I a lab rat/
5) Statement indicating a lack o f tolerance.
Ex: I can't be bothered with this/ what a waste o f time/ she's throwing
away her money/ this guy's jerking her around/
6) Statement of independence or autonomy.
Ex: I don't do things because I’m told to/ I make my own choices/ just
because he said to do it doesn't mean she has to/
7) Disbelief in outcome.
Ex: That'll never work/ this is a failure/ it won't fly/ it'll just get
worse/ she’ll probably go nuts if she does that/
50
EFFICACY
1) Compliance statements.
Ex: I think I can do that/ it seems like something I could do/ I can do
that/
2) Willingness to try.
Ex: well I guess I could give it a shot/ it seems reasonable to try at
least/ I suppose I could do that/
3) Belief that doing the task will result in improvement.
Ex: she'll probably get better/ as long as I do it should help/

Linked assets

University of Southern California Dissertations and Theses

Conceptually similar

PDF

Mood Induction As An Analog To Depression In Older Adults: Aspects Of Depression And Cognitive Effects

PDF

The Emotional, Physiological, And Cognitive Reactions Of Boys And Girls From High-Conflict And Low-Conflict Homes To Simulated Marital Conflict

PDF

Weight Reduction As A Function Of The Timing Of Reinforcement In A Covertaversive Conditioning Paradigm

PDF

An Examination Of Positive And Negative Reinforcement In Classical And Operant Conditioning Paradigms In The Primary Psychopath

PDF

Articulated thoughts regarding cognitions toward older adults

PDF

Content analysis of articulated thoughts of chronic worriers

PDF

Articulated thoughts about intentions to commit anti-gay hate crimes

PDF

Prognostic Expectancy Effects In The Desensitization Of Anxiety Over Invasion Of Body Buffer Zones

PDF

The Effects Of Diphenylhydantoin On The Galvanic Skin Responses Of Psychopathic And Normal Prisoners

PDF

Applying the theory of reasoned action to condom use: The effect of immediate consequences on intention-behavior consistency

PDF

The effects of physical proximity and body boundary size on the self-disclosure interview

PDF

Strategies Of Marital Communication

PDF

The Effects Of Repression-Sensitization, Race, And Levels Of Threat On Extensions Of Personal Space

PDF

Cognitive predictors of intention -behavior consistency in safer sex practices

PDF

Modification Of Low Self-Confidence In Elementary-School Children By Reinforcement And Modeling

PDF

Death Anxiety In Leukemic Children

PDF

Self-Sacrifice, Cooperation, And Aggression In Women Of Varying Sex-Role Orientations

PDF

Smoking And Cognitive Functioning In Non-Demented Swedish Twins

PDF

Evidence for spontaneous situational inferences

PDF

Expectancies for alternative behaviors predict drinking problems: A test of a cognitive reformulation of the matching law

Asset Metadata

Creator Gann, Michael Kelly (author)

Core Title Cognitive Assessment Of Reactance Using The Articulated Thoughts In Simulated Situations Paradigm

Degree Master of Arts

Degree Program Psychology

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag OAI-PMH Harvest,Psychology, clinical,psychology, cognitive

Language English

Contributor Digitized by ProQuest (provenance)

Advisor Davison, Gerald C. (committee chair), Frankel, Andrew Steven (committee member), Hellige, Joseph B. (committee member)

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c18-13934

Unique identifier UC11357707

Identifier 1379583.pdf (filename),usctheses-c18-13934 (legacy record id)

Legacy Identifier 1379583-0.pdf

Dmrecord 13934

Document Type Thesis

Rights Gann, Michael Kelly

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the au...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus, Los Angeles, California 90089, USA