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Cognitive Behavioural Processes Across Psychological Disorders: A Review of the Utility and Validity of the Transdiagnostic Approach
Mansell W, Allison Harvey, Ed Watkins, Roz Shafran
International Journal of Cognitive Therapy - Special Issue on Transdiagnostic Approaches to CBT [W.Mansell Ed.]. 2008;1:181-191.
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Abstract
The transdiagnostic approach states that there are key cognitive and behavioural processes responsible for maintaining symptoms and these are shared across psychological disorders (Harvey, Watkins, Mansell, & Shafran, 2004). The first goal of this article is to justify the potential utility of a transdiagnostic perspective for theory, research and treatment using empirical evidence and clinical vignettes. We then take as an example one set of cognitive processes - attentional processes - to illustrate the approach. Evidence for three attentional processes is provided: vigilance to external concern-related stimuli; vigilance to internal concern-related stimuli (self-focused attention) and attentional avoidance. It is concluded that each of these attentional processes are transdiagnostic. We then discuss three possible resolutions to the question: How can a transdiagnostic perspective be valid when the different psychological disorders present so differently? The three proposals are: (1) variations in idiosyncratic current concerns; (2) variations in the degree of shared processes and (3) distinct processes for specific disorders or groups of disorders. The role of a transdiagnostic approach in supporting the development and testing of theories of psychopathology is highlighted and the need for future studies that incorporate multiple patient groups is discussed.