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Cognitive Behavioral Therapy and Negative Emotions

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Cognitive Behavioral Therapy and Negative Emotions

Carrie Gianotti

Negative emotions and thoughts can bring about harmful psychological and physiological consequences.  Disruptions in the immune, endocrine, and central nervous system as a result of negative effect can precipitate diseases like diabetes, cancer, HIV, rheumatoid arthritis, chronic fatigue syndrome, diabetes, and obesity.  Stress is the prevailing factor when dealing with diseases that interact in a bidirectional way on the body and the mind.  Negative moods have been associated with lowered immune system defenses and therefore stress may produce a negative mood and thus weakening immune responses.  Some emotional responses may be lack of perceived control, anxiety, depressed mood, poor sleep habits and/or lack of sleep.  These factors may be emotional responses to psychological stressors that produce immunological and endocrine changes via brain and central nervous system.  An abnormality in the HPA axis may be from maladaption of stress related stimuli and depression also plays a role in hyperactivity of the HPA axis resulting in abnormal transmittal of neurotransmitters.  Stress responses and coping mechanisms may also play a role in hyperactivity of the HPA axis through genetics, environment, physiology, and psychological traumas.  The sympathetic nervous system may also become dsyregulated as a result of abnormal or maladaptive stress responses.    

Taken all together, stress may produce changes that result in negative affect and thus aggravate or intensify related disease states and result in comorbid psychopathology.  Emotional responses to such disease like cancer, HIV, and diabetes, may place the affected individual into a state of depression.  The individuals behavioral habits may have changed, they may have a limited role at home or work, have less contact with family and other social supporters, have taken on a “sick role,” have become anxious or depressed about their current disease status and lifestyle changes, lack heath care, or may have to alter dietary and exercise habits. 

One way to intervene and affect positive change is through the administration of cognitive-behavioral therapy.  The goal of such a psychological intervention is to replace negative thoughts and emotions to more positive and realistic ones which may in turn enhance immune, endocrine, and emotional functioning.  Cognitive-behavioral therapy can be a useful tool in addressing stress, anxiety, and depression associated with HIV, cancer, rheumatoid arthritis, obesity, chronic fatigue syndrome, somatization disorders, diabetes, and other disease as well.

One cognitive-behavioral approach would be to use relaxation training.  This training aims at reducing psychological arousal through muscle relaxation.  Stress management may also be a tool in reducing distress and prioritizing personal and professional goals in a positive light.  According to Cruess, Antoni, Hayes, Penedo, Ironson, Fletcher, Lutgendorf, and Schneiderman (2002), the use of cognitive-behavioral stress management intervention for HIV infected men resulted in positive behavioral, cognitive, and social changes resulting in reduced psychological stress.  Cognitive-behavioral therapy was also found to be successful in other diseases as well. 

Afari and Buchwald (2003) point out that successful treatment for chronic fatigue syndrome can focus on comorbid depression, improving coping skills, and reduction in catastrophic thinking, sleep disturbances, reduction in pain symptoms, and increase in physical activity.  The authors further attest that chronic fatigue syndrome can be treated effectively through the use of cognitive-behavioral therapy and graded exposure exercise programs. 

Lustman, Griffith, Freedland, Kissel, and Clouse (1998) studied 51 patients with type 2 diabetes to determine if cognitive-behavioral therapy was effective in treating comorbid depression without pharmacological interventions.  Lustman et al (1998) found that cognitive behavioral therapy and supportive diabetes education is an effective non-pharmacological treatment method for major depressed patients with type 2 diabetes.  The authors also posit that cognitive-behavioral therapy may be associated with improved glycemic control in the patients studied. 

Another disease that may bring about positive change in patient populations is rheumatoid arthritis.  Rheumatoid arthritis is an autoimmune disease that results in chronic joint and tissue inflammation that can result in disfigurement and immobility.  Rheumatoid arthritis can, however, be treated in part with cognitive-behavioral therapy techniques.  Evers, Kraaimaat, van Reil, and de Jong (2002), found during a study of cognitive-behavioral interventions for early rheumatoid arthritis patients that the use of helplessness decreased at post-treatment and follow-up assessment, active coping with stress increased at post-treatment, and compliance with medication increased at follow-up assessment in the cognitive-behavioral therapy condition in comparison to the control condition.  Evers et al (2002) continues to state that tailor-made cognitive-behavioral therapy for patients at risk in relatively early rheumatoid arthritis is an effective treatment method.

Somatoform disorders may also benefit from cognitive-behavioral therapy interventions. Somatoform disorders are characterized by persistent physical symptoms and ailments with no organic cause yet are comorbid with anxiety, mood, and personality disorders.  Kroenke and Swindle (2000) found that cognitive-behavioral therapy techniques can be an effective treatment therapy for somatizaton or symptom syndromes.  They posit that cognitive-behavioral treated study participants faired better as compared to control participants by reducing psychological distress and improving function; group therapy also provided promising results. 

Cognitive-behavioral therapy techniques can assist diseased populations by recognizing negative thoughts and emotions and redirecting or restructuring their thinking to positive, realistic outcomes.  Cognitive-behavioral therapy may be used in conjunction with pharmacological interventions or may be used alone.  Nonetheless, cognitive-behavioral therapy can be an effective intervention resulting in positive change.


Afari, N. and Buchwald, D. (2003). Chronic fatigue syndrome: a review. The American
Journal of Psychiatry (160)
2, 221-236. Retrieved October 16, 2006 from ProQuest.

Cruess, S., Antoni, M., Hayes, A., Penedo, F., Ironson, Fletcher, M., Lutgendorf, S., and Schneiderman, N. (2002). Changes in mood and depressive symptoms and related change processes during cognitive-behavioral stress management in HIV-infected men. Cognitive Therapy and Research (26)3, 373-392. Retrieved October 17, 2006 from ProQuest.

Evers, A., Kraaimaat, F., van Reil, P., and de Jong, A. (2002). Tailored cognitive-
behavioral therapy in early rheumatoid arthritis for patients at risk: a randomized controlled trial. Pain (100)1, 141-153. Retrieved October 17, 2006 from PsychArticles. 

Kroenke, K. and Swindle, R. (2000). Cognitive-behavioral therapy for somatization and symptom syndromes. Psychotherapy and Psychosomatics (69)4, 205-215. Retrieved October 18, 2006 form PsychArticles.

Lustman, P., Griffith, L., Freedland, K., Kissel, S., and Clouse, R. (1998). Cognitive-

behavioral therapy for depression in type 2 diabetes. Annals of Internal Medicine (129)8, 613-621. Retrieved October 17, 2006 from ProQuest.