Dysfunctional Cognitions

Progress can occur even if the medical condition remains part of the person's identity. The article defines dysfunctional cognitions as negative automatic thoughts, maladaptive beliefs, and distorted interpretations related to threat, control, vulnerability, trauma, compulsive fears, or anxiety symptoms. The protocol notes that youth evidence linking dysfunctional cognition reductions with symptom improvement is limited and inconsistent. Identification with a medical label should be evaluated for whether it is the major rate-limiting step to progress. Eligible dysfunctional cognition measures assess negative automatic thoughts, maladaptive beliefs, or distorted interpretations relevant to anxiety, OCD, or PTSD in youth. Dysfunctional cognitions are the putative mechanism through which the protocol will test whether CBT improves youth anxiety, OCD, and PTSD outcomes. Dysfunctional cognition scores will be standardised with z-scores, and multiple validated measures within a study will be averaged into one composite cognition score. The primary aim is to test whether pre-to-post treatment reductions in dysfunctional cognitions predict child-reported and clinician-rated clinical impro…