COGNITIVE  SCIENCE  AND  PSYCHIATRY:

 

 

 

AN  OVERVIEW

 

 

 

 

 

Dan J.  Stein, M.D.

 

 

 

 

 

Dept of Psychiatry

College of Physicians and Surgeons, Columbia University,

and the New York State Psychiatric Institute,

722 W 168 St

NY, NY 10032

 

 

 

 

 

 

Running Title:  Cognitive Science and Psychiatry

 

Tel:  212-960-2355

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

    ABSTRACT

 

 

 

     Cognitive science is a multidisciplinary field, comprising cognitive

 

     psychology, artificial intelligence, linguistics, neuroscience, and

 

     anthropology.  In recent years, cognitive science has become a

 

     predominant paradigm in studies of the mind.  This paper reviews work

 

     at the emerging interface between cognitive science and psychiatry.

 

     It is argued that cognitive science has significant potential as an

 

     integrative framework for theorizing and researching psychiatric

 

     disorders and their treatment.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

     INTRODUCTION

 

 

 

     Cognitive science is a relatively new field that incorporates concepts

 

     and methods from philosophy, cognitive psychology, artificial

 

     intelligence, linguistics, neuroscience and anthropology (Gardner,

 

     1985; Posner, 1989).  Whereas behaviorism dominated the psychological

 

     sciences during the first part of this century, cognitive science has

 

     become a central paradigm of the latter part.  This "cognitive

 

     revolution" was fostered by the promise of cognitive science as an

 

     integrated and fertile approach to the mind.  Indeed, departments of

 

     cognitive science have become important loci of interdisciplinary

 

     research and have generated a prodigous literature.

 

 

 

     During the period of the cognitive revolution, significant changes

 

     also took place in psychiatry (Lipowski, 1989).  During the 1950s,

 

     psychoanalysis comprised a dominant school in many departments of

 

     psychiatry.  In subseqent decades, however, a community-focused model

 

     was widely touted.  Most recently, neurobiological approaches have

 

     been given pride of place.  Certainly, there have been calls for a

 

     synthetic or "biopsychosocial" approach to psychiatric disorders and

 

     treatment.  Nevertheless, there has been little progress on the

 

     construction of an integrative framework for such an approach.

 

 

 

     On the whole, cognitive scientists have paid little attention to

 

     clinical phenomena, while clinicians have in turn only occasionally

 

     employed the concepts and methods of cognitive science.  In recent

 

     years, however, dialogue between the two fields has increased (Breger,

 

     1969; Mahoney and Freedman, 1985; Ingram, 1986; Horowitz, 1988a;

 

     Williams, Fraser, MacLeod, and Mathews, 1988; Magaro, 1991; Stein and

 

     Young, 1992a).  In this paper I review research at this intersection,

                                       

     and discuss its potentials and limitations.  I suggest that cognitive

 

     science can provide an important integrative framework for psychiatry.

 

 

 

     COGNITIVE  SCIENCE

 

 

 

     What exactly is cognitive science?  The following three sections

 

     attempt to address this question.  I briefly discuss descriptions and

 

     definitions of cognitive science, its origins and subdisciplines, and

 

     then contrast and compare cognitive science with behaviorist,

 

     psychoanalytic and neurobiological models (Stein, 1992a).

 

 

 

     a)  Descriptions and Definitions

 

 

 

     In general, cognitive scientists are interested in mental structures

 

     and processes, their representational significance, and their physical

 

     instantiation (Stillings, Feinstein, Garfield, Rissland, Rosenbaum,

 

     Weisler, and Baker-Ward, 1987).  Several authors have attempted more

 

     rigorous definitions of cognitive science.  A cognitive

 

     information-processing account, for example, views the mind as an

 

     information-processing system that selects, transforms, encodes,

 

     stores, retrieves, and generates information and behavior (Lachman,

 

     Lachman, and Butterfield, 1979).  A computational view, on the other

 

     hand, emphasizes that, "Cognitive science, sometimes explicitly, and

 

     sometimes implicitly, tries to elucidate the workings of the mind by

 

     treating them as computations, not necessarily of the sort that is

 

     carried out be the digital computer, but of a sort that lies within

 

     [the] broader theory of computation" (Johnson-Laird, 1988, p. 9).

 

 

 

     Restrictive definitions of cognitive science may, however, include

 

     only one or other of the divergent models that cognitive scientists

                                       

     have developed.  Early cognitive scientists viewed the mind as a

 

     sequential processor, similar to the early digital computer.  The mind

 

     was seen as a passive recipient of information, which was registered

 

     in a short-term memory, and perhaps encoded in a long-term memory.

 

     More recent cognitive scientists have, however, pointed out that the

 

     mind is a parallel processor (Rumelhart, Hinton, and the PDP Research

 

     Group, 1986), and have emphasized that mental structures are active

 

     and that they occur within a particular context (Neisser, 1976;

 

     Lakoff, 1987).  Such work may be excluded by a definition of cognitive

 

     science that focuses solely on information-processing and computation.

 

 

 

     On the hand, too broad a definition of cognitive science may prevent a

 

     constrast between cognitive science models and other models often used

 

     by clinicians.  It may be useful to at least specify the broad

 

     categories into which cognitive science models fall.  Cognitive

 

     science models typically specify cognitive architecture in one of two

 

     ways, symbolic and connectionist.  The elements of symbolic systems

 

     are symbols, which are stored in associative structures.  Symbolic

 

     systems include levels-of-processing models (Craik and Lockhart,

 

     1972), spreading activation constructs (Collins and Loftus, 1975), and

 

     schema approaches (Neisser, 1976).  The elements of connectionist

 

     systems are simplified and schematized neurons which are

 

     interconnected in a network.  Again, a variety of these parallel

 

     processing models have been developed (Rumelhart et al., 1986).  In

 

     subsequent sections the application of both symbolic and connectionist

 

     architectures to clinical theory and practice is reviewed.

 

 

 

     b)  Origins and Subdisciplines

 

 

 

     Further understanding of cognitive science can be gained by discussing

                                       

     its origins.  The development of cognitive science models was

 

     encouraged by various factors, including the failure of behaviorism,

 

     the invention of the computer, and various theoretical advances

 

     (Gardner, 1985).  One of the most important of these theoretical

 

     advances was the development of computer science.  The father of this

 

     field was Turing (1936), a British mathematician who described a

 

     simple machine (the Turing machine) that executed instructions in

 

     binary code, and proposed that such a machine could in principle

 

     perform any computational task.  He also described the idea of a

 

     universal Turing machine which takes a coded version of other Turing

 

     machines as input and then emulates their behavior.

 

 

 

     Computer science can immediately be seen as relevant to psychology,

 

     for the question arises of whether the human mind can be instantiated

 

     on a universal Turing machine.  If so, computer science would

 

     constitute a basic science for exploring the hypothesis (Craik, 1943)

 

     that the mind is a symbol manipulating device.  Turing (1950)

 

     suggested it might be possible to program a machine so that a user

 

     communicating with the machine and with a person would be unable to

 

     differentiate the two (the Turing machine test).

 

 

 

     A number of other developments consolidated the importance of

 

     computational constructs for psychology.  Thus, it was proposed that

 

     certain concepts were useful in explaining both computing machines and

 

     human brains.  This was clearly formulated at a seminal meeting in

 

     1948, the Hixon Symposium on "Cerebral Mechanisms in Behavior"

 

     (Jeffress, 1951) at which McCulloch, a professor of psychiatry, and

 

     Von Neumann were the opening speakers.  For example, the all-or-none

 

     property of neuronal activation can be compared with the determination

 

     of Boolean statements as either true or false.  Furthermore, neuronal

                                       

     networks and Boolean statements can be described in elecrical terms as

 

     current that passed or failed to pass in a circuit.

 

 

 

     In addition, it was argued that certain constructs were useful in

 

     explaining both computing machines and human minds.  Hebb (1949), for

 

     example, suggested that synaptic strengthening in neuronal networks

 

     led to learning.  Wiener (1947) proposed that machines and minds that

 

     had feedback mechanisms that displayed purposefulness.  Central to

 

     control and communication engineering was the notion of the message,

 

     whether this was transmitted by electrical, mechanical, or neural

 

     means.  Information, Shannon (1938) showed, was independent of its

 

     physical instantiation.

 

 

 

     It has been suggested that cognitive science was founded in September

 

     1956, at the Symposium on Information Theory at MIT (Gardner, 1985).

 

     Significant research presented at the conference included papers by

 

     the cognitive psychologist, Miller, artificial intelligence workers,

 

     Newell and Simon, and the linguist, Chomksy.  In his paper, Miller

 

     illustrated the importance of empirical studies of cognition by

 

     discussing work on the constraints of short-term memory processes.

 

     Work by other psychologists in the 1950s, including Broadbent and

 

     Cherry in Britain, and Bruner and colleagues at Harvard, gave further

 

     impetus to the development of cognitive psychology, and established

 

     the discipline and its empirical methodologies as a cornerstone of

 

     cognitive science.  Newell and Simon argued that artifial intelligence

 

     was possible, and drew comparisons between artificial and human

 

     problem solving processes.  Together with Minsky and McCarthy they

 

     pioneered the field of artificial intelligence, and helped establish

 

     the importance of a computational methodology for cognitive science.

 

     Finally, Chomsky described his theory of a grammar based on linguistic

                                       

     transformations.  This work, together with his scathing review

 

     (Chomsky, 1959) of Skinner's work on verbal behavior buttressed the

 

     shift from behaviorism to cognitivism, and established linguistics as

 

     a useful frame from which the issues of cognitive science could be

 

     considered.

 

 

 

     Other core disciplines of cognitive science include neuroscience,

 

     anthropology, and philosophy.  Neuroscience comprises a lower limit

 

     for cognitive science, for human cognitive structures and processes

 

     are ultimately based in and constrained by neuroanatomy and

 

     neurochemistry.  Anthropology and social psychology constitute an

 

     upper limit for cognitive science, for cognitive structures and

 

     processes vary from place to place and time to time.  Finally, many of

 

     the questions studied by cognitive scientists were first raised by

 

     philosophers.  Philosophers have also addressed the foundational

 

     principles of the discipline, and more recently, as cognitive science

 

     has advanced, have been faced with the meta-cognitive question of what

 

     the mind and the world are like for this scientific advance to have

 

     taken place.

 

 

 

     Developmental psychology is not usually listed as a central discipline

 

     of cognitive science.  Nevertheless, one of the most important

 

     pre-cognitivists was the developmental psychologist Piaget.  Piaget

 

     detailed the transformation of mental structures from sensorimotor

 

     reflexes to the operations of formal thought (Piaget, 1952).

 

     Contemporary dialogue between developmental psychology and cognitive

 

     science is increasing (Sternberg, 1984; Meltzoff, 1990; Globerson and

 

     Zelniker, 1989).

 

 

 

 

                                       

     c)  Contrasts and Comparisons

 

 

 

     Cognitive science models can be contrasted and compared with the

 

     clinically familiar models of behaviorism, psychoanalysis, and

 

     neurobiology.  Behaviorism, for example, self-consciously makes the

 

     mind into a "black box", asserting that only observable stimuli and

 

     responses can be studied.  In contrast, the cognitive model holds that

 

     what is most interesting are the mental structures in the "black box"

 

     and the processes (operations) whereby they generate cognitive

 

     products (thoughts and feelings).

 

 

 

     Nevertheless, it is possible to see a continuity between behaviorist

 

     and cognitive science models.  While the behaviorist model is limited

 

     to inputs (stimuli) and outputs (responses), the cognitivist model is

 

     concerned with inputs, processing, and outputs.  Like behaviorists,

 

     cognitivists have adopted an empirical stance, which emphasizes the

 

     importance of careful measurement and laboratory experimentation.

 

 

 

     The classical psychoanalytic model of the mind was an energy-based

 

     one.  For Freud (1894), "in mental functions something is to be

 

     distinguished - a quota of affect or sum of excitation - which

 

     possesses all the characteristics of a quantity (though we have no

 

     means of measuring it), which is capable of increase, dimunition,

 

     displacement and discharge, and which is spread over the memory-traces

 

     of ideas somewhat as an electric charge is spread over the surface of

 

     a body".  Freud described how the forces of the unconscious are

 

     expressed, transformed, or repressed, resulting in everyday behaviors

 

     and psychopathology.

 

 

 

     Again, however, it is possible to demonstrate a continuity between

                                       

     psychoanalysis and cognitive science.  Cognitive science and

 

     psychoanalysis both focus on the structures of the mind, and the way

 

     in which these determine mental phenomena.  Furthermore, in Freud's

 

     later work he describes affect not in terms of energy, but in terms of

 

     its role as a signal.  Finally, post-Freudian psychoanalysts,

 

     including the self psychologists, the objects relations school, and

 

     the interpersonalists, have increasingly employed cognitively oriented

 

     constructs such as self and other representations (Stein, 1992b).

 

 

 

     Neurobiological models attempt to explain the biological basis of

 

     mental processes and products.  Proponents of these models may state

 

     that all psychological explanations are reducible to neurobiological

 

     ones.  This view contrasts with the cognitive science argument that

 

     cognitive phenomena necessarily require psychological explanations.

 

     Psychological events are emergent phenomena, and psychological

 

     explanations are not reducible to biological ones.

 

 

 

     Once again, however, it is possible to see a continuity between the

 

     biological model and cognitive science.  Earlier neuroscience was

 

     described as comprising a lower limit of cognitive science.  While

 

     some cognitivists are interested in information-processing in only the

 

     most abstract sense, many others are interested specifically in how

 

     information-processing occurs in the human neurobiological substrate.

 

     This interest is particularly apparent in connectionist work informed

 

     by neuroscience (Rumelhart et al, 1986).

 

 

 

     CLINICAL COGNITIVE SCIENCE

 

 

 

     For the clinician, the question immediately arises of whether

 

     cognitive science models are useful in accounting for clinical

                                       

     phenomena.  However, standard texts of cognitive science make little

 

     reference to psychiatric disorders and treatment.  Nevertheless, a

 

     number of developments in cognitive science have been instrumental in

 

     allowing a bridge to clinical phenomena.  This section briefly reviews

 

     some of these bridges from cognitive science to the clinic, including

 

     research on emotional and unconscious processing, and relevant work in

 

     each of the subdisciplines of cognitive science.

 

 

 

     Cognitive science has been characterized by a disregard for emotion

 

     (Gardner, 1985).  Nevertheless, humans are not only the most

 

     intelligent of the animals, they are perhaps also the most emotional

 

     (Hebb, 1946).  Furthermore, it may be suggested that this relationship

 

     between intelligence and emotionality is a necessary one.  In a

 

     seminal paper, Simon (1967) argued that emotion in humans is

 

     comparable to the prioritized interruption of different processes by

 

     one another in complex artificial intelligence systems with multiple

 

     goals and limited resources.  The idea that cognitive design problems

 

     are solved by emotional processes remains popular in contemporary

 

     cognitive science attempts to theorize emotion (Oatley and

 

     Johnson-Laird, 1987; Sloman, 1987), and has helped generate a

 

     rapidly growing empirical literature on cognitive-affective

 

     processing.  Cognitivist work on emotion has subsequently been

 

     employed in order to understand affective experience and change in the

 

     clinic (Mandler, 1975; Greenberg and Safran, 1990).

 

 

 

     Another important area within cognitive science that has clinical

 

     relevance is the study of unconscious processing.  Research on the

 

     unconscious is not new, and includes the pioneering work of Helmholtz,

 

     Janet, and Freud (Ellenberger, 1970).  However, it was not until the

 

     emergence of cognitive science that the "cognitive unconscious"

                                       

     (Kihlstrom, 1987) became a respectable area of study.  Research has

 

     focused on such areas as selective attention, subliminal perception,

 

     implicit memory, hypnotic suggestion, and dreaming (Erdelyi, 1985;

 

     Foulkes, 1985; Kihlstrom, 1987).  While this work immediately brings

 

     psychoanalysis to mind, there appear to be important differences

 

     between the cognitive unconscious and the psychoanalytic unconscious

 

     (Bowers and Meichenbaum, 1984).  According to Freud, the unconscious

 

     is a set of drives, affects, and motives that has an organization and

 

     content more primitive than those of the consciousness, but that

 

     nevertheless has latent the potential for interacting with other

 

     elements of the psyche.  According to cognitive science, the

 

     unconscious is a set of cognitive processes, including attitudes and

 

     predispositions, that act prior to consciousness, so actively

 

     organizing and ordering experience and behavior.  Nevertheless,

 

     contemporary work on unconscious processing establishes a dialogue

 

     between cognitive and clinical scientists (Bowers and Meichenbaum,

 

     1984; Eagle, 1986; Horowitz, 1988b; Safran and Greenberg, 1986; Uleman

 

     and Bargh, 1989; Singer, 1990; Prigatano and Schachter, 1991; Cloitre,

 

     1992; Stein, 1992b).

 

 

 

     A number of early cognitivists have been interested specifically in

 

     psychiatric disorders.  Ruesch and Bateson (1968) were among the first

 

     to apply cybernetic concepts to psychopathology and psychotherapy.

 

     Within cognitive psychology, Hilgard (1977), whose work will be

 

     discussed later, employed Janet's notion of dissociation and developed

 

     a neodissociative model of the dissociative disorders.  This work

 

     exemplified the potential utility of employing cognitive psychology

 

     constructs to conceptualize psychiatric disorders.

 

 

 

     In artificial intelligence, Colby (1981) pioneered the investigation

                                       

     of clinical phenomena.  He developed a program, PARRY, which

 

     incorporated a model of the paranoid process, and succeeded in

 

     simulating a paranoid patient.  The difficulty of such work, and

 

     Colby's achievement, is illustrated by the limited amount of

 

     subsequent research in this area (Tomkins and Messick, 1963;

 

     Clippinger, 1977).  More recently, however, a number of authors have

 

     employed computer implemented neural networks to model psychopathology

 

     and psychotherapy (Hoffman, 1987; Hestenes, 1991; Cohen and

 

     Servan-Schreiber, 1992l; Williams and Oaksford, 1992; Caspar,

 

     Rothenfluh, and Segal, unpublished manuscript).

 

 

 

     Linguists, neuroscientists, anthropologists and social psychologists

 

     have long been interested in clinical phenomena, and some of this work

 

     has fallen within the realm of clinical cognitive science.

 

     Cognitivist models of the aphasias have their origins in the work of

 

     the "diagram-makers", who constructed modular models of the mind at

 

     the turn of the century (Morton, 1984).  Current cognitive studies of

 

     language may contribute to various clinical areas, such as treatment

 

     of dyslexia (Swerling and Sternberg, 1992), or understanding clinical

 

     dialogue and the mechanisms of the "talking cure" (Oatley, 1992).

 

     Contemporary cognitive neuropsychologists continue to hold that study

 

     of neurologically impaired patients contributes to cognitive theories

 

     of mind (Caramazza, 1992).  Clinical anthropology has tended not to

 

     adopt cognitivist models (Stein, 1992c), but cognitively oriented work

 

     in social psychology has been particularly relevant to clinical

 

     science, and has tackled such important concerns as self and other

 

     representations, and their role in mood disorders (Markus, 1977;

 

     Cantor and Kihlstrom, 1981; Sorrentino and Higgins, 1986; Westen,

 

     1988).  Finally, it may be argued that philosophy, too, constitutes an

 

     important foundational discipline for clinical cognitive research

                                       

     (Mahoney, 1991; Lyddon, 1988; Stein, 1992d).

 

 

 

     Developmental psychologists have long been interested in developmental

 

     arrests and abnormalities.  Since Piaget, cognitive concepts have

 

     increasingly been used in this area.  Developmental research that

 

     draws on cognitive science constructs and focuses on clinical

 

     implications has been particularly influential (Greenspan, 1980;

 

     Stern, 1985; Emde, 1983).

 

 

 

     PSYCHIATRIC  DISORDERS

 

 

 

     The work of cognitive scientists interested in clinical phenomena

 

     provides the basis for employing cognitive constructs to conceptualize

 

     psychiatric disorders, assessment, and treatment.  I will discuss each

 

     of these areas in turn.  While a variety of psychiatric disorders have

 

     been studied from a cognitive science perspective, I will focus on

 

     only a few in order to highlight some important methods and issues in

 

     clinical cognitive science.

 

 

 

     a) Major Depression

 

 

 

     Since their introduction by Ellis, Beck and others, cognitive

 

     therapies have become increasingly accepted as an effective treatment

 

     of depression (Mahoney and Freeman, 1985).  While these therapies are

 

     not necessarily formal extensions of cognitive science, much of this

 

     work has been influenced by the cognitive revolution.  The growing

 

     dialogue between cognitive science and cognitive models of depression

 

     (Ingram and Reed, 1986; Ingram and Wisnicki, 1991) provides the most

 

     comprehensive exemplar of the use of symbolic architectures from

 

     cognitive science to understand psychopathology.

                                       

     Symbolic architectures specify the mind in terms of cognitive

 

     structures, operations, and processes.  Cognitive structures that have

 

     been hypothesized to be central in depression include associative

 

     networks (Ingram, 1984; Teasdale, 1983) and self-schemas (Beck, 1967;

 

     Kuiper, Derry, and MacDonald, 1982).  Associative network theories

 

     characterize depression as having increased availability and/or

 

     accessiblity of negative constructs about the self.  Self-schema

 

     theory characterizes depression as activation of a self-structure that

 

     is negative in content.  While evidence for negative self-schemas in

 

     depression is good, there is less evidence that such schemas are

 

     present in the absence of current depression (Ingram and Reed, 1986;

 

     Ingram and Wisnicki, 1991).

 

 

 

     Research also suggests that cognitive processes in depression are

 

     characterized by a negative selectivity bias (Ingram and Reed, 1986;

 

     Ingram and Wisnicki, 1991).  Studies of encoding may be divided into

 

     studies of personal semantic information (i.e.  information related to

 

     concepts of self) and episodic information (i.e.  information related

 

     to autobiographical events).  Studies of semantic encoding indicate

 

     that enhanced negative encoding is a key factor in information

 

     processing in depression, while studies of episodic encoding indicate

 

     that less accurate encoding of positive information is critical.

 

     Studies of retrieval, on the other hand, suggest that negative

 

     information is more efficiently and positive information is less

 

     efficiently retrieved in depression.  In addition, depressed patients

 

     selectively monitor negative information with a decrease in attention

 

     to positive stimuli.

 

 

 

     Finally, cognitive products in depression include attributions and

 

     automatic thoughts (Ingram and Reed, 1986; Ingram and Wisnicki, 1991).

                                       

     Depressed patients are more likely to make dysfunctional attributions

 

     as to the cause of events.  Negative automatic thoughts appear to be

 

     characteristic of subclinical and clinical depression, and they remit

 

     with treatment.

 

 

 

     Cognitive science models of depression influence our conceptualization

 

     of psychotherapy, and direct further empirical research.  The finding,

 

     for example, that depressed schemas are not present in the absence of

 

     depression suggests that cognitive therapy works not by structural

 

     changes in underlying schemas, but by changes in the activation level

 

     of negative self-schemas.  While cognitive structures such as schemas

 

     are difficult to measure, methodological progress has been made

 

     (Segal, 1988).  Considerable theoretical and empirical research on

 

     cognitive science models of depression nevertheless remains to be

 

     done.  In particular, cognitive science models of depression have,

 

     with few exceptions (Klein, 1976), failed to incorporate

 

     neurobiological knowledge.

 

 

 

     b) Dissociative and Conversion Disorders

 

 

 

     Symbolic architectures, including schema theory, have not only been

 

     adopted by the cognitive therapy tradition, but have also been

 

     employed in psychoanalytically informed research (Wachtel, 1982; Slap

 

     and Saykin, 1983; Segal, 1988; Horowitz, 1988a; Horowitz, 1991).  The

 

     area in which there is perhaps most clearly an intersection between

 

     the constructs of symbolic architecture and psychodynamic theory is

 

     the study of dissociative and conversion disorders.

 

 

 

     The first detailed psychological theory of dissociative and conversion

 

     disorders was developed by Janet (1907).  Like Freud, Janet studied at

                                       

     Charcot's clinic at the Salpetriere.  He too was interested in the

 

     notion of cognitive processes that took place outside of awareness,

 

     for which he coined the term "subconscious".  Janet described the mind

 

     in terms of "automatisms", or elementary structures controlling

 

     experience, thought, and action in various domains, and which together

 

     make up the flow of consciousness.  At times of stress or exhaustion,

 

     one or more automatisms separate from the rest, breaking the unity of

 

     consciousness.  The dissociated automatisms continue to operate, but

 

     are no longer accessible to phenomenal awareness or amenable to

 

     voluntary control, resulting in various dissociative or conversion

 

     symptoms.

 

 

 

     Hilgard (1977) used concepts from cognitive psychology to provide a

 

     neodissociative account of these disorders.  He described the mind in

 

     terms of subordinate cognitive structures each with a degree of

 

     autonomy, a hiererarchical control managing the competition between

 

     these structures, and a central monitoring and controlling structure

 

     (the executive ego).  Subordinate cognitive structures can operate

 

     outside of awareness, or they may be processed consciously through the

 

     executive ego.  Certain physiological (e.g.  anesthesia) or

 

     psychological (e.g.  hypnosis) conditions lead to disruptions in the

 

     connections between the subordinate structures.  Information

 

     processing in the subordinate structures may then take place outside

 

     of phenomenal awareness or voluntary control.  More recently,

 

     Kihlstrom (1990) has used an associative-network model of memory to

 

     further elaborate this view of the dissociative and conversion

 

     disorders.  He describes how disruption of links between

 

     representations of memory or of sensory input and representations of

 

     self may result in lack of awareness of particular memories or

 

     sensations, with continued processing of related representations.

                                       

     While psychoanalytic theory has also emphasized the importance of

 

     unconscious processes in the genesis of these disorders,

 

     neodissociative theory has a view of the unconscious that is

 

     closer to that of cognitive science.  Although there may be

 

     theoretical difficulties with the psychoanalytic energy based view,

 

     the success of the cognitivist revival of Janet's ideas ultimately

 

     depends on its ability to generate empirical work on these relatively

 

     unresearched disorders.

 

 

 

     c) Obsessive-Compulsive Disorder

 

 

 

     Earlier the question of the relationship between cognitive science and

 

     neurobiological models was raised.  This becomes particular relevant

 

     for the clinical cognitive science of disorders about which

 

     neurobiological knowledge is advancing.  Current research on OCD, for

 

     example, has demonstrated involvement of the serotonergic system and

 

     orbitofrontal-basal ganglia-thalamic pathways, and the disorder is

 

     increasingly seen as having a neurobiological basis (Stein and

 

     Hollander, 1992).

 

 

 

     Cognitive science constructs may, however, be helpful in thinking

 

     through the relationship between neurobiological findings and the

 

     psychology of OCD.  Several authors have, for example, suggested that

 

     neuroanatomical structures involved in OCD play a role in

 

     goal-feedback mechanisms (Gray, 1982; Rapoport and Wise, 1988).

 

     Disruption of cybernetic control in OCD results in psychological

 

     features such as repetitive symptoms and strategies of seeking control

 

     (Pitman, 1987).

 

 

 

     Work on neuropsychiatric impairment and serotonergic dysfunction in

                                       

     OCD has led Stein and Hollander (1992) to propose that OCD may involve

 

     a biologically based impairment in determining or in evaluating

 

     goal-feedback responses.  Some patients, perhaps those with high

 

     neurological soft signs, visuospatial difficulties and rapid erroneous

 

     responses on neuropsychological testing, may have difficulty in

 

     determining goal-feedback responses.  Other patients, perhaps those

 

     with serotonergic dysfunction and slow correct responses on

 

     neuropyschological testing, may overevaluate harm associated with

 

     goal discrepancy.

 

 

 

     This model suggests that both biological approaches (normalizing

 

     serotonergic function) and psychological approaches (changing harm

 

     assessment) may be helpful in the treatment of OCD.  On the other

 

     hand, in patients where goal-feedback response impairment is

 

     associated with evidence of structural brain damage, treatment may be

 

     less successful.  The model provides a heuristic for further research

 

     correlating biological, cognitive, and clinical variables in OCD.

 

 

 

     d) Psychotic Disorders

 

 

 

     Sincle the time of Kraepelin and Jung, psychiatrists have used

 

     techniques from experimental psychology to explore

 

     information-processing deficits in psychotic disorders.  More

 

     recently, cognitive science methods have been used to study these

 

     disorders.  There is now a large literature on information-processing

 

     in schizophrenia (Magaro, 1980; Neuchterlein and Dawson, 1984;

 

     Saccuzzo, 1986), and some work on mania (Grossman and Harrow, 1991).

 

     In their review, Neuchterlein and Dawson (1984) highlight two types of

 

     information-processing deficits in schizophrenia - poorer detection of

 

     single, highly familiar stimuli during vigilance, and increases in the

                                       

     time required to recognize an uncomplicated stimulus.

 

     Information-processing tasks may constitute indicators of

 

     vulnerability, may have prognostic value, and may be useful measures

 

     of medication response.  Information-processing deficits in

 

     schizophrenia may also be conceptualized in schema terms (Magaro,

 

     1980).  Finally, a number of theorists have attempted to integrate

 

     information-processing and neurobiological findings (Neuchterlein and

 

     Dawson, 1984).

 

 

 

     Of considerable current interest, however, is work that employs

 

     connectionist architectures from cognitive science to study psychotic

 

     disorders.  This work is of particular interest insofar as

 

     connectionist models succeed in incorporating neurobiological

 

     knowledge.  In an early paper Hoffman noted that different

 

     perturbations of a particular kind of network (the Hopfield network)

 

     led to different forms of neural dysfunction (Hoffman, 1987).  Memory

 

     overload led to disturbances similar to those seen in schizophrenia,

 

     while increased randomness led to disturbances similar to those seen

 

     in mania.  Neural dysfunction in perturbed Hopfield networks is,

 

     however, only loosely similar to that seen in psychosis, and the

 

     neurobiological viability of these perturbations is arguable.

 

 

 

     A more recent connectionist model is that of Cohen and

 

     Servan-Schreiber (1992).  Their neural network simulates performance

 

     of schizophrenic patients on tasks related to the processing of

 

     context.  Furthermore, their network incorporates the neurobiological

 

     finding that dopamine has a modulatory effect on prefrontal cortex by

 

     influencing the responsivity, or gain, of cells in this region.  Thus,

 

     their model simultaneously posits that schizophrenia is characterized

 

     by a particular information-processing deficit with a specific

                                       

     neurobiological underpinnning, and provides a novel and robust 17

 

     methodology to explore this deficit.

 

 

 

     e) Other Disorders

 

 

 

     There are several other disorders which can be understood in terms of

 

     cognitive science constructs.  Space considerations preclude a

 

     discussion of anxiety disorders (Rapee, 1991; Eysenck, 1991), autism

 

     (Litrownik and McInnis, 1986), impulsive (Barratt, 1987) and

 

     antisocial (Gorenstein, 1991) behavior, learning disability (Swerling

 

     and Sternberg, 1992), memory disorders (Shimamura, 1989), personality

 

     disorders (Stein and Young, 1992b), and substance abuse (Hull and

 

     Reilly, 1986).

 

 

 

     CLINICAL  ASSESSMENT

 

 

 

     Conceptualizing various psychiatric disorders in terms of cognitivist

 

     constructs immediately raises the question of employing cognitive

 

     science in clinical assessment.  Cognitive science has assessment

 

     constructs that differ from those of more traditional frameworks

 

     (106).  In general, cognitivists attempt to use empirical methods to

 

     assess the particular psychological structures and processes

 

     responsible for generating mental events.  Many of these methods may

 

     be useful in clinical assessment, for example, of neuropsychological

 

     impairment (Delis, Kramer, Fridlund, Kaplan, 1990), or of maladaptive

 

     schemas of self and other (Young, 1990; Horowitz, 1991).

 

 

 

     The variety and range of paradigms and techniques developed by

 

     cognitive scientists holds promise for their application to clinical

 

     measurement (Merluzzi, Rudy, and Glass, 1981).  It may however be

                                       

     necessary to modify cognitive science laboratory methods before

 

     employing them in the clinic.  For example, early

 

     information-processing studies in patients with depression did not to

 

     use stimuli with negative and depressive content, and therefore failed

 

     to elucidate relevant cognitive structures and processes (Ingram and

 

     Reed, 1986).

 

 

 

     On the other hand, the clinical setting may allow for more precise

 

     assessment than is available to most cognitive scientists.  For

 

     example, measurement of schemas in personality disorder by self-report

 

     questionnaires is problematic, as patients may not be aware of or may

 

     avoid their schemas.  However, during psychotherapy schemas are

 

     explored in various ways and links are drawn between the patient's

 

     behaviors and these schemas (Young, 1990).  In this way psychotherapy

 

     techniques allow assessment to move beyond laboratory based cognitive

 

     science methods.

 

 

 

     TREATMENT  INTEGRATION

 

 

 

     How can a cognitive science approach to psychiatric disorders and

 

     their assessment contribute to psychiatric treatment?  Clearly, the

 

     reformulation of any particular disorder in cognitivist terms will

 

     lead to conceptualization of the treatment of that disorder in the

 

     same terms.  Thus, the paper has already alluded to the treatment of

 

     negative self-schemas in depression, and the treatment of maladaptive

 

     person schemas in personality disorder.  Perhaps more important,

 

     however, is the idea that cognitive science contributes to the theory

 

     of treatment integration.  In recent years there have been frequent

 

     calls for psychotherapy integration and for the integration of

 

     psychotherapy and pharmacotherapy, but there has been little work on

                                       

     the development of theoretical frameworks that allow such an

 

     integration to take place.

 

 

 

     It is notable, however, that within contrasting schools of therapy,

 

     there have been shifts to an increasingly cognitive orientation.  The

 

     cognitive-behavioral treatment tradition has moved from behaviorist

 

     models to linear cognitive models to more complex cognitive models

 

     (Dobson, 1988).  Psychoanalysis has moved away from energy based

 

     models to more cognitivist ones, and several psychoanalysts, beginning

 

     with Blum (1961) and Peterfreund (1971), have pointed to the value of

 

     cognitive science for psychoanalytic meta-theory (Clippinger, 1977;

 

     Erdelyi, 1985; Westen, 1988; Horowitza, 1988; Stein, 1992b).  Finally,

 

     neurobiological findings are increasingly being incorporated into

 

     clinical cognitive science models.

 

 

 

     Schema theory, for example, has allowed both cognitive-behaviorists

 

     (Beck, 1967; Young, 1990; Beck, Freeman and Associates, 1991) and

 

     psychoanalysts (Horowitz, 1988a, 1991; Klein, 1976; Wachtel, 1982;

 

     Slap and Saykin, 1983) to focus on mental structures, their biological

 

     basis, their development and change, and on the way in which they

 

     direct psychological events (Stein, 1992e).  Similarly, neural network

 

     models may allow an integrative conceptual approach to these issues

 

     (Caspar, Rothenfluh, and Segal, unpublished manuscript; Forrest,

 

     1991).  Insofar as cognitive science has conceptual continuities with

 

     other approaches, but does not have their weakness (e.g., emphasizes

 

     empirical methods but avoids reduction of mind to stimulus-response

 

     chains, focuses on mental structures but avoids an energy based

 

     meta-psychology), it may have theoretical advantages.  Furthermore,

 

     conceptual reformulation may also foster technical integration.

 

     During psychotherapy, for example, schema change can then be

                                       

     undertaken by means of affective, cognitive, behavioral, and

 

     interpersonal interventions (Young, 1990).

 

 

 

     DISCUSSION

 

 

 

     A number of advantages of clinical cognitive science are immediately

 

     apparent.  First, it offers integrative theoretical models of clinical

 

     disorders, assessment, and treatment.  Whereas so much contemporary

 

     clinical science may be criticized for being either mindless or

 

     brainless (Lipowski, 1989), clinical cognitive science offers a

 

     multifaceted approach that incorporates and extends earlier paradigms.

 

     In addition, it employs a number of methodologies which encourage

 

     empirical research.  Clinical cognitivists have researched clinical

 

     phenomena outside the office, and have introduced new scales and

 

     measures into the clinic.  Conversely, the study of clinical phenomena

 

     may enrich cognitive science (Stein, 1992a).  Nevertheless, a number

 

     of criticisms of clinical cognitive science may also be offered.  The

 

     foundations of cognitive science have been extensively debated in its

 

     subdiscipline of philosophy; here I will focus on more clinically

 

     oriented issues.

 

 

 

     A first objection states that clinical cognitive science is overly

 

     general or that it is "old wine in a new bottle".  The psychoanalytic

 

     clinician may feel that he or she uses cognitive science concepts and

 

     methods, but simply employs an older terminology.  Clinicians with a

 

     cognitive-behavioral orientation may feel that clinical work is

 

     primarily a pragmatic exercise and that it is unnecessary to introduce

 

     extraneous theoretical baggage.  Thus cognitive science may be seen as

 

     only reframing cinical theory, rather than advancing it.  I would

 

     argue, however, that more accurate reframing constitutes an essential

                                       

     part of scientific progress.  Psychoanalysts who reject energy based

 

     models, for example, are faced with the choice of discarding

 

     metapsychology or of viewing psychoanalysis as a hermeneutic rather

 

     than scientific enterprise.  In providing a possible theoretical

 

     conceptualization of psychodynamic work, cognitive science immediately

 

     goes beyond mere translation of older terminology (Stein, 1992b).

 

     Similarly, while cognitive therapists and cognitive scientists could

 

     conceivably work independently of one another, reframing clinical

 

     phenomena in terms of cognitive science may have immediate advantages.

 

     Successful reframing leads to more comprehensive and powerful models,

 

     and encourages novel methods of treatment and research (Stein, 1992e).

 

 

 

     A converse objection is that cognitivist and computational models are

 

     overly restricted or insufficiently complex.  The word "cognitivist"

 

     itself points to a lack of focus on emotion.  Computational machines

 

     operate along automatic and rigid lines, whereas humans have

 

     context-dependent and fallible minds.  Clinicians with a strong

 

     neurobiological or sociocultural orientation may doubt the ability of

 

     cognitivist models to include biological or sociocultural findings.

 

     Clinicians with an experiential or phenomenological orientation are

 

     particularly likely to question the value of a computational model in

 

     understanding human perceptions, feelings, and experiences.

 

 

 

     I would suggest that this criticism is partially correct and partially

 

     incorrect.  The criticism is wrong insofar as it suggests that the

 

     object of cognitive science models is to replicate human minds.  It is

 

     a truism that there are differences between computers and humans, but

 

     it does not follow that computational models cannot help us understand

 

     human minds.  This distinction can be illustrated by the debate

 

     between Colby (1977), the author of PARRY, and Weizenbaum (1976), who

                                       

     developed a program called ELIZA, that simulated a psychotherapy

 

     session.  Colby is a strong supporter of clinical cognitive science.

 

     However, when Weizenbaum noted that people took his program as an

 

     indication that psychotherapists could be replaced by computers, he

 

     emphasized the limitations of cognitive science, noting that computers

 

     should not be allowed to take over certain human tasks.  However, the

 

     issue is not whether computers can or should replace minds, but rather

 

     whether cognitive science models can and ought to be used to

 

     conceptualize and investigate minds.  It is noteworthy that whereas

 

     PARRY was based on a specific model of paranoid processes (and

 

     therefore directly contributed to the science of psychopathology),

 

     ELIZA was not a model of psychotherapy per se (and did not make a

 

     direct contribution to the science of psychotherapy), but rather a

 

     study of the rules of dialogue.

 

 

 

     What is right about this criticism is that it points to the complexity

 

     of human minds.  Furthermore, early cognitivist models conceived of

 

     the mind as a linear information-processor and may have contributed to

 

     the development of overly simplistic clinical cognitive models.

 

     However, current cognitive science models and clinical cognitive

 

     models have become increasingly sophisticated.  Gardner (1) has

 

     described these developments in terms of the "computational paradox";

 

     namely, that it took the early formal cognitivist models to describe

 

     and elaborate the differences between the serial digital computer and

 

     the human mind.  These advances are increasingly apparent in clinical

 

     cognitive science as well.  Thus clinical cognitive science is

 

     beginning to address both the neurobiological and the sociocultural

 

     limits of cognitive processing.  Furthermore, it may be argued that

 

     clinical cognitive science models have begun to succeed in

 

     incorporating both positivist concerns with empirical measurement and

                                       

     hermeneutic concerns with meaning and context (72).  The complexity of

 

     human minds therefore constitutes a challenge rather than an a priori

 

     objection to clinical cognitive science.

 

 

 

     An important criticism of clinical cognitive science that employs

 

     symbolic architectures involves questions of theoretical precision.

 

     Cognitive science models of mental structures and processes vary in

 

     important ways, and their adoption by clinicians has led to further

 

     diversification.  For example, whereas Horowitz's (1988a) division of

 

     schemas into motivational, role, and value schemas is consistent with

 

     Freud's division of the psyche into id, ego, and superego; Beck and

 

     colleagues' (1991) division of schemas into cognitive, affective, and

 

     action schemas is consistent with their view of the linear progression

 

     of thoughts, feelings, and behaviors.  Furthermore, a variety of

 

     related concepts such as scripts, self-systems, personal constructs,

 

     plans, and frames are popular in the cognitive and clinical

 

     literature.  This diversity may in part reflect the theoretical

 

     fertility of cognitive science, and may be helpful in providing a

 

     range of ideas and models.  Nevertheless, the diversity also reflects

 

     a lack of agreement about the taxonomy of representation, and a lack

 

     of detailed knowledge about the complexities of human cognitive

 

     architecture.  Clearly, further work is necessary to clarify and

 

     consolidate the theoretical apparatus of clinical cognitive science.

 

 

 

     Theoretical diversity contributes to the difficulties that researchers

 

     have experienced in measuring constructs such as schemas.  Problems in

 

     measurement are to some extent expectable with research on posited

 

     entities which underly observable behavior.  Nevertheless, there are

 

     important unresolved complexities in determining how best to approach

 

     the processing of information that differs in target, favorability,

                                       

     content, congruence, and personal relevance (Ingram and Wisnicki,

 

     1991).  Detailed clinical observation and advances in assessment

 

     techniques will be necessary to resolve these methodological

 

     difficulties (Horowitz, 1991).

 

 

 

     Clinical cognitive science that employs connectionist architectures

 

     has emerged only recently.  This field has the potential advantages of

 

     methodological precision and of close links with neuroscience.

 

     However, current paradigms sometimes appear removed from clinical

 

     experience and the dialogue between connectionism and neurobiology

 

     remains rudimentary.  Further work is necessary to narrow the gap

 

     between behavior of neural nets and clinical phenomenology, and to

 

     integrate mechanisms of neural net perturbation with knowledge of

 

     pathogenic mechanisms in biological psychiatry.

 

 

 

     CONCLUSION

 

 

 

     The interdisciplinary nature and rapid development of cognitive

 

     science is of immediate interest to psychiatry.  In this paper, I have

 

     reviewed areas in which cognitive science and clinical science have

 

     established a dialogue.  Clinical cognitive science appears to provide

 

     an integrative and sophisticated framework for conceptualizing and

 

     researching psychiatric disorders and their treatment.  Further

 

     theoretical and empirical work needs to be done to consolidate this

 

     early work.  Nevertheless, there has been sufficient progress to

 

     suggest the promotion of cognitive science as an important theoretical

 

     framework for psychiatry, and to encourage further exploration of this

 

     intersection.

 

 

 

 

                                       

     REFERENCES

 

 

 

     Barratt, E.S.  (1987).  Impulsiveness and anxiety:  Information

 

        processing and electroencephalograph topography.  Journal of

                                                        

        Research in Personality, 21:453-463.

       

 

 

     Beck, A.T.  (1967).  Depression:  Clinical, Experimental, and

                        

        Theoretical Aspects.  New York:  Harper and Row.

      

  Beck, A.T., & Freeman, A., and Associates (1991).  Cognitive Therapy

                                                     

      

         of Personality Disorders.  New York:  Guilford.

       

 

 Blum, G.S.  (1961).  A Model of the Mind.  New York:  Wiley.

                         

 

 

 Bowers, K.S., & Meichenbaum, D. (eds) (1984).  The Unconscious

                                                  

        Reconsidered.  New York:  Wiley.

       

   

 Breger, L. (ed) (1969).  Clinical-cognitive Psychology:  Models and

                            

        Integrations.  Englewood Cliffs, NJ:  Prentice-Hall.

       

 

 

     Cantor, N., Kihlstrom, J. (eds) (1981).  Personality, cognition, and

                                            

        social interaction.  Hillsdale, NJ:  Erlbaum.

      

 

 

     Caramazza, A. (1992).  Is cognitive neuropsychology possible?  Journal

                                                                  

        of Cognitive Neuroscience, 4:80-94.

       

 

 

     Caspar, F., Rothenfluh, T., & Segal, Z. (unpublished).  The appeal of

 

        connectionism for clinical psychology.

 

 

 

     Chomsky, N. (1959).  A review of B.F.  Skinner's Verbal Behavior.

 

        Language, 35:26-58.

     

 

 

     Clippinger, J. (1977).  Meaning and Discourse:  A Computer Model of

                           

        Psychoanalytic Speech and Cognition.  Baltimore:  Johns Hopkins

       

        University Press.

 

 

 

     Cloitre, M. (1992).  The avoidance of emotional processing:  A

 

        cognitive science perspective, in Stein, D.J., & Young,

 

        J.E.  (eds), Cognitive Science and Clinical Disorders.  San Diego:

                    

        Academic Press.

 

 

 

     Cohen, J.D., & Servan-Schreiber, D. (1992), Context, cortex, and

 

        dopamine:  A connectionist approach to behavior and biology in

 

        schizophrenia.  Psychol.  Rev.,  99:45-77.

                       

 

 

     Colby, K.M.  (1981).  Modeling a paranoid mind.  Behavioral and Brain

                                                    

        Sciences, 4:515-560.

      

 

 

     Collins, A.M., & Loftus, E.F.  (1975).  A spreading-activation theory

 

        of semantic processing.  Psychol.  Rev., 82:407-428.

                                

 

 

     Craik, F.I.M., & Lockhart, R.S.  (1972).  Levels of processing:  A

 

        framework for memory research.  J. Verb. Learning Verb. Behav.,

                                       

        11:671-684.

 

 

 

     Craik, K. (1943).  The Nature of Explanation.  Cambridge:  Cambridge

                       

        University Press.

 

 

 

     Delis, D.C., Kramer, J.H., Fridlund, A.J., & Kaplan, E. (1990).  A

 

        cognitive science approach to neuropsychological assessment, in

 

        McReynolds, P., Rosen, J.C., & Chelune, G.J.  (eds), Advances in

                                                          

        Psychological Assessment.  New York:  Plenum Press.

      

 

 

     Dobson, K.S.  (1988).  Historical and philosophical bases of the

 

        cognitive-behavioral therapies, in Dobson, K.S.  (ed).  Handbook of

                                                             

        Cognitive-Behavioral Therapies.  New York, Guilford.

       

 

 

     Eagle, M.N.  (1986).  The psychoanalytic and the cognitive

 

        unconscious, in Stern, R. (ed), Theories of the Unconscious and

                                     

        Theories of the Self.  Hillsdale, NJ:  Erlbaum.

      

 

 

     Ellenberger, H.F.  (1970).  The Discovery of the Unconscious:  The

                                 

        History and Evolution of Dynamic Psychiatry.  New York:  Basic

      

        Books.

 

 

 

     Emde, R.N.  (1983).  The prerepresentational self and its affective

 

        core.  Psychoanalytic Study of the Child.  New Haven:  Yale

               

        University Press.

 

 

 

     Erdelyi, M.H.  (1985).  Psychoanalysis:  Freud's Cognitive Psychology.

                            

        New York:  WH Freeman.

 

 

 

     Eysenck, M.W.  (1991).  Anxiety and cognitive functioning:  A

 

        multifaceted approach, in Lister, R.G., & Weingartner, H.J. (eds),

 

        Perspectives on Cognitive Neuroscience.  Oxford:  Oxford University

       

        Press.

 

 

 

     Forrest, D.V.  (1991).  Mind, brain, and machine:  Object recognition.

 

        J. Am.  Acad.  Psychoanal.,  19:555-577.

       

 

 

     Foulkes, D. (1985).  Dreaming:  A cognitive-psychological analysis.

                       

        Hillsdale, NJ:  Erlbaum.

 

 

 

     Freud, S. (1894).  The neuro-psychoses of defense.  Standard Edition,

                                                       

        3.  London:  Hogarth Press, 1962

 

 

 

     Gardner, H. (1985).  The Mind's New Science:  A History of the

                       

        Cognitive Revolution.  New York: Basic Books.

     

 

 

     Globerson, T., & Zelniker, T. (eds) (1989).  Cognitive Style and

                                               

        Cognitive Development.  Norwood, NJ:  Ablex.

       

 

 

     Gorenstein, E.E.  (1991).  A cognitive perspective on antisocial

 

        personality, in Magaro, P.A. (ed), Cognitive Bases of Mental

                                          

        Disorders.  Newbury Park, CA:  Sage.

     

 

 

     Gray, J.A.  (1982).  The Neuropsychology of Anxiety.  New York:

                         

        Oxford University Press.

 

 

 

     Greenberg, L.S., & Safran, J.D.  (1990).  Emotion in Psychotherapy.

                                             

        New York:  Guilford.

 

 

 

     Greenspan, S.I.  (1980).  Intelligence and Adaptation:  An Integration

                             

        of Psychoanalytic and Piagetian Developmental Psychology.  New

       

        York:  International Universities Press.

 

 

 

     Grossman, L.S., & Harrow, M. (1991).  Thought disorder and cognitive

 

        processes in mania, in Magaro, P.A. (ed), Cognitive Bases of Mental

                                                

        Disorders.  Newbury Park, CA:  Sage.

     

 

 

     Hebb, D.O.  (1946).  On the nature of fear.  Psychol.  Rev.,

                                                

        53:259-276.

 

 

 

     Hebb, D.O.  (1949).  The Organization of Behavior.  New York:  Wiley.

                         

 

 

     Hestenes, D. (1991).  A neural network theory of manic-depressive

 

        illness, in Levine D.S., Leven, S.J.  (eds), Motivation, Emotion,

                                                   

        and Goal Direction in Neural Networks.  Hillside, NJ:  Lawrence

       

        Erlbaum.

 

 

 

     Hilgard, E.R.  (1977).  Divided Consciousness:  Multiple Controls in

                            

        Human Thought and Action.  New York:  Wiley.

      

 

 

     Hoffman, R.E.  (1987).  Computer simulations of neural information

 

        processing and the schizophrenia-mania dichotomy.  Arch.  Gen.

                                                       

        Psychiatry, 44:178-188.

       

 

 

     Horowitz, M.J.  (ed) (1988a).  Psychodynamics and Cognition.  Chicago:

                                 

        University of Chicago Press.

 

 

 

     Horowitz, M.J.  (1988b).  Introduction to psychodynamics:  A new

                              

        synthesis.  New York:  Basic Books.

       

 

 

     Horowitz, M.J.  (1991).  Person schemas and maladaptive interpersonal

                              

        behavior patterns.  Chicago:  Chicago University Press.

       

 

 

     Hull, J.G, & Reilly, N.P.  (1986).  An information processing approach

 

        to alcohol use and its consequences, in Ingram, R.E.  (ed),

 

        Information Processing Approaches to Clinical Psychology.  San

       

        Diego:  Academic Press.

 

 

 

     Ingram, R.E.  (1984).  Toward an information processing analysis of

 

        depression.  Cognitive Therapy and Research, 8:443-478.

                    

 

 

     Ingram, R.E.  (ed) (1986).  Information Processing Approaches to

                              

        Clinical Psychology.  San Diego:  Academic Press.

       

 

 

     Ingram, R.E., & Reed, M.E.  (1986).  Information encoding and

 

        retrieval processes in depression:  Findings, issues, and future

 

        directions, in Ingram, R.E. (ed), Information Processing Approaches

                                         

        to Clinical Psychology.  San Diego:  Academic Press.

       

 

 

     Ingram, R.E., & Wisnicki, K. (1991).  Cognition in depression, in

 

        Magaro, P.A.  (1991).  Cognitive Bases of Mental Disorders.

                             

        Newbury Park, CA:  Sage.

 

 

 

     Janet, P. (1907).  The Major Symptoms of Hysteria.  New York:

                      

        Macmillan.

 

 

 

     Jeffress, L.A.  (ed) (1951).  Cerebral Mechanisms in Behavior.  The

                                  

        Hixon Symposium.  New York:  Wiley.

       

 

 

     Johnson-Laird, P.N.  (1988).  The Computer and the Mind:  An

                                  

        Introduction to Cognitive Science.  Cambridge:  Harvard University

      

        Press.

 

 

 

     Kihlstrom, J.F.  (1987).  The cognitive unconscious.  Science,

                                                           

        237:1145-1151.

 

 

 

     Kihlstrom, J.F., & Hoyt, I.P.  (1990).  Repression, dissociation, and

 

        hypnosis, in Singer, J.L. (ed), Repression and Dissociation:

                                       

        Implications for Personality Theory, Psychopathology, and Health.

       

        University of Chicago Press:  Chicago.

 

 

 

     Klein, G.S.  (1976).  Psychoanalytic Theory:  An Exploration of

                          

        Essentials.  New York:  International Universities Press.

       

 

 

     Koukkou, M. (1988).  A psychophysiological information-processing

 

        model of cognitive dysfunction and cognitive treatment in

 

        depression, in Perris, C., Blackburn, I.M., & Perris, H.  Cognitive

                                                                

        Psychotherapy:  Theory and Practice.  Berlin:  Springer Verlag.

      

 

 

     Kuiper, N.A., Derry, P.A., & MacDonald, M.R.  (1982).  Self-reference

 

        and person perception depression, in Weary, G., Mirels, H. (eds),

 

        Integrations of Clinical and Social Psychology.  New York:  Oxford

       

        Press.

 

 

 

     Lachman, R., Lachman, J.L., & Butterfield, E.C.  (1979).  Cognitive

                                                               ÄÄÄÄÄÄÄÄÄ

         Psychology and Information Processing:  An Introduction.

        

         Hillsdale, NJ:  Erlbaum.

 

 

 

     Lipowski, Z.J.  (1989).  Psychiatry:  Mindless or brainless, both or

 

        neither?  Can. J. Psychiatry, 34:249-254.

                 

 

 

     Lakoff, G. (1987).  Women, Fire, and Dangerous Things:  What

                        

        Categories Reveal about the Mind.  Chicago:  University of Chicago

       

        Press.

 

 

 

     Litrownik, A.J., McInnis, E.T.  (1986).  Information processing and

 

        autism, in Ingram, R.E. (ed), Information Processing Approaches to

                                     

        Clinical Psychology.  San Diego:  Academic Press.

       

 

 

     Lyddon, W.J.  (1988).  Information-processing and constructivist

 

        models of cognitive therapy:  A philosophical divergence.  Journal

                                                                  

        of Mind and Behavior, 9:137-166.

       

 

 

     Magaro, P.A.  (1980).  Cognition in schizophrenia and paranoia:  The

                          

        integration of cognitive processes.  Hillsdale, NJ:  Erlbaum.

      

 

 

     Magaro, P.A.  (ed) (1991).  Cognitive Bases of Mental Disorders.

                                

        Newbury Park, CA: Sage.

 

 

 

     Mahoney, M.J.  (1991).  Human Change Processes.  New York:  Basic

                           

        Books.

 

 

 

     Mahoney, M.J., & Freeman, A. (eds) (1985).  Cognition and

                                               

        Psychotherapy.  New York:  Plenum.

       

 

 

     Mandler, G. (1975).  Mind and Emotion.  New York:  Wiley.

                        

 

 

     Markus, H. (1977).  Self-schemata and processing information about the

 

        self.  J.  Pers.  Soc.  Psychol., 35:63-78.

              

 

 

     Meltzoff, A.N.  (1990).  Towards a developmental cognitive science:

 

        The implications of cross-modal matching and imitation for the

 

        development of representation and memory in infancy.  Ann.  N.Y.

                                                           

        Acad.  Sci.,  608:1-37.

      

 

 

     Merluzzi, T.V., Rudy, T.E., & Glass, C.R.  (1981).  The information

 

        processing paradigm:  Implications for cognitive science, in

 

        Merluzzi, T.V., Glass, C.R., & Genest, M. (eds), Cognitive

                                                       

        Assessment.  New York:  Guilford Press.

     

 

 

     Morton, J. (1984).  Brain-based and non-brain-based models of

 

        language, in Caplan, D., Lecours, A.R., Smith, A. (eds), Biological

                                                                

        Perspectives on Language.  Cambridge:  MIT Press.

       

 

 

     Neisser, U. (1976).  Cognition and Reality.  San Francisco:  WH

                         

        Freeman.

 

 

 

     Neuchterlein, K.H., & Dawson, M.E.  (1984).  Information processing

 

        and functioning in the developmental course of schizophrenic

 

        disorders.  Schizophr. Bull., 10:160-203.

                  

 

 

     Oatley, K. (1991).  Best Laid Plans.  Cambridge:  Cambridge University

                       

        Press.

 

 

 

     Oatley, K., & Johnson-Laird, P.N.  (1987).  Towards a cognitive theory

 

        of emotion.  Cognition and Emotion, 1:29-50.

                    

 

 

     Peterfreund, E. (1971).  Informations, Systems, and Psychoanalysis:

                             

        An Evolutionary Biological Approach to Psychoanalytic Theory.  New

       

        York:  International Universities Press.

 

 

 

     Piaget, J. (1952).  The Origins of Intelligence in Children.  New

                       

        York:  International Universities Press.

 

 

 

     Pitman, R. (1987).  A cybernetic model of obsessive-compulsive

 

        psychopathology.  Compr.  Psychiatry, 28:334-343.

                       

 

 

     Posner, M.I.  (ed) (1989).  The Foundations of Cognitive Science.

                               

        Cambridge:  MIT Press.

 

 

 

     Prigatano, G.P., & Schachter, D.L.  (eds) (1991).  Awareness of

                                                      

        Deficit after Brain Injury:  Clinical and Theoretical Issues.

       

        Oxford University Press:  Oxford.

 

 

 

     Rapee, R.M.  (1991).  Psychological factors in generalized anxiety, in

 

        Rapee, R.M., Barlow, D.M.  (eds), Chronic Anxiety:  Generalized

                                         

        Anxiety Disorder and Mixed Anxiety-Depression.  New York:

       

        Guilford.

 

 

 

     Rapoport, J., & Wise, S. (1988).  Obsessive-compulsive disorder:  A

 

        basal ganglia disease?  in Rapoport, J. (ed), Obsessive-Compulsive

                                                     

        Disorder in Children and Adolescents.  Washington, DC:  APPI Press.

       

 

 

     Ruesch, J., & Bateson, G. (1968).  Communication:  The Social Matrix

                                       

        of Psychiatry.  New York:  Norton.

      

 

 

     Rumelhart, D.E., Hinton, G.E., and the PDP Research Group (1986).

 

        Parallel Distributed Processing:  Explorations in the

       

        Microstructure of Cognition.  Cambridge:  MIT Press.

       

 

 

     Saccuzzo, D.P.  (1986).  An information processing interpretation of

 

        theory and research in schizophrenia, in Ingram, R.E., Information

                                                            

        Processing Approaches to Clinical Psychology.  San Diego:  Academic

       

        Press.

 

 

 

     Safran, J.D., & Greenberg, L.S.  (1986).  Affect and the unconscious:

 

        A cognitive perspective, in Stern, R. (ed), Theories of the

                                                   

        Unconscious and Theories of the Self.  Hillsdale, NJ:  Erlbaum.

       

 

 

     Shannon, C.E.  (1938).  A symbolic analysis of relay and switching

                            

        circuits.  Master's thesis, Massachusetts Institute of Technology.

       

 

 

     Shimamura, A.P.  (1989).  Disorders of memory:  the cognitive science

 

        perspective, in Boller, F., & Grafman, J. (eds), Handbook of

                                                       

        Neuropsychology, 3. Amsterdam:  Elsevier Science Publications.

      

 

 

     Simon, H. (1967).  Motivational and emotional controls of cognition.

 

        Psychol.  Rev., 74:29-39.

       

 

 

     Singer, J.L.  (ed) (1990).  Repression and Dissociation:  Implications

                                

        for Personality Theory, Psychopathology, and Health.  University of

       

        Chicago Press:  Chicago.

 

 

 

     Slap, J.W., & Saykin, A.J.  (1983).  The schema:  Basic concept in a

 

        nonmetapsychological model of the mind.  Psychoanalysis and

                                                

        Contemporary Thought, 6:305-325.

      

 

 

     Sloman, A. (1987).  Motives, mechanisms, and emotions.  Cognition and

                                                           

        Emotion, 1:217-233.

     

 

 

     Sorrentino, R.M., & Higgins, E.T.  (eds) (1986).  Handbook of

                                                      

        Motivation and Cognition:  Foundations of Social Behavior.  New

       

        York:  Guilford Press.

 

 

 

     Stein, D.J.  (1992a).  Clinical cognitive science:  Possibilities and

 

        limitations.  In Stein, D.J., & Young, J.E.  (eds), Cognitive

                                                          

        Science and Clinical Disorders.  San Diego:  Academic Press, 1992.

       

 

 

     Stein, D.J.  (1992b).  Psychoanalysis and cognitive science:

 

        Contrasting models of the mind.  J. Am.  Acad.  Psychoanal.,

                                       

        20:543-559.

 

 

 

     Stein, D.J.  (1992c).  Medical anthropology and psychotherapy

 

        integration:  A cognitivist approach.  Presented at the Annual

 

        Meeting of the Society for the Exploration of Psychotherapy

 

        Integration, San Diego.

 

 

 

     Stein, D.J.  (1992d).  Cognitive science and clinical knowledge.

 

        Integrative Psychiatry.

        

 

 

     Stein, D.J.  (1992e).  Schemas in the cognitive and clinical sciences:

 

        An integrative construct.  Journal of Psychotherapy Integration

                                 

        2:45-64.

 

 

 

     Stein, D.J., Hollander, E. (1992).  Cognitive science and

 

        obsessive-compulsive disorder, in Stein D.J., Young, J.E.  (eds),

 

        Cognitive Science and Clinical Disorders.  San Diego:  Academic

       

        Press.

 

 

 

     Stein, D.J., & Young, J.E.  (eds) (1992a).  Cognitive Science and

                                               

        Clinical Disorders.  San Diego:  Academic Press.

      

 

 

     Stein, D.J., & Young, J.E.  (1992b).  A schema-focused approach to

 

        personality disorder, in Stein, D.J., & Young, J.E. (eds),

 

        Cognitive Science and Clinical Disorders.  San Diego:  Academic

       

        Press.

 

 

 

     Stern, D.  (1985).  The Interpersonal World of the Infant.  New York:

                       

        Basic Books.

 

 

 

     Sternberg, R.J.  (ed) (1984).  Mechanisms of Cognitive Development.

                                   

        New York:  WH Freeman.

 

 

 

     Stillings, N.A., Feinstein, M.H., Garfield, J.L., Rissland, E.L.,

 

        Rosenbaum, D.A., Weisler, S.E., & Baker-Ward, L. (1987).  Cognitive

                                                             

        Science: An Introduction.  Cambridge:  MIT Press.

      

 

 

     Swerling, L.C., & Sternberg, R.J.  (1992).  Information processing,

 

        experience, and reading disability, in Stein, D.J., & Young, J.E.

 

        (eds), Cognitive Science and Clinical Disorders.  DJ, Young JE.

              

        San Diego:  Academic Press.

 

 

 

     Teasdale, J.D.  (1983).  Negative thinking in depression:  Cause,

 

        effect, or reciprocal relationship?  Advances in Behavioural

                                          

        Research and Therapy, 5:3-25.

       

 

 

     Tomkins, S.S., & Messick, S. (eds) (1963).  Computer Simulation of

                                                

        Personality:  Frontier of Psychological Theory.  New York:  Wiley.

      

 

 

     Turing, A. (1936).  On computable numbers, with an application to the

 

        Entscheidungsproblem.  Proceedings of the London Mathematical

                              

        Society, 2nd Series, 42:230-265.

      

 

 

     Turing, A. (1950).  Computing machinery and intelligence.  Mind,

                                                               

        59:422-460.

 

 

 

     Uleman, J.S., & Bargh, J.A.  (eds) (1989).  Unintended Thought.  New

                                               

        York:  Guilford Press.

 

 

 

     Wachtel, P.L.  (1982).  Resistance:  Psychodynamic and behavioral

                          

        approaches.  New York:  Plenum Press.

    

 

 

     Weizenbaum, J. (1976).  Computer Power and Human Reason.  San

                           

        Francisco:  WH Freeman.

 

 

 

     Westen, D. (1988).  Transference and information-processing.  Clinical

                                                                 

        Psychology Review, 8:161-179.

     

 

 

     Wiener, N. (1947).  Cybernetics.  Cambridge:  MIT Press.

                       

 

 

     Williams, J.M.G., Fraser, N.W., MacLeod, C., & Matthews, A. (1988).

 

        An Information Processing Analysis of the Emotional Disorders.  New

       

        York:  Wiley.

 

 

 

     Williams, J.M.G, & Oaksford, M. (1992).  Cognitive science, anxiety,

 

        depression:  From experiments to connectionism, in Stein, D.J., &

 

        Young, J.E.  (eds), Cognitive Science and Clinical Disorders.

                           

        San Diego:  Academic Press.

 

 

 

     Young, J.E.  (1990).  Cognitive therapy for personality disorders:  A

                         

        schema-focused approach.  Sarasota:  Professional Resource

       

        Exchange.