Cognitive Therapy and Research, Vol. 15, No. 6, 1991, pp. 491-502

A Test of RET Theory Using an RET Theory-Based Mood Induction Procedure: The Rationality of Thinking Rationally 1 Steven M. Master and Suzanne M. Miller 2 Temple University

Affective consequences of rational-emotive therapy (RET) theory-based self-statements were assessed in a manner which controlled for demand characteristics. Subjects exposed to irrational self-statements evidenced more subjective anxiety, more automatic negative thoughts, and greater physiological arousal than all other subjects. Subjects exposed to type A self-statements evidenced greater physiological arousal than subjects exposed to rational self-statements, who evidenced greater physiological arousal than subjects exposed to neutral statements. Finally, subjects exposed to rational self-statements were the only group to decrease in physiological arousal over time. These results, while generally consistent with P E T theory, indicate that some modifications may be necessary. KEY WORDS: RET; mood induction; emotion.

Recent research and theorizing in the area of emotion has devoted considerable attention to the origins of maladaptive affective states. Cognitive theorists generally emphasize the causative role of cognition (e.g., Beck, Rush, Shaw, & Emory, 1979). The purpose of the present study was 1This research was supported in part by grant CA416591 from the National Cancer Institute to the second author. Its contents are solely the responsibility of the authors and do not necessarly represent the official views of the National Cancer Institute. We thank Jay Efran for his critical contributions and Adina Birnbaum for technical assistance. 2Address all correspondence to Suzanne M. Miller, Ph.D., Departments of Psychology and Medicine, Weiss Hall, Cecil B. Moore Ave. and 13th Street, Temple University, Philadelphia, Pennsylvania 19122. 491

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to evaluate one major version of this perspective, Albert Ellis' rationalemotive therapy (RET) approach (Ellis, 1977). RET theory, based on the A-B--C model, maintains that behavioral and emotional consequences (point C) are not caused by the activity, action, or agent (point A), but by the individual's rational or irrational self-statements that intervene at point B. A type A self-statement refers to an objective observation of fact concerning a problem area, without a cognitive evaluation. A rational statement asserts wishes and wants. It acknowledges appropriate levels of regret with words like "inconvenient," "unfortunate," and "undesirable." Such beliefs result in behaviors that are adaptive and emotions that are appropriately dysphoric. In contrast, an irrational statement declares an absolute demand or dictate, using words such as "should," "must," "need," or "always." In addition, an irrational statement involves catastrophizing, specifying words like "horrible," "awful," "rotten person," or "I can't stand it." Irrational beliefs result in behaviors that are maladaptive and emotions that are extremely dysphoric. Studies have shown that exposure to i r r a t i o n a l - but not r a t i o n a l self-statements yields performance deficits (Schill, Monroe, Evans, & Ramanaiah, 1978) and increases state anxiety (Rosin & Nelson, 1983). A problem with this work is that the rational self-statements used were not precisely in accord with RET theory, since they did not involve negative, though appropriate, evaluations of problem situations. Other research has focused on the physiological effects of type A, irrational, and neutral statements, omitting rational self-statements altogether. These results generally show a greater physiological response to irrational self-statements than to neutral statements (Rimm & Litvak, 1969; Russell & Brandsma, 1974), and a greater physiological response to high self-relevant type A statements than to neutral statements (Russell & Brandsma, 1974). Only one study compared the physiological consequences of type A, irrational, and rational statements, defined in accord with RET theory (Master & Gershman, 1983). Consistent with previous findings, highly selfrelevant problems led to significantly greater electrodermal responses to irrational and type A self-statements than to neutral statements. Rational and neutral statements did not differ from each other. Overall, irrational self-statements seem to result in heightened arousal. However, the effects of rational self-statements are less dear. Further, many of the studies contain methodological flaws, and hence are difficult to interpret (Smith, 1982). The present study aims to further elucidate the differential consequences of type A, rational, and irrational selfstatements. It involves a multimodal assessment of the subjective, cognitive, behavioral, and physiological consequences of exposure to all three RETrelevant self-statements, defined in accord with the theory.

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RET theory-based and other cognitive mood induction procedures typically use hypothetically arousing self-statements in order to induce affect (Velten, 1968). Some researchers have suggested that these procedures are contaminated by demand characteristics, which induce the subject to behave in a way that conforms to the experimenter's expectation (Coyne, 1982; Polivy & Doyle, 1980). For example, when a subject reads Velton's stimulus statement (designed to induce depression), "I have too many bad things in my life," the subject may believe that s/he is expected to act in a depressed manner. In the present procedure, demand characteristics were minimized by using self-statement stimuli that did not reference affective or somatic states, since this would present a demand to behave in accord with that specification. In addition, we used blind experimenters and automated stimulus presentation. Finally, we included nonreactive physiological measures in our assessment battery. The following four main questions were addressed: 1.

2.

3.

Do rational and irrational self-statements yield greater emotional arousal than neutral statements, as predicted by R E T theory, since the former involve negative evaluations? Do rational self-statements yield less emotional arousal than irrational self-statements, as predicted by R E T theory, since rational evaluations are less negative than irrational evaluations? Are there differences between emotional responses to type A and neutral statements? On the one hand, while type A statements describe a problem, although neutral statements do not, neither involves a negative evaluation. According to a strict interpretation of RET theory, this negative evaluation is necessary and essential for emotional arousal to occur. Therefore, the response to type A and neutral statements should be equivalent. On the other hand, when subjects are exposed to a type A stimulus, they may automatically emit covert irrational and rational self-statements. If the automatically elicited selfstatements are mainly irrational in nature, then the performance of the type A group should be similar to that of the irrational group. If the automatically elicited self-statements are mainly rational in nature, then the performance of the type A group should be similar to that of the rational group. If the automatically elicited self-statements contain both irrational and rational evaluations, as is likely in a nonclinical population, the performance in the type A group should be intermediate to performance in these other two groups. In all cases, the response

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to the type A statements should be greater than the response to the neutral statements. . Do individuals manifest habituation of physiological arousal to self-statements over time? Although not explicitly predicted by RET theory, there may be differences in the manner in which these affect-inducing stimuli are processed over time (Foa & Kozak, 1986). Irrational s e l f - s t a t e m e n t s - - b e c a u s e of their negative nature - - may impede emotional processing, resulting in continued high levels of arousal. Conversely, rational selfs t a t e m e n t s - because of their more positive n a t u r e - may facilitate emotional processing, resulting in progressively decreasing levels of arousal.

METHOD

Overview Subjects were presented with either five type A, five rational, or five irrational self-statements. All statements were of high relevance (concern) to subjects, as assessed by a problem rating list. A fourth group of control subjects viewed statements of a neutral, impersonal content. Subjective, cognitive, physiological, and behavioral assessments of emotional response were obtained for each subject.

Subjects Eighty-four female undergraduate psychology students at Temple University participated in and completed the procedure. Subjects received course credit for their participation. Equal numbers of subjects were assigned randomly to each group: type A, rational, irrational, or control.

Materials Experimental stimuli were developed by Master and Gershman (1983), based on the Coed Problem Rating List (CPRL; Russell & Brandsma, 1974). This list consists of 100 items selected from the responses of female college students who were asked to list important problems of their own and their friends.

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In the present study, subjects rated each item from the Coed Problem Rating List on an 8-point scale, as to the degree of concern and worry it caused them at the present time (where a score of 7 = a serious p r o b l e m , 1 = never a problem, 0 = the item is not applicable). Then, each subject was asked to list her five most important or highest-concern items, which were used as the high-relevance stimuli for each subject. Three experimental stimuli were developed for each item of the Coed Problem Rating List according to R E T theory definitions: point A statement, irrational statement, and rational statement. Examples of the three statements for the problem area (point A statement), "My parents will not allow me to be independent," are: (1) type A - - " M y parents frequently tell me what to do. I usually follow their wishes."; (2) i r r a t i o n a l - "I must be an independent person, but my parents are always telling me what to do. They are absolute dictators and it is terrible being bossed."; (3) r a t i o n a l - "I would like more independence, but my parents frequently tell me what to do. I don't desire them to behave in this manner." Control group stimuli contained neutral and impersonal content. Example: "A check shows there is nothing wrong with the electricity in my house. The light bulb in my lamp must be burnt out." Apparatus

Stimuli were projected on a screen about 4 feet in front of the subject by means of a Kodak 650 H projector, operated in conjunction with digital solid state logic equipment manufactured by BRS/Foringer. Skin resistance (SR) was measured by a Grass Instruments polygraph using a Grass 7P1 D.C. preamplifier. Beckman nonpolarizing Ag/AgC1 electrodes and Beckman conductive jelly were used. Electrodes were attached to the left hand and middle finger. Procedure

Upon entering the experimental room, a subject received a brief explanation of the study, stating that it dealt with an individual's reactions to statements that people say to themselves. Then she filled out a pretest measure of affect, the Multiple Affect Adjective Check List (MAACL; Zuckerman & Lubin, 1965) and the Coed Problem Rating List. After completing the CPRL, the psychophysiological equipment was attached to the subject's hand. Subjects were instructed to focus complete attention on the projected sentences, imagining that the

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sentences were their own thoughts. Next, subjects were told to relax and get as comfortable as possible for approximately 10 min. During this time an experimenter examined the rating list, selected the correct stimuli for the subject, placed the stimuli statements in the slide projector, and adjusted SR to baseline. The first two stimuli presented to all subjects consisted of neutral statements, to allow the experimenter to readjust SR if necessary. The third stimulus presented also consisted of a neutral statement and supplied the covariate for physiological data analysis. Control and experimental subjects then viewed five continuous 60-second presentations of their assigned stimuli. After viewing these stimuli, all subjects completed behavioral, subjective, and cognitive measures. To control for demand characteristics, one experimenter scored the CPRL and selected the stimuli for each subject. The other, who was blind with respect to group membership, administered the various dependent measures.

Measures Subjective. The following self-report measures of arousal were used: (1) the Multiple Affect Adjective Checklist, which includes subscales for state levels of anxiety, depression, and hostility (Zuckerman et al., 1965), was obtained before and after viewing of stimuli; (2) the revised State Anxiety Inventory (SAI; Spielberger, Gorsuch, & Lushene, 1970), was obtained after viewing stimuli. Cognitive. Cognition (non-RET) was measured by the Automatic Thoughts Questionnaire (ATQ; Hollon & Kendall, 1980), after viewing the stimuli. Physiological. Electrodermal activity was measured along the dimensions of amplitude (SR1) and frequency (SR2), while subjects viewed the stimuli. The change score was determined by measuring the onset of each deflection to the point of maximum deflection during the 60 seconds of stimulus presentation (Edelberg, 1967). SR1 (amplitude) data were transformed from skin resistance in kilohms to log conductance, in micromhos (Montagu & Coles, 1966). S R 2 (frequency) was quantified by counting the number of pen deflections during each stimulus interval (see, for example, May & Johnson, 1973). Behavioral. Four behavioral indices of arousal were assessed, based upon demonstrated sensitivity as correlates of affect in the literature (see Master & Miller, 1988): (1) writing speed (Johnson, 1937), (2) graphic constriction-expansion (Johnson, 1937; Wallach & Gahm, 1960, (3) ratings

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of verbal responses to a question (Pope, Blass, Siegman, & Raber, 1970), and (4) verbal counting time (Teasdale & Taylor, 1981).

RESULTS The results are organized as follows. First, baseline measures on the MAACL subseales are presented for each group using ANOVAs, in order to explore whether any pretest mood differences existed between groups. Then, ANCOVAS with appropriate post hoc tests are presented for the subjective, cognitive, physiological, and behavioral data obtained during and after the viewing of experimental stimuli.

Pretest An ANOVA on the pretest scores indicated that there were no significant differences among groups in preexisting levels of depression, hostility, or anxiety.

Subjective An ANOVA revealed significant differences among groups for the State Anxiety Inventory, F(3, 80) = 5.06, p < .003. Post hoc probes using the Newman-Keuls procedure with a = .05 revealed significantly higher scores by subjects in the irrational group than subjects in the other three groups, which did not differ from each other. No significant differences emerged on the MAACL posttreatment scores.

Cognitive The Automatic Thoughts Questionnaire yielded significant differences among groups, F(3, 80) = 9.175, p < .0001. Post hoc probes using the Newman-Keuls procedure with a = .01 yielded significantly higher scores for subjects in the irrational group than for subjects in the other groups, which did not differ from each other.

Physiological SR data were analyzed using an ANCOVA in order to statistically control for the Law of Initial Values (Benjamin, 1967). Responses to a

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neutral triad of stimuli presented immediately prior to the first experimental stimulus provided the covariate. The analysis of SR1 (amplitude) data revealed significant differences among groups, F(3, 79) = 6.14, p < .0001. Post hoc probes using the Newman-Keuls procedure with ~ = .01 revealed that SR1 was significantly greater for the irrational group than for the rational or neutral groups. Further, SR1 was significantly greater for the type A and the rational groups than for the neutral group. No differences emerged between the type A and irrational groups, or between the type A and rational groups. The analysis of SR2 (frequency) also revealed significant differences among groups, F(3, 79) = 11.02, p < .001. Post hoc probes using the Newman- Keuls procedure with tx = .01 revealed that SR2 was significantly greater for the irrational group than for all other groups, SR2 was also significantly greater for the type A group than for the rational and the neutral groups. SR2 for the rational group was greater than that for the neutral group. In order to assess possible habituation effects, the mean of the first two sentences was compared with the mean of the second two sentences. For both SR1 and SR2, the rational group evidenced a decrease over time, t (20) = 2.22, p < .03 and t (20) = 3.95, p < .001, respectively. Significant changes over time were not found in any other group for SR1 or SR2.

Behavioral No significant differences emerged for any of the behavioral measures.

DISCUSSION Emotional consequences of RET theory-based self-statements were found on a variety of dependent measures. The irrational group evidenced greater state anxiety (State Anxiety Inventory) and more negative automatic thoughts (Automatic Thoughts Questionnaire) than other sentence types. This is consistent with RET theory, which predicts arousal with irrational statements. However, these measures may have been influenced by demand characteristics, and may therefore be less sensitive to the experimental manipulation than the physiological measures. The more reliable and valid physiological results provide a useful framework for evaluating the accuracy of RET theory.

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As predicted by RET theory, rational and irrational self-statements yielded greater arousal than neutral statements, and irrational selfstatements yielded greater arousal than rational self-statements. Further, type A self-statements resulted in greater physiological response than to neutral statements, intermediate between the rational and irrational groups. Thus, they appeared to automatically elicit a combination of rational and irrational evaluative cognition. Finally, there was a decrease in electrodermal activity observed for the rational group over time, but not for the irrational group. While not specifically predicted by RET theory, this is consistent with the general cognitive therapy observation of the progressively beneficial effects of therapeutic techniques such as cognitive restructuring. Irrational, as well as type A statements, may be too threatening to be efficiently processed, since they are associated with a perceived high probability of feared consequences. On the other hand, rational self-statements may be less threatening, since they are associated with a lower perceived probability of feared consequences. This may facilitate more efficient affective processing (Foa & Kozak, 1986). These results are generally consistent with other findings showing greater state anxiety for irrational than rational self-statements (Rosin & Nelson, 1983). They are also consistent with previous studies showing a greater physiological response to irrational self-statements than to neutral statements (Master & Gershman, 1983; Rimm & Litvak, 1969; Russell & Brandsma, 1974), a greater physiological response to high relevance type A self-statements than to neutral statements (Master & Gershman, 1983; Russell & Brandsma, 1974), and a greater physiological response to high relevance irrational self-statements and type A self-statements than to rational self-statements (Master & Gershman, 1983). While Russell and Brandsma (1974) found equivalent physiological response to type A and irrational self-statements, and Master and Gershman (1983) found greater physiological response to type A than irrational self-statements, the present study found greater physiological response to irrational than to type A self-statements. These differences may be due, in part, to random fluctuations in the ratio of extraneous rational to irrational cognition elicited by the type A statements. In a nonclinical population, it is likely that most automatic self-statements elicited by type A self-statements comprise a variable combination of rational and irrational self- statements. In addition, Master and Gershman (1983) found equivalent physiological arousal in response to neutral and rational statements, while the present study found greater physiological response to rational than to neutral statements. Although it is difficult to reconcile these differences,

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the general pattern of results remains consistent. Most notably, physiological arousal is greater with type A and irrational statements than with rational and neutral statements. Interestingly, the groups did not differ in their performance on the various behavioral measures. Only one previous study has found behavioral differences between self-statement groups (Schill et al., 1978). The general lack of behavioral effects confirms previous work showing that emotion is best conceptualized as a multimodal, loosely coupled, hypothetical construct (Lang, 1979). In addition, it is possible that the level of affect induced was not of sufficient intensity to activate behavioral differences. Inconsistencies among the self-report, cognitive, behavioral, and physiological data may be partially reconciled by considering differences in time of measurement. Only the physiological indices were obtained during actual exposure to the self-statement stimuli. The other assessments were obtained after termination of these stimuli. It is possible that the strength of the induced mood may have dissipated by the time that the nonphysiological measures were obtained. In the absence of a more enduring affective state, as in clinical contexts, self-report measures may have been vulnerable to subjects' biases and retrospective evaluations. While the present study used a number of techniques to reduce demand characteristics, it is possible that subjects might still have been responding to subtle experimental cues. In other work, we have found that subjects perceive irrational statements to be more associated with "bad feeling" than the other sentence types, which are rated as being equivalent to each other (Master & Miller, 1988). These results suggest that subjects should respond most strongly to the irrational condition, with no other differences. While this was the case for the subjective and cognitive measures, the physiological data were more discriminating. This indicates that even though demand may have been operative, a valid manipulation of mood still occurred (see also Polivy & Doyle, 1980). The present cognitive mood induction procedure provides support for the general premise that cognition is accompanied by emotion, by means of a methodology which helps to control for demand characteristics. Analog mood induction studies provide one line of evidence in evaluating RET theory. Other evidence may come from correlational studies, outcome research, and case histories (see Smith & Allred, 1986 for a recent review of alternative empirical approaches). Clearly, RET theory suffers from being too general, imprecise, and vague. It does not fully explain the principles which underly its predictions. For example, the question of how irrational self-statements elicit greater arousal than rational self-statements is not clearly addressed (Master &

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Gershman, 1983; Russell & Brandsma, 1974). Further research should help to pinpoint the processes underlying these effects. Although RET theory may need clarification, the lower levels of arousal associated with rational and neutral self-statements compared with irrational self-statements provide important support for the efficacy of RET techniques, and help illuminate the mechanisms underlying these effects. The present evidence suggests that the RET technique of consistently refuting irrational self-statements, accompanied by an emphasis on rational self-statements, is beneficial because it facilitates progressively decreasing levels of maladaptive arousal.

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