States-of-mind model: Cognitive balance in the treatment of agoraphobia — II

The states-of-mind (SOM) model, and information theoretic model of positive and negative cognitions/affects, was examined in 73 agoraphobics completing cognitive and behavioral treatments. The SOM model posits that a positive dialogue represents an optimal cognitive balance for coping with stress. The primary aims of the present study included delineating differential cognitive trajectories across treatments and assessment phases; comparing SOMs between subjects achieving low versus high endstate functioning, improvement, and tripartite concordance versus disconcordance on measures of psychophysiology, behavior and anxiety; and, studying the clinical significance of changes in SOM with the use of normative cohorts. The results corroborate prior SOM studies regarding its differential, convergent, external, and social-clinical validity. However, superior functioning was associated with higher SOMS than predicted. Methodologic, conceptual, and psychometric issues raised by some of the findings are discussed, with implications for clinical research.