Qualitative analysis of the cognitive triad in a sample of the general population in response to the COVID-19 pandemic

Abstract

This paper explored cognitive responses to the COVID-19 pandemic in those selfreporting depressive symptoms during a period of realistic health, economic and social threat. Negative cognitions are a key therapy target for evidence-based psychological interventions. A cross-sectional survey was conducted with a convenience sample from the general population between December 2020 and February 2021. Adult respondents (n = 555) completed open text-box questions which provided prompts of the cognitive triad: "I am…/I am not…"; "Other people are…/Other people are not…"; "The world is…". These qualitative data were analysed using reflexive thematic analysis. Thematic responses were compared between people who self-reported moderate depressive symptoms (n = 223) and those who did not (n = 332). Fourteen independent themes were identified. Those self-reporting depressive symptoms described significantly fewer positive cognitions across all three aspects of the cognitive triad, X2 = 60.40 p < 0.01; X2 = 10.51 p < 0.05; X2 = 12.22 p < 0.01. Those self-reporting depressive symptoms also reported more self-referent negative cognitions. These data highlighted that an absence of positive cognitions differentiated the two groups more greatly than negative cognitions. These data have implications for the cognitive targets in psychological therapies in realistic high-stress situations. This paper explored cognitive responses to the COVID-19 pandemic in those selfreporting depressive symptoms during a period of realistic health, economic and social threat. Negative cognitions are a key therapy target for evidence-based psychological interventions. A cross-sectional survey was conducted with a convenience sample from the general population between December 2020 and February 2021. Adult respondents (n = 555) completed open text-box questions which provided prompts of the cognitive triad: "I am…/I am not…"; "Other people are…/Other people are not…"; "The world is…". These qualitative data were analysed using reflexive thematic analysis. Thematic responses were compared between people who self-reported moderate depressive symptoms (n = 223) and those who did not (n = 332). Fourteen independent themes were identified. Those self-reporting depressive symptoms described significantly fewer positive cognitions across all three aspects of the cognitive triad, X2 = 60.40 p < 0.01; X2 = 10.51 p < 0.05; X2 = 12.22 p < 0.01. Those self-reporting depressive symptoms also reported more self-referent negative cognitions. These data highlighted that an absence of positive cognitions differentiated the two groups more greatly than negative cognitions. These data have implications for the cognitive targets in psychological therapies in realistic high-stress situations.

Keywords: COVID-19; Cognitive behavioral therapy; Cognitive triad; Depression; Therapeutic methods.