Assessing internalized beliefs: Development of the Pathogenic Belief Scale

Abstract

The way that people internalize adverse experiences plays an important role in the development of psychopathology. The Pathogenic Belief Scale (PBS) is intended to operationalize a transtheoretical understanding of repetitive patterns of emotion-laden beliefs that develop in childhood and continue to influence people's current experience. Using a cross-sectional survey design, we recruited a large heterogeneous sample of 246 clinic outpatients and 732 adults in the community. Besides the PBS, measures of adverse parenting experiences and common psychopathology were administered. An exploratory factor analysis of the total sample of 978 participants was conducted followed by a convergent validity analysis for the 246 clinic outpatients. The three-factor solution included “cannot rely on others,” “undeserving,” and “interpersonal guilt,” and it showed good psychometric properties, including convergent validity with the measures of adverse parenting experiences and psychopathology. The 34-item PBS offers a promising self-report measure that could help delineate and understand the pathogenic beliefs that heterogeneous samples of patients may hold. Pathogenic beliefs may be relevant to the psychotherapy process, regardless of model or theoretical context.

Interpersonal guilt and the working alliance in psychotherapy: The moderating role of childhood experience

“…On the patient end, for patients who reported more adverse parenting experiences but also believed that they should remain close to their parents, there may be more ambivalence initially towards the therapy and the therapist. In other words, for patients with strong beliefs of interpersonal guilt that warn against abandoning, humiliating or threatening others, and imply omnipotent responsibility for others (Aafjes‐van Doorn, McCollum, Silberschatz, & Snyder, 2021), establishing a strong relationship with therapist may be seen as conflicting with their obligations to their important others. This might then make it harder to collaborate and establish a working relationship with the therapist, especially early in treatment.…”

“…It is also worth noting that this study has used the interpersonal guilt subscale of the pathogenic belief scales (PBS, Aafjes‐van Doorn, McCollum, Silberschatz, & Snyder, 2021) instead of the recently developed scale on interpersonal guilt (e.g. IRS‐15s, Gazzillo et al, 2017, 2018; Faccini et al, 2020).…”

“…The interpersonal guilt subscale of the PBS (Aafjes‐van Doorn, McCollum, Silberschatz, & Snyder, 2021) was used to assess beliefs associated with interpersonal guilt. The PBS is a self‐report measure to assess affect‐laden, pathogenic beliefs based on control‐mastery theory (see Curtis & Silberschatz, 2007).…”

Interpersonal and Social Functioning Among Psychotherapy Patients

“…In previous research, the PBS scores were shown to be reliable (a = 0.96) and valid (Silberschatz and Aafjes-van Doorn, 2017) in American community samples and a sample of outpatients (Aafjes-van Doorn et al, 2021a); the PBS has also been validated in patients with depressive disorder in Thailand (Neelapaijit et al, 2017(Neelapaijit et al, , 2018. The 34-item PBS has been shown to have good psychometric properties, including sufficient reliability and concurrent validity (PBS-SF; Aafjes-van Doorn et al, 2021b), and in the present sample demonstrated good internal consistency.…”

“…Building on previous research regarding the mediating role of pathogenic beliefs on the relationship between childhood trauma and symptom distress (Silberschatz and Aafjes-van Doorn, 2017), indirect effects were hypothesized for perceived adverse parenting on interpersonal and social problems through pathogenic beliefs. In line with previous research (Aafjes-van Doorn et al, 2021b) that identified three different domains of pathogenic beliefs (“cannot rely on others,” “undeserving,” and “interpersonal guilt”), we sought to examine these three domains in parallel mediation analyses. By simultaneously holding constant each of these domains, such analyses would allow for the identification of specific types of pathogenic beliefs that confer difficulties in interpersonal behavior and work and social performance.…”