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Effects of the Cognitive-Behavioral Therapy for Stress Management on Executive Function Components

Published online by Cambridge University Press:  13 February 2017

Ana Santos-Ruiz
Universidad de Granada (Spain)
Humbelina Robles-Ortega
Universidad de Granada (Spain)
Miguel Pérez-García
Universidad de Granada (Spain)
María Isabel Peralta-Ramírez
Universidad de Granada (Spain)
E-mail address:


This study aims to determine whether it is possible to modify executive function in stressed individuals by means of cognitive-behavioral therapy for stress management. Thirty-one people with high levels of perceived stress were recruited into the study (treatment group = 18; wait-list group = 13). The treatment group received 14 weeks of stress management program. Psychological and executive function variables were evaluated in both groups pre and post-intervention. The treatment group showed improved psychological variables of perceived stress (t = 5.492; p = .001), vulnerability to stress (t = 4.061; p = .001) and superstitious thinking (t = 2.961; p = .009). Likewise, the results showed statistically significant differences in personality variables related to executive function, positive urgency (t = 3.585; p = .002) and sensitivity to reward (t = –2.201; p = .042), which improved after the therapy. These variables showed a moderate to high effect size (oscillates between 1.30 for perceived stress and .566 for sensitivity to reward). The cognitive-behavioral therapy for stress management may be an appropriate strategy for improving personality construct components related to executive function, however effects of the therapy are not showed on performance on the tests of executive function applied, as presented studies previous.

Research Article
Copyright © Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2017 

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Ana Santos-Ruiz is now at Universidad de Alicante, Spain.


Bechara, A. (2004). The role of emotion in decision-making: Evidence from neurological patients with orbitofrontal damage. Brain and Cognition, 55, 3040. CrossRefGoogle Scholar
Bechara, A., Damasio, H., Damasio, A. R., & Lee, G. P. (1999). Different contributions of the human amygdala and ventromedial prefrontal cortex to decision-making. Journal of Neuroscience, 19, 54735481.Google Scholar
Bogdan, R., & Pizzagalli, D. A. (2006). Acute stress reduces reward responsiveness: Implications for depression. Biological Psychiatry, 60, 11471154. CrossRefGoogle Scholar
Cyders, M. A., Smith, G. T., Spillane, N. S., Fischer, S., Annus, A. M., & Peterson, C. (2007). Integration of impulsivity and positive mood to predict risky behavior: Development and validation of a measure of positive urgency. Psychological Assessment, 19, 107118. CrossRefGoogle Scholar
Damasio, A. R. (1994). Descartes’ error: Emotion, reason, and the human brain. New York, NY: G. P. Putnam.Google Scholar
De las Cuevas, C., González de Rivera, J. L., Henry Benítez, M., Monterrey, A. L., Rodríguez-Pulido, F., & Gracia Marcos, R. (1991). Análisis factorial de la versión española del SCL-90-R en la población general. [Factorial analysis of the Spanish version of the SCL-90-R in the general population]. Anales de Psiquiatría, 7, 9396.Google Scholar
Diamond, A. (2013). Executive functions. Annual Reviews of Psychology, 64, 135168. CrossRefGoogle ScholarPubMed
Erickson, D. H., Janeck, A. S., & Tallman, K. (2007). A cognitive-behavioral group for patients with various anxiety disorders. Psychiatric Services, 58, 12051211. CrossRefGoogle Scholar
Epstein, S. (2001). CTI: Inventario de pensamiento constructivo –Una medida de la Inteligencia Emocional-. [Constructive thinking inventory - A measure of Emotional Intelligence]. Madrid, Spain: TEA Ediciones S.A.Google Scholar
Ferrando, P. J., Chico, E., & Tous, J. M. (2002). Propiedades psicométricas del test de optimismo Life Orientation Test. [Psychometric properties of the Life Orientation Test]. Psicothema, 14, 673680.Google Scholar
Fisk, J. E., & Sharp, C. A. (2004). Age-related impairments in executive functioning: Updating, inhibition, shifting and access. Journal of Clinical and Experimental Neuropsychology, 26, 874890. CrossRefGoogle Scholar
Groves, S. J., Porter, R. J., Jordan, J., Knight, R., Carter, J. D., McIntosh, V. V. M., … Joyce, P. R. (2015). Changes in neuropsychological function after treatment with metacognitive therapy or cognitive behavior therapy for depression. Depression and Anxiety, 32, 437444. CrossRefGoogle ScholarPubMed
Jurado, M. B., & Rosselli, M. (2007). The elusive nature of executive functions: A review of our current understanding. Neuropsychology Review, 17, 213233. CrossRefGoogle ScholarPubMed
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal and coping. New York: NY: Springer Publishing.Google Scholar
Linares-Ortiz, J., Robles-Ortega, H., & Peralta-Ramírez, M. I. (2014). Modificación de la personalidad mediante una terapia cognitivo-conductual de afrontamiento al estrés [Personality modification by a cognitive-behavioral therapy of stress coping]. Anales de Psicología, 30, 114122. CrossRefGoogle Scholar
Lindauer, R. J. L., Vlieger, E. J., Jalink, M., Olff, M., Carlier, I. V. E., Majoie, C. B. L. M., … Gersons, B. P. R. (2005). Effects of psychotherapy on hippocampal volume in out-patients with post-traumatic stress disorder: A MRI investigation. Psychological Medicine, 35, 14211431. CrossRefGoogle ScholarPubMed
Lupien, S. J., Maheu, F., Tu, M., Fiocco, A., & Schramek, T. E. (2007). The effects of stress and stress hormones on human cognition: Implications for the field of brain and cognition. Brain and Cognition, 65, 209237. CrossRefGoogle ScholarPubMed
McMorris, T., Swain, J., Smith, M., Corbett, J., Delves, S., Sale, C., … Potter, J. (2006). Heat stress, plasma concentrations of adrenaline, noradrenaline, 5-hydroxytryptamine and cortisol, mood state and cognitive performance. International Journal of Psychophysiology, 61, 204215. CrossRefGoogle ScholarPubMed
Meichenbaum, D. (1985). Stress inoculation training: A preventative and treatment approach. New York, NY: Pergamon Press.Google Scholar
Mohlman, J. (2008). More power to executive? A preliminary test of cbt plus executive skills training for treatment of late-life GAD. Cognitive and Behavioral Practice, 15, 306316. CrossRefGoogle Scholar
Navarrete-Navarrete, N., Peralta-Ramírez, M. I., Sabio-Sánchez, J. M., Coín, M. A., Robles-Ortega, H., Hidalgo-Tenorio, C., … Jiménez-Alonso, J. (2010). Effects of the treatment of chronic stress in patients with lupus erythematosus: A randomized controlled trial. Psychotherapy and Psychosomatics, 79, 107115.CrossRefGoogle Scholar
Olver, J. S., Pinney, M., Maruff, P., & Norman, T. R. (2015). Impairments of spatial working memory and attention following acute psychosocial stress. Stress and Health, 31, 115123. CrossRefGoogle ScholarPubMed
Pabst, S., Brand, M., & Wolf, O. T. (2013). Stress and decision making: A few minutes make all the difference. Behavior and Brain Research, 250, 3945. CrossRefGoogle ScholarPubMed
Pabst, S., Schoofs, D., Pawlikowski, M., Brand, M., & Wolf, O. T. (2013). Paradoxical effects of stress and an executive task on decisions under risk. Behavioral Neuroscience, 127, 369379. CrossRefGoogle Scholar
Peralta-Ramírez, M. I., Robles-Ortega, H., Navarrete-Navarrete, N., & Jiménez-Alonso, J. (2009). Aplicación de la terapia de afrontamiento del estrés en dos poblaciones con alto estrés: Pacientes crónicos y personas sanas. [Effectiveness of stress management therapy in two populations with high stress: Chronic patients and healthy people]. Salud Mental, 32, 251258.Google Scholar
Plessow, F., Kiesel, A., & Kirschbaum, C. (2012). The stressed prefrontal cortex and goal-directed behaviour: Acute psychosocial stress impairs the flexible implementation of task goals. Experimental Brain Research, 216, 397408. CrossRefGoogle ScholarPubMed
Porcelli, A. J., Lewis, A. H., & Delgado, M. R. (2012). Acute stress influences neural circuits of reward processing. Frontiers in Neuroscience, 6, 157. CrossRefGoogle ScholarPubMed
Porter, R. J., Bourke, C., Carter, J. D., Douglas, K. M., McIntosh, V. V. W., Jordan, J., … Frampton, C. M. A. (2016). No change in neuropsychological dysfunction or emotional processing during treatment of major depression with cognitive-behaviour therapy or schema therapy. Psychological Medicine, 46, 393404. CrossRefGoogle ScholarPubMed
Qin, S., Hermans, E. J., van Marle, H. J. F., Luo, J., & Fernández, G. (2009). Acute psychological stress reduces working memory-related activity in the dorsolateral prefrontal cortex. Biological Psychiatry, 66(1), 2532. CrossRefGoogle Scholar
Remor, E. (2006). Psychometric properties of a european spanish version of the Perceived Stress Scale (PSS). The Spanish Journal of Psychology, 9, 8693. CrossRefGoogle Scholar
Remor, E., & Carrobles, A. (2001). Versión española de la escala de estrés percibido (PPS-14): Estudio psicométrico en una muestra vih+. [Spanish version of the perceived stress scale (PPS-14): Psychometric study in a sample vih+]. Ansiedad y Estrés, 7, 195201.Google Scholar
Robles-Ortega, H., & Peralta-Ramírez, M. I. (2006). Programa para el control del estrés. [Stress management program]. Madrid, Spain: Pirámide.Google Scholar
Robles-Ortega, H., Peralta-Ramírez, M. I., & Navarrete-Navarrete, N. (2006). Validación de la versión española del Inventario de Vulnerabilidad al Estrés de Beech, Burns y Sheffield. Avances en Psicología de la Salud. [Validation of the Spanish version of the Beech, Burns and Sheffield Stress Vulnerability Inventory. Advances in Health Psychology]. Granada, Spain: Ediciones Sider.Google Scholar
Sandín, B., Chorot, P., & Santed, M. A. (1999). Escala SRLE de Kohn-Macdonald 1992. [Scale SRLE by Kohn-Macdonald 1992]. In Sandín, B. (Ed.), El estrés psicosocial: Conceptos y consecuencias clínicas. [Psychosocial stress: Concepts and clinical consequences]. Madrid, Spain: UNED-FUE.Google Scholar
Santos-Ruiz, A., García-Ríos, M. C., Fernández-Sánchez, J. C., Pérez-García, M., Muñoz-García, M. A., & Peralta-Ramírez, M. I. (2012). Can decision-making skills affect responses to psychological stress in healthy women? Psychoneuroendocrinology, 37, 19121921. CrossRefGoogle Scholar
Sapolsky, R. M. (2004). Why zebras don’t get ulcers? The acclaimed guide to stress, stress-related diseases, and coping (3rd Ed.). New York, NY: Henry Holt and Company, LLC.Google Scholar
Sedó, M. (2005). Test de los Cinco Dígitos [Five Digit Test]. Madrid, Spain: TEA Ediciones.Google Scholar
Starcke, K., Wolf, O. T., Markowitsch, H. J., & Brand, M. (2008). Anticipatory stress influences decision making under explicit risk conditions. Behavioral Neuroscience, 122, 13521360.CrossRefGoogle ScholarPubMed
Torrubia, R., Avila, C., Moltó, J., & Caseras, X. (2001). The sensitivity to Punishment and sensitivity to Reward Questionnaire (SPSRQ) as a mesure of Gray´s anxiety and impulsivity dimensions. Personality and Individual Differences, 31, 837862.CrossRefGoogle Scholar
van den Bos, R., Harteveld, M., & Stoop, H. (2009). Stress and decision-making in humans: Performance is related to cortisol reactivity, albeit differently in men and women. Psychoneuroendocrinology, 34, 14491458. CrossRefGoogle ScholarPubMed
Wechsler, D. (1997). Wechsler Adult Intelligence Scale (3rd Ed.). San Antonio, TX: The Psychological Corporation.Google Scholar
Wilson, B. A., Alderman, N., Burgess, P. W., Emslie, H., & Evans, J. J. (1996). Behavioral assessment of the dysexecutive syndrome. Bury St. Edmunds, UK: Thames Valley Test Company.Google Scholar
WMA (World Medical Association) (2015). Medical Ethics Manual. Ferney-Voltaire, France: Ed. World Medical Association.Google Scholar
Zermatten, A., van der Linden, M., d’Acremont, M., Jermann, F., & Bechara, A. (2005). Impulsivity and decision making. Journal of Nervous and Mental Disease, 193, 647650. CrossRefGoogle ScholarPubMed

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