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Cognitive Bias

Human beings are processing information all of the time: in both a fast and automatic fashion, and as slow and effortful process (e.g., Kahneman, 2011). In the context of psychological therapy the term cognitive bias refers to the ability that people have to selectively attend to and recall information, or to distort information. Clinically, the most widely known aspect of cognitive bias are the cognitive distortions (unhelpful thinking styles) identified by Beck, examples of which include arbitrary inference, over-generalization, and dichotomous thinking (Beck, 1963). Harvey, Watkins, Mansell, and Shafran (2004) define reasoning as “thinking that is concerned with deducing conclusions, generating judgements, and testing hypotheses in a logical and coherent way.” They go on to describe a number of ways in which reasoning processes can become biased with the frequent “result that the conclusion drawn differs from objective reality”. Biases in reasoning or information processing are not necessarily dysfunctional but they often play important roles in maintaining clinical problems, including anxiety and mood disorders. Some forms of cognitive bias which are important in CBT include:
  • biased interpretation of ambiguous stimuli, which might include misinterpreting someone’s facial expression;
  • making biased attributions such as misinterpreting the degree to which the cause of an event is to do with ourselves, or misinterpreting the degree to which the cause of an event is stable or transient;
  • biased expectancies, such as a patient with anxiety expecting that negative outcomes are very likely to happen;
  • biased heuristics, such as the emotional reasoning heuristic whereby mood influences the conclusions an individual draws.
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Anger Thought Challenging Record

Disputing thoughts is a critical skill in cognitive therapy. The Anger Thought Monitoring Record helps clients to identify and challenge their angry t ... https://www.psychologytools.com/resource/anger-thought-challenging-record/

Worksheet

Behavioral Experiment (Portrait Format)

Behavioral experiments allow individuals to test the validity of their beliefs and assumptions. They are a core experiential technique for therapeutic ... https://www.psychologytools.com/resource/behavioral-experiment-portrait-format/

Worksheet

Catching Your Thoughts (CYP)

Before thoughts can be examined or challenged they must be ‘caught’ – they must be noticed and distinguished from events and feelings. The Catch ... https://www.psychologytools.com/resource/catching-your-thoughts-cyp/

Worksheet

Challenging Your Negative Thinking

A cornerstone of cognitive behavioral therapy is that an individual’s interpretation of an event determines how they feel and behave. We all experie ... https://www.psychologytools.com/resource/challenging-your-negative-thinking/

Guide

Cognitive Behavioral Model Of Anorexia Nervosa (Fairburn, Cooper, Shafran, 2003)

Anorexia nervosa is an eating disorder characterized by restriction of energy intake and intense fear of gaining weight. For women, the lifetime preva ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-anorexia-nervosa-fairburn-cooper-shafran-2003/

Information Handout

Cognitive Behavioral Model Of Body Dysmorphic Disorder (BDD: Veale, 2004)

Individuals with body dysmorphic disorder (BDD) experience distress associated with their body image. The Cognitive Behavioral Model Of Body Dysmorphi ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-body-dysmorphic-disorder-bdd-veale-2004/

Information Handout

Cognitive Behavioral Model Of Bulimia Nervosa (Fairburn, Cooper, Shafran, 2003)

Bulimia nervosa is an eating disorder characterized by binge eating followed by purging. Among young women, the point prevalence of bulimia is about 1 ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-bulimia-nervosa-fairburn-cooper-shafran-2003/

Information Handout

Cognitive Behavioral Model Of Health Anxiety (Salkovskis, Warwick, Deale, 2003)

Health anxiety is characterized by a preoccupation with having or acquiring a serious illness, and a high level of anxiety about health. People with h ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-health-anxiety-salkovskis-warwick-deale-2003/

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Cognitive Behavioral Model Of Low Self-Esteem (Fennell, 1997)

Low self-esteem is characterized as a negative sense of the self and co-occurs with many other mental health problems. Although not formally represent ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-low-self-esteem-fennell-1997/

Information Handout

Cognitive Behavioral Model Of Panic (Clark, 1986)

The Cognitive Behavioral Model Of Panic identifies catastrophic misinterpretation of body sensations as a criticial maintenance factor which serves to ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-panic-clark-1986/

Information Handout

Cognitive Behavioral Model Of Social Phobia (Clark, Wells, 1995)

People suffering from social anxiety disorder (previously known as social phobia) experience persistent fear or anxiety concerning social or performan ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-social-phobia-clark-wells-1995/

Information Handout

Cognitive Behavioral Model Of Tinnitus (McKenna, Handscombe, Hoare, Hall, 2014)

The Cognitive Behavioral Model Of Tinnitus identifies cognitive, behavioral, and perceptual changes which operate to maintain tinnitus perception and ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-tinnitus-mckenna-handscombe-hoare-hall-2014/

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Core Belief Magnet Metaphor

Core beliefs (schemas) are self-sustaining. They act to ‘attract’ confirmatory evidence and ‘repel’ (or distort) disconfirmato ... https://www.psychologytools.com/resource/core-belief-magnet-metaphor/

Information Handout

Court Trial Thought Challenging Record

Thought challenging records are commonly used in CBT to help people to evaluate their negative automatic thoughts for accuracy and bias. This Court Tr ... https://www.psychologytools.com/resource/court-trial-thought-challenging-record/

Worksheet

Dysfunctional Thought Record

The Dysfunctional Thought Record is a worksheet to record and challenge dysfunctional thoughts. It encourages clients to identify the involvement of a ... https://www.psychologytools.com/resource/dysfunctional-thought-record/

Worksheet

Fact Or Opinion

One cognitive error which commonly results in distress is to act on our opinions as though they were facts. This CBT exercise helps clients to practic ... https://www.psychologytools.com/resource/fact-or-opinion/

Exercise

Health Anxiety Thought Record

Individuals with health anxiety experience clinically significant distress associated with health concerns. This thought-challenging record enables cl ... https://www.psychologytools.com/resource/health-anxiety-thought-record/

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Hindsight Bias

Survivors of loss or trauma often think “If only …”. Hindsight Bias is a cognitive bias / cognitive illusion which makes events seem mor ... https://www.psychologytools.com/resource/hindsight-bias/

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How Trauma Can Affect You (CYP)

Trauma can result in a wide variety of symptoms, experiences, and behaviors. As well as post-traumatic stress disorder (PTSD), prevalence rates of oth ... https://www.psychologytools.com/resource/how-trauma-can-affect-you-cyp/

Information Handout

Low Self-Esteem Formulation

Fennell’s cognitive behavioral model of low self-esteem proposes that negative beliefs about the self are maintained by biased information processin ... https://www.psychologytools.com/resource/low-self-esteem-formulation/

Worksheet

Obsessive Compulsive Disorder (OCD) Formulation

An important treatment implication of the cognitive behavioral model of OCD is that clinicians can work at the level of the meaning of the intrusion. ... https://www.psychologytools.com/resource/obsessive-compulsive-disorder-ocd-formulation/

Worksheet

Process Focused Case Formulation

The Process-Focused Case Formulation encourages clinicians to make hypotheses regarding mechanisms or processes which they believe may be maintainin ... https://www.psychologytools.com/resource/process-focused-case-formulation/

Worksheet

Prompts For Challenging Negative Thinking

The CBT model proposes that how we think affects the way we feel. Challenging our unhelpful thoughts (cognitive restructuring) is an essential skill w ... https://www.psychologytools.com/resource/prompts-for-challenging-negative-thinking/

Exercise

PTSD Formulation

This PTSD Formulation is designed for use in trauma-focused cognitive therapy for PTSD (CT-PTSD): an empirically supported treatment for Post-Traumati ... https://www.psychologytools.com/resource/ptsd-formulation/

Worksheet

Schema Formulation

Beck’s cognitive model proposes that cognition and perception in the here-and-now is influenced by our ‘schemas’ which shape our per ... https://www.psychologytools.com/resource/schema-formulation/

Worksheet

Schema Metaphors

Core beliefs (schemas) are self-sustaining. They act to ‘attract’ confirmatory evidence and ‘repel’ or ‘distort’ d ... https://www.psychologytools.com/resource/schema-metaphors/

Information Handout

Social Anxiety Formulation

People suffering from social anxiety disorder (previously known as social phobia) experience persistent fear or anxiety concerning social or performan ... https://www.psychologytools.com/resource/social-anxiety-formulation/

Worksheet

Thought Distortion Monitoring Record

Thinking is often biased in particular ways and individuals often have their own characteristic patterns of bias. The Thought Distortion Monitoring Re ... https://www.psychologytools.com/resource/thought-distortion-monitoring-record/

Worksheet

Thought Record (Considered Response)

Thought records exist in multiple variants, depending on the needs and abilities of the client. This Thought Record (Considered Response) is a cogniti ... https://www.psychologytools.com/resource/thought-record-considered-response/

Worksheet

Thought Record (Evidence For And Against)

CBT Thought Records exist in multiple variants, depending on the needs and abilities of the client. This Thought Record (Evidence For And Against) is ... https://www.psychologytools.com/resource/thought-record-evidence-for-and-against/

Worksheet

Thoughts And Depression

Depression is associated with cognitive biases, one of which is a failure to notice positive information. This information handout presents this conce ... https://www.psychologytools.com/resource/thoughts-and-depression/

Information Handout

Thoughts In CBT (Psychology Tools For Living Well)

Cognitive behavioral therapy can help your clients to live happier and more fulfilling lives. Psychology Tools for Living Well is a self-help course ... https://www.psychologytools.com/resource/thoughts-in-cbt-psychology-tools-for-living-well/

Chapter

Unhelpful Thinking Styles

Human thinking is subject to a number of characteristic biases. Cognitive restructuring is the process of helping individuals to overcome their biases ... https://www.psychologytools.com/resource/unhelpful-thinking-styles/

Information Handout

What Keeps Depression Going?

Our “What Keeps Disorder Going?” series is a set of one-page diagrams explaining how common mental health conditions are maintained. Frien ... https://www.psychologytools.com/resource/what-keeps-depression-going/

Information Handout

What Keeps Low Self-Esteem Going?

Our “What Keeps Disorder Going?” series is a set of one-page diagrams explaining how common mental health conditions are maintained. Frien ... https://www.psychologytools.com/resource/what-keeps-low-self-esteem-going/

Information Handout

Recommended Reading

  • Beck, A. T., Rush, A. J., Shaw, B. F., Emery, G. (1979). Cognitive therapy of depression. New York: Guilford
  • Burns, D. D. (1980. Feeling good. New York: Avon Books

What Is Cognitive Bias?

Disorders That May Be Maintained by Cognitive Bias

Cognitive biases, including biased interpretations, attributions, expectancies, or heuristics, are thought to contribute to the maintenance of:

  • panic disorder (interpretation bias, attribution bias, expectancy bias, emotional reasoning);
  • specific phobia (expectancy bias, emotional reasoning);
  • social phobia (interpretation bias, attribution bias, expectancy bias);
  • obsessive compulsive disorder (OCD) (attribution bias, expectancy bias, emotional reasoning);
  • post-traumatic stress disorder (PTSD) (interpretation bias, attribution bias, expectancy bias, emotional reasoning);
  • generalized anxiety disorder (GAD) (interpretation bias, attribution bias, expectancy bias, emotional reasoning);
  • pain disorder (interpretation bias, expectancy bias);
  • health anxiety (interpretation bias, attribution bias, expectancy bias);
  • eating disorders (interpretation bias, attribution bias, expectancy bias);
  • depression (interpretation bias, attribution bias, expectancy bias);
  • bipolar disorder (attribution bias);
  • psychosis (interpretation bias, attribution bias, expectancy bias);
  • substance misuse (interpretation bias, attribution bias, expectancy bias).

Helpful Questions for Assessing Cognitive Bias

Some helpful questions for assessing cognitive bias:

  • What do you think will happen if you do X or Y?
  • What predictions are you making in this situation?
  • What sort of evidence are you using to make this judgment or prediction?
  • What do you expect will happen here?
  • How do you know what will happen?

Treatment Approaches That Target Cognitive Bias

A wide range of treatment interventions are designed to target cognitive bias. These can include:

References

  • Beck, A. T. (1963). Thinking and depression: I. Idiosyncratic content and cognitive distortions. Archives of General Psychiatry, 9(4), 324–333.
  • Harvey, A. G., Watkins, E., Mansell, W., & Shafran, R. (2004). Cognitive behaviouralprocesses across psychological disorders: A transdiagnostic approach to research and treatment. New York: Oxford University Press.
  • Kahneman, D. (2011). Thinking, fast and slow. New York: Farrar, Straus and Giroux.