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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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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:

data gathering exercises that aim to overcome attentional biases;
thought-challenging exercises that aim to identify and then overcome cognitive distortions;
exposure and behavioral experiments that target expectancy biases.

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.

Cognitive Bias

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Problem

Therapy tool

Language

Anger Thought Challenging Record

Behavioral Experiment (Portrait Format)

Catching Your Thoughts (CYP)

CBT Thought Record

Challenging Your Negative Thinking

Cognitive Behavioral Model Of Anorexia Nervosa (2003)

Cognitive Behavioral Model Of Body Dysmorphic Disorder (BDD) (2004)

Cognitive Behavioral Model Of Bulimia Nervosa (2003)

Cognitive Behavioral Model Of Health Anxiety (2003)

Cognitive Behavioral Model Of Panic (1986)

Cognitive Behavioral Model Of Tinnitus (2014)

Core Belief Magnet Metaphor

Court Trial Thought Challenging Record

Daily Record of Dysfunctional Thoughts

Dysfunctional Thought Record

Fact Or Opinion

Health Anxiety Thought Record

Hindsight Bias

Maintenance Of Obsessive Compulsive Disorder (OCD)

Process Focused Case Formulation

Prompts For Challenging Negative Thinking

Schema Formulation

Schema Metaphors

Thought Challenging Record 7 Column

Thought Distortion Monitoring Record

Thoughts And Depression

Thoughts In CBT (Psychology Tools For Living Well)

Unhelpful Thinking Styles

Recommended Reading

What Is Cognitive Bias?

Disorders That May Be Maintained by Cognitive Bias

Helpful Questions for Assessing Cognitive Bias

Treatment Approaches That Target Cognitive Bias

References