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Cognitive Distortion / 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: Read more

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69 of 69 resources

Anger Thought Challenging Record

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

Worksheets

Anxiety - Self-Monitoring Record

Developing self-monitoring skills teaches clients to systematically observe and record specific targets such as their own thoughts, body feelings, emo ... https://www.psychologytools.com/resource/anxiety-self-monitoring-record

Worksheets

Before I Blame Myself And Feel Guilty

Guilt is a common post-traumatic reaction and is often the result of cognitive bias. This CBT worksheet explores common cognitive biases that have bee ... https://www.psychologytools.com/resource/before-i-blame-myself-and-feel-guilty

Exercises

Behavioral Experiment

Behavioral experiments are planned experiential activities to test the validity of a belief. They are one of the most powerful techniques available to ... https://www.psychologytools.com/resource/behavioral-experiment

Worksheets

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

Worksheets

Belief Driven Formulation

Cognitive behavioral theory proposes that our thoughts, feelings, and behavior in the here-and-now are influenced by our schemas / core beliefs / assu ... https://www.psychologytools.com/resource/belief-driven-formulation

Worksheets

Belief-O-Meter (CYP)

The Belief-O-Meter is an engaging way of helping children and adolescents to relate to their thoughts differently. It is a form of cognitive restructu ... https://www.psychologytools.com/resource/belief-o-meter-cyp

Worksheets

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

Worksheets

CBT Appraisal Model

The CBT Appraisal Model worksheet is a transdiagnostic formulation tool. The centrality of appraisals underpins all of the disorder-specific cognitive ... https://www.psychologytools.com/resource/cbt-appraisal-model

Worksheets

CBT Thought Record Portrait

The CBT Thought Record is an essential tool in cognitive behavioral therapy. Thought challenging records help people to evaluate their negative automa ... https://www.psychologytools.com/resource/cbt-thought-record-portrait

Worksheets

Challenging Your Negative Thinking (Archived)

NOTE: An improved version of this resource is available here: Evaluating Unhelpful Automatic Thoughts. Older versions of a resource may be archived in ... https://www.psychologytools.com/resource/challenging-your-negative-thinking

Archived

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 handouts

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 handouts

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 handouts

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

Information handouts

Cognitive Behavioral Model Of Insomnia (Harvey, 2002)

Insomnia is a highly prevalent sleep disorder characterized by difficulty initiating or maintaining sleep, or having non-restorative sleep for at leas ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-insomnia-harvey-2002

Information handouts

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 handouts

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 handouts

Cognitive Behavioral Model Of Post Traumatic Stress Disorder (PTSD: Ehlers & Clark, 2000)

Anke Ehlers' & David Clark's Cognitive Behavioral Model Of Post-Traumatic Stress Disorder (PTSD) is an influential account of the condition. The ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-post-traumatic-stress-disorder-ptsd-ehlers-clark-2000

Information handouts

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 handouts

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

Information handouts

Compassionate 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 Compassi ... https://www.psychologytools.com/resource/compassionate-thought-challenging-record

Worksheets

Core Belief Magnet Metaphor

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

Information handouts

Court Trial Thought Challenging Record (Archived)

NOTE: An improved version of this resource is available here: Thought Record - Courtroom Trial. Older versions of a resource may be archived in the ev ... https://www.psychologytools.com/resource/court-trial-thought-challenging-record

Archived

Decatastrophizing

Catastrophic thinking (magnification) is characteristic of many anxiety problems. This CBT worksheet for decatastrophizing is a tool for cognitive res ... https://www.psychologytools.com/resource/decatastrophizing

Exercises

Depression - Self-Monitoring Record

Worksheets

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

Worksheets

Evaluating Unhelpful Automatic Thoughts

The Evaluating Unhelpful Automatic Thoughts guide is written for clients who struggle with negative automatic thoughts. It provides a comprehensive in ... https://www.psychologytools.com/resource/evaluating-unhelpful-automatic-thoughts

Guides

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

Exercises

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

Worksheets

Hindsight Bias

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

Information handouts

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 handouts

Identifying The Meaning Of Body Sensations

Some anxiety disorders (including panic and health anxiety), are concerned with body sensations and symptoms. The Identifying The Meaning Of Body Sens ... https://www.psychologytools.com/resource/identifying-the-meaning-of-body-sensations

Worksheets

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

Worksheets

Managing Social Anxiety: Therapist Guide

Managing Social Anxiety – A Cognitive-Behavioral Therapy Approach comes in two volumes. This page is for the Therapist Guide. Click on the following ... https://www.psychologytools.com/resource/managing-social-anxiety-therapist-guide

Treatments That Work®

Mastery Of Your Anxiety And Panic: Therapist Guide

Mastery Of Your Anxiety And Panic comes in two volumes. This page is for the Therapist Guide. Click on the following link to access the accompanying C ... https://www.psychologytools.com/resource/mastery-of-your-anxiety-and-panic-therapist-guide

Treatments That Work®

Mastery Of Your Anxiety And Panic: Workbook

Mastery Of Your Anxiety And Panic comes in two volumes. This page is for the Workbook. Click on the following link to access the accompanying Therapis ... https://www.psychologytools.com/resource/mastery-of-your-anxiety-and-panic-workbook

Treatments That Work®

Meaning In Tinnitus

The psychological approach to tinnitus proposes that it is the meaning attached to perceptions which gives rise to distress - this is similar to the a ... https://www.psychologytools.com/resource/meaning-in-tinnitus

Exercises

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

Worksheets

Overcoming Depression: Therapist Guide

Overcoming Depression – A Cognitive Therapy Approach comes in two volumes. This page is for the Therapist Guide. Click on the following link to acce ... https://www.psychologytools.com/resource/overcoming-depression-therapist-guide

Treatments That Work®

Overcoming Depression: Workbook

Overcoming Depression – A Cognitive Therapy Approach comes in two volumes. This page is for the Client Workbook. Click on the following link to acce ... https://www.psychologytools.com/resource/overcoming-depression-workbook

Treatments That Work®

Overcoming Eating Disorders: Therapist Guide

Overcoming Eating Disorders comes in two volumes. This page is for the Therapist Guide. Click on the following link to access the Client Workbook.&nbs ... https://www.psychologytools.com/resource/overcoming-eating-disorders-therapist-guide

Treatments That Work®

Overcoming Insomnia: Therapist Guide

Overcoming Insomnia comes in two volumes. This page is for the Therapist Guide. Click on the following link to access the Client Workbook. It is ... https://www.psychologytools.com/resource/overcoming-insomnia-therapist-guide

Treatments That Work®

Overcoming Insomnia: Workbook

Overcoming Insomnia comes in two volumes. This page is for the Client Workbook. Click on the following link to access the accompanying Therapist Guide ... https://www.psychologytools.com/resource/overcoming-insomnia-workbook

Treatments That Work®

Overcoming Your Eating Disorder: Workbook

Overcoming Eating Disorders comes in two volumes. This page is for the Client Workbook. Click on the following link to access the accompanying Therapi ... https://www.psychologytools.com/resource/overcoming-your-eating-disorder-workbook

Treatments That Work®

Panic - Self-Monitoring Record

Worksheets

Panic Attack Record Form

Self-monitoring of thoughts, feelings and symptoms is an essential skill for clients engaged in cognitive behavioral therapy (CBT). The Panic Attack R ... https://www.psychologytools.com/resource/panic-attack-record-form

Worksheets

Positive Belief Record

Some cognitive change can happen quickly - for example challenging negative automatic thoughts. Other cognitive structures such as schemas are more de ... https://www.psychologytools.com/resource/positive-belief-record

Worksheets

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

Worksheets

Prolonged Exposure Therapy For PTSD: Therapist Guide

Prolonged Exposure Therapy For PTSD comes in two volumes. This page is for the Therapist Guide. Click on the following link to access the accompanying ... https://www.psychologytools.com/resource/prolonged-exposure-therapy-for-ptsd-therapist-guide

Treatments That Work®

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

Exercises

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

Worksheets

Schema Formulation

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

Worksheets

Schema Metaphors

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

Information handouts

Self-Monitoring Record (Universal)

Worksheets

Simple Thought Challenging Record

Disputing thoughts is a critical skill in cognitive therapy. The Simple Thought Challenging Record encourages clients to identify alternative perspect ... https://www.psychologytools.com/resource/simple-thought-challenging-record

Worksheets

Simple Thought Record

Self-monitoring of thoughts, feelings, and symptoms is an essential skill in cognitive behavioral therapy (CBT). This Simple Thought Record is an exce ... https://www.psychologytools.com/resource/simple-thought-record

Worksheets

Social Anxiety Formulation

Worksheets

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

Worksheets

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

Worksheets

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

Worksheets

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 handouts

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

Books & Chapters

Understanding Depression

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-depression

Guides

Understanding Panic

Guides

Unhelpful Thinking Styles

Human thinking is subject to a number of characteristic biases. In the 1960s, Aaron Beck identified several of these biases which were common in his d ... https://www.psychologytools.com/resource/unhelpful-thinking-styles

Information handouts

What Is Memory?

Like other aspects of cognition, transient difficulties with memory can be caused by stress or fatigue and there is a documented decline in memory fun ... https://www.psychologytools.com/resource/what-is-memory

Information handouts

What Keeps Depression Going?

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

Information handouts

What Keeps Low Self-Esteem Going?

Information handouts

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 Distortion / Cognitive Bias

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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