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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:

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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:

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.

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