Catastrophizing

Catastrophizing is a cognitive distortion where individuals habitually anticipate the worst possible outcomes in situations, often leading to increased anxiety and emotional discomfort.

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Professional version

Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.

Client version

Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.

Overview

Catastrophizing is a common thinking bias outlined in cognitive-behavioral therapies. It involves jumping to the most severe conclusions without evidence, fostering anxiety and distress. This information handout is a part of the cognitive distortions series, designed to provide mental health professionals with tools to assist clients in recognizing and addressing these patterns. Catastrophizing plays a significant role in various clinical disorders, including anxiety disorders, PTSD, and chronic pain.

Why Use This Resource?

By addressing catastrophizing, therapists can help clients:

  • Recognize and label catastrophic thoughts.
  • Develop healthier cognitive patterns.
  • Reduce anxiety by evaluating the likelihood and impact of feared outcomes.
  • Encourage coping strategies for managing distressing thoughts.

Key Benefits

Awareness

Helps clients identify catastrophic thinking patterns.

Education

Provides psychoeducation on cognitive distortions.

Strategies

Offers practical interventions such as self-soothing and decatastrophizing.

Who is this for?

Generalized Anxiety Disorder (GAD)

Concerns about the worst happening, leading to chronic worry.

Panic Disorder

Fears of catastrophic health outcomes from minor bodily sensations.

Post-Traumatic Stress Disorder (PTSD)

Persistent thoughts of catastrophic events post-trauma.

Health Anxiety

Excessive worries about severe illness from normal physical changes.

Chronic Pain

Exaggerated thoughts about pain intensity and its future impact.

Integrating it into your practice

01

Educate

Provide information on cognitive distortions and their effects on emotions.

02

Identify

Encourage clients to notice and label catastrophic thoughts as they occur.

03

Address

Using strategies such as worry postponement and decatastrophizing to address this distortion.

Theoretical Background & Therapist Guidance

Catastrophizing is a cognitive distortion where individuals exaggerate the severity and probability of negative events. This cognitive pattern often results from automatic thoughts that are inaccurate but compelling. Beck's model of cognitive therapy emphasizes catching and reappraising these thoughts to reduce distress. The evolutionary perspective suggests that catastrophic thinking evolved as a mechanism for threat anticipation and preparedness.  Various therapeutic strategies such as cognitive restructuring, grounding techniques, and behavioral experiments are employed to address this distortion. The resource provides practical guidance for clinicians to support clients in identifying and addressing catastrophic thinking.

What's inside

  • Detailed information about cognitive distortions.
  • Insights into catastrophizing and its impact.
  • Strategies for identifying and addressing catastrophic thoughts.
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FAQs

Catastrophizing is thinking about situations in the worst possible terms and assuming catastrophic outcomes are likely.
It can contribute to increased stress, anxiety, and disturbed sleep by underestimating coping capabilities and overestimating threats.
Look for “What if...?” thoughts or fears about future events.
Strategies include such as self-soothing, worry postponement, data logs for event probability, and decatastrophizing can be helpful.

How This Resource Improves Clinical Outcomes

Integrating this resource into therapy can lead to:

  • Enhanced client insight into distorted thinking patterns.
  • Reduced frequency and intensity of catastrophic thoughts.
  • Improved anxiety management and emotional regulation.
  • Better engagement with coping strategies and problem-solving.

Therapists benefit from:

  • A structured approach to address cognitive distortions.
  • An accessible resource for clients.
  • Suggestions for relevant interventions.

Clinicians Who Use This Resource Also Use

References And Further Reading

  • Abramson, L. Y., Seligman, M. E., & Teasdale, J. D. (1978). Learned helplessness in humans: Critique and reformulation. Journal of Abnormal Psychology, 87, 49-74. DOI: 10.1037/0021-843X.87.1.49.
  • Beck, A. T. (1963). Thinking and depression: I. Idiosyncratic content and cognitive distortions. Archives of General Psychiatry, 9, 324-333. DOI: 10.1001/archpsyc.1963.01720160014002.
  • Beck, A. T., Freeman, A., Davis, D. D., & Associates. (2004). Cognitive therapy of personality disorders (2nd ed). Guilford Press.
  • Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. Guilford Press.
  • Beck, J. S. (1995). Cognitive therapy: Basics and beyond. Guilford Press.
  • Bryant, R. A. (2001). Posttraumatic stress disorder and mild brain injury: controversies, causes and consequences. Journal of Clinical and Experimental Neuropsychology, 23(6), 718-728.
  • Burns, D. D. (1981). Feeling good: The new mood therapy. Penguin.
  • Clark, D. M. (1986). A cognitive approach to panic. Behaviour research and therapy, 24, 461-470. DOI: 10.1016/0005-7967(86)90011-2.
  • Davey, G. C., & Wells, A. (Eds.). (2006). Worry and its psychological disorders: Theory, assessment and treatment. John Wiley & Sons.
  • Ellis, A. (1962). Reason and emotion in psychotherapy. Lyle Stuart.
  • Flavell, J. H. (1979). Metacognition and cognitive monitoring: A new area of cognitive-developmental inquiry. American Psychologist, 34, 906. DOI: 10.1037/0003-066X.34.10.906.
  • Gilbert, P. (1998). The evolved basis and adaptive functions of cognitive distortions. British Journal of Medical Psychology, 71, 447-463. DOI: 10.1111/j.2044-8341.1998.tb01002.x.
  • Hiller, R., Lovato, N., Gradisar, M., Oliver, M., Slater, A. (2014). Trying to fall asleep while catastrophising: what sleep-disordered adolescents think and feel. Sleep Medicine, 15, 96-103. DOI: 10.1016/j.sleep.2013.09.014.
  • Hinrichsen, H., & Clark, D. M. (2003). Anticipatory processing in social anxiety: Two pilot studies. Journal of Behavior Therapy and Experimental Psychiatry, 34, 205-218. DOI: 10.1016/S0005-7916(03)00050-8.
  • Jenness, J. L., Jager‐Hyman, S., Heleniak, C., Beck, A. T., Sheridan, M. A., & McLaughlin, K. A. (2016). Catastrophizing, rumination, and reappraisal prospectively predict adolescent PTSD symptom onset following a terrorist attack. Depression and Anxiety, 33, 1039-1047. DOI: 10.1002/da.22548.
  • Kendall, P. C., & Ingram, R. (1987). The future for cognitive assessment of anxiety: Let’s get specific. In L. Michelson & L. M. Ascher (Eds.), Anxiety and stress disorders: Cognitive-behavioral assessment and treatment (pp. 89-104). The Guilford Press.
  • Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer.
  • Noël, V. A., Francis, S. E., Williams-Outerbridge, K., & Fung, S. L. (2012). Catastrophizing as a predictor of depressive and anxious symptoms in children. Cognitive Therapy and Research, 36, 311-320. DOI: 10.1007/s10608-011-9370-2.
  • Provencher, M. D., Freeston, M. H., Dugas, M. J., & Ladouceur, R. (2000). Catastrophizing assessment of worry and threat schemata among worriers. Behavioural and Cognitive Psychotherapy, 28, 211-224. DOI: 10.1017/S1352465800003027.
  • Salkovskis, P. M., & Warwick, H. M. (1986). Morbid preoccupations, health anxiety and reassurance: a cognitive-behavioural approach to hypochondriasis. Behaviour Research and Therapy, 24, 597-602. DOI: 10.1016/0005-7967(86)90041-0.
  • Seligman, M. E., Allen, A. R., Vie, L. L., Ho, T. E., Scheier, L. M., Cornum, R., & Lester, P. B. (2019). PTSD: Catastrophizing in combat as risk and protection. Clinical Psychological Science, 7, 516-529. DOI: 10.1177/2167702618813532.
  • Severeijns, R., Vlaeyen, J. W., van den Hout, M. A., & Weber, W. E. (2001). Pain catastrophizing predicts pain intensity, disability, and psychological distress independent of the level of physical impairment. The Clinical Journal of Pain, 17, 165-172.
  • Shafran, R. (2005). Cognitive-behavioral models of OCD. In J. S. Abramowitz & A. C. Houts (Eds.), Obsessive-compulsive disorder: Concepts and controversies (pp. 229-260). Springer.
  • Shafran, R., Thordarson, D. S., & Rachman, S. (1996). Thought-action fusion in obsessive compulsive disorder. Journal of Anxiety Disorders, 10, 379-391. DOI: 10.1016/0887-6185(96)00018-7.
  • Startup, H. M., & Davey, G. C. (2001). Mood as input and catastrophic worrying. Journal of Abnormal Psychology, 110, 83-96. DOI: 10.1037/0021-843X.110.1.83.
  • Startup, H., Freeman, D., & Garety, P. A. (2007). Persecutory delusions and catastrophic worry in psychosis: developing the understanding of delusion distress and persistence. Behaviour Research and Therapy, 45, 523-537. DOI: 10.1016/j.brat.2006.04.006.
  • Sullivan, M. J., Thorn, B., Haythornthwaite, J. A., Keefe, F., Martin, M., Bradley, L. A., & Lefebvre, J. C. (2001). Theoretical perspectives on the relation between catastrophizing and pain. The Clinical Journal of Pain, 17, 52-64.
  • Vasey, M. W., & Borkovec, T. D. (1992). A catastrophizing assessment of worrisome thoughts. Cognitive Therapy and Research 16, 505-520. DOI: 10.1007/BF01175138.
  • Veen, G., & Arntz, A. (2000). Multidimensional dichotomous thinking characterizes borderline personality disorder. Cognitive Therapy and Research 24, 23-45. DOI: 10.1023/A:1005498824175.
  • Westbrook, D., Kennerley, H., & Kirk, J. (2011). An introduction to cognitive behaviour therapy: Skills and applications (2nd ed.). Sage.

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