cognitive distortions

Meaning: Cognitive distortions are habitual, automatic, illogical or exaggerated thoughts that bias how a person interprets events, usually toward the negative. In the cognitive view (associated with Beck), emotion and behavior depend on how a situation is interpreted, not on the situation itself, so distorted interpretations can maintain depression and anxiety. Examples: all-or-nothing thinking (a B+ means failure), overgeneralization (one rejection means nobody likes me), catastrophizing (expecting the worst outcome), personalization (blaming oneself for events outside one's control), and emotional reasoning (I feel afraid, so I must be in danger).

On the MCAT: A vignette quotes a person's thought, such as "I missed one question, so I will fail medical school," and asks which distortion it shows or which therapy addresses it. Cognitive-behavioral therapy has the client identify the thought, test it against evidence, and replace it with a more realistic one. Related ideas include Beck's cognitive triad (negative view of self, the world, and the future) and pessimistic attributional style.

Common confusion: Distortions are not the same as cognitive biases and heuristics, such as confirmation bias or the availability heuristic, which describe errors in everyone's judgment. They are also not delusions: a distorted thought exaggerates reality but is often open to evidence, while a delusion is a fixed false belief.