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Cognitive biases in anxiety disorders and their effecton cognitive-behavioral treatment
Michelle G. Craske, PhD
Deborah C. Pontillo, MA
Cognitive theorists hypothesize that cognitive biases are a major component in the development and maintenance of anxiety disorders. These include attentional biases toward threat-related information, distorted judgments of risk, and selective memory processing. The empirical evidence for these cognitive biases in anxiety disorder populations is reviewed. Potential deleterious effects of these biases on the process of cognitive-behavioral therapy are also discussed, as are possible ways of overriding those effects and maximizing treatment efficacy. (Bulletin of the Menninger Clinic, 65[1], 5877)
Cognitive processes have been incorporated extensively in conceptualizations of the anxiety disorders over the past 2 decades. Cognitive biases are defined as any selective or nonveridical processing of emotion-relevant information (Mineka & Sutton, 1992, p. 65) and tend to be emotion-, content-, and task-specific, in contrast to global deficits in cognitive functioning. Thus the content of biases differs from one anxiety disorder to the next. By generating further distress, such biases are believed to contribute to the maintenance of excessive anxiety and anxiety disorders. The source of these biases is not well understood. Some speculate that they derive from core belief systems, danger-laden in focus, that lead to distorted processing of information about the world, self, and future through a filter of automatic thoughts and images of danger (Beck, Emery, & Greenberg, 1985).
We first review the wealth of evidence for the presence of such cognitive biases in anxiety disorders. In particular, we present the literature regarding attentional bias, memory bias, and judgment bias.
This article is based on a presentation at the 22nd Annual Menninger Winter Psychiatry Conference held March 510, 2000, at Park City, Utah.
Dr. Craske is a professor of psychology in the Department of Psychology, University of California, Los Angeles. Ms. Pontillo is a graduate student in the Department of Psychology at the University of California, Los Angeles. Correspondence may be sent to Dr. Craske at the Department of Psychology, UCLA, 405 Hilgard Avenue, Los Angeles, CA 90095-1563; e-mail: [email protected]. (Copyright 2001 The Menninger Foundation)
58 Bulletin of the Menninger Clinic
Cognitive biases in anxiety disorders
These biases are present, in varying degrees, in all the anxiety disorders, although the content varies according...