For over 50 years, Beck's cognitive model has provided an evidence-based way to conceptualize and treat psychological disorders. The generic cognitive model represents a set of common principles that can be applied across the spectrum of psychological disorders. The updated theoretical model provides a framework for addressing significant questions regarding the phenomenology of disorders not explained in previous iterations of the original model. New additions to the theory include continuity of adaptive and maladaptive function, dual information processing, energizing of schemas, and attentional focus. The model includes a theory of modes, an organization of schemas relevant to expectancies, self-evaluations, rules, and memories. A description of the new theoretical model is followed by a presentation of the corresponding applied model, which provides a template for conceptualizing a specific disorder and formulating a case. The focus on beliefs differentiates disorders and provides a target for treatment. A variety of interventions are described.


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Literature Cited

  1. Alloy LB, Abramson LY, Walshaw PD, Gerstein RK, Keyser JD. et al. 2009. Behavioral approach system (BAS)-relevant cognitive styles and bipolar spectrum disorders: concurrent and prospective associations. J. Abnorm. Psychol. 118:459 [Google Scholar]
  2. Am. Psychiatr. Assoc 2000. Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: Am. Psychiatr. Assoc, 4th. ed., text rev.
  3. Bandura A. 1962. Social learning through imitation. Neb. Symp. Motiv. MR Jones Lincoln: Univ. Neb. Press [Google Scholar]
  4. Bartlett FC. 1932. Remembering: A Study in Experimental and Social Psychology New York: Macmillan
  5. Beck AT. 1963. Thinking and depression: idiosyncratic content and cognitive distortions. Arch. Gen. Psychiatry 9:324–33 [Google Scholar]
  6. Beck AT. 1964. Thinking and depression: II. Theory and therapy. Arch. Gen. Psychiatry 10:561–71 [Google Scholar]
  7. Beck AT. 1967. Depression: Clinical, Experimental, and Theoretical Aspects Philadelphia: Univ. Penn. Press
  8. Beck AT. 1996. Beyond belief: a theory of modes, personality, and psychopathology. Frontiers of Cognitive Therapy P Salkovskis 1–25 New York: Guilford [Google Scholar]
  9. Beck AT. 1999. Prisoners of Hate: The Cognitive Basis of Anger, Hostility, and Violence New York: HarperCollins
  10. Beck AT. 2008. The evolution of the cognitive model of depression and its neurobiological correlates. Am. J. Psychiatry 165:969–77 [Google Scholar]
  11. Beck AT, Emery G, Greenberg RL. 1985. Anxiety Disorders and Phobias: A Cognitive Perspective New York: Basic Books
  12. Beck AT, Sokol L, Clark DA, Berchick R, Wright F. 1992. A crossover study of focused cognitive therapy for panic disorder. Am. J. Psychiatry 149:778–83 [Google Scholar]
  13. Beck JS. 1995. Cognitive Therapy: Basics and Beyond New York: Guilford
  14. Bhar SS, Beck AT, Butler AC. 2012. Beliefs and personality disorders: an overview of the personality beliefs questionnaire. J. Clin. Psychol. 68:88–100 [Google Scholar]
  15. Butler AC, Chapman JE, Forman EM, Beck AT. 2006. The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clin. Psychol. Rev. 26:17–31 [Google Scholar]
  16. Clark DA, Beck AT. 2011. Cognitive Therapy of Anxiety Disorders: Science and Practice New York: Guilford
  17. Clark DA, Taylor S. 2009. The transdiagnostic perspective on cognitive-behavioral therapy for anxiety and depression: new wine for old wineskins?. J. Cogn. Psychother. 23:60–66 [Google Scholar]
  18. Clark DM, Wells A. 1995. A cognitive model of social phobia. Social Phobia: Diagnosis, Assessment, and Treatment RG Heimberg, M Liebowitz, D Hope, F Scheier 69–93 New York: Guilford [Google Scholar]
  19. Cooper MJ, Rose KS, Turner H. 2006. The specific content of core beliefs and schema in adolescent girls high and low in eating disorder symptoms. Eat. Behav. 7:27–35 [Google Scholar]
  20. Crits-Christoph P, Gibbons MB, Barber JP, Gallop R, Beck AT. et al. 2003. Mediators of outcome of psychosocial treatments for cocaine dependence. J. Consult. Clin. Psychol. 71:918–25 [Google Scholar]
  21. Disner SG, Beevers CG, Haigh EA, Beck AT. 2011. Neural mechanisms of the cognitive model of depression. Nat. Rev. Neurosci. 12:467–77 [Google Scholar]
  22. Dobson KS. 2009. Handbook of Cognitive-Behavioral Therapies New York: Guilford
  23. Dobson KS, Hamilton KE. 2004. Cognitive restructuring: behavioral tests of negative cognitions. Cognitive Behavior Therapy: Applying Empirically Supported Techniques in Your Practice W O'Donohue, JE Fisher, SC Hayes 84–88 Hoboken, NJ: Wiley [Google Scholar]
  24. Donegan E, Dugas MJ. 2012. Generalized anxiety disorder. J. Consult. Clin. Psychol. 80:490–96 [Google Scholar]
  25. Dozois DJA, Bieling PJ, Patelis-Siotis I, Hoar L, Chudzik S. et al. 2009. Changes in self-schema structure in cognitive therapy for major depressive disorder. J. Consult. Clin. Psychol. 77:1078–88 [Google Scholar]
  26. Ellis A. 1958. Rational psychotherapy. J. Gen. Psychol. 59:35–49 [Google Scholar]
  27. Epictetus. 1865. The Works of Epictetus: Consisting of His Discourses, in Four Books, the Enchiridion, and Fragments transl. TW Higginson Boston: Little, Brown
  28. Fergus TA. 2013. Health-related dysfunctional beliefs and health anxiety: further evidence of cognitive specificity. J. Clin. Psychol. In press
  29. Forgeard MJ, Haigh EA, Beck AT, Davidson RJ, Henn FA. et al. 2011. Beyond depression: toward a process-based approach to research, diagnosis, and treatment. Clin. Psychol. (New York) 18:275–99 [Google Scholar]
  30. Fournier J, DeRubeis R, Beck A. 2012. Dysfunctional cognitions in personality pathology: the structure and validity of the Personality Belief Questionnaire. Psychol. Med. 42:795–805 [Google Scholar]
  31. Fresco DM, Flynn JJ, Mennin DS, Haigh EP. 2011. Mindfulness-based cognitive therapy. Acceptance and Mindfulness in Cognitive Behavior Therapy: Understanding and Applying the New Therapies JD Herbert, EM Forman 57–82 Hoboken, NJ: Wiley [Google Scholar]
  32. Gibb BE, Beevers CG, McGeary JE. 2013. Toward an integration of cognitive and genetic models of risk for depression. Cogn. Emot. 27:193–216 [Google Scholar]
  33. Goldin PR, Ziv M, Jazaieri H, Werner K, Kraemer H. et al. 2012. Cognitive reappraisal self-efficacy mediates the effects of individual cognitive-behavioral therapy for social anxiety disorder. 801034–40
  34. Grant PM, Beck AT. 2009. Defeatist beliefs as a mediator of cognitive impairment, negative symptoms, and functioning in schizophrenia. Schizophr. Bull. 35:798–806 [Google Scholar]
  35. Greenberger D, Padesky CA. 1995. Mind Over Mood New York: Guilford
  36. Harvey A, Watkins E, Mansell W, Shafran R. 2004. Cognitive Behavioural Processes Across Psychological Disorders: A Transdiagnostic Approach to Research and Treatment New York: Oxford Univ. Press
  37. Hofmann SG, Asmundson GJG, Beck AT. 2013. The science of cognitive therapy. Behav. Ther. 44:199–212 [Google Scholar]
  38. Hofmann SG, Asnaani A, Vonk IJJ, Sawyer AT, Fang A. 2012. The efficacy of cognitive behavioral therapy: a review of meta-analyses. Cogn. Ther. Res. 36:427–40 [Google Scholar]
  39. Hofmann SG, Meuret AE, Rosenfield D, Suvak MK, Barlow DH. et al. 2007. Preliminary evidence for cognitive mediation during cognitive-behavioral therapy of panic disorder. J. Consult. Clin. Psychol. 75:374–79 [Google Scholar]
  40. Hofmann SG, Smits JAJ. 2008. Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. J. Clin. Psychiatry 69:621–32 [Google Scholar]
  41. Hull CL. 1943. Principles of Behavior: An Introduction to Behavior Theory Oxford, UK: Appleton-Century
  42. Ingram RE. 1990. Self-focused attention in clinical disorders: review and a conceptual model. Psychol. Bull. 107:1939–455 [Google Scholar]
  43. Insel TR, Cuthbert BN, Garvey MA, Heinssen RK, Pine DS. et al. 2010. Research Domain Criteria (RDoC): toward a new classification framework for research on mental disorders. Am. J. Psychiatry 167:748–51 [Google Scholar]
  44. Jarrett RB, Minhajuddin A, Borman PD, Dunlap L, Segal ZV. et al. 2012. Cognitive reactivity, dysfunctional attitudes, and depressive relapse and recurrence in cognitive therapy responders. Behav. Res. Ther. 50:280–86 [Google Scholar]
  45. Kelly GA. 1955. The Psychology of Personal Constructs. 1 A Theory of Personality. 2 Clinical Diagnosis and Psychotherapy Oxford, UK: Norton
  46. Kleim B, Grey N, Wild J, Nussbeck FW, Stott R. et al. 2013. Cognitive change predicts symptom reduction with cognitive therapy for posttraumatic stress disorder. J. Consult. Clin. Psychol. 81:383–93 [Google Scholar]
  47. Kraemer HC, Wilson T, Fairburn CG, Agras WS. 2002. Mediators and moderators of treatment effects in randomized clinical trials. Arch. Gen. Psychiatry 59:877–83 [Google Scholar]
  48. Lazarus RS, Folkman S. 1984. Stress, Appraisal, and Coping New York: Springer
  49. Mansell W, Harvey A, Watkins ER, Shafran R. 2008. Cognitive behavioral processes across psychological disorders: a review of the utility and validity of the transdiagnostic approach. Int. J. Cogn. Ther. 1:181–91 [Google Scholar]
  50. Mansell W, Harvey A, Watkins E, Shafran R. 2009. Conceptual foundations of the transdiagnostic approach to CBT. J. Cogn. Psychother. 23:6–19 [Google Scholar]
  51. Pavlickova H, Varese F, Turnbull O, Scott J, Morriss R. et al. 2013. Symptom-specific self-referential cognitive processes in bipolar disorder: a longitudinal analysis. Psychol. Med. 43:1895–907 [Google Scholar]
  52. Pavlov I. 1927. Conditioned Reflexes New York: Oxford Univ. Press
  53. Piaget J, Warden M. 1926. The Language and Thought of the Child New York: Harcourt Brace
  54. Quilty L, McBride C, Bagby R. 2008. Evidence for the cognitive mediational model of cognitive behavioural therapy for depression. Psychol. Med. 38:1531–41 [Google Scholar]
  55. Raes AK, Koster EHW, Loeys T, De Raedt R. 2011. Pathways to change in one-session exposure with and without cognitive intervention: an exploratory study in spider phobia. J. Anxiety Disord. 25:964–71 [Google Scholar]
  56. Schneider W, Chein JM. 2003. Controlled & automatic processing: behavior, theory, and biological mechanisms. Cogn. Sci. 27:525–59 [Google Scholar]
  57. Schulz SM, Alpers GW, Hofmann SG. 2008. Negative self-focused cognitions mediate the effect of trait social anxiety on state anxiety. Behav. Res. Ther. 46:438–49 [Google Scholar]
  58. Schwartz DR, Carney CE. 2012. Mediators of cognitive-behavioral therapy for insomnia: a review of randomized controlled trials and secondary analysis studies. Clin. Psychol. Rev. 32:664–75 [Google Scholar]
  59. Segal ZV, Bieling P, Young T, MacQueen G, Cooke R. et al. 2010. Antidepressant monotherapy versus sequential pharmacotherapy and mindfulness-based cognitive therapy, or placebo, for relapse prophylaxis in recurrent depression. Arch. Gen. Psychiatry 67:1256–64 [Google Scholar]
  60. Skinner BF. 1938. The Behavior of Organisms: An Experimental Analysis Oxford, UK: Appleton-Century
  61. Staring ABP, ter Huurne M-AB, van der Gaag M. 2013. Cognitive behavioral therapy for negative symptoms (CBT-n) in psychotic disorders: a pilot study. J. Behav. Ther. Exp. Psychiatry 44:300–6 [Google Scholar]
  62. Teachman BA, Marker CD, Clerkin EM. 2010. Catastrophic misinterpretations as a predictor of symptom change during treatment for panic disorder. J. Consult. Clin. Psychol. 78:964–73 [Google Scholar]
  63. Teasdale JD, Segal Z, Williams JMG. 1995. How does cognitive therapy prevent depressive relapse and why should attentional control (mindfulness) training help?. Behav. Res. Ther. 33:25–39 [Google Scholar]
  64. ter Kuile MM, van Lankveld JJDM, de Groot E, Melles R, Neffs J, Zandbergen M. 2007. Cognitive-behavioral therapy for women with lifelong vaginismus: process and prognostic factors. Behav. Res. Ther. 45:359–73 [Google Scholar]
  65. Tolman EC. 1936. Operational behaviorism and current trends in psychology. Proc. 25th Anniv. Celebr. Inaug. Grad. Stud., Univ. South. Calif.89–103 Univ. South. Calif., Los Angeles
  66. Tolman EC. 1941. Motivation, learning and adjustment. Proc. Am. Philos. Soc. 84:543–63 [Google Scholar]
  67. Totterdell P, Kellett S, Mansell W. 2012. Cognitive behavioural therapy for cyclothymia: cognitive regulatory control as a mediator of mood change. Behav. Cogn. Psychother. 40:412–24 [Google Scholar]
  68. Wells A, Clark DM, Salkovskis P, Ludgate J, Hackmann A, Gelder M. 1995. Social phobia: the role of in-situation safety behaviors in maintaining anxiety and negative beliefs. Behav. Ther. 26:153–61 [Google Scholar]
  69. Wilson GT, Fairburn CC, Agras WS, Walsh BT, Kraemer H. 2002. Cognitive-behavioral therapy for bulimia nervosa: time course and mechanisms of change. J. Consult. Clin. Psychol. 70:267–74 [Google Scholar]
  70. Woodruff-Borden J, Brothers AJ, Lister SC. 2001. Self-focused attention: commonalities across psychopathologies and predictors. Behav. Cogn. Psychother. 29:169–78 [Google Scholar]
  71. Woody SR, Whittal ML, McLean PD. 2011. Mechanisms of symptom reduction in treatment for obsessions. J. Consult. Clin. Psychol. 79:653–64 [Google Scholar]
  72. Wright JH, Basco MR, Thase ME. 2006. Learning Cognitive-Behavior Therapy: An Illustrated Guide Arlington, VA: Am. Psychiatr. Publ.

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