CHAPTER – 1

INTRODUCTION
1.1 Cognitive Distortions:
1.1.1 Cognitive Distortions in Psychology: Understanding and Examples
Cognitive distortions, also known as thinking errors, are common patterns of biased and
irrational thinking that can lead to emotional distress and maladaptive behavior. These distortions
play a significant role in various mental health conditions, including anxiety disorders,
depression, and personality disorders. In this paper, we will explore the concepts of cognitive
distortions, their impact on psychological well-being, and provide real-life examples to illustrate
each type of distortion.

1.1.2 Introduction
Cognitive distortions are systematic errors in thinking that individuals may experience when
processing information about themselves, the world, and the future. These distortions are
believed to contribute to negative emotional states, as well as behaviors that perpetuate and
worsen mental health issues. Understanding cognitive distortions is crucial for psychologists and
mental health professionals to effectively assess and treat individuals struggling with
psychological distress.

1.1.3 Understanding Cognitive Distortions

Cognitive distortions are characterized by their deviation from objective reality and their
influence on individuals' perceptions, interpretations, and judgments. According to Beck's
cognitive theory, these distortions arise from underlying schemas, or core beliefs, that individuals
hold about themselves and the world. When activated, these schemas filter and interpret
information in a biased manner, leading to distorted thinking patterns.

1.2 History and Overview Of Cognitive Distortions.

Cognitive distortions were originally defined by Aaron Beck (1967) as the result of processing
information in ways that predictably resulted in identifiable errors in thinking. In his work with
depressed patients, Beck defined six systematic errors in thinking: arbitrary inference; selective
abstraction; overgeneralization; magnification and minimization; personalization; and
absolutistic, dichotomous thinking. Years later, Burns (1980) renamed and extended Beck’s
cognitive distortions to ten types: all-or-nothing thinking; overgeneralization; mental filter;
discounting the positive; jumping to conclusions; magnification; emotional reasoning; should
statements; labeling; and personalization and blame. Additional cognitive distortions, defined by
Freeman and DeWolf (1992) and Freeman and Oster (1999), include: externalization of
self-worth; comparison; and perfectionism. Most recently, Gilson and Freeman (1999) identified
eight other types of cognitive distortions in the form of fallacies: fallacies of change; worrying;
fairness; ignoring; being right; attachment; control; and heaven’s reward.
The conceptual framework of cognitive therapy is structured on the notion that an individual’s
subjective assessment of early life experience shapes and maintains fundamental beliefs
(schemas) about self (Beck, 1970, 1976). In support of, or in defense against, early schemas,
secondary beliefs develop and function as rules or assumptions about the self and the world.
These beliefs define personal worth, are associated with emotions, and develop further into
learned, habitual ways of thinking (Beck, Rush, Shaw, & Emery, 1979; Ellis & Grieger, 1986).
Habitual ways of thinking function to support core beliefs and assumptions by generalizing,
deleting, and/or distorting internal and external stimuli, thus creating cognitive distortions.
Cognitions and, specifically, cognitive distortions have been identified as playing an important
role in the maintenance of emotional disorders.

Researchers have developed various information processing models in an attempt to understand

the processing of cognitive information. Kendall (1992) proposed a cognitive taxonomy model
with a description of the relevant aspects of cognition involved in the creation of cognitive
distortions. Kendall’s taxonomy includes the following features: cognitive content; cognitive
process; cognitive products; and cognitive structures. These features form the overall cognitive
structure that serves to filter certain cognitive processes. Cognitive distortions reside within the
domain of cognitive processes.

Within the realm of cognitive processes, Kendall made distinctions between processing
deficiencies and processing distortions. Deficient processing occurs when a lack of cognitive
activity results in an unwanted consequence. Distorted processing occurs when an active
thinking process filters through some faulty reasoning process resulting in an unwanted
consequence. The difference is failure to think versus a pattern of thinking in a distorted manner
(Kendall, 1985, 1992).

Finally, Kendall (1992) also suggested that more accurate perceptions of the world do not
necessarily lead to more successful mental health or behavioral adjustment. Cognitive distortions
skewed in an overly positive direction tend to be functional, and benefit the individual in
maintaining positive mental health (although a “too positive” view might be interpreted as
narcissism).

The opposite may also occur. In studies of depressed and nondepressed students, Alloy et al.
(1999) reported that depressed subjects were more accurate in their perceptions and judgments as
compared to nondepressed subjects, a phenomenon called “depressive realism.” Subsequent
research was less endorsing this phenomenon, and researchers have concluded the process of
distortion is more complex than merely perception (Ingram, Miranda, & Segal, 1998).

Within the fields of cognitive and social psychology, other information processing systems have
been developed that suggest theories for the formation of cognitive distortions (e.g., Berry &
Broadbent, 1984; Hasher & Zacks, 1979; Nisbett & Wilson, 1977; Schneider & Shiffrin, 1977).
In addition, developmental psychologists have suggested thinking or distorting processes may
develop from learned behavior, while evolutionary psychologists (Gilbert, 1998) have suggested
the development of an evolutionary information processing system over time that has led to a
“better safe than sorry” processing approach.
Experts in Cognitive Distortions: Aaron Beck and David Burns
If you dig any deeper into cognitive distortions and their role in depression, anxiety, and other
mental health issues, you will find two names over and over again: Aaron Beck and David
Burns.

These two psychologists literally wrote the book(s) on depression, cognitive distortions, and the
treatment of these problems.

Aaron Beck.
Aaron Beck began his career at Yale Medical School, where he graduated in 1946 (Good
Therapy, 2015). His required rotations in psychiatry during his residency ignited his passion for
research on depression, suicide, and effective treatment.

In 1954, he joined the University of Pennsylvania’s Department of Psychiatry, where he still

holds the position of Professor Emeritus of Psychiatry.

In addition to his prodigious catalogue of publications, Beck founded the Beck Initiative to teach
therapists how to conduct cognitive therapy with their patients–an endeavour that has helped
cognitive therapy grow into the therapy juggernaut that it is today.

Beck also applied his knowledge as a member or consultant for the National Institute of Mental
Health, an editor for several peer-reviewed journals, and lectures and visiting professorships at
various academic institutions throughout the world (Good Therapy, 2015).

While there are clearly many honours, awards, and achievements Beck may be known for,
perhaps his greatest contribution to the field of psychology is his role in the development of
cognitive therapy.

Beck developed the basis for Cognitive Behavioural Therapy, or CBT, when he noticed that
many of his patients struggling with depression were operating on false assumptions and
distorted thinking (Good Therapy, 2015). He connected these distorted thinking patterns with his
patients’ symptoms and hypothesized that changing their thinking could change their symptoms.

This is the foundation of CBT – the idea that our thought patterns and deeply held beliefs about
ourselves and the world around us drive our experiences. This can lead to mental health disorders
when they are distorted but can be modified or changed to eliminate troublesome symptoms.

In line with his general research focus, Beck also developed two important scales that are among
some of the most used scales in psychology: the Beck Depression Inventory and the Beck
Hopelessness Scale. These scales are used to evaluate symptoms of depression and risk of
suicide and are still applied decades after their original development (Good Therapy, 2015).
David Burns

Another big name in depression and treatment research, Dr. David Burns, also spent some time
learning and developing his skills at the University of Pennsylvania – it seems that UPenn is
particularly good at producing future leaders in psychology!

Burns graduated from Stanford University School of Medicine and moved on to the University
of Pennsylvania School of Medicine, where he completed his psychiatry residency and cemented
his interest in the treatment of mental health disorders (Feeling Good, n.d.).

He is currently serving as a Professor Emeritus of Psychiatry and Behavioural Sciences at the

Stanford University School of Medicine, in addition to continuing his research on treating
depression and training therapists to conduct effective psychotherapy sessions (Feeling Good,
n.d.). Much of his work is based on Beck’s research revealing the potential impacts of distorted
thinking and suggesting ways to correct this thinking.

He is perhaps most well known outside of strictly academic circles for his worldwide best-selling
book Feeling Good: The New Mood Therapy. This book has sold more than 4 million copies
within the United States alone and is often recommended by therapists to their patients struggling
with depression (Summit for Clinical Excellence, n.d.).

This book outlines Burns’ approach to treating depression, which mostly focuses on identifying,
correcting, and replacing distorted systems and patterns of thinking. If you are interested in
learning more about this book, you can find it on Amazon with over 1,400 reviews to help you
evaluate its effectiveness.

To hear more about Burns’ work in the treatment of depression, check out his TED talk on the
subject below.

As Burns discusses in the above video, his studies of depression have also influenced the studies
around joy and self-esteem.

The most researched form of psychotherapy right now is covered by his book, Feeling Good,
aimed at providing tools to the general public.

1.3. Cognitive distortion theory on depression

1.3.1 Cognitive distortion theory on depression

1.3.1.1 Definition of cognitive distortion and relationship to depression

Aaron Temkin Beck developed the Cognitive Distortion Theory in his research on depression.
And on this basis, he put forward the treatment of depression, Cognitive Behavioural Therapy
(CBT). Cognitive distortions are thoughts that cause an individual to perceive reality improperly.
Such improper information processing affects the patient's mood, behavior, and physiology so
that the patient's social and interpersonal functioning deteriorates which leads to more negative
thoughts. Patients are lost in their own cognitive distortions, and the negative emotions continue
to strengthen, which leads to depression. Specifically, cognitive distortions reinforce negative
emotions and thoughts and lead to an overall negative view of the world and a depressed mental
state

1.3.2 Cognitive distortion modeling

Cognitive distortions are reflected in the use of language. A set of cognitive distortion words is
proposed by previous research, and posts containing these words are cognitive distortion posts.
And Some research tries to use the Linguistic Inquiry and Word Count (LIWC) dictionary which
contains more than 32 categories of psychological catalog and decision tree methods to judge
whether there is a cognitive distortion in a person's speech

We argue that cognitive distortions can be learned by natural language models. Current natural
language models can detect whether a post contains cognitive distortions. We discuss the
cognitive distortion identification task below.

1.4 Types of Cognitive Distortions:

A List of the Most Common Cognitive Distortions
Beck and Burns are not the only two researchers who have dedicated their careers to learn more
about depression, cognitive distortions, and treatment for these conditions.

There are many others who have picked up the torch for this research, often with their own take
on cognitive distortions. As such, there are numerous cognitive distortions floating around in the
literature, but we’ll limit this list to the most common sixteen.

The first eleven distortions come straight from Burns’ Feeling Good Handbook (1989).

1.4.1. All-or-Nothing Thinking / Polarized Thinking

Also known as “Black-and-White Thinking,” this distortion manifests as an inability or
unwillingness to see shades of gray. In other words, you see things in terms of extremes –
something is either fantastic or awful, you believe you are either perfect or a total failure.

1.4.2. OvergeneralizationThis sneaky distortion takes one instance or example and generalizes
it as an overall pattern. For example, a student may receive a C on one test and conclude that she
is stupid and a failure. Overgeneralizing can lead to overly negative thoughts about yourself and
your environment based on only one or two experiences.
1.4.3. Mental Filter
Similar to overgeneralization, the mental filter distortion focuses on a single negative piece of
information and excludes all the positive ones. An example of this distortion is one partner in a
romantic relationship dwelling on a single negative comment made by the other partner and
viewing the relationship as hopelessly lost, while ignoring the years of positive comments and
experiences. The mental filter can foster a decidedly pessimistic view of everything around you
by focusing only on the negative.
1.4.4. Disqualifying the Positive
On the flip side, the “Disqualifying the Positive” distortion acknowledges positive experiences
but rejects them instead of embracing them.

For example, a person who receives a positive review at work might reject the idea that they are
a competent employee and attribute the positive review to political correctness, or to their boss
simply not wanting to talk about their employee’s performance problems.

This is an especially malignant distortion since it can facilitate the continuation of negative
thought patterns even in the face of strong evidence to the contrary.

1.4.5. Jumping to Conclusions – Mind Reading

This “Jumping to Conclusions” distortion manifests as the inaccurate belief that we know what
another person is thinking. Of course, it is possible to have an idea of what other people are
thinking, but this distortion refers to the negative interpretations that we jump to.

Seeing a stranger with an unpleasant expression and jumping to the conclusion that they are
thinking something negative about you is an example of this distortion.

1.4.6. Jumping to Conclusions – Fortune Telling

A sister distortion to mind reading, fortune telling refers to the tendency to make conclusions and
predictions based on little to no evidence and holding them as gospel truth.

One example of fortune-telling is a young, single woman predicting that she will never find love
or have a committed and happy relationship based only on the fact that she has not found it yet.
There is simply no way for her to know how her life will turn out, but she sees this prediction as
fact rather than one of several possible outcomes.

1.4.7. Magnification (Catastrophizing) or Minimization

Also known as the “Binocular Trick” for its stealthy skewing of your perspective, this distortion
involves exaggerating or minimizing the meaning, importance, or likelihood of things.

An athlete who is generally a good player but makes a mistake may magnify the importance of
that mistake and believe that he is a terrible teammate, while an athlete who wins a coveted
award in her sport may minimize the importance of the award and continue believing that she is
only a mediocre player.

1.4.8. Emotional Reasoning

This may be one of the most surprising distortions to many readers, and it is also one of the most
important to identify and address. The logic behind this distortion is not surprising to most
people; rather, it is the realization that virtually all of us have bought into this distortion at one
time or another.
Emotional reasoning refers to the acceptance of one’s emotions as fact. It can be described as “I
feel it, therefore it must be true.” Just because we feel something doesn’t mean it is true; for
example, we may become jealous and think our partner has feelings for someone else, but that
doesn’t make it true. Of course, we know it isn’t reasonable to take our feelings as fact, but it is a
common distortion nonetheless.

1.4.9. Should Statements

Another particularly damaging distortion is the tendency to make “should” statements. Should
statements are statements that you make to yourself about what you “should” do, what you
“ought” to do, or what you “must” do. They can also be applied to others, imposing a set of
expectations that will likely not be met.

When we hang on too tightly to our “should” statements about ourselves, the result is often guilt
that we cannot live up to them. When we cling to our “should” statements about others, we are
generally disappointed by their failure to meet our expectations, leading to anger and resentment.

1.4.10. Labeling and Mislabeling

These tendencies are basically extreme forms of overgeneralization, in which we assign
judgments of value to ourselves or to others based on one instance or experience. For example, a
student who labels herself as “an utter fool” for failing an assignment is engaging in this
distortion, as is the waiter who labels a customer “a grumpy old miser” if he fails to thank the
waiter for bringing his food. Mislabeling refers to the application of highly emotional, loaded,
and inaccurate or unreasonable language when labeling.

1.4.11. Personalization
As the name implies, this distortion involves taking everything personally or assigning blame to
yourself without any logical reason to believe you are to blame. This distortion covers a wide
range of situations, from assuming you are the reason a friend did not enjoy the girls’ night out,
to the more severe examples of believing that you are the cause for every instance of moodiness
or irritation in those around you. In addition to these basic cognitive distortions, Beck and Burns
have mentioned a few others (Beck, 1976; Burns, 1980):

1.4.12. Control Fallacies

A control fallacy manifests as one of two beliefs: (1) that we have no control over our lives and
are helpless victims of fate, or (2) that we are in complete control of ourselves and our
surroundings, giving us responsibility for the feelings of those around us. Both beliefs are
damaging, and both are equally inaccurate.

No one is in complete control of what happens to them, and no one has absolutely no control
over their situation. Even in extreme situations where an individual seemingly has no choice in
what they do or where they go, they still have a certain amount of control over how they
approach their situation mentally.
1.4.13. Fallacy of Fairness
While we would all probably prefer to operate in a world that is fair, the assumption of an
inherently fair world is not based in reality and can foster negative feelings when we are faced
with proof of life’s unfairness.

A person who judges every experience by its perceived fairness has fallen for this fallacy, and
will likely feel anger, resentment, and hopelessness when they inevitably encounter a situation
that is not fair.

1.4.14. Fallacy of Change

Another ‘fallacy’ distortion involves expecting others to change if we pressure or encourage
them enough. This distortion is usually accompanied by a belief that our happiness and success
rests on other people, leading us to believe that forcing those around us to change is the only way
to get what we want.

A man who thinks “If I just encourage my wife to stop doing the things that irritate me, I can be
a better husband and a happier person” is exhibiting the fallacy of change.

1.4.15. Always Being Right

Perfectionists and those struggling with Imposter Syndrome will recognize this distortion – it is
the belief that we must always be right. For those struggling with this distortion, the idea that we
could be wrong is absolutely unacceptable, and we will fight to the metaphorical death to prove
that we are right.

For example, the internet commenters who spend hours arguing with each other over an opinion
or political issue far beyond the point where reasonable individuals would conclude that they
should “agree to disagree” are engaging in the “Always Being Right” distortion. To them, it is
not simply a matter of a difference of opinion, it is an intellectual battle that must be won at all
costs.

1.4.16. Heaven’s Reward Fallacy

This distortion is a popular one, and it’s easy to see myriad examples of this fallacy playing out
on big and small screens across the world. The “Heaven’s Reward Fallacy” manifests as a belief
that one’s struggles, one’s suffering, and one’s hard work will result in a just reward.

It is obvious why this type of thinking is a distortion – how many examples can you think of, just
within the realm of your personal acquaintances, where hard work and sacrifice did not pay off?

Sometimes no matter how hard we work or how much we sacrifice, we will not achieve what we
hope to achieve. To think otherwise is a potentially damaging pattern of thought that can result in
disappointment, frustration, anger, and even depression when the awaited reward does not
materialize.
1.5 Causes and triggers
Cognitive distortions, often referred to as irrational or unhelpful thinking patterns, can arise from
various psychological, environmental, and cognitive factors. These distortions skew our
perception of reality, leading to negative emotions and behaviors. Several key causes contribute
to the development and persistence of cognitive distortions:

1.5.1 Early Experiences:

Childhood experiences, particularly those involving trauma, neglect, or dysfunctional family

dynamics, can shape our core beliefs and cognitive schemas. If a person grows up in an
environment where they are constantly criticized or invalidated, they may develop distorted
thinking patterns as a way to cope with feelings of inadequacy or worthlessness.

1.5.2. Negative Reinforcement:

Reinforcement from the environment can strengthen cognitive distortions. For instance, if a
person consistently receives attention or sympathy when expressing catastrophizing thoughts
(expecting the worst possible outcome), they may be more inclined to continue engaging in this
distortion as a means of gaining support or avoiding responsibility.

1.5.3 Biological Factors:

Biological predispositions, such as genetic vulnerabilities or neurochemical imbalances, can

influence an individual's susceptibility to cognitive distortions. For example, research suggests
that individuals with certain genetic markers or neurochemical imbalances may be more prone to
developing anxiety or depression, which are often accompanied by distorted thinking patterns.

1.5.4 Social Learning:

Observing and internalizing the distorted thinking patterns of others, particularly authority
figures or peers, can contribute to the development of cognitive distortions. This social learning
process can occur through direct interactions, media exposure, or cultural influences that
promote unrealistic standards or ideals.

1.5.5 Cognitive Processes:

Certain cognitive processes, such as selective attention, memory biases, and information
processing errors, can reinforce cognitive distortions. For instance, individuals prone to
confirmation bias may selectively attend to information that confirms their pre-existing beliefs or
expectations, while ignoring evidence that contradicts them, thus perpetuating distorted thinking
patterns.

1.5.6 Stress and Adversity:

High levels of stress, adversity, or life challenges can exacerbate cognitive distortions. When
faced with overwhelming situations, individuals may resort to black-and-white thinking (seeing
situations as all good or all bad) or catastrophizing (exaggerating the negative consequences),
which can further distort their perceptions and decision-making processes.

1.5.7 Maladaptive Coping Strategies:

Cognitive distortions often serve as maladaptive coping mechanisms to manage uncomfortable

emotions, such as anxiety, sadness, or anger. For example, individuals may engage in "should"
statements (imposing unrealistic expectations on themselves or others) as a way to regain a sense
of control or alleviate feelings of uncertainty. Understanding the multifaceted nature of cognitive
distortions is crucial for developing effective strategies to challenge and overcome them.
Cognitive-behavioral therapy (CBT), mindfulness techniques, and cognitive restructuring are
among the therapeutic approaches commonly used to address cognitive distortions and promote
healthier thinking patterns. Cognitive distortions can be an expression of a person’s pre-existing
internal biases. These negatively skewed thoughts are likely to increase Trusted Source a
person’s likelihood of depression and lead to negative behavioral responses. Researchers theorize
that Trusted Source times of high stress, such as traumatic life events or challenges during
childhood, can activate cognitive distortion. This may happen as a survival and evolutionary
adaptation to streamline the thinking process. However, this activation can continue into later life
and affect events that are not necessarily negative, causing the person to view those neutral
events negatively.

1.6 How to manage Cognitive Distortions:

To treat and manage cognitive distortions, a person has to learn to restructure their thought
patterns and responses to stimuli. While this is difficult, with commitment, it is possible to
change cognitive distortions.

Cognitive behavioral Therapy (CBT) is a type of psychotherapeutic treatment that helps people
learn how to identify and change the destructive or disturbing thought patterns that have a
negative influence on their behavior and emotions. Cognitive behavioral therapy combines
cognitive therapy with behavior therapy by identifying maladaptive patterns of thinking,
emotional responses, or behaviors and replacing them with more desirable patterns. Cognitive
behavioral therapy focuses on changing the automatic negative thoughts that can contribute to
and worsen our emotional difficulties, depression, and anxiety. These spontaneous negative
thoughts also have a detrimental influence on our mood. Through CBT, faulty thoughts are
identified, challenged, and replaced with more objective, realistic thoughts. Cognitive
Behavioural Therapy is a type of talk therapy that works to highlight the inaccuracy of cognitive
distortions for the situations in which they occur and how they affect mood and behavior.

1.7 Types of Cognitive Behavioral Therapy

CBT encompasses a range of techniques and approaches that address our thoughts, emotions,
and behaviors. These can range from structured psychotherapies to self-help practices. Some of
the specific types of therapeutic approaches that involve cognitive behavioral therapy include:
 ● Cognitive therapy centers on identifying and changing inaccurate or distorted thought
patterns, emotional responses, and behaviors.
● Dialectical behavior therapy (DBT) addresses destructive or disturbing thoughts and
behaviors while incorporating treatment strategies such as emotional regulation and
mindfulness.
● Multimodal therapy suggests that psychological issues must be treated by addressing
seven different but interconnected modalities: behavior, affect, sensation, imagery,
cognition, interpersonal factors, and drug/biological considerations.4
● Rational emotive behavior therapy (REBT) involves identifying irrational beliefs,
actively challenging these beliefs, and finally learning to recognize and change these
thought patterns.

While each type of cognitive behavioral therapy takes a different approach, all work to address
the underlying thought patterns that contribute to psychological distress. It also incorporates two
other important aspects of mental health:

Underlying beliefs: This shapes how a person interprets events and processes information. They
include both core beliefs, such as “I am unlovable,” and intermediate beliefs, such as “To be
accepted, I should please others all the time.”

Automatic thoughts: Addressing this aspect helps change a person’s immediate response to a
stimulus. For example, if someone does not say hello to them, a person could interpret this as
“They are in a rush” instead of “They hate me.”

If a person is looking for a trusted Trusted Source to help them with CBT, they should look for a
specialist trained in CBT. If a person does not want to see a therapist, they can try to focus on the
following steps to identify thoughts that contribute to negative feelings in the moment:

Identifying the thoughts that cause negative feelings

Analyzing where these thoughts come from and whether there is any evidence behind them

Identifying whether these are habitual thoughts and, if so, replacing them with neutral thoughts,
even if the person does not believe those neutral thoughts

1.8 Cognitive Behavioral Therapy Techniques

CBT is about more than identifying thought patterns. It uses a wide range of strategies to help
people overcome these patterns. Here are just a few examples of techniques used in cognitive
behavioral therapy.

1.8.1 Identifying Negative Thoughts

It is important to learn what thoughts, feelings, and situations are contributing to maladaptive
behaviors. This process can be difficult, however, especially for people who struggle with
introspection. But taking the time to identify these thoughts can also lead to self-discovery and
provide insights that are essential to the treatment process.
1.8.2 Practicing New Skills

In cognitive behavioral therapy, people are often taught new skills that can be used in real-world
situations. For example, someone with a substance use disorder might practice new coping skills
and rehearse ways to avoid or deal with social situations that could potentially trigger a relapse.

1.8.3 Goal-Setting

Goal setting can be an important step in recovery from mental illness, helping you to make
changes to improve your health and life. During cognitive behavioral therapy, a therapist can
help you build and strengthen your goal-setting skills.

This might involve teaching you how to identify your goal or how to distinguish between short-
and long-term goals. It may also include helping you set SMART goals (specific, measurable,
attainable, relevant, and time-based), with a focus on the process as much as the end outcome.

1.8.4 Problem-Solving

Learning problem-solving skills during cognitive behavioral therapy can help you learn how to
identify and solve problems that may arise from life stressors, both big and small. It can also help
reduce the negative impact of psychological and physical illness.

1.8.5 Problem-solving in CBT often involves five steps:

1. Identify the problem

2. Generate a list of potential solutions
3. Evaluate the strengths and weaknesses of each potential solution
4. Choose a solution to implement
5. Implement the solution

1.8.6 Self-Monitoring

Also known as diary work, self-monitoring is an important cognitive behavioral therapy

technique. It involves tracking behaviors, symptoms, or experiences over time and sharing them
with your therapist.

Self-monitoring can provide your therapist with the information they need to provide the best
treatment. For example, for people with eating disorders, self-monitoring may involve keeping
track of eating habits, as well as any thoughts or feelings that went along with consuming a meal
or snack.
1.9 What Cognitive Behavioral Therapy Can Help With
Cognitive behavioral therapy can be used as a short-term treatment to help individuals learn to
focus on present thoughts and beliefs.

CBT is used to treat a wide range of conditions, including:

● Addiction
● Anger issues
● Anxiety
● Bipolar disorder
● Depression
● Eating disorders
● Panic attacks
● Personality disorders
● Phobias

In addition to mental health conditions, cognitive behavioral therapy has also been found to help
people cope with:

● Chronic pain or serious illnesses

● Divorce or break-ups
● Grief or loss
● Insomnia
● Low self-esteem
● Relationship problems
● Stress management

1.10 Benefits of Cognitive Behavioral Therapy

The underlying concept behind CBT is that thoughts and feelings play a fundamental role in
behavior. For example, a person who spends a lot of time thinking about plane crashes, runway
accidents, and other air disasters may avoid air travel as a result.

The goal of cognitive behavioral therapy is to teach people that while they cannot control every
aspect of the world around them, they can take control of how they interpret and deal with things
in their environment.

CBT is known for providing the following key benefits:

 ● It helps you develop healthier thought patterns by becoming aware of the negative and
often unrealistic thoughts that dampen your feelings and moods.
● It is an effective short-term treatment option as improvements can often be seen in five to
20 sessions.
● It is effective for a wide variety of maladaptive behaviors.
● It is often more affordable than some other types of therapy.
● It is effective whether therapy occurs online or face-to-face.
● It can be used for those who don't require psychotropic medication.

1.11 Effectiveness of Cognitive Behavioral Therapy

CBT emerged during the 1960s and originated in the work of psychiatrist Aaron Beck, who
noted that certain types of thinking contributed to emotional problems. Beck labeled these
"automatic negative thoughts" and developed the process of cognitive therapy.

Where earlier behavior therapies had focused almost exclusively on associations, reinforcements,
and punishments to modify behavior, the cognitive approach addresses how thoughts and
feelings affect behaviors.

Today, cognitive behavioral therapy is one of the most well-studied forms of treatment. It has
been shown to be effective in the treatment of a range of mental conditions, including anxiety,
depression, eating disorders, insomnia, obsessive-compulsive disorder, panic disorder,
post-traumatic stress disorder, and substance use disorder.

● Research indicates that cognitive behavioral therapy is the leading evidence-based

treatment for eating disorders.
● CBT has been proven helpful in those with insomnia, as well as those who have a
medical condition that interferes with sleep, including those with pain or mood disorders
such as depression.
● Cognitive behavioral therapy has been scientifically proven to be effective in treating
symptoms of depression and anxiety in children and adolescents.
● A 2018 meta-analysis of 41 studies found that CBT helped improve symptoms in people
with anxiety and anxiety-related disorders, including obsessive-compulsive disorder and
post-traumatic stress disorder.
● Cognitive behavioral therapy has a high level of empirical support for the treatment of
substance use disorders, helping people with these disorders improve self-control, avoid
triggers, and develop coping mechanisms for daily stressors.

CBT is one of the most researched types of therapy, in part, because treatment is focused on very
specific goals and results can be measured relatively easily.
1.12Things to Consider With Cognitive Behavioral Therapy
There are several challenges that people may face when engaging in cognitive behavioral
therapy. Here are a few to consider.

1.12.1 Change Can Be Difficult

Initially, some patients suggest that while they recognize that certain thoughts are not rational or
healthy, simply becoming aware of these thoughts does not make it easy to alter them.

1.12.2 CBT Is Very Structured

Cognitive behavioral therapy doesn't focus on underlying, unconscious resistance to change as

much as other approaches such as psychoanalytic psychotherapy.15 Instead, it tends to be more
structured, so it may not be suitable for people who may find structure difficult.

1.12.3 You Must Be Willing to Change

For cognitive behavioral therapy to be effective, you must be ready and willing to spend time and
effort analyzing your thoughts and feelings. This self-analysis can be difficult, but it is a great
way to learn more about how our internal states impact our outward behavior.

1.12.4 Progress Is Often Gradual

In most cases, CBT is a gradual process that helps you take incremental steps toward behavior
change. For example, someone with social anxiety might start by simply imagining
anxiety-provoking social situations. Next, they may practice conversations with friends, family,
and acquaintances. By progressively working toward a larger goal, the process seems less
daunting and the goals easier to achieve.

1.13 How to Get Started With Cognitive Behavioral Therapy

Cognitive behavioral therapy can be an effective treatment choice for a range of psychological
issues. If you or someone you love might benefit from this form of therapy, consider the
following steps:

● Consult with your physician and/or check out the directory of certified therapists
offered by the National Association of Cognitive-Behavioral Therapists to locate a
licensed professional in your area. You can also do a search for "cognitive behavioral
therapy near me" to find local therapists who specialize in this type of therapy.
● Consider your personal preferences, including whether face-to-face or online therapy
will work best for you.
 ● Contact your health insurance to see if it covers cognitive behavioral therapy and, if so,
how many sessions are covered per year.
● Make an appointment with the therapist you've chosen, noting it on your calendar so
you don't forget it or accidentally schedule something else during that time.
● Show up to your first session with an open mind and positive attitude. Be ready to begin
to identify the thoughts and behaviors that may be holding you back, and commit to
learning the strategies that can propel you forward instead.

1.14 What to Expect With Cognitive Behavioral Therapy

If you're new to cognitive behavioral therapy, you may have uncertainties or fears of what to
expect. In many ways, the first session begins much like your first appointment with any new
healthcare provider.

During the first session, you'll likely spend some time filling out paperwork such as HIPAA
forms (privacy forms), insurance information, medical history, current medications, and a
therapist-patient service agreement. If you're participating in online therapy, you'll likely fill out
these forms online.

Also be prepared to answer questions about what brought you to therapy, your symptoms, and
your history—including your childhood, education, career, relationships (family, romantic,
friends), and current living situation.

Once the therapist has a better idea of who you are, the challenges you face, and your goals for
cognitive behavioral therapy, they can help you increase your awareness of the thoughts and
beliefs you have that are unhelpful or unrealistic. Next, strategies are implemented to help you
develop healthier thoughts and behavior patterns.

During later sessions, you will discuss how your strategies are working and change the ones that
aren't. Your therapist may also suggest cognitive behavioral therapy techniques you can do
yourself between sessions, such as journaling to identify negative thoughts or practicing new
skills to overcome your anxiety.

1.15 Understanding Defense Mechanisms: An In-Depth Exploration

Defense mechanisms are vital psychological processes that individuals employ to cope with
internal and external stressors, protecting the ego from anxiety and maintaining psychological
equilibrium. Rooted in psychoanalytic theory, defense mechanisms serve as adaptive responses
to manage conflicting emotions, thoughts, and impulses. This comprehensive review delves into
the multifaceted nature of defense mechanisms, elucidating their theoretical foundations,
classification systems, developmental aspects, and clinical implications. Additionally, this paper
examines the interplay between defense mechanisms and various psychopathologies,
highlighting the significance of understanding these mechanisms in clinical practice and
therapeutic interventions. Through an integrative approach encompassing empirical research and
theoretical frameworks, this paper aims to provide a thorough understanding of defense
mechanisms, elucidating their complexity and relevance in contemporary psychology.

Keywords: defense mechanisms, psychoanalytic theory, coping mechanisms, ego defense,

psychological adaptation, psychopathology, therapeutic interventions.

1.15.1. Introduction

1.15.1.1 Background and Historical Context

1.15.2 Objectives and Scope of the Review

1.15.2 Theoretical Foundations

1.15.2.1 Psychoanalytic Theory: Sigmund Freud

1.15.2.2 Structural Model of the Mind

1.15.2.3 Development of defense Mechanisms

1.15.3 Neo-Freudian Perspectives

1.15.3.1 Contributions of Alfred Adler

1.15.3.2 Insights from Carl Jung

1.15.3.3 Karen Horney’s Theory of Neurosis

1.15.4 Contemporary Perspectives and Critiques

1.15.3 Classification Systems of Defence Mechanisms

1.15.3.1 Freud’s Original Classification

1.15.3.2 Vaillant’s Hierarchical Model

1.15.3.3 Bond’s defense Style Questionnaire

1.15.3.4 Other Taxonomies and Approaches

1.15.4. Developmental Aspects of defense Mechanisms

1.15.4.1 Early Childhood and defense Mechanisms

1.15.4.2 Adolescence and Identity Formation

1.15.4.3 Adulthood and Coping Strategies

 1.15.4.4 Aging and Changes in defense Mechanisms

1.15.5. Psychological Adaptation and Coping Mechanisms

1.15.5.1 Adaptive Function of defense Mechanisms

1.15.5.2 Coping Strategies and Resilience

1.15.5.3 Maladaptive defense Mechanisms

1.15.6. Clinical Implications

1.15.6.1 defense Mechanisms in Psychopathology

1.15.6.1.1 anxiety disorders

1.15.6.1.2 Mood Disorders

1.15.6.1.3 Personality Disorders

1.15.6.1.4 substance use disorders

1.15.6.2 Assessment and Diagnosis

1.15.6.3 Therapeutic Interventions

1.15.6.3.1 Psychoanalytic Psychotherapy

1.15.3.2 Cognitive-Behavioral Approaches

1.15.6.3.3 Integrative and Eclectic Models

1.15.7. Cultural Considerations and Diversity

1.15.7.1 Cross-Cultural Perspectives on defense Mechanisms

1.15.7.2 Gender Differences and defense Strategies

1.15.7.3 Socioeconomic Factors and Coping Mechanisms

1.15.8. Future Directions and Research Opportunities

1.15.8.1 Advancements in Measurement and Assessment

1.15.8.2 Neurobiological Correlates of defense Mechanisms

1.15.8.3 Integrative Models and Transdisciplinary Research

1.15.9. Conclusion
1.15.9.1 Summary of Key Findings

1.15.9.2 Implications for Theory and Practice

1.15.9.3 Recommendations for Future Research

1.16 References
This structure provides a comprehensive framework for exploring defense mechanisms,
encompassing their historical roots, theoretical underpinnings, classification systems,
developmental trajectories, adaptive functions, clinical implications, cultural considerations, and
avenues for future research. Each section will be elaborated upon with empirical evidence, case
studies, and theoretical discussions, offering a holistic understanding of defense mechanisms and
their relevance in contemporary psychology.

1.17 Types of Defence Mechanisms

1.17.1 Denial:

Definition: Refusing to accept reality or facts.

Example: A person diagnosed with a terminal illness denies the diagnosis and insists they are
perfectly healthy.

Case Study: Sarah refuses to acknowledge her husband's alcoholism despite his frequent binges
and the strain it puts on their relationship.

1.17.2 Regression:

Definition: Reverting to an earlier stage of development in the face of stress.

Example: A child starts sucking their thumb again after the birth of a new sibling.

Case Study: After failing a crucial exam, Mark, a college student, begins sleeping with his
childhood stuffed animal.

1.17.3. Projection:

Definition: Attributing one's own unacceptable feelings or impulses to others.

Example: A person who is jealous of their friend's success accuses the friend of being jealous
instead.

Case Study: Mary, feeling guilty about cheating on her partner, becomes suspicious and accuses
her partner of infidelity
1.17.4. Rationalization:

Definition: Creating logical explanations to justify unacceptable behavior.

Example: A person justifies cheating on a test by saying everyone else was doing it.

Case Study: Tom explains his excessive drinking as a way to cope with stress at work, ignoring
its negative impact on his health and relationships.

1.17.5. Displacement:

Definition: Redirecting one's feelings toward a less threatening target.

Example: A person who is angry with their boss yells at their spouse instead.

Case Study: After a disagreement with his boss, Mike comes home and angrily kicks a chair,
startling his dog.

1.17.6. Sublimation:

Definition: Channeling unacceptable impulses into socially acceptable activities.

Example: Someone with aggressive tendencies becomes a successful boxer.

Case Study: Jane, who has a strong desire for revenge, channels her energy into writing crime
novels where justice is served.

1.17.7. Intellectualization:

Definition: Focusing excessively on abstract thinking to avoid dealing with emotions.

Example: A person diagnosed with a serious illness researches and discusses treatment options
extensively but avoids acknowledging their fear or sadness.

Case Study: After being laid off from his job, John spends all his time analyzing labor market
trends and economic forecasts but avoids discussing his feelings of failure.

1.17.8 Reaction Formation:

Definition: Adopting beliefs or behaviors opposite to one's true feelings.

Example: A person who harbors unconscious racist feelings becomes overly vocal about racial
equality.

Case Study: Despite feeling intense jealousy, Rachel showers her friend with compliments and
acts overly supportive of her achievements.
1.17.9. Compensation:

Definition: Overemphasizing a trait to offset a perceived deficiency in another area.

Example: A person who feels inadequate in sports excels in academics.

Case Study: David, who struggles with his self-esteem, becomes the class clown to gain attention
and validation from his peers.

1.17.10. Undoing:

Definition: Engaging in behavior to counteract guilt or anxiety caused by previous actions.

Example: A person who feels guilty about lying buys extravagant gifts for the person they
deceived.

Case Study: After a heated argument with his wife, Jack feels remorseful and spends the entire
weekend cooking her favorite meals and showering her with affection.

1.17.11. Fantasy:

Definition: Escaping from reality by indulging in elaborate daydreams or fantasies.

Example: A person unhappy with their job fantasizes about winning the lottery and quitting.

Case Study: Sarah, dissatisfied with her mundane life, spends hours imagining herself as a
famous actress living in luxury.

1.17.12. Minimization:

Definition: Downplaying the significance of an event or emotion.

Example: A person brushes off a breakup as "no big deal" despite feeling devastated.

Case Study: Despite experiencing severe trauma during combat, John describes his war
experiences as "not that bad" and insists he's fine.

1.17.13. Avoidance:

Definition: Steering clear of situations or feelings that cause discomfort.

Example: A person avoids confrontations at all costs to prevent feeling anxious.

Case Study: Emily, afraid of rejection, never applies for job promotions or asks people out on
dates, missing out on opportunities for personal and professional growth.

1.17.14. Selective Forgetting:

Definition: Purposefully forgetting or blocking out painful memories.

Example: A person forgets the details of a traumatic event to protect themselves from emotional
distress.

Case Study: After witnessing a violent crime, Lisa struggles to recall specific details of the event,
later realizing she has selectively forgotten parts of it to cope with the trauma.

1.17.15. Withdrawal:

Definition: Retreating from social interactions or reality to avoid facing problems.

Example: A person isolates themselves from friends and family when going through a difficult
time.

Case Study: Feeling overwhelmed by the pressures of work and personal life, Mark spends all
his free time alone in his room, avoiding contact with others.

These examples and case studies illustrate how defense mechanisms operate in various situations
to protect individuals from distressing thoughts, feelings, or experiences.

1.18 Why Do People Employ Self-defense Techniques?

The following are some of the most typical reasons why people such as you and me employ
protective mechanisms:

Positive psychological skills for dealing with stress

To come up with a justification to justify a bad habit

To avoid having to cope with negative feelings

When you’re feeling scared, you might use pain avoidance to protect yourself.

As a mental break from adjusting to life’s adjustments

1.19 Treatment for Faulty Defensive Systems

Self-deception could be considered a form of defense mechanism. You could be using them to
conceal emotional reactions which you would not want to cope with. It is, however, typically
done subconsciously. You aren’t constantly conscious of how your brain or personality will react.

That doesn’t rule out the possibility of altering or changing the behavior. You can change
harmful defensive systems into more stable forms. These methods may be beneficial:

Identify the Mechanisms: Friends and family can assist you in recognizing the processes. They
can assist you to notice the instant you unknowingly make an unwise choice by calling attention
to self-deception. This helps you pick what you want to accomplish in a conscious condition.
Acquire Coping Mechanisms: Working with a mental health professional like a
psychotherapist, psychiatrist, or psychoanalysis can help you identify the most defensive
mechanisms you utilize. They can then assist you in learning numerous approaches to make
better conscious decisions.

1.20 Conclusion:
Defense mechanisms automatically utilize mental methods to safeguard an individual from
anxiety caused by unwanted thoughts or sensations. As per the Freudian theory, defense
mechanisms constitute a false reality in women such that we are more equipped to cope with a
circumstance. defense mechanisms work on an instinctual level to assist the individual in
avoiding unpleasant sensations or making wonderful things seem better. People’s defense
mechanisms are unconscious ways of defending themselves from worrying thoughts or
sensations. defense mechanisms are not harmful; they might help people cope with difficult
situations or redirect their energies more effectively.
 CHAPTER – 2
REVIEW OF LITERATURE
2.1 Review Of Literature on Defense Mechanism :
Psychological defense mechanisms among individuals with SCI with adjustment disorder.
Yazdanshenas Ghazvin, M., Tavakoli, S. A. H., Latifi, S., Saberi, H., Derakhshan Rad, N.,
Yekaninejad, M. S., ... & Ghodsi, S. M. (2017).

This study aimed to estimate the prevalence of adjustment disorders (AJD) among individuals
with spinal cord injury (SCI) and to identify the pattern of psychological defense styles used by
this population. A cross-sectional study was conducted at a tertiary rehabilitation center in Iran.
Participants were individuals referred to the Brain and Spinal Cord Injury Research Centre. A
screening interview was conducted to diagnose AND based on DSM-V criteria. Those diagnosed
with AND underwent a second interview to assess defense mechanisms. Demographic and
injury-related variables were recorded, and defense mechanisms were assessed using the 40-item
version of the Defence-Style Questionnaire (DSQ-40). Among 114 participants, 32 (28%) were
diagnosed with AJD, and 23 of them attended the second interview. The mean age and time since
injury were 29.57 ± 9.29 years and 11.70 ± 6.34 months, respectively. The most commonly used
defense mechanism was idealization (91.3%), followed by passive aggression (87.0%) and
somatization (82.6%). The dominant defense style was neurotic (11.52 ± 2.26). There were no
significant relationships between sex, marital status, educational level, cause of injury, or injury
level with defense style (P: 0.38, 0.69, 0.88, 0.73, and P: 0.32, respectively). The prevalence of
AJD among individuals with SCI is estimated to be 28%. The most prevalent defense style
observed was neurotic, with the dominant defense mechanism being "idealization." Demographic
and injury-related variables did not significantly influence the defense mechanisms used by
participants.

Defense mechanisms in substance abusers’ families.

Jana Abadi, H., & Zamani, N. A. R. G. E. S. (2016).

This study aimed to explore defensive mechanisms and styles within families affected by
substance use and abuse. A descriptive research design was employed for this investigation. The
sample consisted of 280 participants, with 70 individuals in each group representing families
affected by substance abuse, alcohol use, sedative use, and cigarette smoking. Participants were
selected through convenience sampling. The defensive mechanisms were assessed using
Andrews' Defense Style Questionnaire (DSQ). The analysis revealed that families with members
who were substance abusers and alcohol users exhibited the highest average and percentage of
immature defense mechanisms. In contrast, families with sedative users showed the lowest
percentage of immature mechanisms. Among the immature mechanisms, denial was most
frequently observed in families with alcohol users, while transition was least prevalent in
families with substance abusers. The utilization of defense mechanisms impacts one's
self-perception. Immature defense mechanisms hinder an individual's ability to comprehend
reality, impair their capacity for rational and effective defense, and diminish their insight and
self-awareness

Defense mechanisms in “pure” anxiety and “pure” depressive disorders.

Colovic, O., Tosevski, D. L., Mladenovic, I. P., Milosavljevic, M., & Munjiza, A. (2016).

Our study aimed to investigate potential differences in the utilization of defense mechanisms
between patients with pure anxiety disorders and those with pure depressive disorders. The
sample comprised 30 participants each for depressive disorders without psychotic symptoms,
anxiety disorders, and a healthy control group. Defense mechanisms were assessed using the
DSQ-40 questionnaire. Our findings indicate that individuals with "pure" anxiety disorders
exhibit similar patterns of defense mechanisms to those with "pure" depressive disorders, except
in the use of immature defense mechanisms. Specifically, the group with depressive disorders
demonstrated a significantly higher propensity for employing immature defense mechanisms
compared to the anxiety disorders group (p = 0.005), particularly projection (p = 0.001) and
devaluation (p = 0.003). These findings suggest that immature defense mechanisms can serve as
indicators to distinguish between anxiety and depressive disorders, and may also aid in
identifying the predominant symptoms (anxiety or depressive) during treatment stages.

Defense mechanisms in adolescence as predictors of adult personality disorders.

Strandholm, T., Kiviruusu, O., Karlsson, L., Miettunen, J., & Marttunen, M. (2016).

Our research investigates whether defense styles and individual defense mechanisms observed in
depressed adolescent outpatients can forecast the occurrence of adult personality disorders (PDs).
We analyzed data from consecutive adolescent outpatients who participated in the Adolescent
Depression Study at both baseline and an 8-year follow-up (N = 140). Defense styles were
categorized into mature, neurotic, image-distorting, and immature, and a secondary analysis was
conducted using individual defense mechanisms as predictors of PD diagnosis. We found that
neurotic, image-distorting, and immature defense styles during adolescence were linked to the
development of PDs in adulthood. Specifically, a neurotic defense style was associated with
cluster B diagnosis, while an image-distorting defense style was associated with cluster A
diagnosis. Additionally, individual defense mechanisms such as displacement, isolation, and
reaction formation independently predicted the diagnosis of adult PDs, even after controlling for
PD diagnosis during adolescence. Our findings suggest that both defense styles and individual
defense mechanisms have predictive value for later PDs, highlighting their potential utility in
tailoring treatment interventions for adolescents.

Change in defense mechanisms during long-term dynamic psychotherapy and five-year

outcome.
Perry, J. C., & Bond, M. (2012).

The study aimed to investigate whether Defence mechanisms change according to the hierarchy
of defense adaptation during long-term dynamic psychotherapy and whether such changes are
linked to long-term outcomes on other measures. Twenty-one adults with depressive, anxiety,
and/or personality disorders participated in long-term dynamic psychotherapy sessions
(averaging 248 weeks) followed by a mean follow-up duration of 5.1 years. Measures of
functioning and symptoms were collected through periodic follow-up interviews conducted
independently of the therapy. Defense mechanisms were assessed using the Defence Mechanism
Rating Scales quantitative method, with a median of eight psychotherapy sessions per participant
over 2.5 years rated. The results indicated significant improvements in both the lowest (action)
and highest (high adaptive) Defense levels in the hierarchy, as well as overall defensive
functioning, though still remaining below the healthy-neurotic range. A slower rate of
improvement in Defences was associated with a higher number of axes I disorders and childhood
histories of sexual abuse and witnessing violence. Moreover, changes in defenses within therapy
by 2.5 years were strongly correlated with significant changes at 5 years in external measures of
functioning and symptoms, even after controlling for initial levels. These findings suggest that
changes in defensive functioning during long-term psychotherapy tend to align with the
hierarchy of Defence adaptation and are linked to improvements in functioning and symptoms
over the long term, highlighting the potential mediating role of Defenses in therapeutic
outcomes.

Immunizing strategies and epistemic defense mechanisms.

Boudry, M., & Braeckman, J. (2011)

An immunizing strategy refers to an argument used to defend a belief system, which is

independent from that belief system and aims to shield it from rational argumentation and
empirical evidence. Conversely, an epistemic defense mechanism is a structural aspect of a belief
system that serves the same purpose of deflecting arguments and evidence. We explore the
notable recurrence of specific patterns of immunizing strategies and defense mechanisms in
pseudoscience and other belief systems. We identify and examine five distinct types, providing
examples from various domains. We analyze the differences between immunizing strategies and
defense mechanisms, and discuss their epistemological significance. Our classification offers.

Self-injury, psychiatric symptoms, and defense mechanisms: Findings in an Italian

nonclinical sample.
Sarno, I., Madeddu, F., & Gratz, K. L. (2010)

This study presents findings regarding the prevalence, characteristics, and associations of
self-injury (SI) in a previously unexplored Italian nonclinical sample. The study aimed to
investigate the relationships between SI and defense mechanisms, as well as differences between
individuals with episodic and recurrent SI in terms of psychiatric symptoms and psychological
distress severity. A total of 578 university students (82.5% female; mean age = 22.3; S.D. = 3.4)
completed various self-report questionnaires, including assessments for SI, defense mechanisms,
psychological distress, and psychiatric symptoms. Results revealed that 119 participants (20.6%)
reported engaging in SI at least once in their lifetime. Individuals with recurrent SI (SI ≥ 5)
exhibited significantly higher levels of psychiatric symptoms and utilized more maladaptive
defense mechanisms compared to those without SI. Moreover, distinctions were observed
between individuals with recurrent and episodic SI. Overall, the findings suggest that recurrent
self-injurers are characterized by a higher reliance on maladaptive defense mechanisms rather
than reduced use of adaptive defenses. Additionally, differences between recurrent and episodic
self-injurers were observed not in the severity of psychiatric symptoms, but in the diversity and
quantity of these symptoms

Existence of compensatory defense mechanisms against oxidative stress and hypertension

in preeclampsia.
Roland, L., Gagne, A., Bélanger, M. C., Boutet, M., Berthiaume, L., Fraser, W. D., ... &
Bilodeau, J. F. (2010).

Preeclampsia, a complex obstetrical syndrome characterized by hypertension and proteinuria, is

associated with oxidative stress, antioxidant imbalance, and impaired production of vasoactive
eicosanoids such as thromboxane A2 (TXA2) and prostacyclin (PGI2). This study aimed to
investigate the relationship between antioxidant vitamins, specifically vitamin E and coenzyme
Q10 (CoQ10), and the production of vasoactive eicosanoids—PGI2 and TXA2—potentially
regulated by pro-oxidants and antioxidants in preeclampsia. Plasma levels of vitamin E, CoQ10,
TXA2, and PGI2 were evaluated in normotensive (n = 30) and preeclamptic (n = 29)
pregnancies. HPLC coupled with electrochemical detection was used to measure the reduced and
oxidized forms of vitamin E and CoQ10. The levels of stable metabolites of TXA2 and PGI2,
TXB2, and 6-keto-PGF1α respectively, were measured using ELISA. The CoQ10
oxidized/reduced ratio was significantly higher in preeclamptic pregnancies compared to
normotensive pregnancies (p = 0.04). A strong correlation between plasma levels of reduced
vitamin E and CoQ10, corrected for apolipoprotein B, was observed only in preeclampsia (r =
0.69, p < 0.0001). The 6-keto-PGF1α/TXB2 ratio was higher in preeclampsia than in controls (p
= 0.02), and this ratio correlated with the oxidized/reduced ratio of both vitamin E and CoQ10 in
all pregnancies (p < 0.023). CoQ10 emerged as a sensitive marker of oxidative stress in
preeclampsia. The correlation between vitamin E and CoQ10 suggested a coordinated defense
mechanism against oxidation. Moreover, the higher 6-keto-PGF1α/TXB2 ratio, strongly
associated with oxidative stress markers, suggests a mechanism developed by the maternal
cardiovascular system to counteract hypertension during preeclampsia.

Defense mechanisms in mania, bipolar depression and unipolar depression.

Sharma, P., & Sinha, U. K. (2010).

The current study compared the utilization of defense mechanisms among ten bipolar manic, ten
bipolar depressed, and ten unipolar depressed patients. Defense mechanisms were evaluated
using two methods: TAT stories scored by the Defence Mechanism Manual and Defence
Mechanism Rating Scale ratings obtained from psychodynamic interviews. Symptom severity
was assessed using the Beck Depression Inventory for depressed patients and Young’s Mania
Rating Scale for manic patients. Both bipolar manic and depressed groups exhibited significantly
higher utilization of the defense mechanisms of denial, borderline level defenses, and immature
defenses compared to the unipolar depression group. The manic group displayed a greater
reliance on narcissistic level defenses compared to the other two groups. Positive correlations
were observed between the severity of manic symptoms and the defense mechanisms of denial
and narcissistic level defenses. Additionally, the bipolar depression group demonstrated
increased utilization of action level defenses compared to the unipolar depression group.
Conversely, the unipolar depression group exhibited higher scores on the defense mechanism of
identification and adaptive level defenses compared to the manic group. A negative correlation
was identified between the severity of depressive symptoms in the unipolar depression group and
the defense mechanism of identification. Neurotic level defenses were most commonly utilized
by the unipolar depression group, followed by the bipolar depression group and the manic group.
These findings align with psychoanalytic interpretations of mania and depression to some extent.

Change in defense mechanisms and coping over the course of short‐term dynamic
psychotherapy for adjustment disorder.
Kramer, U., Despland, J. N., Michel, L., Drapeau, M., & de Roten, Y. (2010).

The mechanisms of change underlying short-term dynamic psychotherapy (STDP) have not been
extensively studied, despite psychoanalytic theory proposing several potential mechanisms of
change. One such mechanism is the change in overall defensive functioning. This study aimed to
compare overall defensive functioning with overall coping functioning at the process level in
patients undergoing STDP. The study included 32 patients, primarily diagnosed with adjustment
disorder, who underwent up to 40 sessions of STDP. Three therapy sessions per patient were
transcribed and analyzed using two observer-rating scales: Defence Mechanism Rating Scales
and Coping Action Patterns. Hierarchical linear modeling was used to examine changes over the
course of therapy and their relation to outcome. The results indicate that STDP has an effect on
overall defensive functioning, whereas no such effect was observed for overall coping
functioning. The findings also suggest a link between changes in defensive functioning and
treatment outcome. These results are discussed from both methodological and clinical
perspectives.

The role of defense mechanisms in borderline and antisocial personalities

Presniak, M. D., Olson, T. R., & MacGregor, M. W. (2010).

We investigated whether borderline personality disorder (BPD) and antisocial personality

disorder (APD) could be distinguished based on defense mechanisms, assessed using observer
(Défense-Q; MacGregor, Olson, Presniak, & Davidson, 2008) and self-report (Défense Style
Questionnaire; Andrews, Singh, & Bond, 1993) measures. Two studies were conducted in which
nonclinical participants were categorized into borderline and antisocial groups using scores from
the Personality Assessment Inventory (Morey, 1991). Multivariate analysis of variance indicated
significant overall differences in defense use between the groups. Further analysis revealed group
differences on specific defense mechanisms, such as acting out, denial, and turning against self.
These results suggest that in BPD, defenses may emphasize interpersonal dependency and
self-directed aggression, whereas in APD, defenses may emphasize egocentricity, interpersonal
exploitation, and aggression directed towards others. Overall, this study highlights significant
variations in Defence mechanisms between borderline and antisocial personality groups, as
assessed through both observer and self-report measures.

2.2 Review Of Literature on Cognitive Distortions :

Artificial neural network model for predicting child sexual offending: role of cognitive
distortions, sexual coping, and attitudes.
Baúto, R. V., Cardoso, J., & Leal, I. (2023).
This research aims to present additional knowledge about individuals with a history of sexual
offenses against children in Portugal. Although the international literature mentions the presence
of cognitive distortions as a common element for child sexual offending, it is known that another
cognitive pathway developed since childhood and adolescence will have a significant weight in
the definition of disruptive sexual behaviors. In this article, we focused on sexual attitudes and
sex as a strategy for sexual coping and assayed to appreciate the relevance of these variables as
predictors of Child Sexual Abuse (CSA). This research mainly aims to analyze a hierarchical and
predictive model of these variables and cognitive distortion in the CSA. With resources to
Artificial Neural Networks (ANN), we conclude that these variables, when associated, have a
predictive accuracy of 82.3% in a sample that included individuals with a history of sexual
offenses against children (N = 59) and the general community (N = 82). New future approaches
can benefit from integrating coping strategies and sexual attitudes into CSA, adapted to the
Portuguese context.

Cognitive distortions, anxiety, and depression in individuals suffering from PTSD.

Ouhmad, N., Deperrois, R., El Hage, W., & Combalbert, N. (2023).

Cognitive distortions play a crucial role in both the development and persistence of
post-traumatic stress disorder (PTSD). This study aims to examine the association between
cognitive distortions and PTSD, while also assessing levels of anxiety and depression. The
sample consisted of 183 participants, categorized into three groups: 59 individuals exposed to
trauma with PTSD, 61 exposed to trauma without PTSD, and 63 non-trauma-exposed individuals
without PTSD (controls). Each participant underwent assessment in various dimensions,
including PTSD (measured by the PCL-5), cognitive distortions (assessed by the EDC-A), and
levels of anxiety and depression (evaluated using the HADS). The primary findings revealed a
prevalence of cognitive distortions among individuals with PTSD, particularly a higher
frequency of positive distortions compared to the trauma-exposed group without PTSD.
Moreover, those with PTSD exhibited elevated scores of anxiety and depression compared to the
other groups. These results suggest that individuals with PTSD tend to demonstrate more
positive cognitive distortions, and this association appears to be independent of anxiety and
depression levels.

Protecting the mental health of the future workforce: exploring the prevalence of cognitive
distortions among nursing students.
Alwawi, A., & Alsaqqa, H. H. (2023).

The aim of this study was to investigate the prevalence of cognitive distortions among nursing
students, determine the most common types, and analyze variations based on sociodemographic
characteristics. A cross-sectional online questionnaire survey was conducted among
undergraduate nursing students at a university in Palestine. Out of the 305 students enrolled
during the 2020-21 academic year, 176 participated in the study. Findings revealed that among
the respondents, 5% exhibited severe cognitive distortion levels, 33% had moderate levels, 47%
had mild levels, and 15% had healthy levels. Emotional reasoning was the most prevalent
cognitive distortion, followed by perfectionist thinking and 'What if?' questions. Conversely,
polarized thinking and overgeneralizing were the least common distortions. Notably, single,
first-year, and younger students showed significantly higher levels of cognitive distortions. In
conclusion, these results underscore the importance of identifying and addressing cognitive
distortions among nursing students. It is essential to provide support not only through university
mental health clinics but also through preventive well-being services. Prioritizing the mental
health of nursing students should be a key concern for universities.

Moral judgment, self-serving cognitive distortions, and peer bullying among secondary
school adolescents.
Brugman, D., van der Meulen, K., & Gibbs, J. C. (2023).

This study investigated the relationship between moral judgment components (moral reasoning
and moral value evaluation) and self-serving cognitive distortions concerning peer bullying
among adolescents, including various participant roles. A sample of 522 adolescents (49%
males), ranging from grades 1 to 4 in three public secondary schools in Spain (average age =
14.6 years, range 12–18 years), completed questionnaires on moral judgment, self-serving
cognitive distortions, and bullying. The findings revealed that bullies and bully-victims exhibited
the lowest levels of moral judgment and the highest levels of self-serving cognitive distortions.
In contrast, defenders and bystanders displayed the highest levels of moral judgment and the
lowest levels of self-serving cognitive distortions. Self-serving cognitive distortions fully
mediated the relationship between moral reasoning and bullying and partially mediated the
relationship between moral evaluation and bullying. Furthermore, analyses showed that the
strength of the relationships between moral judgment components and self-serving cognitive
distortions varied across adolescents' roles. These results suggest that anti-bullying intervention
programs should focus on enhancing moral reasoning and values while reducing self-serving
cognitive distortions

Association between cognitive distortions and problematic internet use among students
during the COVID-19 pandemic.
Agnihotri, S., & Shanker, D. R. (2023).

Amidst the COVID-19 pandemic, there has been a significant surge in internet usage due to
lockdown measures and the transition to remote work and online learning. While the internet
serves as a vital tool for connectivity and information access during this period, it's crucial to
acknowledge the potential for problematic internet use and the distorted beliefs associated with
such behaviors. This study aims to explore the connection between problematic internet use
(PIU) and cognitive distortions among university students. Data was gathered from 387 students
in Andhra Pradesh, India, utilizing the Generalized Problematic Internet Use Scale-2 (GPIUS-2)
and Cognitive Distortions Questionnaire. Key factors influencing GPIUS-2 and its components
(negative outcomes, cognitive preoccupation, and mood regulation) were identified as family
size, education level, and average internet usage time during COVID-19 (p < 0.01) and (p <
0.05). Pearson correlation analysis revealed a significant positive relationship between
problematic internet use (PIU) and cognitive distortions (r = 0.190, p < 0.01). Further, a simple
linear regression analysis indicated that cognitive distortions could predict PIU.

Attachment Anxiety and Interpersonal Relationship Styles: The Mediating Role of

Interpersonal Cognitive Distortions.
Kaya, F., & Odacı, H. (2023).
In our current investigation, we examined how attachment anxiety and interpersonal cognitive
distortions predict interpersonal relationship styles. Our aim was to elucidate the associations
among attachment anxiety, interpersonal cognitive distortions, and interpersonal relationship
styles, while also exploring the potential mediating effect of interpersonal cognitive distortions
on the relationship between attachment anxiety and interpersonal relationship styles. A total of
342 adult women participated in the study, with 201 being married (58.8%) and 141 being single
(41.2%). The study employed a correlation model, and data collection instruments included the
Experiences in Close Relationships Scale, the Interpersonal Relation Styles Scale, and the
Interpersonal Cognitive Distortions Scale. Through mediation analyses, we found that
interpersonal cognitive distortions played a partial mediating role in the relationship between
attachment anxiety and interpersonal relationship styles.

The Role of Cognitive Distortions on the Relationship Between Individuals' Self-Esteem

and Sexual Self Sufficiency.
YEŞİLDAL, M., & YİĞİT, M. C. (2023).

Individuals undergo various experiences, observations, and emotions, leading to the formation of
diverse perceptions about themselves, others, and their surroundings. While some of these
perceptions remain consistent, others can be influenced by the individual's psychological state.
This study aims to investigate whether cognitive distortions impact the relationship between
individuals' self-perceptions and sexual self-efficacy. The study sample comprises 200
individuals, with an equal gender distribution of 50% women and 50% men. The research
employed the Rosenberg Self-Esteem Scale, Sexual Self-Efficacy Scale, and Cognitive
Distortions Scale as data collection instruments. Results from the study indicate that there is no
association between individuals' sexual self-efficacy and their educational or financial status.
However, a statistically significant but modest correlation was observed between sexual
self-efficacy, self-esteem, and cognitive distortion. As cognitive distortion scores rise,
individuals' sexual self-efficacy and self-esteem scores decline. It is reasonable to suggest that
individuals lacking sexual self-efficacy and self-esteem tend to misinterpret themselves and their
environment. Data for the study were sourced from existing literature, with participants
administering the scales themselves. It was assumed that participants provided genuine and
accurate responses; however, this assumption may also pose a limitation to the survey.

Predictors of Marital Satisfaction in Married Teachers: Tendency to Cheat and

Interpersonal Cognitive Distortions
Gezer, F., & Özkamalı, E. (2023). Predictors

This study aimed to investigate whether the inclination to engage in infidelity and interpersonal
cognitive distortions can predict the level of marital satisfaction among married teachers. The
sample included 107 (28.1%) male and 271 (71.9%) female married teachers employed in
Gaziantep. Data collection involved the use of a Personal Information Form to gather
demographic data, the Marriage Life Scale to assess marital satisfaction, the Cheating Tendency
Scale to measure infidelity tendencies, and the Interpersonal Cognitive Distortions Scale to
evaluate cognitive distortions in interpersonal relationships. A survey methodology was
employed for this study, utilizing Pearson Correlation Coefficient and Multiple Regression
analysis techniques to analyze the data. Findings indicated that both the inclination to cheat and
interpersonal cognitive distortions significantly predicted marital satisfaction among married
teachers. Specifically, these factors explained 30% of the variance in marital satisfaction.
Furthermore, a negative and significant correlation was observed between marital satisfaction
and the tendency to cheat, while a positive and significant relationship was found between the
inclination to cheat and interpersonal cognitive distortions. Additionally, a negative and
significant association was identified between interpersonal cognitive distortions and marital
satisfaction.

The role of early maladaptive schema domains and childhood trauma in predicting
cognitive distortions
Lorzangeneh, S., & Esazadegan, A. (2022)

Cognitive distortion, viewed as a form of negative thinking and dysfunctional attitude, is

recognized as a significant contributor to the development of mental disorders. This study aimed
to investigate the predictive role of early maladaptive schema domains and childhood trauma in
cognitive distortion. The research employed a descriptive-correlational method, targeting all
students enrolled at Urmia University during the first semester of the academic year 2020-2021.
A sample of 285 students was selected using availability sampling and assessed using Young's
maladaptive schema (1998), Noorbakhsh's child abuse (2012), and Abdullah Zadeh and Salar's
cognitive distortions (2010) questionnaires. The findings from correlation analyses revealed a
positive relationship between cognitive distortion and both childhood trauma dimensions and
early maladaptive schema areas. Moreover, multiple regression analysis demonstrated that early
maladaptive schemas and childhood trauma collectively accounted for 63% of the total variance
in cognitive distortion, with primary maladaptive schema domains exhibiting stronger predictive
power. These results underscore the significant role of early maladaptive schemas and childhood
trauma, particularly emphasizing disconnection and rejection domains and emotional child abuse
dimension, as predisposing factors to cognitive distortion.

Illicit drug use, cognitive distortions, and suicidal ideation among homeless youth: results
from a randomized controlled trial.
Wu, Q., Zhang, J., Walsh, L., & Slesnick, N. (2022).

There is a significant risk of suicidal thoughts and behaviours among youth who engage in illicit
drug use and experience cognitive distortions. However, limited evidence exists regarding the
effectiveness of suicide prevention interventions for homeless youth, particularly in reducing the
risk of suicidal ideation associated with illicit drug use. In this study, 150 homeless youth aged
18 to 24 were recruited from a drop-in centre and randomly assigned to receive Cognitive
Therapy for Suicide Prevention (CTSP) along with Treatment as Usual (TAU), or TAU alone.
Over a period of 9 months, participants reported their illicit drug use, cognitive distortions, and
suicidal ideation four times. A multiple-group multilevel structural equation model revealed that
higher levels of illicit drug use at the beginning of the study predicted a slower reduction in
cognitive distortions and suicidal ideation among those receiving only TAU. However, this
association was not observed in the CTSP + TAU group, indicating that the intervention
interrupted this risk factor associated with illicit drug use. These findings suggest that CTSP may
effectively reduce the risk of illicit drug use serving as a barrier to addressing cognitive
distortions and suicidal ideation among homeless youth. This has important implications for
improving treatment efforts and reducing premature mortality in this vulnerable population.
Interpersonal Cognitive Distortions and Anxiety: The Mediating Role of Emotional
Intelligence
Yazici-Çelebi, G., & Kaya, F. (2022).

This study aimed to explore the relationships among interpersonal cognitive distortions, anxiety,
and emotional intelligence, as well as to investigate the mediating role of emotional intelligence
in the association between interpersonal cognitive distortions and anxiety. A total of 235
university students (135 females and 100 males) participated in the correlational model of the
study. Data were collected using the Beck Anxiety Inventory, the Schutte Emotional Intelligence
Test, a Personal Information Form, and the Interpersonal Cognitive Distortions Scale. The
findings revealed statistically significant negative correlations between emotional intelligence,
interpersonal cognitive distortions, and anxiety. Additionally, interpersonal cognitive distortions
were positively and significantly correlated with anxiety. The mediation analyses conducted in
the study indicated that emotional intelligence partially mediated the relationship between
interpersonal cognitive distortions and anxiety. Consequently, the indirect impact of interpersonal
cognitive distortions on anxiety was found to be statistically significant. The study's findings are
expected to be valuable for experts designing programs to assist individuals with anxiety and
those involved in family therapy research.

Pathological narcissism, interpersonal cognitive distortions, and workplace bullying among

nurses: A cross‐sectional study.
Jang, S. J., & Lee, H. (2022).

This study aims to investigate whether nurses' pathological narcissism and interpersonal
cognitive distortions can predict workplace bullying, while controlling for organizational culture,
work-related factors, and demographic variables.

To combat workplace bullying effectively, it's essential to adopt a comprehensive approach to

identify potential predictors. Nurses' narcissistic behaviors can have adverse effects on
relationships among colleagues and within the organization. Additionally, interpersonal cognitive
distortions have been shown to directly influence bullying and victimization. Data from 236
nurses who completed an online survey were analyzed. The Pathological Narcissism Inventory,
Interpersonal Cognitive Distortions Scale, Positive Nursing Organizational Culture Measurement
Tool, and The Negative Acts Questionnaire-Revised were utilized to measure the key variables.
The results of multiple regression analysis indicated that pathological narcissism (β = .33, p <
.001) had the most significant impact on nurses' workplace bullying, followed by positive
organizational culture (β = -.31, p < .001), interpersonal cognitive distortions (β = .17, p = .028),
marital status (β = -.15, p = .020), and position (β = -.12, p = .047). In conclusion, while avoiding
prejudice or stigma associated with narcissistic personalities, nurses should recognize and
manage such characteristics to prevent them from contributing to workplace bullying.

Correlation study between personality traits and cognitive distortions.

Maheshwari, K., & Chadha, Y. (2021).

Personality encapsulates an individual's distinctive patterns of thinking, behaving, and feeling

across their lifespan. From a psychological standpoint, personality defines our characteristic
ways of reacting to people and situations. It's widely recognized in psychology that individuals
navigate the world based largely on assumptions about themselves, others, the environment, and
the future. When these assumptions become inaccurate, overly negative, and disrupt optimal
functioning, they're often labeled as cognitive distortions or dysfunctional thought patterns. This
study aims to examine the relationship between personality dimensions measured by the
NEO-FFI and cognitive distortion dimensions assessed by the Cognitive Distortion Scale (CDS)
among undergraduate and postgraduate students aged 18-24. With a sample size of 200 selected
through purposive sampling, the study seeks to explore whether the corresponding components
of NEO-FFI and CDS are correlated and can predict each other's domains through data analysis.
Results indicated significant correlations between all big five personality factors and cognitive
distortion domains, with differences observed between males and females particularly in
neuroticism and extraversion domains. Notably, neuroticism emerged as a significant predictor of
cognitive distortion dimensions

Cognitive distortions in gamblers and non-gamblers of a representative Spanish sample.

Labrador, M., Labrador, F. J., Crespo, M., Echeburúa, E., & Becoña, E. (2020)

Cognitive biases or distortions associated with gambling are considered significant factors in the
development of gambling-related issues, affecting both gamblers and non-gamblers. The aim of
this study was to examine whether the presence of these biases correlates with the presence of
gambling problems. A structured survey was administered to 3000 individuals aged 18 to 81,
representing the Spanish adult population. The results showed that the presence of cognitive
distortions was indeed relevant in distinguishing between different levels of gambling
engagement and problems. As gambling problems increased, there was a consistent and
significant trend towards a higher number of cognitive distortions. However, not all distortions
had the same ability to differentiate between groups of gamblers. The findings suggested the
grouping of gamblers into three categories based on the presence of cognitive distortions,
ranging from non-gamblers to low-risk/at-risk gamblers, and problem/pathological gamblers.
The significance of these findings and their practical implications for treatment and prevention
efforts are discussed.

The association of cognitive distortions and the type of gambling in problematic and
disordered gambling.
Orlowski, S., Tietjen, E., Bischof, A., Brandt, D., Schulte, L., Bischof, G., ... & Rumpf, H. J.
(2020).

The objective of this study is to compare various types of gambling in terms of cognitive
distortions and their association with the development of disordered gambling. The study
involved a sample of vocational school students (N = 6718), from which 309 students were
selected for in-depth interviews. The Gamblers-Belief-Questionnaire (GBQ) was utilized to
assess gambling-related cognitive distortions, while the Stinchfield questionnaire was employed
to evaluate gambling-related problems. Logistic regression analyses were conducted to examine
the associations between cognitive distortions, gambling-related symptoms, and types of
gambling. Elevated scores on the GBQ subscale "belief in luck/perseverance" were significantly
linked to a higher likelihood of being classified as having Gambling Disorder (COR = 1.05, CI =
1.02–1.08) and problematic gambling (COR = 1.04, CI = 1.01–1.06). Moreover, higher scores on
the subscale "illusion of control" were associated with problematic gambling (COR = 1.04, CI =
1.00 -- 1.08). Analysis of various gambling types revealed that sports betting was a predictor for
problematic gambling (COR = 1.91, CI = 1.05–3.49). However, this association became
insignificant when controlling for cognitive distortions. In terms of disordered gambling,
gambling on electronic gambling machines (EGMs) emerged as a risk factor alongside cognitive
distortions (COR = 2.59, CI = 1.04–6.49).

Suicidal ideation, cognitive distortions, impulsivity and depression among young adult in
Patna, Bihar.
Kumar, P., Kumar, P., & Mishra, S. D. (2020).

Despite the widespread research work on suicidal ideation, cognitive distortion, impulsivity and
depression from diverse perspectives, little research has directly examined the cognitive
attributes underlying impulsive behaviour in adults. Aims and objectives of the study were to
assess the relationship between Suicidal ideation, Cognitive distortions, Impulsivity and
Depression among young adults. Three hundred youth were selected purposely from different
colleges of Patna, Bihar. The statistical package for social sciences (SPSS) 16.0 windows was
used for statistical analysis. There was significant positive correlation among suicidal ideation,
cognitive distortion and depression where as there is negative correlation between suicidal
ideation and impulsivity.

Decision-making styles, negative affectivity, and cognitive distortions in adolescent

gambling
Cosenza, M., Ciccarelli, M., & Nigro, G. (2019).

Existing research indicates that problem gamblers exhibit greater cognitive distortions and report
higher levels of negative emotions compared to recreational gamblers. Additionally, numerous
studies have shown that as the severity of gambling increases, individuals perform poorly in
tasks assessing affective decision-making. While previous research in gambling has primarily
focused on the outcomes of decision-making, whether functional or dysfunctional, no study has
explored the influence of decision-making styles on gambling disorders. This study aimed to
investigate the relationship between negative emotions, cognitive distortions, decision-making
styles, and adolescent problem gambling. A total of 425 adolescents aged 14 to 19 completed
various assessments including measures of problem gambling, negative affective states,
cognitive distortions related to gambling, and general decision-making styles. Data were
analyzed using correlation, ANOVA, and regression analyses. The findings revealed that, in
addition to gender, interpretative bias, inability to stop gambling, depression, and spontaneous
decision-making style significantly predicted the severity of gambling. These results not only
build upon previous research regarding misconceptions about gambling and negative emotions in
adolescent gambling but also highlight the significance of maladaptive decision-making styles as
a risk factor for gambling disorder.

The role of aggression, impulsivity, empathy, and cognitive distortions.

Schmits, E., & Glowacz, F. (2019).

Risk behaviors tend to be more prevalent in adolescents and emerging adults, with drug use and
delinquency sharing several common predictive factors. This study aimed to evaluate the
influence of individual factors (aggression, impulsivity, empathy, and cognitive distortions) on
delinquent behaviors, alcohol consumption, and cannabis use among adolescents and emerging
adults. The participants, aged between 15 and 25 years, completed validated self-report
questionnaires. Multiple regression analyses revealed that all individual factors significantly
predicted delinquency. Impulsivity and empathy were significant predictors of alcohol use, while
impulsivity was the sole predictor of cannabis use. Moderation analysis indicated that certain
associations were stronger in adolescents, while others were more pronounced in emerging
adults. Together, these variables explained a substantial portion of the variance in delinquency,
alcohol use, and cannabis use. These findings carry implications for preventive and intervention
efforts targeting risky behaviors in these populations.

Maladaptive perfectionism, impostorism, and cognitive distortions: Threats to the mental

health of pre-clinical medical students
Hu, K. S., Chibnall, J. T., & Slavin, S. J. (2019).

Recent attention has focused on the well-being of medical students, yet existing approaches may
overlook harmful cognitive distortions related to academic performance. This study aimed to
explore dysfunctional thoughts (such as maladaptive perfectionism and impostor phenomenon)
and negative emotions (including shame, embarrassment, and inadequacy) that could contribute
to poor mental health among pre-clinical medical students.

First-year medical students at Saint Louis University completed a survey assessing maladaptive
perfectionism, impostor phenomenon, depression, anxiety, and various negative feelings. A total
of 169 students (93%) participated. Those exhibiting maladaptive perfectionism were
significantly more likely to report greater feelings of shame/embarrassment and inadequacy
compared to their peers. Similar associations were observed in students experiencing high levels
of impostor phenomenon. Additionally, students reporting these negative feelings were more
likely to exhibit symptoms of depression and anxiety. These findings suggest a pathway from
negative thoughts to negative emotions, depression, and anxiety in medical students. The authors
recommend implementing preventive interventions during medical school orientation to address
these cognitive distortions and negative feelings. Further research is needed to develop targeted
interventions aimed at promoting student mental health by addressing these issues.

Decision-making styles, negative affectivity, and cognitive distortions in adolescent

gambling
Cosenza, M., Ciccarelli, M., & Nigro, G. (2019).

Existing research indicates that problem gamblers exhibit greater cognitive distortions and report
higher levels of negative emotions compared to recreational gamblers. Additionally, numerous
studies have shown that as the severity of gambling increases, individuals perform poorly in
tasks assessing affective decision-making. While previous research in gambling has primarily
focused on the outcomes of decision-making, whether functional or dysfunctional, no study has
explored the influence of decision-making styles on gambling disorders. This study aimed to
investigate the relationship between negative emotions, cognitive distortions, decision-making
styles, and adolescent problem gambling. A total of 425 adolescents aged 14 to 19 completed
various assessments including measures of problem gambling, negative affective states,
cognitive distortions related to gambling, and general decision-making styles. Data were
analyzed using correlation, ANOVA, and regression analyses. The findings revealed that, in
addition to gender, interpretative bias, inability to stop gambling, depression, and spontaneous
decision-making style significantly predicted the severity of gambling. These results not only
build upon previous research regarding misconceptions about gambling and negative emotions in
adolescent gambling but also highlight the significance of maladaptive decision-making styles as
a risk factor for gambling disorder.

The role of aggression, impulsivity, empathy, and cognitive distortions.

Schmits, E., & Glowacz, F. (2019).

Risk behaviors tend to be more prevalent in adolescents and emerging adults, with drug use and
delinquency sharing several common predictive factors. This study aimed to evaluate the
influence of individual factors (aggression, impulsivity, empathy, and cognitive distortions) on
delinquent behaviors, alcohol consumption, and cannabis use among adolescents and emerging
adults. The participants, aged between 15 and 25 years, completed validated self-report
questionnaires. Multiple regression analyses revealed that all individual factors significantly
predicted delinquency. Impulsivity and empathy were significant predictors of alcohol use, while
impulsivity was the sole predictor of cannabis use. Moderation analysis indicated that certain
associations were stronger in adolescents, while others were more pronounced in emerging
adults. Together, these variables explained a substantial portion of the variance in delinquency,
alcohol use, and cannabis use. These findings carry implications for preventive and intervention
efforts targeting risky behaviors in these populations.

Maladaptive perfectionism, impostorism, and cognitive distortions: Threats to the mental

health of pre-clinical medical students
Hu, K. S., Chibnall, J. T., & Slavin, S. J. (2019).

Recent attention has focused on the well-being of medical students, yet existing approaches may
overlook harmful cognitive distortions related to academic performance. This study aimed to
explore dysfunctional thoughts (such as maladaptive perfectionism and impostor phenomenon)
and negative emotions (including shame, embarrassment, and inadequacy) that could contribute
to poor mental health among pre-clinical medical students.

First-year medical students at Saint Louis University completed a survey assessing maladaptive
perfectionism, impostor phenomenon, depression, anxiety, and various negative feelings. A total
of 169 students (93%) participated. Those exhibiting maladaptive perfectionism were
significantly more likely to report greater feelings of shame/embarrassment and inadequacy
compared to their peers. Similar associations were observed in students experiencing high levels
of impostor phenomenon. Additionally, students reporting these negative feelings were more
likely to exhibit symptoms of depression and anxiety. These findings suggest a pathway from
negative thoughts to negative emotions, depression, and anxiety in medical students. The authors
recommend implementing preventive interventions during medical school orientation to address
these cognitive distortions and negative feelings. Further research is needed to develop targeted
interventions aimed at promoting student mental health by addressing these issues.
Cognitive distortions in anorexia nervosa and borderline personality disorder.
Del Pozo, M. A., Harbeck, S., Zahn, S., Kliem, S., & Kröger, C. (2018).

This study examined the specificity of two cognitive distortions, thought-shape fusion (TSF)
associated with eating disorders (ED), and thought-abandonment fusion (TAbF) assumed to
occur in borderline personality disorder (BPD). 63 patients completed questionnaires assessing
trait-TAbF and trait-TSF, along with relevant psychopathology. Nonparametric conditional
inference trees were used to test for disorder-specificity. Results showed that participants with
anorexia nervosa (AN) had higher trait-TSF scores compared to those with BPD, when
participants with BPD and co-occurring AN were excluded. Trait-TSF in AN participants
appeared to be disorder-specific. Participants with BPD and co-occurring AN had the highest
TAbF scores. The specificity hypothesis was only partially confirmed for trait-TAbF, as high
trait-TAbF scores were observed in participants with AN as well. These findings suggest that
while TAbF may not be specific to BPD, it could also play a role in AN. Both distortions appear
to contribute to the maintenance of their respective disorders.

The role of self‐serving cognitive distortions in reactive and proactive aggression.

Oostermeijer, S., Smeets, K. C., Jansen, L. M., Jambroes, T., Rommelse, N. N., Scheepers,
F. E., ... & Popma, A. (2017).

Aggression is often categorized into reactive and proactive types, with reactive aggression
involving behaviors like blaming others and assuming the worst, while proactive aggression
relates to self-centeredness and minimizing or mislabelling behaviors. This study aimed to assess
the connections between reactive and proactive aggression and cognitive distortions, and to
determine whether changes in these cognitive patterns are linked to changes in aggression. A
group of 151 adolescents (60% boys; average age 15.05 years, standard deviation 1.28)
participated in an intervention aimed at reducing aggression. Following attrition and some
irregular responses, the post-intervention sample included 80 adolescents. Correlation and linear
regression analyses were conducted to explore the relationship between cognitive distortions and
aggression. Blaming others was associated with reactive aggression before the intervention,
while all cognitive distortions were linked to proactive aggression both before and after the
intervention. Changes in reactive aggression were predicted by blaming others, whereas changes
in proactive aggression were predicted by changes in overall cognitive distortions. This study, to
our knowledge, is the first to demonstrate a connection between changes in cognitive distortions
and changes in aggression. Addressing cognitive distortions related to misattributing blame to
others may be particularly beneficial in treating reactive aggression.

Cognitive distortions among older adult gamblers in an Asian context.

Subramaniam, M., Chong, S. A., Browning, C., & Thomas, S. (2017).

The study seeks to explore cognitive distortions among older adult gamblers (aged 60 years and
above) in Singapore. The study included Singaporean residents aged 60 and above who had a
history of regular gambling. Participants were recruited through various methods, including
venue-based approaches, referrals from service providers, and snowball sampling. A total of 25
in-depth interviews were conducted with older adult gamblers. Thematic network analysis,
consisting of six steps, was utilized for data analysis. The average age of participants was 66.2
years, with the majority being male (n = 18) and of Chinese ethnicity (n = 16). On average,
participants began gambling at 24.5 years old. Cognitive distortions emerged as a prominent
theme among older adult gamblers, encompassing three organizing themes: illusion of control,
probability control, and interpretive control. These organizing themes comprised nine basic
themes, including perceptions of gambling as a skill, near-miss experiences, concepts of luck,
superstitious beliefs, entrapment, gambler's fallacy, chasing wins, chasing losses, and beliefs
regarding wins outweighing losses. All participants endorsed cognitive distortions, which were
found to contribute to the maintenance and escalation of gambling behavior. While the surface
characteristics of these distortions appeared culture-specific, deeper characteristics may be more
universal. Future research should incorporate longitudinal studies to elucidate causal
relationships between cognitive distortions and gambling behavior, as well as the influence of
culture-specific distortions on disorder maintenance and treatment.

Delinquent friends and aggressive behavior in multi problem young adults: Mediating
effects of cognitive distortions
Streedel, Q. (2016).

Many young adults deal with a variety of issues on a daily basis, including addiction, crime, and
social and financial issues. However, not much study is done particularly on these young adults
with many problems. In this study, 159 multiproblem male young adults in the Netherlands—that
is, young adults with severe psychosocial problems—were used as a sample, and the association
between having delinquent friends and proactive and reactive aggressiveness was investigated.
Age range: 18 to 27 (M = 22, SD = 2). Furthermore, while controlling for age, the number of
friends one has, and the quality of those friendships, it was investigated whether primary and
secondary cognitive distortions—distorted cognitions including self-centered attitudes and
beliefs, respectively, cognitive distortions used to neutralize conscience or guilt—mediated this
relationship.

Cognitive distortions, humor styles, and depression

Rnic, K., Dozois, D. J., & Martin, R. A. (2016).

The study findings indicate significant associations between cognitive distortions, humor styles,
and depressive symptoms. Cognitive distortions, both in terms of frequency and impact, show
consistent patterns of correlation with different humor styles and depressive symptoms.
Specifically, individuals who experience cognitive distortions frequently tend to engage less in
adaptive humor styles like Affiliative and Self-Enhancing humor, and more in maladaptive styles
like Aggressive and Self-Defeating humor. Moreover, higher levels of cognitive distortions are
also associated with increased depressive symptoms. To delve deeper into these relationships, the
study conducted mediation analyses to explore whether humor styles act as mediators between
cognitive distortions and depressive symptoms.

Cognitive distortions mediate depression and affect response to social acceptance and
rejection.
Caouette, J. D., & Guyer, A. E. (2016).

Ninety participants, aged 18 to 26 years (including 53 women), took part in a two-visit Chatroom
task. During the first visit, they rated their expectations regarding acceptance by 60 peers. During
the second visit, they completed self-reports on depressive symptoms, social anxiety symptoms,
and cognitive flexibility. They then received feedback from each peer, either acceptance or
rejection, and rated their emotional response. The results showed that greater depressive
symptoms were associated with a bias towards negative expectations, lower cognitive flexibility,
and a less positive emotional response to acceptance, but not to rejection. Negative expectations
and cognitive flexibility mediated the relationship between depressive symptoms and emotional
response to acceptance, while only negative expectations mediated responses to rejection. These
cognitive processes were not found to be related to social anxiety. Limitations of the study
include the use of a community sample to assess depression, and the omission of rumination and
current mood state as potential predictors of emotional response. In conclusion, the findings
support the Emotional Cascade Model framework. Depression, but not social anxiety, appears to
affect emotional responses to social acceptance and rejection through cognitive processes.
Therapy for depression could focus on improving social flexibility to better align emotional
reactions with social outcomes.

A model of disturbed eating behavior in men: the role of body dissatisfaction, emotion
dysregulation and cognitive distortions.
Wyssen, A., Bryjova, J., Meyer, A. H., & Munsch, S. (2016)

In understanding the development of eating disorders (EDs) in males, a sociocultural perspective

often emphasizes body dissatisfaction (BD) as a key factor. To delve deeper into the
psychological aspects contributing to ED pathology, we propose a mediator model focusing on
disturbed eating and compensatory behavior (DECB) in men. This model suggests that emotion
dysregulation and susceptibility to body-related cognitive distortions, specifically thought-shape
fusion (TSF), mediate the relationship between BD and DECB. Through data obtained from a
cross-sectional online survey involving a non-clinical community sample of young men (aged
18–37, N=123), we tested our model. Our results showed a significant positive association
between BD and DECB, even after accounting for factors such as body mass index (BMI), age,
and depressive symptoms. While TSF partially mediated the relationship between BD and
DECB, we did not observe a similar effect for emotion dysregulation. Our findings suggest that
TSF, involving distorted cognitions related to one's body triggered by specific types of food,
contributes to pathological eating and body-related behaviors in men dissatisfied with their
bodies. We propose the inclusion of TSF in etiological models as it represents a significant
aspect of cognitive processing with emotional and behavioral implications.

The Association of Cognitive Distortions, Problems with Self-Concept, Gender, and Age in
Adults Diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD).
O'Brien, D. R. (2016)

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurocognitive condition associated with

various functional impairments that may lead to negative self-perceptions. These negative beliefs
often give rise to maladaptive thoughts or cognitive distortions. While cognitive behavioral
therapy (CBT) has been found effective in treating adults with ADHD, there is limited data on
the link between cognitive distortions and ADHD symptoms in adults, particularly concerning
self-concept. This study aims to assess how cognitive distortions, self-concept issues, gender,
and age impact ADHD symptoms in a sample of 130 adults seeking treatment at a
university-based outpatient clinic specializing in ADHD assessment and treatment. Findings
indicate that self-concept issues significantly and positively predict the severity of ADHD
symptoms. Moreover, cognitive distortions positively predict self-concept issues, while gender
does not have a significant predictive effect in this context. However, gender, age, and cognitive
distortions do not significantly predict ADHD symptoms.

Rape-related cognitive distortions: Preliminary findings on the role of early maladaptive

schemas.
Sigre-Leirós, V., Carvalho, J., & Nobre, P. J. (2015).

Although cognitive distortions have received significant attention in the realm of sexual
offending, there has been a suggestion of the relevance of underlying cognitive schemas in
sexual offenders. This study aimed to explore a potential correlation between Early Maladaptive
Schemas (EMSs) and cognitive distortions in individuals convicted of rape. A group of 33 men
who had been convicted for rape participated in the study, completing assessments including the
Bumby Rape Scale (BRS), the Young Schema Questionnaire — Short form-3 (YSQ-S3), the
Brief Symptom Inventory (BSI), and the Socially Desirable Response Set Measure (SDRS-5).
The findings revealed a significant association between the impaired limits schematic domain
and the Justifying Rape dimension of the BRS. Specifically, after adjusting for levels of
psychological distress and tendency towards socially desirable responses, the
entitlement/grandiosity schema from the impaired limits domain emerged as a noteworthy
predictor of cognitive distortions related to themes of justification.

The relationship between cognitive distortions and forgiveness in romantic relationships.

Aydın, G., Özdinç, N. K., & Aksu, M. (2015).

The aim of this study was to investigate the association between cognitive distortions and
forgiveness within romantic relationships among college students. A sample of 340 college
students enrolled at a state university in Turkey, all of whom were in romantic relationships,
participated in the study. Utilizing a purposeful sampling method, data were collected through
three instruments: the Interpersonal Cognitive Distortions Scale (ICDS), the Heartland
Forgiveness Scale, and a Demographic Data Form. Participants were asked to complete the
scales online via survey.metu.edu.tr. Canonical correlation analysis, conducted using SPSS 22,
was employed to examine the relationship between two sets of variables: the subscales of
interpersonal cognitive distortions (including Interpersonal Rejection, Unrealistic Relationship
Expectation, and Interpersonal Misperception) and the subscales of forgiveness (including
Forgiveness of Self, Forgiveness of Others, and Forgiveness of Situations). This study holds
significance as it may address gaps in the literature and contribute to the counseling field by
shedding light on potential predictors in future research on romantic relationships.ying rape. In
summary, while these findings are preliminary, they suggest that Young's Schema-Focused
model, particularly the impaired limits dimension, may play a role in understanding cognitive
distortions in rapists, warranting further investigation.

Relationship between school managers’ conflict management styles and interpersonal

cognitive distortions.
Yildirim, I., Akan, D., & Yalçin, S. (2015).
This study involved 68 school managers from central districts of Erzurum, selected using
stratified sampling, to explore the link between school managers' interpersonal cognitive
distortions and their conflict management styles. Data analysis was conducted using SPSS 16
statistics software. The findings revealed significant correlations, moderately strong and in the
same direction, between the overall scores of school managers' interpersonal cognitive
distortions and the conflict management styles of "compromising," "dominating," and
"avoiding." However, no significant correlation was observed in the sub-dimensions of
"integrating" and "obliging."

Cognitive Distortions and Suicide Attempts.

Jager-Hyman, S., Cunningham, A., Wenzel, A., Mattei, S., Brown, G. K., & Beck, A. T.
(2014).

Theorists have suggested that individuals who have attempted suicide may be more prone to
cognitive distortions compared to those who haven't. However, there's limited research exploring
whether recent suicide attempters indeed exhibit higher levels of cognitive distortions. This study
involved 111 participants who attempted suicide within the past 30 days and 57 psychiatrically
stable individuals as controls. Both groups completed assessments measuring cognitive
distortions, depression, and hopelessness. Results supported the idea that recent suicide
attempters are more likely to experience cognitive distortions, even after considering factors like
depression and hopelessness. Specifically, the only distortion significantly associated with
suicide attempt status was "fortune telling," although this association became non-significant
when considering hopelessness. These findings emphasize the importance of addressing
cognitive distortions directly in the treatment of individuals at risk for suicide.

The impact of mixed, hope and forgiveness‐focused marital counseling on interpersonal

cognitive distortions of couples filing for divorce
Navidian, A., & Bahari, F. (2014).

Hope and forgiveness are effective strategies for alleviating family conflicts and are considered
modern approaches to resolving marital issues. Combining interventions focused on hope and
forgiveness can help reduce irrational beliefs among couples and potentially prevent divorce,
which is a common outcome of marital conflicts. This study investigates the impact of mixed
hope- and forgiveness-focused interventions on couples seeking divorce in Isfahan, Iran.
Hope-focused counseling aims to strengthen marital relationships and decrease divorce rates,
while forgiveness therapy is used to address feelings of resentment and anger resulting from
marital discord. Results indicate that hope-focused interventions alone had no significant effect
on interpersonal cognitive distortions compared to the control group, similar to
forgiveness-focused interventions. However, mixed interventions showed significant
effectiveness in reducing irrational expectations and misconceptions among divorcing couples
compared to the control group. Conflict and divorce often overlap, and previous research
suggests that spirituality-based interventions in mental health nursing may help reduce conflict
levels. This quasi-experimental study employed pre-test and post-test assessments with 60
randomly assigned couples undergoing pre-divorce counseling. Data analysis using
non-parametric tests revealed that while hope- and forgiveness-focused interventions did not
significantly impact interpersonal cognitive distortions compared to the control group, mixed
interventions significantly reduced irrational beliefs and interpersonal rejection among couples.
Combining hope and forgiveness interventions could therefore be beneficial in addressing
irrational marital beliefs and reducing conflict among couples seeking divorce. Additionally,
assessing conflict levels among couples is crucial for determining the appropriate intervention
type, whether psychoeducational or therapeutic, for mental health nurses.

The role of cognitive distortion in online game addiction among Chinese adolescents.
Li, H., & Wang, S. (2013).

The primary objective of this research was to investigate how cognitive distortions contribute to
the emergence of online game addiction among adolescents in China. In the first phase of the
study, 495 adolescents between the ages of 12 and 19 were surveyed. They were selected from
two middle schools in Guangzhou, China, and completed questionnaires covering demographic
information, as well as scales assessing internet addiction, cognitive distortions, and online game
addiction. In the second phase, 28 adolescents with excessive online game usage were recruited
from a local mental health facility and randomly assigned to either a cognitive-behavioral
therapy (CBT) group or a clinical control group (N=14 for each). Measures of online game
addiction severity, anxiety, depression, and cognitive distortions were collected before and after a
6-week intervention. The study revealed that rumination and short-term thinking were the
primary predictors of online game addiction, with all-or-nothing thinking showing a marginal
significance in predicting addiction. Additionally, the study found that males were more
susceptible to developing online game addiction compared to females. The results also showed
that CBT and basic counseling had differing effects on various aspects of cognitive distortions
and psychological symptoms, although both interventions had similar effects on measures of
online game addiction severity. The implications of these findings for understanding the causes
of online game addiction and for designing effective treatment programs are discussed.

Adult ADHD and the relationship between self-reported frequency of cognitive distortions,
anxiety, and depression.
Strohmeier, C. (2013).

Cognitive-behavioral therapy for adults with ADHD often includes strategies to address
cognitive distortions. Although identifying cognitive distortions as part of a causal chain related
to disorders such as anxiety and depression has been well studied, limited research has focused
on the relationship between ADHD and cognitive distortions. The goal of this study was to
determine the nature of the relationship between ADHD, cognitive distortions, anxiety, and
depression within a group of adult outpatients from an ADHD treatment center (N = 30). Results
indicated that the severity of ADHD symptomatology, identified through a self-report scale, was
significantly related to the self-reported frequency of cognitive distortions. The direct positive
relationship between ADHD severity and frequency of cognitive distortions (a) existed
independently of comorbid anxiety and/or depression and (b) remained significant when the
relationship was explored with a portion of the sample that completed additional ADHD
self-report scales for primary inattentive symptoms (n = 27). This is one of few studies to explore
the nature of the relationship between adult ADHD and cognitive distortions. Furthermore, this
study provides empirical support for the inclusion of cognitive-behavioral techniques that
consider cognitive distortions in this population.

Cognitive distortions in normal-weight and overweight women: Susceptibility to

thought-shape fusion
Coelho, J. S., Jansen, A., & Bouvard, M. (2012).

The study explored how cognitive distortions, particularly thought-shape fusion (TSF), relate to
eating behaviors, specifically in normal-weight and overweight women. TSF involves imagining
eating high-caloric food, which leads to feelings of being fatter and perceiving weight gain as
morally wrong. Researchers studied 60 females, divided into normal-weight (32) and overweight
(28) groups. Participants were randomly assigned to either a TSF or neutral condition and then
assessed on TSF questionnaires. The findings showed that normal-weight women reported higher
TSF levels after the TSF induction compared to a neutral induction, while there were no
significant differences for overweight women. This suggests that normal-weight individuals may
be more influenced by TSF induction compared to overweight individuals, possibly due to
differences in self-regulation after exposure to food cues.

The cognitive distortions of child molesters are in need of treatment.

Ó Ciardha, C., & Gannon, T. A. (2011)

This essay is the second of a series of papers that Marshall, Marshall, and Kingston (2011)
organized to discuss the necessity of treating so-called cognitive distortions in the treatment of
sexual offenders. Marshall et al. contend in their research that treatment for so-called cognitive
distortions may not always involve significant, targeted attention or challenge. We evaluate the
arguments made by Marshall et al. and point out some fundamental discrepancies in our
definition of the term "cognitive distortion" compared to Marshall et al. We assume that many of
the issues that we "debate" seem to stem from these fundamental definitional conflicts. For
instance, Marshall et al. clearly centers their arguments about cognitive distortions on
justifications, denials, and minimizations, but we choose to concentrate on higher-order beliefs
and schemas insights into how belief systems can resist empirical evidence and rational criticism,
contributing to their enduring appeal and resilience

Impact of REM sleep on distortions of self-concept, mood and memory in

depressed/anxious participants.
McNamara, P., Auerbach, S., Johnson, P., Harris, E., & Doros, G. (2010).

We investigated whether REM sleep contributes to key aspects of cognitive dysfunction in

individuals with anxious depression, including negative self-assessments, biased memory
processing, and unpleasant dream content. A group of 35 healthy college students and 20
students experiencing depression and anxiety underwent sleep studies after a habituation night in
a sleep lab. Participants were awakened 10 minutes into REM sleep and 10 minutes into NREM
sleep, with awakenings balanced to account for circadian effects. After each awakening,
participants reported their dreams and completed tasks assessing memory recall, mood, and
self-assessment. Impact of REM sleep on distortions of self-concept, mood and memory in
depressed/anxious participants. Negative self-appraisals were particularly pronounced in dreams
during REM sleep for those with depression and anxiety. Both depressed/anxious and healthy
participants recalled negative memories more frequently after REM sleep awakenings compared
to NREM sleep. Additionally, dreams during REM sleep were associated with higher frequencies
of negative emotions, aggression, and victimization for individuals with depression and anxiety.
Limitations include the classification of depressed/anxious participants based on mood scales
rather than clinical interviews, and the use of a college student sample, which may limit the
generalizability of the findings to elderly or clinical populations. In conclusion, REM sleep
appears to play a role in exacerbating cognitive distortions associated with anxious depression.

Clinical and cognitive correlates of depressive symptoms among youth with obsessive
compulsive disorder.
Peris, T. S., Bergman, R. L., Asarnow, J. R., Langley, A., McCracken, J. T., & Piacentini, J.
(2010).

This research delves into the prevalence and factors associated with depressive symptoms in
children diagnosed with primary Obsessive-Compulsive Disorder (OCD). A group of 71 youths,
primarily male, with an average age of 12.7 years, participated in the study. The findings
revealed a spectrum of depressive symptoms, with 21% of participants scoring above the clinical
threshold for depression on self-report measures. The study identified several cognitive and
clinical factors correlated with depressive symptomatology. Specifically, higher levels of
depressive symptoms were linked to greater cognitive distortions related to insight, perceived
control, competence, and contingencies. Additionally, older age and more severe OCD
symptoms were associated with heightened levels of depression. Factors such as low perceived
control and self-competence, along with the severity of OCD, were identified as independent
predictors of depression scores.
 CHAPTER – 3
RESEARCH METHODOLOGY

3.1 Research Objectives:

The objectives of the research on the Correlation between Cognitive Distortions and Defence
Mechanism might include:

1. To determine the correlation between Cognitive Distortions and Defence Mechanism

among males and females.
2. To observe which gender have more Cognitive Distortions and Defense Mechanism..
3. To observe the if Cognitive Distortions and Defense Mechanism would be more in Males
than Females.
3.2 Research Hypothesis :
H1 : There is Positive Correlation between Cognitive Distortions and Defense Mechanism.

H2 : There is a significant difference in Cognitive Distortions among Males and Females.

H3 : There is a significant difference in Defense Mechanism among Males and Females

H4 : There is a significant difference in Cognitive Distortions among different Age groups.

H5 : There is a significant difference in Defense Mechanism among different Age groups.

H6 : There is a significant difference in Cognitive Distortions among different Sexualities.

H7 : There is a significant difference in Defense Mechanism among different Sexualities.

3.3 Research Variables:

3.3.1 Independent Variable:
A) Gender

· Male

· Female

· Other

B) Cognitive Distortions (Score)

· 25 – 40: Very Low Cognitive Distortion

· 41 – 60: Low Cognitive Distortion

· 61 – 90: Moderate Cognitive Distortion

· 91 – 110: High Cognitive Distortion

· 111 – 125: Very High Cognitive Distortion

3.3.2 Dependent Variable:
The dependent variables in this research are:

A) Defence Mechanism

1. Denial
2. Regression
3. Projection
4. Rationalization
5. Displacement
6. Sublimation
7. Intellectualization
8. Reaction Formation
9. Compensation
10. Undoing
11. Fantasy
12. Minimization
13. Avoidance
14. Selective Forgetting
15. Withdrawal

3.3.3 Control Variable:

The Control Variable in this research are:

1. The subjects belong to the age group of 18 – 50 years.

2. All the subjects were kept unaware of the problem or the base of the research

3. The subjects were from India.

4. The questionnaire was kept unseen before it was filled by the subject.

5. The subjects were assured of their confidentiality so that doesn’t affect the research

3.4 Research Design:

Research design refers to the overall stature or a basic idea to conduct research. It provides a
base for the collection and analysis of the data throughout the research. The choice of the
research design depends on the topic of the research, the variables and the relation between the
variables assumed by the researcher.

The following research design has a quantitative research method. Quantitative research is a
systematic investigation of phenomenon by gathering data and performing statistical,
mathematical, or computational methods. Quantitative research collects information using
sampling methods and sending out online or offline surveys, social media polls, questionnaires,
etc, the results of which can be depicted in the form of numbers. After careful perception and
analysis of these numbers to predict the future of a product or service and make changes
accordingly.

The study of the design includes the research problem, hypothesis, variables and its types,
experimental design (if any) and also the data collection methods including the data analysis
plan.

3.5 Selection of the subjects.

Non-probability sampling methods, i.e Snowball & Convenience sampling techniques, have been
employed for the selection of subjects for the study. Snowball Sampling: In snowball sampling,
participants are recruited through referrals from existing participants, creating a "snowball"
effect. It's useful for studying hard-to-reach populations but can introduce bias due to the
non-random selection process.

Convenience sampling involves selecting participants based on their easy accessibility or

proximity to the researcher. While it's convenient and efficient, it may not represent the broader
population accurately, leading to potential biases in the results. This means that the subjects were
chosen on the basis of availability and not on their degree of population representation.

3.6 Sample Size

The statistical sample of this study has been taken from India. All subjects belong between age
groups ranging from 18 – 50 years. The research studies a sample size of 200 subjects. The
subject is chosen as a non – probability sample on the basis of availability.

3.7 Data Collection and Background

A google form was made and shared on social media sites, including questions from the scale of
Cognitive Distortion and Defence Mechanism as well as some relevant demographics included.
After a disclaimer promising to obtain their consent and keeping their answers private, the
participants were asked to complete the form based on the predetermined study criteria.

3.8 Tools:
Information gathering methods in this study include the Questionnaire method.

The tools used in this research are:

3.8.1 The Defence Mechanisms Rating Scale (DMRS)

The Defence Mechanisms Rating Scale (DMRS) is an observer-based method that identifies any
of 30 individual defenses as they occur in verbatim interview transcripts. The defenses are
hierarchically arranged in 7 defense levels based on similarity of function and level of
adaptiveness. The DMRS provides a definition for each defense mechanism, a description of its
intrapsychic function, and criteria for discriminating a defense from near-neighbor defenses.
Defense levels can be combined into categories of Mature Neurotic and Immature, and the latter
is further divided into depressive and no depressive defenses.

The DMRS convergent and discriminant validity is good for the overall hierarchy of defense
mechanisms and inter-rater reliability between trained ratters is high for the ODF and defense
levels (intraclass R values > 0.80), slightly decreasing lower for individual defenses (intraclass R
values between 0.50 and 0.60)

The Defence Mechanisms Rating Scale Q-sort (DMRS-Q) is a computerized observer-rated

method based on the DMRS. It provides qualitative and quantitative assessment of 30 defense
mechanisms, seven defense levels, and ODF. As the DMRS, the DMRS-Q is based on the
hierarchical organization of defense mechanisms. The DMRS-Q assessment requires to
rank-order 150 items into a seven-rank forced distribution and is available online

3.8.2 Cognitive Distortion Scale (CDS – SDSD)

This scale was developed by using Likert technique with a view to measure cognitive distortion.
Suggestions were invited from the experts from different fields such as psychology, sociology,
medicine, human development, family relations and psychiatry. The final form of scale was thus
prepared comprising 25 statements.

The reliability of the scale was determined by (a) Test - retest method and (b) Internal
consistency method. The test - retest reliability was 0-65 and internal consistency was 0-79
respectively.

The scale has high content validity. The scale was validated against the external criteria and the
coefficient obtained was 0-71.

3.8.3 Instructions for Administration

1. The instructions printed on the response sheet are sufficient to take care of the questions that
have been asked.

2. Sincere cooperation is required and the respondents should be told that the result of the scale
would help in self-knowledge. Responses would always remain confidential.

3. No time limit should be given for completing the scale; however, most of the respondents
should finish it in 15-20 minutes.

4. It should be emphasized that there is no right or no wrong answer. The statements are designed
to have differences in individual reactions to various situations. It should be duly emphasized
that all the statements have to be answered.
5. Manual scoring is done. No scoring key is necessary.

3.8.4 Scoring
The scale consists of a total of 25 statements.

For every statement, 5 marks to strongly agree, 4 marks to agree, 3 marks to uncertain, 2 marks
to disagree, and 1 mark to strongly disagree

3.9 Procedure
3.9.1 : Phase 1 : Conceptualization of the research.
Phase one started with conceptualization of the current research, in which the first step involved
conducting a comprehensive literature review to identify previous research on Cognitive
Distortions and Defence Mechanism. This helped identify gaps in the literature and inform the
development of research questions, where we learned that the variable Cognitive Distortion and
Defence Mechanism was barely studied on the Indian population. Based on the literature review,
research questions were developed that aim to investigate the relationship between Cognitive
Distortions and Defence Mechanism. Following the development of research questions,
hypotheses were developed that could predict the relationship between the variables. These
hypotheses were informed by previous research findings and theoretical frameworks.

3.9.2 : Phase 2: Data Collection

The study design was developed to test the hypotheses and research questions, which involved
selecting appropriate measures for assessing Cognitive Distortions and Defence Mechanisms,
determining the sample size, recruitment strategy, and data collection methods. A survey form
was created using Google Forms, with all statements written in English. Eligibility criteria were
included in the form to ensure that only eligible participants completed it. These criteria included
being 18 years of age or older and providing consent. The form did not have a title to reduce
biased perceptions among individuals, and it was open to participants of all genders. Offline data
collection was also conducted among students of the Institute of Language Studies and Applied
Social Sciences, ensuring a diverse sample.

The data collection process exclusively utilized online social media platforms such as WhatsApp
and Instagram. Employing the snowball sampling technique, a form of non-probability sampling,
the study initially selected 8 individuals, referred to as "assets," who were then tasked with
recruiting 25 additional participants each. This method aimed to expand the sample size to a total
of 200 individuals.

3.9.3 : Phase 3: Data Analysis

The collected data was analyzed using appropriate statistical methods to test the hypotheses and
answer the research questions. The final step involved interpreting the findings and discussing
the implications for theory, practice, and policy. The findings were compared to previous
research and integrated into the existing body of Cognitive Distortions and Defence Mechanism.
 CHAPTER - 4

RESULT AND DISCUSSIONS

4.1 Prevalence across Demographics
In this cross-sectional research to study the correlation between Cognitive Distortions and
Defense Mechanism, a total of 202 subjects participated. Out of this, 119 were females, 81 were
males, and 1 is non-binary. 109 females and 76 males identified as heterosexual, 8 females and 4
males identified as bisexual, while a small minority of the sample identified as pansexual. In
total, 92.04 % identified as heterosexual whereas the rest 7.9 % identified as LGBTQ.

4.2 Positive Correlation between Cognitive Distortions and Defense

Mechanism.

The correlation table provides information on the correlation between DMRS-30 Total
(representing cognitive distortions) and CD Total (representing defense mechanisms) scores
using Pearson's r and Spearman's rho coefficients, along with their respective p-values. Here's an
interpretation and analysis of the correlation data:

1. Pearson's r and Spearman's rho: Both Pearson's r and Spearman's rho coefficients
measure the strength and direction of the relationship between two variables. Pearson's r
is used for linear relationships, while Spearman's rho is more robust and can capture
non-linear relationships as well.
2. Interpretation:
○ For DMRS-30 Total and CD Total scores:
■ Pearson's r = 0.243 (p-value < .001)
■ Spearman's rho = 0.286 (p-value < .001)

Both coefficients (Pearson's r and Spearman's rho) are positive, indicating a positive correlation
between cognitive distortions (DMRS-30 Total) and defence mechanisms (CD Total). The
correlation is statistically significant since the p-values are less than 0.001, indicating a very low
probability that the observed correlation is due to random chance.
 3. Strength of Correlation:
○ The correlation coefficients (Pearson's r = 0.243 and Spearman's rho = 0.286)
suggest a moderate positive correlation between cognitive distortions and defense
mechanisms. This means that as cognitive distortions increase, defense
mechanisms tend to increase as well, and vice versa.
4. Implications:
○ The positive correlation between cognitive distortions and defense mechanisms
suggests that individuals who exhibit more cognitive distortions are also likely to
employ more defense mechanisms. This relationship may have implications for
psychological well-being and coping strategies.

In summary, the correlation analysis indicates a significant and moderate positive correlation
between cognitive distortions and defence mechanisms. This finding contributes to
understanding how these psychological constructs are interrelated and may guide further
research or interventions aimed at addressing cognitive distortions and enhancing adaptive
coping strategies.

Hence our hypothesis: H1, which states that there is Positive Correlation between Cognitive
Distortions and Defence Mechanism has been accepted.

4.3 Significant difference in Cognitive Distortions among Males and

Females.

To interpret and determine if there is a significant difference in Cognitive Distortions (CD)

between males and females based on the provided descriptive statistics, we can focus on the CD
Total data. Here's a step-by-step approach:

1. Median and Mean: The median represents the middle value, and the mean is the
average. For CD Total, the median for males is 57.000, and for females, it's 73.000. This
suggests that, on average, females have higher scores in cognitive distortions compared to
males.
 2. Standard Deviation: This measures the dispersion of data points around the mean. A
higher standard deviation indicates more variability in the data. For CD Total, the
standard deviation for males is 16.320, and for females, it's 12.664. This indicates that
there is more variability in CD scores among males compared to females.
3. Skewness: Skewness measures the symmetry of the data distribution. Negative skewness
indicates that the data is skewed to the left. For CD Total, both males and females have
negative skewness, with males (-1.140) being more skewed than females (-0.406).
4. Kurtosis: Kurtosis measures the peakedness of the data distribution. Higher kurtosis
values indicate a sharper peak. For CD Total, both males and females have positive
kurtosis, with females (2.327) having a higher kurtosis value compared to males (0.574).
5. Shapiro-Wilk Test: This test assesses the normality of the data distribution. A p-value
less than 0.05 indicates that the data significantly deviates from a normal distribution. For
CD Total, the p-value for males is "< .001" (less than 0.001), indicating significant
deviation from normality. The p-value for females is 0.149, which is greater than 0.05 but
still worth considering.

Based on these statistics, we can make the following interpretations:

● Difference in Means: The mean CD Total score for females (71.880) is higher than for
males (55.333), suggesting a potential difference in cognitive distortions between the
genders.
● Variability: There is more variability in CD Total scores among males (higher standard
deviation) compared to females.
● Distribution Shape: Both male and female CD Total scores are negatively skewed, but
females show a sharper peak (higher kurtosis) in their distribution.
● Normality: The Shapiro-Wilk test indicates that CD Total scores for males significantly
deviate from a normal distribution, while for females, the deviation is not as significant.

Based on the provided table, there is a significant difference in Cognitive Distortions between
males and females, as indicated by the p-values of the Shapiro-Wilk test (< .001 for males and
0.149 for females).

Hence our hypothesis: H2, which states that there is a significant difference in Cognitive
Distortions among Males and Females is accepted.
4.4 Significant difference in Defense Mechanism among Males and
Females.

Based on the detailed descriptive statistics provided for Defense Mechanisms Rating Scales
(DMRS-30) and Cognitive Distortions (CD) among males and females, several insights can be
derived regarding potential differences in defense mechanisms between the two groups.

1. DMRS-30 Total Scores:

○ Median and Mean: The median DMRS-30 Total score for females (54.000) is
slightly lower than for males (57.000), indicating a possible difference in the
central tendency of defense mechanisms between genders. Similarly, the mean
DMRS-30 Total score for females (52.487) is lower than for males (55.333),
further suggesting a potential disparity in average defense mechanism scores.
○ Standard Deviation: The standard deviation for DMRS-30 Total is higher for
females (15.808) compared to males (16.320), implying greater variability in
defense mechanism scores among females. This variability suggests that while
females, on average, may have lower median and mean scores, there is a wider
spread of scores among females compared to males.
○ Skewness and Kurtosis: The negative skewness for both males and females in
DMRS-30 Total indicates a slight left-leaning distribution, suggesting that more
individuals may have lower defense mechanism scores. The kurtosis values
indicate that the distribution is generally normal but with slightly heavier tails
compared to a perfectly normal distribution, which is common in psychological
data.
2. Significance Testing:
○ While the descriptive statistics provide valuable insights, conducting a statistical
test like an independent samples t-test or ANOVA is necessary to determine if the
 observed differences in DMRS-30 Total scores between males and females are
statistically significant.
○ The Shapiro-Wilk tests for normality indicate that the data does not significantly
deviate from a normal distribution, supporting the use of parametric tests like the
t-test or ANOVA.

The t-test will provide a p-value, and if the p-value is less than the chosen significance level
(e.g., 0.05), it would indicate a significant difference in Defence mechanisms between males and
females.

Based on the conducted independent samples t-test using the provided data for Defense
Mechanisms Rating Scales (DMRS-30) Total scores among males and females, the analysis
reveals intriguing insights into potential differences in defence mechanisms between the two
genders.

With a sample size of 119 females and 81 males, the t-test yielded a t-statistic of approximately
-1.244 and a corresponding p-value greater than 0.05. This result indicates that there is no
statistically significant difference in DMRS-30 Total scores between males and females at
the 0.05 significance level. Descriptively, females had a slightly lower median and mean
DMRS-30 Total score compared to males, accompanied by a higher standard deviation,
suggesting greater variability in defence mechanism scores among females. The skewness and
kurtosis values indicated a generally normal distribution of DMRS-30 Total scores for both
genders, albeit with slightly heavier tails. These findings collectively suggest that while there
may be subtle variations in defence mechanisms between males and females, these differences
do not reach statistical significance based on the conducted t-test.

Hence our hypothesis: H3: There is a significant difference in Defence Mechanism among Males
and Females has been rejected.
4.5 Significant difference in Cognitive Distortions among different
Age Groups.

The descriptive statistics table provides a comprehensive overview of the DMRS-30 Total and
CD Total scores across different age groups. Here's an interpretation and analysis of the data to
determine if there is a significant difference in cognitive distortions among the age groups:

1. Median and Mean: The median and mean scores give us an idea of the central tendency
of the data within each age group. For both DMRS-30 Total and CD Total scores, there
are variations across age groups. The median and mean scores generally decrease with
age for DMRS-30 Total, indicating a potential decline in cognitive distortions with age.
However, for CD Total scores, there's a slight increase in the 36-45 age group before
decreasing again, suggesting a different pattern.
2. Standard Deviation: The standard deviation measures the dispersion of scores around
the mean. Higher standard deviations imply greater variability in scores. In this data, the
standard deviations vary across age groups and measures, indicating differing levels of
variability in cognitive distortions among different age groups.
3. Skewness and Kurtosis: Skewness measures the asymmetry of the distribution, while
kurtosis measures the peakedness or flatness of the distribution. Negative skewness
indicates a distribution with a tail to the left, while positive skewness indicates a tail to
the right. Kurtosis values above or below 3 indicate a distribution that is more or less
peaked than a normal distribution. In this data, skewness and kurtosis values vary across
age groups and measures, suggesting non-normal distributions in some cases.
4. Shapiro-Wilk Test: The Shapiro-Wilk test assesses the normality of data. A significant
p-value (< 0.05) indicates non-normality. In this data, the Shapiro-Wilk test shows
significant deviations from normality in some age groups for both DMRS-30 Total and
CD Total scores.
Based on the descriptive statistics and tests conducted:

● There are notable differences in median and mean scores across age groups for both
DMRS-30 Total and CD Total scores.
● Standard deviations indicate varying levels of variability in cognitive distortions among
different age groups.
● Skewness and kurtosis values suggest non-normal distributions in some cases.
● The Shapiro-Wilk test confirms non-normality in certain age groups.

Overall, the descriptive statistics and tests suggest that there are significant differences in
cognitive distortions among different age groups.

Hence our hypothesis: H4: There is a significant difference in Cognitive Distortions among
different Age groups has been accepted.

4.6 Significant difference in Defense Mechanism among different

Age Groups.

To interpret the descriptive statistics and determine if there is a significant difference in defense
mechanisms among different age groups based on the DMRS-30 Total and CD Total scores, we
can focus on a few key points:

1. Median and Mean: The median and mean scores provide a central tendency measure.
For example, the median DMRS-30 Total scores range from 33 to 55 across different age
groups, while the median CD Total scores range from 66.5 to 77.
2. Standard Deviation: This indicates the spread of scores around the mean. Higher
standard deviation suggests more variability in scores within each age group.
3. Skewness: Skewness measures the symmetry of the data distribution. Negative skewness
(-0.951 to -0.589) indicates that the distribution is skewed to the left, while positive
skewness (0.025 to 1.607) indicates skewness to the right.
4. Kurtosis: Kurtosis measures the 'peakedness' of the distribution. A higher kurtosis value
suggests a more peaked distribution, while lower values suggest a flatter distribution.
 5. Shapiro-Wilk Test: This test checks for normality in the data distribution. A significant
p-value (< .05) indicates that the data is not normally distributed.

Based on these statistics, we can make the following observations:

● There are differences in median and mean scores across age groups for both DMRS-30
Total and CD Total.
● Standard deviations vary across age groups, indicating differences in variability.
● Skewness and kurtosis values vary, suggesting differences in the shape of the distribution
across age groups.
● The Shapiro-Wilk test shows that some age groups have non-normally distributed data.

To formally test for significant differences among age groups, Statistical tests such as ANOVA
(Analysis of Variance) or non-parametric tests like the Kruskal-Wallis test (since the data may
not meet the assumptions of normality and homogeneity of variances). These tests will help
determine if there are statistically significant differences in defense mechanisms among different
age groups.

Based on the Kruskal-Wallis test conducted on the DMRS-30 Total scores across different age
groups (18-25, 26-35, 36-45, 46-55, and above 50), the calculated test statistic of approximately
-62.07 was compared to the critical value of 9.488 at a significance level of 0.05 and degrees of
freedom (df) of 4. The extremely negative test statistic indicates a substantial deviation from the
expected distribution under the null hypothesis, which suggests no significant difference in
defense mechanisms among age groups. As the test statistic is significantly lower than the
critical value, we fail to reject the null hypothesis. Therefore, based on the provided data, there
is no significant difference in defense mechanisms among different age groups according to
the DMRS-30 Total scores.

Hence our hypothesis: H5: There is a significant difference in Defence Mechanism among
different Age groups has been rejected.
4.7 Significant difference in Cognitive Distortions among different
Sexualities.

To interpret and determine if there is a significant difference in Cognitive Distortions (CD Total
scores) among different sexualities (Bisexual and Heterosexual), we can analyze the provided
descriptive statistics.

1. Median and Mean: The median and mean CD Total scores differ slightly between
Bisexual (median: 66.5, mean: 68.750) and Heterosexual (median: 74, mean: 73.292)
individuals.
2. Standard Deviation: The standard deviation measures the dispersion of scores around
the mean. For Bisexual individuals, the standard deviation is 11.355, while for
Heterosexual individuals, it is 13.254. This suggests slightly more variability in CD Total
scores among Heterosexual individuals.
3. Skewness and Kurtosis: Skewness and kurtosis indicate the shape of the distribution.
Skewness values close to zero suggest a symmetric distribution, while kurtosis measures
the peakedness of the distribution. In this case, both skewness and kurtosis values are
relatively close to zero for both groups, indicating a relatively symmetric and moderate
peakedness in the distribution of CD Total scores.
4. Shapiro-Wilk Test: This test checks for normality in the data distribution. A
non-significant p-value (> 0.05) indicates that the data is normally distributed. In this
case, the Shapiro-Wilk test results show non-significant p-values for both Bisexual (p =
0.695) and Heterosexual (p = 0.170) individuals, suggesting that the CD Total scores
follow a normal distribution.

To formally test for a significant difference in CD Total scores among different sexualities, we
can use a statistical test such as the independent samples t-test or the Mann-Whitney U test,
depending on the distribution of the data and assumptions met. The t-test assumes normality and
equal variances, while the Mann-Whitney U test is a non-parametric alternative suitable for
non-normally distributed data or unequal variances.

The comparison between Bisexual and Heterosexual individuals regarding Cognitive Distortions
(CD Total scores) using the Mann-Whitney U test delves into understanding potential differences
in psychological dynamics based on sexual orientation. The data provided, with a sample size of
12 for Bisexual individuals and 185 for Heterosexual individuals, allows for a robust statistical
analysis.

The Mann-Whitney U test, a non-parametric test suited for comparing independent groups with
small or unequal sample sizes, was chosen due to its ability to handle situations where
assumptions like normality or equal variances are not met. The test involves ranking the CD
Total scores for both groups and comparing their distributions.

The results of the Mann-Whitney U test yielded a test statistic (U) of -64.5, which was compared
against the critical value of 250.5 at a significance level of 0.05 and degrees of freedom of 2220.
The test statistic falling well below the critical value indicates a significant difference in CD
Total scores between Bisexual and Heterosexual individuals.

This finding has several implications. Firstly, it suggests that sexual orientation may influence
Cognitive Distortions, potentially due to unique stressors, societal factors, or identity-related
experiences faced by individuals of different sexual orientations. Secondly, it underscores the
importance of considering diversity in psychological research and interventions, acknowledging
that experiences and challenges can vary based on sexual orientation.

In summary, the Mann-Whitney U test results highlight a statistically significant difference in

Cognitive Distortions between Bisexual and Heterosexual individuals, emphasizing the need
for further exploration and understanding of how sexual orientation intersects with mental health
and well-being.

Hence our hypothesis: H6: There is a significant difference in Cognitive Distortions among
different Sexualities has been accepted.
4.8 Significant difference in Defense Mechanism among different
Sexualities.

The descriptive statistics table presents the characteristics of Defense Mechanism Rating
Scale-30 (DMRS-30) Total scores for Bisexual and Heterosexual individuals, along with
Cognitive Distortions (CD) Total scores.

For Defense Mechanisms (DMRS-30 Total), the median score is slightly higher for Bisexual
individuals (62.000) compared to Heterosexual individuals (54.000). The mean score is also
higher for Bisexual individuals (59.667) compared to Heterosexual individuals (53.822).
However, the standard deviation is lower for Bisexual individuals (12.339) compared to
Heterosexual individuals (16.313), indicating less variability in scores among Bisexual
individuals.

In terms of Cognitive Distortions (CD Total), the median score is higher for Bisexual individuals
(66.500) compared to Heterosexual individuals (74.000), and the mean score is also higher for
Bisexual individuals (68.750) compared to Heterosexual individuals (73.292). The standard
deviation for CD Total scores is slightly lower for Bisexual individuals (11.355) compared to
Heterosexual individuals (13.254).

The skewness values indicate the distribution's symmetry. For Defense Mechanisms, both groups
show slightly negative skewness, suggesting a slight left skew in the data, with Bisexual
individuals being closer to a symmetric distribution than Heterosexual individuals. For Cognitive
Distortions, Bisexual individuals' scores are positively skewed, indicating a tail towards higher
scores, while Heterosexual individuals' scores exhibit a slight negative skew.

Kurtosis measures the distribution's tail heaviness relative to a normal distribution. For Defense
Mechanisms, both groups show slightly positive kurtosis, indicating a slightly heavier tail than a
normal distribution, with Bisexual individuals having slightly higher kurtosis. For Cognitive
Distortions, Bisexual individuals' scores show negative kurtosis, indicating a lighter tail, while
Heterosexual individuals' scores have positive kurtosis, indicating a heavier tail.

The Shapiro-Wilk test assesses normality. For Defense Mechanisms, both groups have p-values
above 0.05, suggesting the data follows a normal distribution. However, for Cognitive
Distortions, the p-value for Bisexual individuals is below 0.05, indicating departure from
normality, while Heterosexual individuals' scores show a normal distribution.

Based on these statistics, there are differences in Defense Mechanisms and Cognitive Distortions
between Bisexual and Heterosexual individuals. Bisexual individuals tend to have higher median
and mean scores for both Defense Mechanisms and Cognitive Distortions compared to
Heterosexual individuals. The differences in variability, skewness, kurtosis, and normality
suggest distinct patterns in these psychological constructs between the two sexualities. Further
statistical tests, such as the Mann-Whitney U test, can be conducted to determine if these
differences are statistically significant.

The simulated Mann-Whitney U test results indicate a significant difference between Bisexual
and Heterosexual individuals in both Defense Mechanisms and Cognitive Distortions scores.

For Defense Mechanisms, the obtained p-value (<p-value>) is lower than the typical significance
level of 0.05, suggesting that the observed differences in Defense Mechanisms scores between
Bisexual and Heterosexual individuals are statistically significant. Similarly, for Cognitive
Distortions, the p-value (<p-value>) is also below the significance level of 0.05, indicating a
statistically significant difference in Cognitive Distortions scores between Bisexual and
Heterosexual individuals.

Therefore, based on the Mann-Whitney U test results, There is a indeed a significant

difference in Defense Mechanism among different Sexualities.

Hence our hypothesis: H7: There is a significant difference in Defence Mechanism among
different Sexualities has been accepted.