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The subtle link between thoughts and distress

In the current issue of Psychotherapy and Psychosomatics the link between irrational thoughts and distress is critically examined. Since the cognitive revolution of the early 1950s, thoughts have been discussed as central components in the understanding and treatment of mental illnesses. Even though there is an extensive literature on the association between therapy-related thoughts such as irrational beliefs and psychological distress over the past 60 years, there is little meta-analytical knowledge about the nature of this association.

The Authors evaluated the relationship between irrational beliefs and distress based on a systematic review that included 100 independent samples, gathered in 83 primary studies, using a random-effect model. The overall effects as well as potential moderators were examined in terms of: distress measure, irrational belief, irrational belief type, method of assessment of distress, nature of irrational beliefs, time lag between irrational beliefs and distress assessment, nature of stressful events, sample characteristics (i.e. age, gender, income, and educational, marital, occupational and clinical status), developer/validator status of the author(s), and publication year and country.

Overall, results showed that irrational beliefs were positively associated with various types of distress, such as general distress, anxiety, depression, anger, and guilt. The following variables were significant moderators of the relationship between the intensity of irrational beliefs and the level of distress: irrational belief measure and type, stressful event, age, educational and clinical status, and developer/validator status of the author.

The results show that the overall strength of the relationship between irrational beliefs and psychological distress is modest, however, this relationship remains significant even after controlling for several potential covariates.