Cognitive distortion — MRCPsych Paper A MCQ

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EasyPsychologyCognitive distortionMRCPsych Paper A

A 28-year-old woman with depression receives a work appraisal containing several positive comments and one mild criticism. She disregards all the positive feedback and focuses exclusively on the criticism as evidence that she is incompetent. Which cognitive distortion is illustrated?

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Correct answer: C — Selective abstraction

Selective abstraction is the extraction and disproportionate emphasis of one negative detail while the wider, more balanced context is ignored. Here, the woman focuses exclusively on the single criticism and discounts several positive comments. Overgeneralisation would involve deriving a broad rule or repeated pattern from one event. Arbitrary inference is reaching a conclusion without adequate supporting evidence, but the defining feature here is selective attention to part of the available evidence. Personalisation involves attributing external events to oneself without justification. Catastrophising means predicting or construing an outcome as disproportionately disastrous. Selective abstraction is a recognised cognitive error in depressive thinking and is targeted during cognitive therapy.

Reference: Blake E, Dobson KS, Sheptycki AR, Drapeau M. The Relationship between Depression Severity and Cognitive Errors. American Journal of Psychotherapy. 2016;70(2):203–221. https://www.nice.org.uk/guidance/ng222/documents/guideline-appendix-21