Role of irrational beliefs in depression and anxiety: a review

doi:10.4236/health.2010.28130

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Vol.2, No.8, 862-877 (2010)

doi:10.4236/health.2010.28130

HEALTH

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Role of irrational beliefs in depression and anxiety:

a review

K. Robert Bridges*, Richard J. Harnish

Department of Psychology, The Pennsylvania State University, New Kensington, USA; *Corresponding Author: krb3@psu.edu

Received 23 February 2010; revised 19 April 2010; accepted 20 April 2010.

ABSTRACT

Irrational beliefs play a central role in cognitive

theory and therapy; they have been shown to be

related to a variety of disorders such as de-

pression and anxiety. Irrational beliefs, which

can be assessed via clinical interviewing tech-

niques, are frequently assessed by self-report

measures, both clinically and for research pur-

poses. Much of the research demonstrating the

effect of irrational beliefs has utilized such

measures. The present article reviews the em-

pirical work on irrational beliefs assessment

and identifies 25 scales and techniques. The

measures are organized according to their theo-

retical affiliation (i.e., either the Ellis or Beck

model), with the goal of providing investigators

a source to identify the available tests, their

shortcomings, and potential applications. The

authors conclude with recommendations which

would strengthen empirical cohesion and pre-

cision in the measurement of irrational beliefs.

Keywords: Depression; Anxiety; Depressive

Disorders; Anxiety Disorders; Manifest Anxiety

Scale; Psychological Tests; Personality Inventory

1. INTRODUCTION

Irrational beliefs, a central idea in cognitive theory

and therapy, have been shown to play a primary role in

numerous disorders, including depression and anxiety.

[1-3] Because of these beliefs, depressed and anxious

persons systematically distort the meaning of events to

interpret their experiences in a sustained, negative, self-

defeating way [4]. Given the importance of irrational

beliefs in the etiology of these disorders, we submit that

clinicians and researchers should use the most psycho-

metrically sound tests when measuring this construct.

However, identifying the most appropriate test is be-

coming more difficult owing to the increasing number

and variety of irrational beliefs measures appearing in

the literature. Despite the importance of irrational beliefs

assessment, there have been no comprehensive reviews

of the tests based on both the theories of Albert Ellis and

Aaron Beck currently available to clinicians and inves-

tigators.

Most of the tests of irrational beliefs developed thus

far have grown out of the work of Ellis, who developed

rational-emotive behavior therapy or REBT [5], and

Beck, who was instrumental in creating cognitive ther-

apy or CT [2]. These measures have been used in re-

search and clinical assessment for over 40 years; Jones’

1968-69 Irrational Beliefs Test was the most successful

of the early measures [6]. As noted by Jones and Trower

[7], the theories developed by Ellis and Beck are equally

appealing because of their application to clinical inter-

vention. However, they make different claims about the

nature of the irrational beliefs that are fundamental to

many disorders, and problematic behaviors and emotions.

The measures based on these two models reflect the ma-

jor theoretical differences between Ellis and Beck.

Ellis developed rational-emotive therapy (RET), now

known as rational-emotive behavior therapy (REBT) in

1955 [8] as a product of his dissatisfaction with the ef-

fectiveness and time required of psychoanalysis. Spe-

cifically, he rejected its lengthy therapeutic process and

its focus on early-life influences [9]. The main idea be-

hind REBT is that the most important causes of self-

defeating and inappropriate behaviors are not the events

but the beliefs about the events. Included is the thesis

that emotions are caused by our thoughts, and emotional

dysfunction is caused by irrational thoughts and beliefs.

REBT is based on the ABC model of psychopathology

[10] in which people experience unpleasant activating

environmental events. These activating events (A) do not

cause disturbed emotional and behavioral consequences

(C); instead, they are caused by the distorted/irrational

beliefs (B) about the event. Initially, Ellis proposed 11

types of irrational beliefs. Subsequent developments in

REBT created four categories: demandingness, awfulizing

(or catastrophizing), low frustration tolerance, and global

K. R. Bridges et al. / HEALTH 2 (2010) 862-877

863

evaluation (or self-downing) [11].

The core irrational belief in REBT is demandingness

[12]. It refers to absolutistic requirements expressed in

terms of “must’s”, “have to’s”, “ought’s”, and “should’s”.

The other beliefs include: awfulizing beliefs, which refer

to the evaluation of a bad event as worse than it should

be; low frustration tolerance, the belief that it is not pos-

sible to bear certain circumstances (which makes a situa-

tion intolerable); and global evaluation, which describes

pervasive negative ratings about the world and oneself.

These four irrational beliefs are considered to be the

fundamental etiological factors in emotional and behav-

ior disorders.

Like Ellis, Beck [13] was disenchanted with psycho-

analysis and developed another version of the ABC

model. Beck, who was instrumental in creating cognitive

therapy (CT), believed that many disorders are produced

and maintained by negative beliefs and thinking styles

that people have about themselves, their circumstances,

and their future. Such cognitive errors include a belief in

excessive personal causality for negative events and the

belief that the worst possible outcome is the most likely.

These cognitive distortions guide a person’s interpreta-

tion of new experiences and increase the likelihood of

behavior disorders. For Beck, negative life events acti-

vate this cognitive triad of irrational beliefs: negative be-

liefs about oneself (“I’m not good enough.”), the world

(“This is an awful place.”), and the future (“Something

bad will always happen.”). These irrational beliefs are

activated by negative life events and produce systematic

errors in thinking. The most frequent errors include “all

or nothing” thinking (the tendency to view the event in

only two ways, versus a continuum), arbitrary inference

(a predisposition to reach negative conclusions without

supporting evidence), selective abstraction (the tendency

to pay attention to one negative detail as opposed to the

whole picture), magnification/minimization (unreasona-

bly minimizing the positive and maximizing the negative

when evaluating a situation), and labeling (globally

evaluating things negatively while dismissing any evi-

dence that supports a less extreme view).

While the theories of Beck and Ellis share fundamen-

tal ideas about the basic reasons for psychological dis-

orders (i.e., Ellis and Beck proposed therapies that are a

mixture of cognitive and behavior therapy, both use an

ABC model that posits dysfunctional cognitions cause

psychopathology, and that such cognitions are distorted,

inaccurate or irrational), slight differences emerge be-

tween the two. Specifically, the theories make different

claims about the nature of irrational beliefs that are fun-

damental to the development of many disorders [5]. For

Ellis, psychopathology is due to repeated focusing on

distress-producing thoughts (e.g., I should be liked by

everyone), while Beck proposed psychopathology is

caused by illogical thought processes (e.g., all or nothing

thinking). That is Ellis’ theory seems to be more focused

on the particular thoughts that cause emotional distress;

whereas, Beck’s theory seems to be more focused on the

thought processes themselves that produce emotional

upset. (See Dryden and Ellis [5] for a more detailed

analysis of these differences.).

The two theories have generated numerous measures

of irrational beliefs. Some of the tests of irrational be-

liefs generated by these theories have been widely used

and have undergone numerous revisions, while others

have seen only limited use. What follows is a review of

25 measures of irrational beliefs from their date of in-

ception, including their theoretical affiliation, evidence

of their reliability and validity, and their revision history.

2. METHOD

2.1. How the Measures Were Selected

To identify the measures to be included in this review, a

literature search was performed on PsycINFO, an elec-

tronic database of the psychological literature that spans

work published from the 1800s to the present. PsycINFO

searches included such terms as “measures of irrational

thoughts”, “thinking”, “cognitions”, and “beliefs”. Once

articles were identified, we narrowed our review through

the following criteria: 1) the measure was published or

completed after 1968, when the Irrational Beliefs Test

[14], noted earlier as the most successful early test, first

appeared; 2) the measure, along with a scoring key, was

readily available; and 3) the measure was written in

English or had an English language version available. Of

the 31 articles describing an irrational belief measure we

found, six were eliminated based on our aforementioned

criteria resulting in a review of 25 measures. See Table 1

for an alphabetical list of measures reviewed, including

their authors, type of scale or response, and sample items.

Below in the body of the text, the measures are pre-

sented in their chronological order. In Table 1, the

measures are presented in alphabetical order so that in-

vestigators may readily locate the measures reviewed.

2.2. Evaluation Criteria

For each measure of irrational beliefs, we evaluated and

reviewed the measure’s reliability and validity. Reliability

refers to the consistency of a measure while validity refers

to how well a test measures the characteristics it claims to

measure. We rated measures that possessed a reliability

coefficient of 0.90 or higher as excellent, those with a reli-

ability coefficient of 0.80 to 0.89 as very good, those with

a reliability coefficient of 0.70 to 0.79 as good, and those

with a reliability coefficient of 0.60 to 0.69 as suspect.

K. R. Bridges et al. / HEALTH 2 (2010) 862-877

864

Table 1. Description of Irrational Belief Scales.

Name of

Scale/Other

Forms/Also

Known As

Author(s)

Number

of Items/

Number

of Fators

or Sub-

scales

Rating

Scale Source Original

Purpose Sample Items

Irrational Belief Scales Based on the Ellis Model

Belief Scale

(BS)/No/

M.S. Belief

Scale, MSBS,

Irrational Belief

Scale,

IBS

Malouff &

Schutte,

1986

20 items/

1 factor

5-point

Likert

Journal of

Consulting

and Clinical

Psychology

Depression, neuroti-

cism.

“It is terrible when things do not go

the way I would like.”

“Life should be easier than it is.”

“To be happy, I must maintain the

approval of all the persons I consider

significant.”

Camatta & Na-

goshi Scale/No/

Camatta &

Nagoshi,

1995

10 items/

Not re-

ported

Not re-

ported

Alcoholism:

Clinical and

Experimental

Research

Research;

Predictor of alcohol

use problems.

“It is awful and catastrophic when

things are not the way I’d like them

to be.”

“I have little or no ability to control

the sorrows and disturbances in my

life.”

“Some people are wicked and should

be severely blamed and punished for

their wickedness.”

Child and Ado-

lescent Scale of

Irrationality

(CASI)/

Short form

(CASI-

Revised)/

Bernard &

Laws, 1987

44 items/

6 sub-

scales

5-point

Likert

Journal of

Cognitive

Psychother-

apy: An In-

ternational

Quarterly

Emotional problems;

Anxiety,

depression

in younger popula-

tions.

“I can’t stand having to behave well

and follow rules.”

“It’s really awful to have lots of

homework to do.”

“Teachers should really act fairly all

the time.”

Common Beliefs

Survey-III

(CBS-III)/

Short form Ex-

ists (CBS-II SF)/

Bessai,

1977

54 items/

9 sub-

scales

5-point

Likert

Unpublished;

contact scale

author for a

copy

Clinical instrument

to distinguish clients

from non-clients

(clinical population

not identified); Anxi-

ety, depression.

“There is a right way to do every-

thing.”

“Being approved by others is very

important.”

“A person can’t help feeling guilty

about wrongdoings.”

Ellis Emotional

Efficiency In-

ventory (EEEI)/

No/NA

Ellis, 1992 60 items/

3 factors

5-point

Likert

Question-

naire: The

elegant solu-

tion to emo-

tional and

behavioral

problems

Designed to measure

an individual’s abil-

ity to cope with emo-

tional dysfunction

associated with awfu-

lizing, ego-disturbance

and discomfort dis-

turbance.

“I often pity myself when people

treat me unfairly.”

“I am quite pessimistic and often see

things in a bad or hopeless light.”

“I often feel insulted and embar-

rassed.”

Evaluative Be-

liefs Scale

(EBS)/No/

Chadwick,

Trower, &

Dagnan,

1999

18 items/

3 factors

5-point

Likert

Cognitive

Therapy and

Research

Research; Nature of

evaluative beliefs in

individuals with

anger disorders.

“I am a total failure.”

“People think I’m a bad person.”

“Other people are worthless.”

K. R. Bridges et al. / HEALTH 2 (2010) 862-877

865

General Attitude

and Belief Scale

(GABS)/

No/Attitudes

Belief Scale 2,

ABS 2,

A&B II,

ABS II

DiGiuse-

ppe, Leaf,

Exner, &

Robin,

1988

72 items/

7 sub-

scales

5-point

Likert

Unpublished;

contact scale

authors for a

copy

Research; To unravel

the dynamics of be-

havior disorders, the

irrational beliefs

behind them.

“I can’t stand hassles in my life.”

“I cannot tolerate not doing well at

important tasks and it is unbearable

to fail.”

“I must be liked by important people,

and I will not accept not being liked

by them.”

Idea Inventory/

No/NA

Kassinove,

Crisci, &

Tiegerm-

an, 1977

33items/

4 factors

3-point

Likert

Journal of

Community

Psychology

To measure rational-

ity across age (i.e.,

developmental trends

in rationality).

“I feel like I’m a stupid person when I

don’t do as well as my friends.”

“I constantly worry about dangerous

accidents occurring.”

“I get upset and angry then my plans

go wrong.”

Irrational Beliefs

Inventory (IBI)/

No/NA

Koopmans,

Sanderm-

an, Timm-

erman &

Emmelka-

mp, 1994

50 items/

5 sub-

scales

5-point

Likert

European

Journal of

Psychological

Assessment

Research; Role

of irrational beliefs in

depression. Also

phobias, OCD, pro-

crastination, para-

normal beliefs.

“I hate to fail at anything.”

“I often get excited or upset when

things go wrong.”

“I avoid facing my problems.”

Irrational Beliefs

Survey (IBS)/

No/Irrational

Beliefs Scale

Watson,

Vassar,

Plemel,

Herder,

Manifold,

& Ander-

son, 1990

11 items/

4 factors

5-point

Likert

Journal of

Clinical

Psychology

Research instrument;

Designed to opera-

tionalize Ellisonian

irrational beliefs.

“I am often upset over other people’s

problems.”

“It is easier to avoid some of life’s

difficulties and responsibilities than

it is to face them.”

“I do not believe I am worthwhile

unless I am thoroughly competent at

everything I do.”

Irrational Beliefs

Test (IBT)/

IBT Revised

(Woods, 1992)/

Jones,

1968

100

items/

8 factors

5-point

Likert

Unpublished;

contact scale

author for a

copy

Research; To identify

the role of irrational

beliefs in depression,

assertiveness, locus of

control, self-esteem,

social skills deficits,

alcoholism.

“I dislike for others to make my

decisions for me.”

“It is annoying but not upsetting to

be criticized.”

“I find it hard to go against what

others think.”

Perfectionism

Cognitions In-

ventory (PCI)/

No/NA

Flett, Hew-

itt, Blank-

stein &

Gray, 1998

25 items/

1 factor

5-point

Likert

Journal of

Personality

and Social

Psychology

A measure of auto-

matic thoughts that

reflect personality

factors associated

with vulnerability to

psychological disor-

ders; specifically

anxiety, depression.

“Why can’t I be perfect?”

“Things are seldom ideal.”

“I am too much of a perfectionist.”

Rational Behav-

ior Inventory

(RBI)/

No/NA

Shorkey &

Whiteman,

1977

38 items/

11 factors

5-point

Likert

Educational

and Psycho-

logical Meas-

urement

Clinical instrument

for assessment,

treatment planning,

& evaluation of cli-

ents, by therapists

who used RET.

“I find that my occupation and social

life tend to make me unhappy.”

“I usually try to avoid chores which I

dislike doing.”

“I worry about little things.”

K. R. Bridges et al. / HEALTH 2 (2010) 862-877

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Situational

Self-Statement

and Affective

State Inventory

(SSSASI)/

No/NA

Harrell,

Cham-

bless, &

Calhoun,

1981

5 items/

10 factors

5-point

Likert

Cognitive

Therapy and

Research

Useful in assessing

dimensions important

to REBT; that certain

classes of maladap-

tive cognitions are

linked to emotional

distress (anxiety,

depression). There is

also a SSSASI-

thoughts measure.

In response to situations;

“I’ve really done a lousy job. I’ve let

everybody down. My work just

hasn’t been any good. I don’t think I

can do any better.”

“I wish I had done better. I still think

my work is good and with a little

more persistence, I will do better in

the next contest.”

“I guess it really is difficult for peo-

ple to straighten things out some-

times. I hope when we see each other

again we’ll be able to talk without so

much conflict.”

Smith

Irrational Beliefs

Inventory (SIBI)/

No/NA

Smith,

2002

24 items/

6 factors

4-point

Likert

Stress man-

agement: A

comprehen-

sive handbook

of techniques

and strategies

Research instrument;

Attempts to address

the issue of the factor

structure of irrational

belief items “to iden-

tify a core set of

replicable and mean-

ingful irrational be-

lief factors”.

“I always need help on important

problems.”

“Things didn’t turn out like I wanted;

this is a disaster.”

“I’m just a failure.”

Survey of Per-

sonal

Beliefs (SPB)/

No/NA

Demaria,

Kassinove,

& Dill,

1989

50 items/

5 factors

6-point

Likert

Journal of

Personality

Assessment

Identifying irrational

beliefs in clinical &

university popula-

tions. Expression of

anger, hopelessness,

anxiety, depression,

all due to the RET

theoretical emphasis

on irrational think-

ing.

“There are some things in life that I

just can’t stand.”

“There are times when awful things

happen.”

“I clearly should not make some of

the mistakes I make.”

Irrational Belief Scales Based on the Beck Model

Automatic

Thoughts Ques-

tionnaire-30

(ATQ-30)/

Companion

piece ATQ-N/

Hollon &

Kendall,

1980

30 items/

4 factors

5-point

Likert

Cognitive

Therapy and

Research

Designed to measure

automatic thoughts

associated with de-

pression.

“I can’t finish anything.”

“I’m a loser.”

“My life is a mess.”

Cognition

Checklist (CCL)/

No/NA

Beck,

Brown,

Steer, Ei-

delson, &

Riskind,

1987

26 items/

2 factors

5-point

Likert

Journal of

Abnormal

Psychology

Designed to measure

the content-specificity

hypothesis of the

cognitive model by

measuring the fre-

quency of automatic

thoughts relevant to

anxiety and depres-

sion.

“I will never overcome my prob-

lems.”

“I’m a social failure.”

“People will laugh at me.”

Cognitive Triad

Inventory (CTI)/

No/NA

Beckham,

Leber,

Watkins,

Boyer, &

Cook,

1986

36 items/

6 factors

7-point

Likert

Journal of

Consulting

and Clinical

Psychology

Role of the cognitive

triad in the develop-

ment and mainte-

nance of depression.

“I can’t do anything right.”

“There is no reason for me to be

hopeful about my future.”

“My family doesn’t care what hap-

pens to me.”

K. R. Bridges et al. / HEALTH 2 (2010) 862-877

867

Crandell Cogni-

tions Inventory

(CCI)/

No/NA

Crandell &

Cham-

bless, 1986

45 items/

4 factors

5-point

Likert

Behaviour

Research and

Therapy

A measure of fre-

quency of depressive

thoughts; designed to

measure self-referent

statements associated

with depression.

“Everything I do is a failure.”

“I’ll never do as well as others.”

“Nothing seems exciting anymore.”

Dysfunctional

Attitudes Scale

(DAS)/

Two parallel

40-item forms

DAS-A,

DAS-B/

Weissman

& Beck,

1978

100

items/

9 factors

7-point

Likert

Unpublished;

contact scale

authors for

copy

Designed to measure

Depressionogenic

schemas constituting

predispositions to

depression.

“Being alone leads to unhappiness.”

“If I ask a question, it makes me look

stupid.”

“I am nothing if a person I love

doesn’t love me.”

General

Cognitive Error

Questionnaire

(CEQ)/

No/NA

LeFebvre,

1981

24 vi-

gnettes/

5-point

Likert

Journal of

Consulting

and Clinical

Psychology

Measures cognitive

errors linked to de-

pression; Also looked

at levels of depres-

sion in bulimia.

“Last time you went skiing, you took

a hard fall and got shook up. You’re

supposed to go skiing this weekend

but think, ‘I’ll probably fall

and break my leg and there will be

no one to help me.’”

“You have been working for six

months as a car salesperson. You had

never been a salesperson before and

were just fired because you were not

meeting your quotas. You thought,

‘Why try to get another job, I’ll just

get fired. ’”

“Last night your spouse said s/he

thought you should have a serious

discussion about sex. You think to

yourself, ‘S/he hates the way we

make love.’”

Personality Be-

lief Question-

naire (PBQ)/

PBQ-Short

Form/NA

Beck &

Beck, 1991

126

items/

9 sub-

scales

5-point

Likert

Unpublished;

contact scale

authors for a

copy

Examines role of

irrational beliefs in

personality disorders:

Avoidant, obses-

sive-compulsive,

dependent, narcissis-

tic, paranoid, and

borderline.

“I am socially inept and socially

undesirable in work or social situa-

tions.”

“Unpleasant feelings will escalate

and get out of control.”

“I am helpless when I’m left on my

own.”

Irrational Belief Scales Not Linked to Either the Ellis or Beck Model

Fear of Negative

Evaluation Scale

(FNE)/No/NA

Watson &

Friend,

1969

items/2

factors

True/

False

Journal of

Consulting

and Clinical

Psychology

Assess degree of

apprehension at the

prospect of being

evaluated negatively.

“I often worry that I will say or do

wrong things.”

“I am frequently afraid of other peo-

ple noticing my shortcomings.”

“I worry about what kind of impres-

sion I make on people.”

Penn State Worry

Scale/ No/NA

Meyer,

Miller,

Metzger, &

Borkovec,

1990

items/1

factor

5-point

Likert

Behavior

Research and

Therapy

Identify the role of

worry in anxiety

disorders

“I worry all the time.”

“My worries overwhelm me.”

“Once I start worrying, I can’t stop.”

Next, we were interested in evaluating the measure’s

reported validity or how well the measure assesses what

it claims to measure. More specifically, three dimensions

of a measure’s validity were explored: 1) concurrent

validity or how well the measure correlates with another

related measure; 2) discriminant validity or how well the

K. R. Bridges et al. / HEALTH 2 (2010) 862-877

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measure fails to correlate with other measures, and 3)

construct validity or how well the measure has been op-

erationalized. Table 2 presents a summary of our psy-

chometric evaluation for each measure of irrational be-

liefs. The measures are ordered in such a way that those

that possess the strongest psychometric properties are

presented first, followed by those that possess weaker

psychometric properties. Given the large number of irra-

tional beliefs measures appearing in the literature, we

recommend that investigators utilize only those with the

most psychometric support.

3. RESULTS

3.1. Measures Based on the Ellis Model

Irrational Beliefs Test (IBT). Jones [14] developed the

100-item IBT which requires respondents to indicate

their level of agreement or disagreement with each of the

items on a 5-point scale. Half of the items indicate the

presence of a particular irrational belief, the other half its

absence. Lohr and Parkinson[15] reported that the IBT

demonstrated positive correlations with measures of

anxiety and depression. Whereas the IBT initially was

one of the most popular measures of irrational beliefs, its

use has gradually diminished due to criticisms that these

beliefs were not measured independently of the emo-

tional consequences they were hypothesized to cause [16].

Nonetheless, it still sees occasional use (see Munoz-

Eguileta [17]). Woods [18] argued that a modified IBT

could be useful; he identified 47 IBT items that meas-

ured beliefs and found that these items were related to

emotional distress, psychosomatic symptoms, and suici-

dal contemplation.

Rational Behavior Inventory (RBI). Developed by

Shorkey and Whiteman [19], the RBI is a 38-item in-

strument designed for use in the assessment and treat-

ment planning of REBT clients. The answers range from

strongly agree to strongly disagree on a 5-point Likert

scale which results in 11 rationality factors plus a total

rationality score. The RBI has been shown to correlate

highly with self-report measures of depression and anxi-

ety [20]. Along with the IBT, the RBI has been the most

frequently used measure of irrational cognitions [21] but

suffers from the same psychometric inadequacies as the

IBI: low reliabilities of its subscales and the confusion of

irrational cognitions with negative affect [22]. Indeed,

Keinhorst, van den Bout, and de Wilde [23] found that

only those items on the RBI that are emotion-bearing

correlate with emotional distress. Additional research on

the factor structure of the RBI suggested discarding

some of the items that loaded poorly in order to improve

the purity of RBI factors [24].

Idea Inventory. The Idea Inventory [25] is a 33-item,

3-point Likert scale comprised of the 11 original Ellis

irrational beliefs. The items are presented as an irrational

idea, and any disagreement represents rational thinking.

The measure results in a total irrationality score plus

scores on each individual belief. While Smith [26] noted

that this scale has shortcomings in that it does not meas-

ure ideas independently of emotional consequences,

Jacobsen, Tamkin, and Hyer [27] found that the inven-

tory had excellent internal consistency and strong dis-

criminant validity. However, Kassinove (personal com-

munication June 26, 2009) suggested that the Idea In-

ventory no longer be used as it is based on the original

Ellis formulation and was “very old.”

Common Beliefs Survey-III (CBS-III). The CBS-III

[28] is a 54-item measure with six, 9-item subscales;

each item is rated on a 5-point Likert-type scale. Agree-

ment indicates irrationality for 29 items and rationality

for 25 items. The CBS-III has demonstrated very good

psychometric properties [29] including satisfactory in-

ternal consistency, test-retest reliability, and convergent

and discriminant validity. For example, irrational beliefs

as measured by the CBS-III were found to be related to

substantial variance in two negative indices of well-

being, depression and anxiety [30]. Additionally, there is

the CBS-III SF (short form) with 19 items, which has

also demonstrated good psychometric properties [31].

The CBS-III continues to be used extensively.

The Situational Self-Statement and Affective State In-

ventory (SS SASI). The SSSASI [32] presents respon-

dents with five hypothetical irritating events and disap-

pointing outcomes; each vignette is followed by five

possible thoughts and five possible emotions the indi-

vidual might experience following the vignette. Having

read a vignette, the subject responds to five feeling

statements (angry, anxious, suspicious, depressed, and

hopeful) and five self-statements, indicating the level of

agreement with each one. Higher scores indicate greater

irrationality. The SSSASI is a measure of thoughts and

feelings that permits the determination of the relation

between cognitions and affective state, a central REBT

tenet (i.e., that maladaptive cognitions are linked to

emotional distress). Such correlations were found in

clinical and non-clinical populations [33]; clinical re-

spondents endorsed negative irrational thoughts signifi-

cantly more than non-clinical participants [34]. The

SSSASI has been found to have satisfactory internal

consistency and test-retest reliability, although lower

than that of the CBS-III, perhaps due to its assessment of

reactions to highly specific situations [34].

The Belief Scale (BS). The BS [35] is a 20-item meas-

ure of Ellis’ original list of irrational beliefs. It was de-

signed to correct the content validity problems of previ-

ous measures such as the IBT and RBI. Each item is

ated on a 5-point scale, and item ratings are summed to r

K. R. Bridges et al. / HEALTH 2 (2010) 862-877

869

Table 2. Comparison of Psychometric Properties.

Name of Scale/Other

Forms/Also Known As Author(s) Reliabilitya Concurrent

Validityb

Discriminant

Validityc

Construct

Validityd

Irrational Belief Scales Based on the Ellis Model

Child and Adolescent Scale of

Irrationality (CASI)/Short form

(CASI-Revised)/NA

Bernard & Laws, 1987**** ++  ††

General Attitude and Belief Scale

(GABS)/No/Attitudes Belief

Scale 2, ABS 2,A&B II, ABS II

DiGiuseppe, Leaf,

Exner, & Robin, 1988**** ++

 ††

Perfectionism Cognitions Inven-

tory (PCI)/No/NA

Flett, Hewitt, Blank-

stein, & Gray, 1998 **** ++

 ††

Situational Self-Statement and

Affective State Inventory

(SSSASI)/No/NA

Harrell, Chambless, &

Calhoun, 1981 ****



Belief Scale (BS)/No/M.S. Belief

Scale, MSBS, Irrational Belief

Scale, IBS

Malouff & Schutte,

1986 *** ++

 ††

Common Beliefs Survey-III

(CBS-III)/

Short form Exists (CBS-II

SF)/NA

Bessai, 1977 *** ++  ††

Irrational Beliefs Inventory (IBI)/

No/NA

Koopmans, Sander-

man, Timmerman &

Emmelkamp, 1994

*** ++

 ††

Survey of Personal Beliefs

(SPB)/No/NA

Demaria, Kassinove,

& Dill, 1989 *** ++

 †

Idea Inventory

/No/NA

Kassinove, Crisci, &

Tiegerman, 1977

Split-half, first

third-second third = 0.84,

first third-final third =

0.90, second third-final

third = 0.91

+  †

Evaluative Beliefs Scale

(EBS)/No/NA

Chadwick, Trower, &

Dagnan, 1999 *** + †

Irrational Beliefs Test (IBT)/IBT

Revised (Woods, 1992)/NA Jones, 1968 ** ++  ††

Irrational Beliefs Survey

(IBS)/No/Irrational Beliefs Scale

Watson, Vassar, Ple-

mel, Herder, Manifold,

& Anderson, 1990

** +

 †

Camatta & Nagoshi

Scale/No/NA

Camatta & Nagoshi,

1995 ** +

 †

Ellis Emotional Efficiency In-

ventory (EEEI)/No/NA Ellis, 1992 ** + †

Rational Behavior Inventory

(RBI)/No/NA

Shorkey & Whiteman,

1977 Split half = 0.73 +  †

K. R. Bridges et al. / HEALTH 2 (2010) 862-877

870

Smith Irrational Beliefs Inven-

tory (SIBI)/No/NA Smith, 2002 *

Irrational Belief Scales Based on the Beck Model

Automatic Thoughts

Questionnaire-30

(ATQ-30)/Companion piece

ATQ-N/NA

Hollon & Kendall,

1980 **** ++

 ††

Personality Belief Questionnaire

(PBQ)/

PBQ-Short Form/NA

Beck & Beck, 1991 **** ++  ††

Cognitive Triad Inventory

(CTI)/No/NA

Beckham, Leber, Wat-

kins, Boyer, & Cook,

1986

**** +

 †

Crandell Cognitions Inventory

(CCI)/

No/NA

Crandell & Chambless,

1986 **** +

 †

Cognition Checklist (CCL)/

No/NA

Beck, Brown, Steer,

Eidelson, & Riskind,

1987

****



Dysfunctional Attitudes Scale

(DAS)/

Two parallel 40-item forms

DAS-A, DAS- B/NA

Weissman & Beck,

1978 *** ++

 ††

General Cognitive Error Ques-

tionnaire (CEQ)/No/NA LeFebvre, 1981 *** +  †

Irrational Belief Scales Not Linked to Either the Ellis or Beck Model

Fear of Negative Evaluation

Scale (FNE)/No/NA Watson & Friend, 1969**** ++  ††

Penn State Worry Scale/

No/NA

Meyer, Miller,

Metzger, & Borkovec,

1990

**** ++

 ††

Note: Within a group, measures are ordered based on the strength of their psychometric properties; aCronbach’s alpha for total scale; subscales may

have lower Cronbach’s alpha (**** ≥ 0.9; *** ≥ 0.8, ** ≥ 0.7; * ≤ 0.7); bSignificant correlations with three types of measures that should be related

were examined: self-reported psychopathology, clinical ratings, and behavior or performance ratings. ++ at least two of the three types of concurrent

validity reported in the literature; + at least one type of concurrent validity reported in the literature; cSignificant differences between the measure and

other, theoretically distinct measures. at least two studies reported adequate discriminant validity;  at least one study reported adequate dis-

criminant validity; dSignificant differences between participants high and low on the symptomatology or those who have differences in symptomatol-

ogy, or diagnosed and undiagnosed participants. †† at least two studies reported adequate construct validity; † at least one study reported adequate

construct validity.

produce a total score. The Belief Scale is referred to by

several titles in the literature, including the MSB and

M.S. Belief Scale [36], the MSBS [37], and the Irra-

tional Beliefs Scale or IBS [38]. The BS has shown good

internal consistency and stability, and the scale has cor-

related highly with other measures of irrational beliefs.

BS scores were positively correlated with levels of de-

pression and anxiety in psychiatric patients [36].

The Child and Adolescent Scale of Irrationality

(CASI). The CASI [39] was designed to assess adoles-

cents’ overall level of irrational thinking; it consists of

44 statements set in a Likert-type format, which yields

six sub-scores and a total irrationality score. There are

three clusters of general irrational ideas and two irra-

tional belief scales within each of the three clusters for

examples see Burnett [40]. An abridged version with 25

items, the CASI-Revised, was developed by Burnett.[41]

There is evidence, provided by Burnett [40], of sound

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871

reliability and construct validity. Bernard and Cronan

[12] found significant correlations between the CASI

and trait anxiety.

The General Attitude and Belief Scale (GABS). The

GABS [42] was developed to take account of three con-

tent domains which are recurrent themes in irrational

beliefs (achievement, approval, and comfort), and four

processes of irrational thinking (demandingness, awfu-

lizing, self-downing, and low frustration tolerance). Ac-

cording to Bernard [43] the GABS has good reliability

and convergent/discriminant validity. Using this scale,

investigators found a direct relationship between irra-

tional beliefs and depression [44]. The literature is not

always clear about the name and history of this measure,

however. It has been referred to as the Attitudes and Be-

liefs Scale 2 or ABS 2 [45], the A & B II [18], and the

ABS II [46] with DiGiuseppe et al. [42] as its authors.

The Attitude and Belief Scale has been attributed to Bur-

gess [47] as well as DiGiuseppe & Leaf [48]. Research-

ers have reported on a 72-item version [43] and a 55-

item version [49] of the GABS. This measure does re-

quire the permission of its authors for use (i.e., Fulop,

personal communication, June 30, 2009).

The Survey of Personal Beliefs (SPB). The SPB [50] is

occasionally referred to as the Personal Beliefs Test or

PBT [51] in the literature. They are in fact the same test

(H. Kassinove, personal communication, June 29, 2009).

The SPB contains 50 items which are scored on a 6-

point Likert scale and is designed for people over 16

years of age. It includes items from the PBT which were

reworded to conform more clearly to REBT theory. Ini-

tial results with the SPB indicated satisfactory total and

scale reliability [50]. Validity research indicated that

total rationality was related to negative affect [52].

Irrational Beliefs Survey (IBS). The IBS [53] is an

11-item scale which, using simplified language, grew out

of an earlier measure of irrational thinking [54]. The

original test was based on an early formulation of Elli-

sonian [55] theory. Respondents answer via a 5-point

scale ranging from strongly disagree to strongly agree.

Maltby and Day [56] found one factor in a non-clinical

population resulting in one composite score; while addi-

tion research [57] found a significant correlation be-

tween IBS scores and a depressive attributional style.

The IBS was not initially named by Watson et al. [53];

Day and Maltby [57] referred to it as the Irrational Be-

liefs Survey, while Egan, Canale, del Rosario, and White

[58] referred to it as the Irrational Beliefs Scale.

The Ellis Emotional Efficiency Inventory (EEEI). The

EEEI [59-60] assesses irrational and rational coping re-

sponses to past irrational beliefs instead of latent irra-

tional beliefs. The 60-item instrument is scored on a 5-

point Likert scale. It measures overall levels of REBT

disputing as well as three main factors: anti-awfulizing,

anti-self-downing, and anti-low-frustration tolerance dis-

putes. Poor coping on the EEEI is indicative of higher

long-term levels of emotional dysfunction. The EEEI

demonstrated a stable three-factor structure and strong

convergent/divergent validity [61].

Irrational Beliefs Inventory (IBI). This 50-item scale,

developed in the Netherlands by Koopmans, Sanderman,

Timmerman, and Emmelkamp [22], is based on the item

pool of the IBT and the RBI. The IBI is distinguishable

from these scales in that it measures cognitions rather

than negative affect, a criticism leveled at the IBT and

RBI. The IBI is answered via a 5-point scale and con-

sists of five subscales (worrying, rigidity, need for ap-

proval, problem avoidance, and emotional irresponsibil-

ity) plus a total score. Research has demonstrated con-

sistent psychometric properties across several cultures,

including the American version [62]; internal consis-

tency was found to be of an acceptable magnitude, and

the five subscales were found to be independent of each

other. The IBI has been used to investigate the role of

irrational beliefs in obsessive-compulsive disorder, so-

cial phobias, and therapy for depression [62].

Camatta and Nagoshi Scale. The irrational beliefs

scale of Camatta and Nagoshi [63], which is unnamed,

was designed to be a brief test of a respondent’s prone-

ness to Ellisonian irrational beliefs. According to its au-

thors, each of the 10 items describe one irrational belief

identified by Ellis [55]. The test was found to have good

internal reliability and to be a good predictor of alcohol

use problems [64].

The Perfectionism Cognitions Inventory (PCI). The

PCI [65] is a 25-item measure of automatic thoughts and

beliefs that perfection must be attained; the thoughts

assessed via the PCI are consistent with the observations

by Ellis [66] about irrational thinking and perfectionism.

The PCI differs from other measures in that it assesses

the frequency of these thoughts which had occurred

during the previous week. Respondents rate statements

about the need to be perfect on a scale of 0 (not at all) to

4 (all the time). Scores may fluctuate based on recent

experiences. The PCI was found to have an adequate

degree of internal consistency and validity [67]. Dys-

functional thinking as measured by the PCI has been

shown to be associated with higher levels of depressive

symptomatology and anxiety [67].

Evaluative Beliefs Scale (EBS). The EBS [3], devel-

oped in response to criticisms of earlier irrational beliefs

tests, is a distinctively cognitive measure of purely nega-

tive evaluative beliefs. It is an 18-item, self-report in-

strument constructed to measure negative person evalua-

tions across three dimensions: where an individual be-

lieves others are making evaluations of them, where the

K. R. Bridges et al. / HEALTH 2 (2010) 862-877

872

individual makes an evaluation of him- or herself, and

where the individual evaluates others. The EBS was de-

signed to identify an individual’s global negative evalua-

tive beliefs. Item responses are made on a five-point

scale. The EBS was found to have good internal reliabil-

ity, an adequate factor structure, and good predictive

validity for anxiety and depressive symptoms [3].

Smith Irrational Beliefs Inventory (SIBI). The 24-item

SIBI [68] is situation specific in that it asks respondents

to rate on a 4-point Likert scale how much they dis-

played irrational thinking during a recent recalled

stressful situation. This format is used in order to be

consistent with Ellis’ [55] original conceptualization of

irrational beliefs as higher-order cognitions inaccessible

through simple self-report scales. Amutio and Smith [69]

found that the SIBI displayed a consistent seven-factor

structure across situational formats and cultures.

3.2. Measures Based on the Beck Model

The Dysfunctional Attitudes Scale (DAS). The DAS [70],

a 100-item, self-report instrument answered on a 7-point

Likert scale, was developed to assess dysfunctional be-

liefs and thoughts posited by Beck and his colleagues as

being associated with vulnerability to depression. It was

later transformed into two parallel 40-item forms, the

DAS-A and the DAS-B [71]. Reliability and validity

data for the DAS support its use as a measure of depres-

sionistic beliefs [72]; it has been argued that the DAS-A

is one of the most efficient instruments for measuring

the cognitive distortions associated with depression. [71]

DAS scores for outpatients being treated for depressive

disorders decreased following treatment [73]. The Dys-

functional Attitudes Scale for Medically Ill Elders or

DASMIE [74] incorporated items from the DAS along

with new items to measure dysfunctional attitudes

among the medically ill elderly.

Automatic Thoughts Questionnaire-30 (ATQ-30). In

the ATQ-30 [75], respondents indicate for each of 30

specific, negative thoughts how frequently the thought

has occurred to them during the past week. The ATQ-30

has high internal consistency and discriminates depressed

from non-depressed samples [76]. There are companion

pieces to the ATQ-30: the Automatic Thoughts Question-

naire-Positive or ATQ-P and the ATQ-N (Negative) [77].

The ATQ correlates inversely with depressive symptoms;

it distinguishes patients with depression from non-

patients in both frequency of negative thoughts and de-

gree of belief in these thoughts [78].

The General Cognitive Error Questionnaire (CEQ).

The CEQ [4], designed to measure cognitive errors re-

lated to general life experiences, provides 24 vignettes

followed by a dysfunctional cognition about the vignette.

Respondents rate, via a 5-point scale, how similar the

thought is to what they would think. Vignettes are cate-

gorized according to four types of cognitive errors iden-

tified by Beck, including catastrophizing, overgeneraliz-

ing, personalizing, and selective abstraction. High

test-retest, alternate form, and internal consistency reli-

abilities have been found, along with moderate correla-

tions with other depressive cognitions inventories [79].

The Cognitive Triad Inventory (CTI). The 36-item CTI

[80] utilizes a 7-point Likert-type scale to measure a

central component of Beck’s cognitive theory of depres-

sion, the cognitive triad. This includes negative views of

the self, the world, and the future. The CTI was devel-

oped to measure these negative views, which have been

empirically linked to depression [1]. The CTI, which has

items phrased in positive and negative directions, shows

good to excellent internal consistency, and the total score

correlates highly with measures of depression [81].

The Crandell Cognitions Inventory (CCI). The CCI

[82] is a 45-item self-report measure of the frequency of

depressive thoughts. Respondents rate on a 5-point scale

how frequently they think each self-statement. Higher

total scores indicate a higher frequency of depressive

thinking. A strength of the CCI is that it was developed

and normed with a clinical population. It has been dem-

onstrated to discriminate among depressed, non-de-

pressed psychiatric, and normal respondents, and has

high internal reliability [82].

The Cognition Checklist (CCL). The CCL [83] was

developed to measure the frequency of automatic

thoughts relevant to anxiety and depression. The CCL

has a 12-item subscale of anxious cognitions and a 14-

item subscale of depressed cognitions rated on a 5-point

scale. The measure contains irrational cognitions related

to danger, thought to be a characteristic of anxiety, plus

irrational cognitions related to depression to test explic-

itly the content-specificity hypothesis of the Beck model.

Patients diagnosed with anxiety disorders had higher

mean CCL anxiety scores while patients diagnosed with

depressive disorders had higher mean depression scores

supporting the validity of the CCL [83].

The Personality Belief Questionnaire (PBQ). The PBQ

[84] is a 126-item, self-report measure of beliefs related

to personality disorders. The PBQ includes 14 items,

each representing nine scales: Avoidant, Dependent, Ob-

sessive-Compulsive, Histrionic, Passive-Aggressive, Nar-

cissistic, Paranoid, Schizoid, and Antisocial personality

disorders. Good test-retest reliability and internal con-

sistency estimates were found for all of the PBQ scales,

and patients with specific personality disorders endorsed

dysfunctional beliefs consistent with their disorder [85].

The PBQ-Short Form (SF), a shorter and more refined

version [86], was found to be more desirable for clinical

and research purposes.

K. R. Bridges et al. / HEALTH 2 (2010) 862-877

873

3.3. Measures not Linked to either the Ellis

or Beck Model

Fear of Negative Evaluation Scale (FNE). The 30-

item, true-false, FNE [87] was developed to determine

the degree to which individuals experience apprehension

due to the possibility of being unfavorably evaluated.

Performance on the FNE has been shown to be corre-

lated significantly with measures of anxiety and depres-

sion [88]. A Brief Fear of Negative Evaluation or BFNE

[89] changed the response format to a 5-point scale and

reduced the measure to 12 items. Results from a revised

version of the BFNE suggested that the different factor

structures reported in the literature may reflect related

but distinct constructs, and that more research is needed

on its factor structure [90].

Penn State Worry Questionnaire (PSWQ). The PSWQ

[91] is a 16-item inventory, based on a 5-point Likert

scale, assesses the frequency of pathological worry. The

PSWQ possesses high internal consistency and good

test-retest reliability, and was found to significantly dis-

criminate samples who met the diagnostic criteria for

generalized anxiety disorder. Cognitive therapy pro-

duced reductions in PSWQ scores. Lim, Kim, Lee, and

Kwon [92] observed that, as with the BFNE above, there

is still some debate regarding the factor structure of the

PSWQ.

3.4. Discussion and Recommendations

Inasmuch as irrational beliefs play a central role in cog-

nitive theory and therapy, they are a major focus in

treatment and, consequently, are a primary intervention

target. As noted by Beck et al. [85], these irrational be-

liefs, if they are correctly identified, are a key conceptual

theme linking an individual’s dysfunctional responses to

the present situation. With the continued proliferation of

irrational beliefs measures, we feel that it is essential that

investigators continue to assess and reassess the psy-

chometric properties of these tests and to determine if

there is indeed a need for additional tests which appear

to be measuring the same concept. This reassessment is

all the more critical given the role of irrational thinking,

as measured by traditional and newer context specific

measures, in behaviors and cognitions which while pro-

blematic, are not always considered to be pathological:

gambling [93], obesity [94], postpartum depression [95],

health practices [96], procrastination [97], exam-related

distress [98], and even belief in the paranormal [99].

However, we did not include these measures in this re-

view as we limited it to measures related only to depres-

sion and anxiety.

Several problems in the evaluation of extant tests of

irrational beliefs became apparent during the course of

conducting this review. The authors of the tests were

frequently the sole source of reliability and validity evi-

dence which varied considerably among published work.

This makes it difficult to reach objective conclusions

about the tests. Additionally, investigators incorporating

these measures in their research are inconsistent in nam-

ing and describing the development of the tests, which

causes unnecessary confusion for investigators attempt-

ing to replicate the original research.

Unfortunately, it appears many of the early measures

whose psychometric properties are in doubt are still used

today; the Irrational Beliefs Test [14], the Rational Be-

havior Inventory [19], and the Idea Inventory [25] still

see occasional use in research and appear in the litera-

ture. These tests contained many items that in fact did

not measure beliefs; only 63% of the items in the IBT

actually measured beliefs and only 57% of items in the

RBI measured beliefs [100]. This raises an important

point regarding the psychometric properties of measures

of irrational beliefs: Such measures should assess beliefs

－both irrational and rational－and not emotional or

behavioral responses.

Newer assessment measures have since evolved out of

the theories of Ellis and Beck. Such measures include

the Perfectionism Cognitions Inventory [65], the Smith

Irrational Beliefs Inventory [68], the Ellis Emotional

Efficiency Inventory [59], the Evaluative Beliefs Scale

[3], and the Irrational Beliefs Inventory [22]. Although

some of the newer tests are not used in research or cited

in the literature as frequently, they should be used be-

cause they possess better psychometric properties com-

pared to the earlier, more frequently used, scales.

Some of the most commonly used irrational beliefs

tests still contain items that measure emotions and be-

haviors rather than beliefs. These tests are used based on

popularity and convenience even though newly devel-

oped tests may have higher validity. Thus, our recom-

mendation for clinicians and researchers interested in

assessing irrational beliefs are to use the newer and more

specialized measures of irrationality. These newer meas-

ures should not be overshadowed by more commonly

used tests which have less sound psychometric qualities.

Finally, the theories of Ellis and Beck have been applied

more recently to specific problems involving irrational

thought; while these scales were not included in this

review for reasons noted earlier, we find the Academic

Rational Beliefs Scale [58], the Gambler’s Beliefs Ques-

tionnaire [93], and the Irrational Food Beliefs Scale [94]

to possess excellent psychometric properties and should

be more widely used when assessing context specific

problems involving irrational beliefs.

There are promising new developments in the assess-

ment of irrational beliefs, as well as challenges. Many

popular assessment tools do not have the best psycho-

K. R. Bridges et al. / HEALTH 2 (2010) 862-877

874

metric support yet continue to be used because of con-

venience and commonality. Newer, more narrowly fo-

cused measures are being developed which appear to

possess better psychometric properties (e.g., the Perfec-

tionism Cognitions Inventory). Whatever the future

holds for measurement of irrational beliefs, the contin-

ued improvement of these tests is essential to the study

and treatment of depression, anxiety, and other disorders.

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