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In a new study published in the Journal of Clinical Psychological Science, authors Mohammed Al-Mosaiwi and Tom Johnstone from the Department of Psychology, School of Psychology and Clinical Languages at the University of Reading in the U.K. demonstrate how people with anxiety and depression tend to use more absolute words and engage in absolutist thinking than those who don't have a mental health issue.

Absolute or all-or-nothing thinking is a type of cognitive distortion and irrational belief. For example, using words like “always”, “totally”, and “entire” to describe situations instead of non-absolute words like “rather”, “somewhat”, or “likely”, can tell psychologists, psychiatrists, and therapists whether you have a black and white view of the world.

So if you're saying things like, "I always get depressed on rainy days," for example, instead of "I tend to likely feel down when it's raining outside," leaving open the possibility that it actually might not be rainy days that are making you sad instead of absolutely suggesting that when it's raining outside, you absolutely feel depressed despite other factors that may also come into play, you may be partaking in absolutist thinking. 

But whereas previously, practitioners would rely on theoretical and anecdotal support for targeting absolutist thinking as part of the cognitive therapy they deliver to their clients, Mosaiwi and Johnstone’s current study may provide the empirical evidence needed to justify its inclusion. Currently, practitioners only focus on improving absolutist thinking if it is their preference to do so. Mosaiwi and Johnstone believe they are on the cusp of new thinking and their current study may change the way therapy is delivered going forward.

“Recently, research into treating cognitive vulnerabilities and preventing relapse has migrated toward the new ‘third-wave’ therapies,” write Mosaiwi and Johnstone. “These therapies, such as mindfulness-based cognitive therapy and acceptance and commitment therapy, are largely geared toward increasing cognitive flexibility. Our findings are therefore in step with the recent trend toward cultivating adaptive cognitive processes (i.e., flexibility) as distinct from changing the content of thoughts (i.e., negativity)."

The researchers collected posts from 63 different Internet forums for their study representing over 6,400 members in April and May of 2015 and December and January of 2016. Along with their control forum, they aimed to collect 30,000 words. Posts in the forums had to contain a minimum of 100 words, the author of the post had to be a member of the group participating in the forum, and the post had to be written in continuous prose, it couldn’t be a list or a poem. Informed consent was not required but all posts were public.

To analyze whether the comments contained absolute words, the researchers constructed dictionaries of absolutist and non-absolutist words. They started off with 300 absolutist words and 200 non-absolutist words and after testing, their dictionaries were reduced to 22 absolutist words and 43 non-absolutist words to combine a single list of 65 words which they further reduced to a 19-word absolutist dictionary for their study.

Researchers tested four hypotheses: 1) Whether posts using absolutist words by people in anxiety, depression, and suicidal ideation forms would be significantly greater than those in the control group; 2) Whether posts using absolutist words by those in the suicidal ideation forum would be significantly greater than those in the anxiety and depression forum groups; 3) Whether posts using absolutist words by people in Borderline Personality Disorder (BPD) and Eating Disorder (ED) forums would be significantly higher than those in Post-Traumatic Stress Disorder and schizophrenia control forum groups; and 4) Whether posts using absolutist words in the recovery forum group would be significantly greater than those in the control forum groups.

What they found was their hypotheses were correct in all four circumstances, and that absolute words could provide more of an indication of a mental illness than psychological distress. In particular, absolutist thinking had been found to be heavily associated with suicidal ideation, BPD and ED and since the words we use are usually outside of our conscious control, they can serve as “implicit” markers.

“We believe a shift in focus to how we think rather than what we think,” write Mosaiwi and Johnstone, “can provide greater insight into possible cognitive mechanisms underlying affective disorders.”

References:

Association for Psychological Science, (2018), Mohammed Al-Mosaiwi and Tom Johnstone, In an Absolute State: Elevated Use of Absolutist Words Is a Marker Specific to Anxiety, Depression, and Suicidal Ideation, http://journals.sagepub.com/doi/pdf/10.1177/2167702617747074