INTRODUCTION: Chapter one of this thesis presents a systematic review and two meta-analyses examining the associations between self-reported Beckian cognitive distortions and depression and anxiety symptoms in adults. Although cognitive distortions are a central component of cognitive models of emotional disorders and are a common focus in Cognitive Behavioural Therapy, the strength of their association with depressive and anxiety symptoms has not been quantitatively synthesised. The present review aims to consolidate the existing evidence base to clarify the strength of this association, with implications for cognitive theory and clinical practice. Chapter two of this thesis presents an empirical project investigating associations between vertical and horizontal mental health concept expansion with cognitive distortions, anxiety symptoms, depressive symptoms, resilience, and help-seeking attitudes in a sample of UK university students aged 18–25. While previous research has examined concept expansion in relation to experience of prior mental health problems and help-seeking, no study has explored all of these variables within a single analysis. This study aims to extend the literature by examining these associations and exploring potential mediating pathways involving cognitive distortions. METHODS: In chapter one, a systematic search of PsycINFO (Ovid), MEDLINE, Embase, Scopus and Proquest Dissertations & Theses Global databases was conducted. A narrative review and two meta-analyses were then carried out to determine the size of the effect found between Beckian cognitive distortions and depression and anxiety symptoms. In chapter two, a cross-sectional study was utilised where participants were asked to complete self-report questionnaires examining concept expansion, cognitive distortions, depression symptoms, anxiety symptoms, help-seeking attitudes and resilience. These variables were then explored using Pearson’s correlations, hierarchical multiple regressions and exploratory bootstrapped mediation analyses. RESULTS: In chapter one, 17 eligible studies were included in the systematic review. The cognitive distortions and depression symptoms meta-analysis included 16 independent effects from 14 studies and showed a moderate positive association. The cognitive distortions and anxiety symptoms meta-analysis included 13 independent effects from 9 studies and showed a moderate positive association. In chapter two, both horizontal and vertical concept expansion were positively correlated with depression symptoms, anxiety symptoms and help-seeking attitudes and negatively correlated with resilience. However, when the variables were added to the hierarchical regression, only help-seeking attitudes remained significantly associated with vertical and horizontal concept expansion. Exploratory mediation analysis suggested that the catastrophising and labelling cognitive distortions subscales may contribute to the relationship between concept expansion and depression and anxiety symptoms, but the effect sizes were small in magnitude. CONCLUSION: The results from chapter one align with Beck's cognitive model and support the role of cognitive distortions in depression and anxiety symptoms. Chapter two suggests that broader mental health concepts are modestly associated with depression and anxiety symptoms but are more robustly associated with help-seeking attitudes. Additionally, they suggest that catastrophising and labelling may be involved in the association between concept expansion and depression and anxiety symptoms. The findings of both chapters contribute to theoretical accounts of mental health conceptualisation and have implications for clinical practice and future research.
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Phil Reed (2026) studied this question.
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