Cognitive behavioral therapy and a study on women's perceptions about fractures shows the importance of how we think

by Salene Jones, PhD, research associate at Group Health Research Institute

I'm a behavioral health researcher and one topic I study is broadly referred to as cognitions. Cognitions are thoughts and can include attitudes, beliefs, or even brief, passing ideas like, “What am I going to do after writing this post?” One form of cognitions is called perceptions and these include what we think of others, ourselves, or even our own health. And how we think can have an impact on our physical and mental health.

I recently published a paper on perceptions of risk for fracture and how these perceptions relate to exercise and medical care usage. We found that women who thought they had a lower risk of breaking a bone had higher quality of life, rated their health as better, and walked more than women who thought they had a higher risk of fractures. These results weren't affected by the women’s actual risk for fracture or whether their perceptions were correct. The flip side was that women perceiving lower risk were less likely to get bone scans that might detect fracture risk. Our study showed us that there may be certain benefits to having particularly optimistic or positive perceptions, even if they are incorrect, but the same perceptions could have drawbacks such as possibly not seeking needed care.

Understanding the power of positive and negative cognition

I often hear the common advice to “just think positively” to reduce stress and depression. While that might work for some people, some situations are generally, objectively bad and it doesn’t make sense to think positively about them. Plus, it’s impossible to think positively all the time. And sometimes, it makes more sense to change the situation or our behavior rather than how one thinks about it. But, negative thoughts about a situation may be overly negative. For example, worry, a form of repetitive negative thinking, increases anxiety and depression.

Treatments that target our thoughts, such as cognitive behavioral therapy—one of the most scientifically validated treatments for most mental health concerns—focuses on changing incorrect, negative thoughts. My recent study and my work in cognitive behavioral therapy show the power of our thoughts on our health.

My colleagues and I are now examining how both positive and negative thinking affect long-term survivors of cancer. A continued focus on how people think can help us lead healthier lives. As we saw when we studied perceptions of fracture risk, how people think can affect their behavior and how they feel. The more scientists understand about how cognitions affect health, the better prepared we are to help our patients become and stay healthy.