Automatic Thoughts Questionnaire – Revised (ATQ-R)

Abstract

The Automatic Thoughts Questionnaire – Revised (ATQ-R) is a widely utilized psychometric instrument designed to assess the frequency and intensity of self-referent verbal statements, or automatic thoughts, associated with depression. Originally developed by Hollon and Kendall in 1980 (ATQ), the revised version (ATQ-R) typically includes 40 items that reflect both negative and positive self-statements, capturing the breadth of cognitive processes central to Cognitive Behavioral Therapy (CBT) models of psychopathology. It serves as a crucial tool for both clinical assessment and research, helping to quantify the cognitive component of depressive symptoms and track changes resulting from therapeutic intervention.

Keywords

Automatic Thoughts Questionnaire, ATQ-R, Depression, Cognitive self-statements, Cognitive Behavioral Therapy, Psychopathology, Assessment.

Authors

Steven D. Hollon, Philip C. Kendall, Ann Lumry, Thomas H. Harrell, Nancy B. Ryon, Alan E. Kazdin, E. Burgess, D. A. F. Haaga, Rick E. Ingram, Greg Siegle, Richard G. Netemeyer, D. A. Williamson Scot Burton.

Purpose

The primary purpose of the ATQ-R is the quantitative assessment of the frequency of automatic, self-referent cognitions characteristic of individuals experiencing depression. By measuring these specific thought patterns, the scale aids clinicians in diagnosing and tracking progress during interventions, particularly those rooted in Cognitive Behavioral Therapy (CBT). The original ATQ focused heavily on negative thoughts, but the revised versions often integrate items reflecting positive self-statements to provide a more comprehensive picture of the cognitive balance.

The scale is also essential for research investigating the cognitive model of depression, allowing researchers to examine the relationship between specific cognitive distortions and the severity of affective symptoms. It provides a standardized method for identifying the cognitive content linked to depressive episodes.

Construct

The ATQ-R measures the construct of depressotypic cognitions, which are the stream of relatively autonomous, spontaneous thoughts that occur in response to situations or events. These thoughts are often negative, distorted, and self-critical in individuals with depression, aligning with Aaron Beck’s cognitive model. The scale operationalizes the frequency of these automatic thoughts across several hypothesized domains: personal maladjustment and desire for change, negative self-concept and negative expectations, low self-esteem, and helplessness.

The revised iterations, especially those integrating positive items, reflect the understanding that the cognitive profile of depression involves not only the presence of negative automatic thoughts but also the relative absence of positive automatic thoughts. The overall score reflects the degree of maladaptive cognitive processing, serving as a robust measure of cognitive vulnerability to depression.

Validity

Extensive research supports the validity of the ATQ and ATQ-R across various populations. Studies have demonstrated strong concurrent validity, showing high correlations between ATQ scores and other established measures of depression severity, such as the Beck Depression Inventory (BDI). The scale also exhibits strong discriminant validity, effectively differentiating clinically depressed individuals from non-depressed control groups and those with other forms of psychopathology, suggesting specificity to depressotypic cognitions.

Furthermore, the scale has shown excellent construct validity, as scores predictably change in response to effective psychological treatment (e.g., CBT), indicating that it measures a construct relevant to therapeutic change. Research by Hollon, Kendall, and Lumry (1986) specifically highlighted the clinical specificity of these cognitions in major depression.

Reliability

The ATQ-R is generally regarded as having excellent internal consistency and acceptable test-retest reliability. Across numerous studies, internal consistency estimates (Cronbach’s alpha) typically fall into the high range (e.g., .90s), indicating that the items reliably measure the same underlying construct of automatic negative thinking. This high reliability is crucial for its use in clinical settings where precise measurement of symptom severity is necessary.

Test-retest reliability is also generally strong, confirming the stability of the measure over short intervals, especially in untreated clinical samples. However, scores are expected to change over longer periods when therapeutic intervention leads to cognitive restructuring, demonstrating the scale’s sensitivity to change.

Factor Analysis

Initial factor analysis of the original 30-item ATQ typically yielded a single, strong factor representing global negative automatic thoughts. However, subsequent factor analysis of the revised and expanded 40-item versions (including both positive and negative statements) often suggests a multi-factor structure, generally distinguishing clearly between negative automatic thoughts (NATs) and positive automatic thoughts (PATs).

Studies examining the ATQ-R often identify four or more specific negative sub-factors (e.g., self-blame, hopelessness, low self-esteem) and one strong positive factor, supporting the idea that the scale captures distinct dimensions of cognitive content related to depression and resilience. Netemeyer et al. (2002) explored the psychometric properties of shortened versions, further validating the underlying factor structure across different lengths of the instrument.

Instrument

Test Type: Self-report questionnaire / Psychometric scale.

Format: 40 items rated on a 5-point Likert scale.

Language Available: English (Original), Portuguese, and numerous other translations.

Population Group: Clinical and non-clinical adults, and adapted versions for children (e.g., Children’s Automatic Thoughts Questionnaire).

Age Group: Typically 18+ (Adult version). Adapted versions are used for younger populations.

Population Details: Primarily used with individuals diagnosed with or screening positive for Major Depressive Disorder or related affective disturbances.

Test Methodology: Respondents rate how frequently they have experienced each thought over the past week (or a similar specified period) using the following scale: 1 = “not at all,” 2 = “somewhat,” 3 = “moderately,” 4 = “very much,” and 5 = “totally.”

Keywords

Cognitive restructuring, Self-report, Depressive cognitions, Psychometric scale, Clinical assessment, Mental health screening, Cognitive distortions.

Authors

Author ORCID Identifier: Not specified in source content.

Affiliation Email addresses: Not specified in source content.

Correspondence Address: Not specified in source content.

Permissions & Fee and Test Year

The original ATQ was developed in 1980 by Hollon and Kendall. Subsequent revisions and validations, including the ATQ-R and versions incorporating positive thoughts, were published throughout the 1980s and 1990s. Specific information regarding current licensing fees or permissions for commercial use should be obtained directly from the authors or relevant publishing bodies, though the scale items are frequently used in academic research.

The original PDF for the Portuguese Version of the Automatic Thoughts Questionnaire-Revised can be downloaded here: Portuguese Version of the Automatic Thoughts Questionnaire-Revised.

Reference’s

The development and validation of the ATQ and its revisions are supported by key publications:

• Hollon, S. D., & Kendall, P. C. (1980). Cognitive self-statements in depression: Development of an automatic thoughts questionnaire. Cognitive Therapy and Research, 4(4): 383-395.
• Harrell, Thomas H., Ryon, Nancy B. (1983). Cognitive-behavioral assessment of depression: Clinical validation of the Automatic Thoughts Questionnaire. Journal of Consulting and Clinical Psychology, 51(5): 721-725.
• Hollon, Steven D., Kendall, Philip C., Lumry, Ann. (1986). Specificity of depressotypic cognitions in clinical depression. Journal of Abnormal Psychology, 95(1): 52-59.
• Kendall, P. C., Howard, B. L., & Hays, R. C. (1989). Self-referent speech and psychopathology: The balance of positive and negative thinking. Cognitive Therapy and Research, 13 (6), 583–598.
• Kazdin Alan E. (1990). Evaluation of the Automatic Thoughts Questionnaire: Negative Cognitive Processes and Depression Among Children. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 2(1): 73-77.
• Burgess, E., & Haaga, D. A. F. (1994). The Positive Automatic Thoughts Questionnaire- Revised: Equivalent measures of positive thinking? Cognitive Therapy and Research, 18, 15–24.
• Ingram, Rick E., Kendall, Philip C., Siegle, Greg. Et al. (1995). Psychometric properties of the Positive Automatic Thoughts Questionnaire. Psychological Assessment, 7(4): 495-507
• Netemeyer, Richard G., Netemeyer, D. A. WILLIAMSON SCOT BURTON. Et al. (2002). Psychometric properties of shortened versions of the Automatic Thoughts Questionnaire. Educational and Psychological Measurement, 62(1): 111-129

Items of the Automatic Thoughts Questionnaires – Revised (ATQ-R)

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

1. I feel like I’m up against the world.
2. I’m no good.
3. I’m proud of myself.
4. Why can’t I ever succeed?
5. No one understands me.
6. I’ve let people down.
7. I feel fine.
8. I don’t think I can go on.
9. I wish I were a better person.
10. No matter what happens, I know I’ll make it.
11. I’m so weak.
12. My life is not going the way I want it to.
13. I can accomplish anything.
14. I’m so disappointed in myself.
15. Nothing feels good anymore.
16. I feel good.
17. I can’t stand this anymore.
18. I can’t get started.
19. What’s wrong with me?
20. I’m warm and comfortable.
21. I wish I were somewhere else.
22. I can’t get things together.
23. I hate myself.
24. I feel confident I can do anything I set my mind to
25. I’m worthless.
26. I wish I could just disappear.
27. What’s the matter with me?
28. I feel very happy.
29. I’m a loser.
30. My life is a mess.
31. I’m a failure.
32. This is super
33. I’ll never make it.
34. I feel so helpless.
35. Something has to change.
36. There must be something wrong with me.
37. I’m luckier than most people.
38. My future is bleak.
39. It’s just not worth it.
40. I can’t finish anything.

Scoring is typically conducted using a 5-point frequency scale: 1 = “not at all,” 2 = “somewhat,” 3 = “moderately,” 4 = “very much,” and 5 = “totally.”