Automatic Thoughts Questionnaire (ATQ-30)

The Automatic Thoughts Questionnaire (ATQ-30) is a foundational, validated clinical tool designed to measure the frequency of negative, depressogenic…

Questions: 30
Duration: 15 min
Original title: ATQ-30 — Automatic Thoughts Questionnaire
Adaptation: Automatic Thoughts Questionnaire (ATQ-30)
Authors: Hollon, S.D. & Kendall, P.C.
Created: 1980

The Automatic Thoughts Questionnaire (ATQ-30) is a foundational, validated clinical tool designed to measure the frequency of negative, depressogenic self-statements. Grounded in the cognitive model of depression, it captures the fleeting, involuntary thoughts that sustain low mood, self-criticism, and hopelessness. It is widely used by mental health professionals to identify automatic thoughts at baseline and track changes in cognitive patterns throughout treatment.

Administering the ATQ-30 provides clinicians with a quantifiable measure of the patient's internal dialogue, shedding light on specific themes of personal maladjustment, negative expectations, and low self-esteem. Because these rapid appraisals often drive emotional and behavioral responses, accurately assessing their frequency is a critical step in building a robust cognitive case formulation.

As a repeatable measure, the ATQ-30 is highly sensitive to the cognitive shifts that occur during evidence-based interventions like cognitive behavioral therapy. It allows clinicians to monitor whether the patient's pattern of negative thinking is effectively softening over time, ensuring that the therapeutic strategy directly addresses the cognitive maintenance cycles of depression.

Example result

Fictitious result, computed from a sample set of answers.

Overall score

90/ 150

A 30-item self-report questionnaire assessing the frequency of negative automatic thoughts associated with depression over the past week. It operationalizes Beck's cognitive model by measuring the negative content of internal dialogue (negative view of self, world, and future). Used in CBT for screening, initial assessment, and monitoring the progression of depressogenic cognitions.

généralemixed · students · nondepressed students (criterion group) · United States · n = 21 · 1980 · Hollon et al. (1980)effectif faible

30150

M = 48.57 ± 10.89

cliniquemixed · pathology: depression · depressed students (BDI ≥ 11 and MMPI-D ≥ 26) · United States · n = 14 · 1980 · Hollon et al. (1980)effectif faible

30150

M = 79.64 ± 22.29

cliniquemixed · pathology: depression · depressed patients (DEP) · United States · n = 21 · 1983 · Harrell et al. (1983)effectif faible

30150

M = 88.9 ± 21.15

cliniquemixed · clinical population · nondepressed psychiatric patients (NDEP-P) · United States · n = 20 · 1983 · Harrell et al. (1983)effectif faible

30150

M = 42.35 ± 9.96

cliniquemixed · clinical population · nondepressed medical patients (NDEP-M) · United States · n = 20 · 1983 · Harrell et al. (1983)effectif faible

30150

M = 38.35 ± 8.17

Scoring

Sum, total score from 30 to 150, each item is rated on a 5-point scale (from 1 to 5).

Helplessness / Despair (Helplessness)

9/ 10

Helplessness

items 29, 30

210

Low self-esteem

5/ 10

Low self-esteem

items 17, 18

210

Negative self-concept and negative expectations

20/ 35

Negative self-concepts and negative expectations

items 2, 3, 9, 21, 23, 24, 28

735

Personal maladjustment and desire for change

17/ 25

Personal maladjustment and desire for change

items 7, 10, 14, 20, 26

525

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What the test measures

The ATQ-30 assesses the frequency of negative automatic thoughts over the past week, evaluating four distinct cognitive dimensions linked to depression.

Personal maladjustment and desire for change: The subjective sense of failing to cope and the intense wish to be different or escape one's current state.
Negative self-concepts and negative expectations: Persistent self-deprecation, global beliefs of personal inadequacy, and a pessimistic view of future outcomes driven by deep-seated core beliefs.
Low self-esteem: Absolute declarations of self-hatred and fundamental worthlessness.
Helplessness: A pervasive sense of futility, resignation, and an inability to initiate or complete tasks.

This questionnaire is intended for use with adults exhibiting signs of depression or pervasive negative thinking patterns in clinical or research settings.

When and why to use it

Clinicians typically administer the ATQ-30 when assessing depressive symptoms or structuring a cognitive-focused intervention. It helps pinpoint the specific cognitive distortions fueling the patient's distress.

Intake and baseline assessment: To quantify the initial burden of negative automatic thoughts and inform the treatment plan.
Monitoring cognitive change: To track whether therapeutic techniques successfully challenge automatic thoughts and reduce their frequency across sessions.
Differentiating cognitive profiles: To identify whether a patient's presentation is primarily driven by helplessness, self-hatred, or negative expectations, guiding targeted interventions.
Evaluating treatment efficacy: To objectively measure cognitive symptom reduction before concluding an episode of care.

Using this validated scale provides a standardized metric of cognitive distress that enhances subjective clinical impressions, enabling a more precise tracking of how inner speech evolves during treatment.

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The questions

Listed below are a variety of thoughts that pop into people's heads. Please read each thought and indicate how frequently, if at all, the thought occurred to you over the last week.
1. I have a hard time dealing with the world.
Probes the patient's subjective sense of facing insurmountable external opposition.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
2. I'm no good.
Assesses global negative self-evaluation and fundamental feelings of inadequacy.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
3. Why do I never succeed?
Evaluates the presence of overgeneralization regarding personal failures and achievements.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
4. No one understands me.
Explores feelings of interpersonal alienation and perceived emotional isolation.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
5. I've let others down.
Measures the burden of guilt and the perception of failing others' expectations.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
6. I don't think I can go on.
Assesses cognitive signs of emotional exhaustion and passive resignation.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
7. I wish I were a better person.
Probes feelings of personal deficiency and the longing for fundamental character change.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
8. I'm so weak.
Evaluates self-perceptions of fragility, vulnerability, or lack of resilience.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
9. My life isn't going the way I want it to.
Assesses dissatisfaction with one's current life trajectory and unmet expectations.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
10. I'm disappointed in myself.
Measures the intensity of self-directed frustration and internal criticism.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
11. Nothing is as good as it used to be.
Probes the cognitive experience of anhedonia and the loss of pleasure.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
12. I can't stand this any longer.
Evaluates the patient's perceived inability to tolerate ongoing emotional distress.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
13. I can't get things started.
Assesses cognitive barriers to initiation and the presence of avolition.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
14. What's wrong with me?
Explores pervasive self-doubt and the internal search for personal defects.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
15. I wish I were someone else.
Measures the desire for escapism and avoidance of present circumstances.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
16. I can't make things work.
Probes the subjective experience of disorganization or feeling overwhelmed by daily demands.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
17. I hate myself.
Assesses the presence of acute self-loathing and active self-rejection.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
18. I'm worthless.
Evaluates the absolute devaluation of one's own fundamental value.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
19. I wish I could disappear.
Explores passive suicidal ideation or the profound urge to erase one's presence.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
20. What is wrong with me?
Measures ongoing internal questioning focused on perceived personal brokenness.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
21. I'm a loser.
Assesses the internalization of a defeated, globally negative identity.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
22. My life is a mess.
Probes catastrophic appraisals of one's current circumstances and overall life organization.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
23. I'm a failure.
Evaluates absolute, all-or-nothing self-judgments regarding life outcomes.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
24. I'm not going to make it.
Assesses hopelessness regarding future success and the anticipation of inevitable defeat.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
25. I'm so hopeless.
Measures the perceived lack of agency or control over one's psychological state or environment.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
26. Something has to change.
Explores the urgent, yet often vague, distress-driven recognition of an unsustainable situation.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
27. There must be something wrong with me.
Evaluates the assumption of an underlying, unfixable personal flaw.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
28. My future is bleak.
Assesses the cognitive distortion of fortune-telling paired with profound pessimism.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
29. It's not worth it.
Probes cognitive apathy, resignation, and the devaluation of effort.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time
30. I can't finish things.
Measures cognitive interference related to task completion and sustained focus.
- Not at all
- Sometimes
- Pretty often
- Often
- All the time