Currently submitted to: JMIR Mental Health
Date Submitted: Apr 30, 2026
Open Peer Review Period: May 1, 2026 - Jun 26, 2026
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Was Epictetus Right? Do Feelings REALLY Result from Thoughts?
ABSTRACT
Does belief in negative thoughts cause emotional suffering? Drawing from Epictetus and modern CBT, we tested this question using nonrecursive structural equation modeling (SEM) on real-time app data. In a cohort of 290 beta testers, belief in negative thoughts (NT) had a strong causal effect on negative feelings (NF), while reverse causation was negligible and no third-variable confounds were detected. These findings replicated in a second cohort of 6,690 commercial users of a newer, chatbot-guided app. Again, NT → NF remained robust, NF → NT was weak, and third-variable effects appeared only after extended chatbot interaction. Belief in the cognitive model predicted greater emotional relief, and users’ change expectations were remarkably accurate. Pre-post reductions in NT and NF were large and rapid—often within days. These results affirm the core claim of cognitive therapy: distorted beliefs drive emotional distress. Digital TEAM-CBT may offer scalable, AI-augmented mental health tools that rival therapist-delivered treatment.
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