Evaluation (the process attributing value to outcomes) underlies “hot” aspects of cognition, such as emotion, affect, and motivation. In several psychopathologies, such as depression and addiction, impairments in evaluation are critical. Contemporary theories highlight the reference-dependent nature of evaluation, whereby outcomes are evaluated relative to their context. Surprisingly, reference-dependent evaluation remains to be explored in the context of psychopathology. We offer a computational theory of how impaired reference-dependent evaluation might underlie mental illness. The theory proposes that evaluation derives from comparing an outcome against a reference point parameter and by weighting any discrepancy by an uncertainty parameter. Maladaptive evaluation is proposed to occur when these parameters do not reflect the true context statistics. Depending on which parameter is altered, different forms of maladaptive evaluation emerge, each associated with specific clinical conditions. This model highlights how the concept of reference-dependent evaluation can elucidate several clinical conditions, including perfectionism, depression, and addiction.