In the recent methodological literature, various models have been proposed to account for the phenomenon that reversed items (defined as items for which respondents' scores have to be recoded in order to make the direction of keying consistent across all items) tend to lead to problematic responses. In this article we propose an integrative conceptualization of three important sources of reversed item method bias (acquiescence, careless responding, and confirmation bias) and specify a multisample confirmatory factor analysis model with 2 method factors to empirically test the hypothesized mechanisms, using explicit measures of acquiescence and carelessness and experimentally manipulated versions of a questionnaire that varies 3 item arrangements and the keying direction of the first item measuring the focal construct. We explain the mechanisms, review prior attempts to model reversed item bias, present our new model, and apply it to responses to a 4-item self-esteem scale (N = 306) and the 6-item Revised Life Orientation Test (N = 595). Based on the literature review and the empirical results, we formulate recommendations on how to use reversed items in questionnaires.