Low Perceived Self-Efficacy Impedes Discriminative Fear Learning

Feeling more confident to encounter negative emotions: The mediating role of distress tolerance on the relationship between self-efficacy and outcomes of exposure and response prevention for OCD

BACKGROUND

While exposure and response prevention (ERP) is the first-line treatment for obsessive-compulsive disorder (OCD), up to half of patients do not effectively respond. In an effort to better understand the mechanisms behind ERP, the inhibitory learning model emphasizes the roles of increasing perceived self-efficacy and distress tolerance. While self-efficacy and distress tolerance have separately been shown to predict OCD symptoms and treatment outcomes, no studies have assessed their joint effects in ERP. The current study examined distress tolerance as a mediator of the relationship between self-efficacy and ERP outcomes.

METHODS

Patients in an intensive ERP-based treatment program (N = 116) completed weekly self-report measures.

RESULTS

Over the course of treatment, as OCD symptoms reduced, self-efficacy and distress tolerance both significantly increased. Importantly, increases in self-efficacy and distress tolerance mediated each other in explaining symptom reduction, suggesting a possible bi-directional effect.

LIMITATIONS

The temporal relationship between changes in self-efficacy and distress tolerance is worthy of further investigation. In addition, the current sample had limited racial diversity and might not be representative of patients receiving lower levels of care. Findings merit replication to be ascertained of their reliability.

CONCLUSIONS

Findings suggest that during ERP, patients gain confidence in their abilities both to cope with general challenges and to withstand distress, potentially helping them engage with exposures and overcome initial fears. These findings provide support for the inhibitory learning model and highlight the mechanistic roles of self-efficacy and distress tolerance in ERP. Clinical implications to target both in treatment are discussed.

Understanding Health-Promoting Behaviors and Influential Factors in Schizophrenia Patients

(1) Background: People who are diagnosed with schizophrenia experience a reduced average lifespan compared to the general population. Also, approximately 85% of individuals with schizophrenia have chronic physical illnesses. Moreover, 60% of premature deaths in this population could be prevented through the adoption of health-promoting behaviors. (2) Methods: This study involved the recruitment of 220 participants from an outpatient clinic in Seoul, South Korea. Inclusion criteria comprised adults aged 19 years or older with a confirmed diagnosis of schizophrenia. Data collection occurred between 25 May 2021 and 2 August 2021, utilizing self-report questionnaires. A total of 202 responses were subjected to analysis using SPSS 23.0 and AMOS 23.0. (3) Results: The findings indicate that the final model is characterized by the following values: Normed x2 = 2.240, RMSEA = 0.079, TLI = 0.926, x2 = 562.2 (p < 0.001), AGFI = 0.830, GFI = 0.814, and CFI = 0.938. Notably, health knowledge did not exhibit a significant direct or overall impact on health-promoting behaviors. Conversely, social support and psychiatric symptoms demonstrated direct, indirect, and total effects on health promotion through an intervening variable. This study underscores the pivotal role of self-efficacy as the most influential factor affecting health-promoting behaviors in individuals with schizophrenia. (4) Conclusions: enhancing self-efficacy emerges as a crucial element in the design and implementation of intervention programs aimed at improving health-promoting behaviors in individuals with schizophrenia.

Recognition memory, primacy vs. recency effects, and time perception in the online version of the fear of scream paradigm

Anxiety disorders are characterized by cognitive dysfunctions which contribute to the patient’s profound disabilities. The threat of shock paradigm represents a validated psychopathological model of anxiety to measure the impact of anxiety on cognitive processes. We have developed an online version of the threat of scream paradigm (ToSP) to investigate the impact of experimental anxiety on recognition memory. Two animated passive walkthrough videos (either under threat of scream or safety conditions) were shown to healthy participants. Recognition memory, primacy vs. recency effects, and subjective estimations of the length of encoding sessions were assessed. Subjective anxiety, stress, and emotional arousal ratings indicated that experimental anxiety could successfully be induced (Safe-Threat) or reversed (Threat-Safe) between the two passive walkthrough sessions. Participants exposed to distress screams showed impaired retrieval of complex information that has been presented in an animated environment. In the threat condition, participants failed to recognize details related to the persons encountered, their spatial locations, as well as information about the temporal order and sequence of encounters. Participant groups, which received a threat announcement prior to the first walkthrough session (Threat-Threat vs. Safety-Safety and Threat-Safety vs. Safety-Threat) showed poorer recognition memory as compared to the groups that received a safety announcement (P = 0.0468 and P = 0.0426, respectively; Mann–Whitney U test, Cohen’s d = 0.5071; effect size r = 0.2458). In conclusion, experimental anxiety induced by the online version of the ToSP leads to compromised recognition memory for complex multi-dimensional information. Our results indicate that cognitive functions of vulnerable populations (with limited mobility) can be evaluated online by means of the ToSP.

A Decade in Review: A Systematic Review of Virtual Reality Interventions for Emotional Disorders

Research is increasingly demonstrating the therapeutic benefits of virtual reality interventions for various mental health conditions, though these rarely translate from research to application in clinical settings. This systematic review aims to examine the efficacy of current virtual reality interventions for emotional disorders, with a focus on clinical and technological features that influence translation of treatments from research to clinical practice. A comprehensive systematic literature search was conducted following PRISMA guidelines, for studies including the application of a virtual reality intervention to a clinical population of adults with an emotional disorder. Thirty-seven eligible studies were identified, appraised, and assessed for bias. Treatment effects were typically large across studies, with virtual reality being considered an efficacious treatment modality for various anxiety disorders and post-traumatic stress disorder. Virtual reality interventions were typically used for delivering exposure in cognitive behavioural therapy approaches. Considerable variability was seen in cost, technological specifications, degree of therapist involvement, delivery format, dosage, duration, and frequency of treatment. Suboptimal methodological rigour was identified in some studies. Remote use of virtual reality was rare, despite increasing options for in home use. Virtual reality interventions have the potential to overcome barriers to care and better meet the needs of consumers. Future research should examine the efficacy of virtual reality for treatment of depressive disorders and obsesive compulsive disorder. Improved methodological reporting and development of transdiagnostic and remotely delivered virtual reality interventions, will likely increase the translation of this treatment modality.

Three Needs and Information Anxiety on Knowledge Purchase Intentions across Online Knowledge Platforms

Given the recent advances in technology, knowledge-based products have become increasingly prevalent. Many companies offer interdisciplinary resources for incumbent learners to break through chronological and geographical constraints. Therefore, it is important to investigate the factors that motivate learners to pay for knowledge-based products. The purpose of this research was to identify the relevant factors that contribute to purchasing intentions and to clarify the reasons why people purchase knowledge-based products. This study involved 406 valid participants over 20 years of age with knowledge purchase experience. The results demonstrated that incumbent learners' need for affiliation has a positive effect on involvement, and that involvement has a significant positive impact on knowledge purchase intentions. The key factor influencing learners to pay for knowledge-based products is their involvement in learning. Information anxiety interferes with the relationship between involvement and knowledge purchase intentions. However, no linear relationship was found between cognitive styles and involvement. Field-dependent learners show greater involvement and also information anxiety than field-independent learners. The research offers suggestions for practical use and future research from the perspective of knowledge-product marketing.