Pub Date : 2025-11-01DOI: 10.1016/j.brat.2025.104903
Eliza M. Ferguson, David D.J. Cooper, Jessica R. Grisham
Emerging evidence suggests that rescripting aversive memories related to obsessive-compulsive disorder (OCD) may improve symptoms and OCD-relevant cognitive and affective outcomes. We aimed to validate an online, audio-guided imagery rescripting protocol by comparing it with a focused, thought-listing control. A sample of Prolific online workers (n = 112) with high OCD symptoms identified a memory associated with OCD-related experiences, then were randomly assigned to complete either the rescripting or control task. Select outcomes were re-assessed one-week post-experiment. Feared self-perceptions improved for the rescripting, but not the control condition; these improvements were maintained for idiosyncratic and state feared-self beliefs, but not trait fear-of-self. Participants in the rescripting condition also reported significantly greater reductions in state anxiety and urge to neutralise, compared to controls. No changes were observed in obsessional beliefs for either condition. There were no between-condition differences in engagement in behavioural neutralisation post-experiment. A small but significant increase in reporting OCD symptoms was found at follow-up; this did not differ between conditions and was consistent with heightened awareness of symptoms. These findings provide preliminary evidence that imagery rescripting in a standardised audio-guided format may be an effective adjunctive treatment for OCD to facilitate cognitive and affective change.
{"title":"Evaluation of a brief, online imagery rescripting intervention targeting fear-of-self in high obsessive-compulsive participants","authors":"Eliza M. Ferguson, David D.J. Cooper, Jessica R. Grisham","doi":"10.1016/j.brat.2025.104903","DOIUrl":"10.1016/j.brat.2025.104903","url":null,"abstract":"<div><div>Emerging evidence suggests that rescripting aversive memories related to obsessive-compulsive disorder (OCD) may improve symptoms and OCD-relevant cognitive and affective outcomes. We aimed to validate an online, audio-guided imagery rescripting protocol by comparing it with a focused, thought-listing control. A sample of Prolific online workers (<em>n</em> = 112) with high OCD symptoms identified a memory associated with OCD-related experiences, then were randomly assigned to complete either the rescripting or control task. Select outcomes were re-assessed one-week post-experiment. Feared self-perceptions improved for the rescripting, but not the control condition; these improvements were maintained for idiosyncratic and state feared-self beliefs, but not trait fear-of-self. Participants in the rescripting condition also reported significantly greater reductions in state anxiety and urge to neutralise, compared to controls. No changes were observed in obsessional beliefs for either condition. There were no between-condition differences in engagement in behavioural neutralisation post-experiment. A small but significant increase in reporting OCD symptoms was found at follow-up; this did not differ between conditions and was consistent with heightened awareness of symptoms. These findings provide preliminary evidence that imagery rescripting in a standardised audio-guided format may be an effective adjunctive treatment for OCD to facilitate cognitive and affective change.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"195 ","pages":"Article 104903"},"PeriodicalIF":4.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-31DOI: 10.1016/j.brat.2025.104907
Anton Regorius , Jule Lepper , Christiane A. Melzig , Christoph Benke
Objective
Exposure therapy is a first-line treatment for social anxiety, yet many individuals show limited response or relapse after treatment. Deficits in reward processes have been linked to impaired extinction learning and may undermine exposure efficacy. This study investigated whether supplementing in-vivo exposure with reward-enhancing strategies can improve outcomes for public speaking anxiety, particularly in individuals with elevated anhedonia.
Method
This preregistered study (ClinicalTrials: NCT06258889) randomized 40 adults with public speaking anxiety to: in-vivo exposure paired with reward-focused (EXP + RF) or cognitive restructuring (EXP + CR) techniques. Participants completed a preparatory and exposure session. Outcomes were assessed at baseline, intermediate and post-treatment. Primary outcomes included public speaking anxiety, assessed via Personal Report of Public Speaking Anxiety (PRPSA), and mean fear ratings during a behavioral approach test (BAT; standardized 3-min speech). Baseline anhedonia, assessed via Temporal Experience of Pleasure Scale (TEPS), was examined as a moderator.
Results
Both groups improved significantly in public speaking anxiety and fear during BAT from baseline to post-treatment, with no between-group differences. Exploratory analyses revealed that treatment efficacy in public speaking anxiety differed between treatment groups as a function of individuals’ levels of anhedonia. In individuals with high anhedonia, EXP + RF led to greater reduction in public speaking anxiety than EXP + CR (d = 1.43, p = .04). No differences emerged for low or medium anhedonia. Anhedonia did not moderate other outcomes.
Conclusion
Individuals with elevated anhedonia derived greater benefit from exposure therapy for social anxiety when augmented with reward-enhancing strategies, highlighting treatment optimization in this subgroup and stratified treatment planning.
{"title":"Augmenting in vivo exposure with reward-focused strategies: A randomized controlled trial providing preliminary evidence for improved outcomes in individuals with elevated anhedonia","authors":"Anton Regorius , Jule Lepper , Christiane A. Melzig , Christoph Benke","doi":"10.1016/j.brat.2025.104907","DOIUrl":"10.1016/j.brat.2025.104907","url":null,"abstract":"<div><h3>Objective</h3><div>Exposure therapy is a first-line treatment for social anxiety, yet many individuals show limited response or relapse after treatment. Deficits in reward processes have been linked to impaired extinction learning and may undermine exposure efficacy. This study investigated whether supplementing in-vivo exposure with reward-enhancing strategies can improve outcomes for public speaking anxiety, particularly in individuals with elevated anhedonia.</div></div><div><h3>Method</h3><div>This preregistered study (ClinicalTrials: NCT06258889) randomized 40 adults with public speaking anxiety to: in-vivo exposure paired with reward-focused (EXP + RF) or cognitive restructuring (EXP + CR) techniques. Participants completed a preparatory and exposure session. Outcomes were assessed at baseline, intermediate and post-treatment. Primary outcomes included public speaking anxiety, assessed via <em>Personal Report of Public Speaking Anxiety</em> (PRPSA), and mean fear ratings during a behavioral approach test (BAT; standardized 3-min speech). Baseline anhedonia, assessed via <em>Temporal Experience of Pleasure Scale</em> (TEPS), was examined as a moderator.</div></div><div><h3>Results</h3><div>Both groups improved significantly in public speaking anxiety and fear during BAT from baseline to post-treatment, with no between-group differences. Exploratory analyses revealed that treatment efficacy in public speaking anxiety differed between treatment groups as a function of individuals’ levels of anhedonia. In individuals with high anhedonia, EXP + RF led to greater reduction in public speaking anxiety than EXP + CR (<em>d</em> = 1.43, <em>p</em> = .04). No differences emerged for low or medium anhedonia. Anhedonia did not moderate other outcomes.</div></div><div><h3>Conclusion</h3><div>Individuals with elevated anhedonia derived greater benefit from exposure therapy for social anxiety when augmented with reward-enhancing strategies, highlighting treatment optimization in this subgroup and stratified treatment planning.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"195 ","pages":"Article 104907"},"PeriodicalIF":4.5,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145467150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-30DOI: 10.1016/j.brat.2025.104887
Tomas Meaney , Vijay Yadav , Isaac R. Galatzer-Levy , Richard Bryant
Extensive research on cognitive reappraisal and expressive suppression suggests that they produce distinct emotion outcomes. The present study, conducted in 2021, assessed whether these regulation strategies produced distinctive facial, vocal and linguistic responses to emotionally evocative, negative images relative to control conditions. Participants (N = 65) were asked to describe these images after being instructed to engage in cognitive reappraisal or no regulation, or expressive suppression compared to no regulation. Cognitive reappraisal was distinguished from no regulation by higher levels of vocal activity, more positive speech and less self-reported negative reactions to the images, suggesting that it changed the valence of the elicited emotion. Expressive suppression was distinguished from no regulation by diminished overall facial expressivity, negative facial expressivity and head movement deviation. These patterns indicate that these emotion regulation strategies result in distinct emotional responses across multiple emotional channels.
{"title":"The distinctive digital phenotypes of different emotion regulation strategies","authors":"Tomas Meaney , Vijay Yadav , Isaac R. Galatzer-Levy , Richard Bryant","doi":"10.1016/j.brat.2025.104887","DOIUrl":"10.1016/j.brat.2025.104887","url":null,"abstract":"<div><div>Extensive research on cognitive reappraisal and expressive suppression suggests that they produce distinct emotion outcomes. The present study, conducted in 2021, assessed whether these regulation strategies produced distinctive facial, vocal and linguistic responses to emotionally evocative, negative images relative to control conditions. Participants (N = 65) were asked to describe these images after being instructed to engage in cognitive reappraisal or no regulation, or expressive suppression compared to no regulation. Cognitive reappraisal was distinguished from no regulation by higher levels of vocal activity, more positive speech and less self-reported negative reactions to the images, suggesting that it changed the valence of the elicited emotion. Expressive suppression was distinguished from no regulation by diminished overall facial expressivity, negative facial expressivity and head movement deviation. These patterns indicate that these emotion regulation strategies result in distinct emotional responses across multiple emotional channels.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"195 ","pages":"Article 104887"},"PeriodicalIF":4.5,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145467152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-28DOI: 10.1016/j.brat.2025.104904
Baraah Abu Saleh , Baruch Perlman , Gil Burg , Nilly Mor
Belief updating—the revision of beliefs in light of new evidence—is central to adaptive cognition and emotion regulation yet often disrupted in emotional disorders. This study examines the overlooked process of internally driven inferential update, the capacity to move spontaneously between competing causal explanations for an event regardless of new information. We address two gaps in literature: whether benefits depend on shift direction or on shifting itself, and whether effects persist to the next day. In two studies we tested inference updating for participants’ personally meaningful negative events. On Day 1 they were assigned to one of three conditions: shifting from depressogenic-to-benign inferences, the reverse shift, or a no-shift control condition. Outcomes were assessed immediately after the manipulation and 24 h later. We tested whether change in symptoms depended on shift direction or on the mere flexibility of shifting across inferences, regardless of direction. We further tested whether trait brooding was associated with the effects of shifting. Across studies, immediate benefits—improved mood and reduced state rumination—were specific to the depressogenic-to-benign condition. On Day 2, Study 1 showed that only the depressogenic-to-benign shift increased benign inferences, whereas Study 2 found that both shift directions did so relative to the no-shift condition. Trait brooding affected emotional reactivity and next-day inferences but did not interact with condition. These findings suggest that internally driven inferential shifts are a viable form of belief updating about emotionally-laden events and highlight the clinical utility of inferential flexibility for addressing maladaptive cognitive and emotional processes.
{"title":"Updating inferences about negative events: Does the direction of the update matter?","authors":"Baraah Abu Saleh , Baruch Perlman , Gil Burg , Nilly Mor","doi":"10.1016/j.brat.2025.104904","DOIUrl":"10.1016/j.brat.2025.104904","url":null,"abstract":"<div><div>Belief updating—the revision of beliefs in light of new evidence—is central to adaptive cognition and emotion regulation yet often disrupted in emotional disorders. This study examines the overlooked process of internally driven inferential update, the capacity to move spontaneously between competing causal explanations for an event regardless of new information. We address two gaps in literature: whether benefits depend on shift direction or on shifting itself, and whether effects persist to the next day. In two studies we tested inference updating for participants’ personally meaningful negative events. On Day 1 they were assigned to one of three conditions: shifting from depressogenic-to-benign inferences, the reverse shift, or a no-shift control condition. Outcomes were assessed immediately after the manipulation and 24 h later. We tested whether change in symptoms depended on shift direction or on the mere flexibility of shifting across inferences, regardless of direction. We further tested whether trait brooding was associated with the effects of shifting. Across studies, immediate benefits—improved mood and reduced state rumination—were specific to the depressogenic-to-benign condition. On Day 2, Study 1 showed that only the depressogenic-to-benign shift increased benign inferences, whereas Study 2 found that both shift directions did so relative to the no-shift condition. Trait brooding affected emotional reactivity and next-day inferences but did not interact with condition. These findings suggest that internally driven inferential shifts are a viable form of belief updating about emotionally-laden events and highlight the clinical utility of inferential flexibility for addressing maladaptive cognitive and emotional processes.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"195 ","pages":"Article 104904"},"PeriodicalIF":4.5,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-26DOI: 10.1016/j.brat.2025.104905
Zohar Klein , Reut Zabag , Dan E. Hay , Einat Levy-Gigi , Eva Gilboa-Schechtman
Cognitive models propose that biased information processing in social anxiety (SA) and depression facilitates negative and inhibits the processing of positive self-information. These biases are postulated to reinforce persistent negative views of the self. Biased updating of self-beliefs in response to valanced new information in both SA and depression is theoretically postulated. The results, however, are not fully consistent with theoretical postulations. Importantly, self-information is structured around two main domains - agency (e.g., competence, assertiveness) and communion (e.g., warmth, connectedness). These domains distinctly influence the way information about the self is processed and integrated. However, this distinction is missing from the examination of self-belief updating. The current study examined how individuals update agentic and communal self-beliefs in response to negative and positive social feedback. We employed a novel ‘SocialMirror’ paradigm in a large subclinical sample (N = 560). In this two-phase reversal learning task, participants received negative feedback followed by positive feedback on their personality traits. SA was uniquely associated with increased negative updating of agentic, but not communal, self-beliefs. Depression was uniquely associated with reduced positive updating across both domains. Notably, these findings remained evident even after statistically controlling for initial beliefs. Across the sample, updating was domain dependent, with agentic traits being less malleable. These findings suggest domain- and valence-related patterns of self-belief updating in SA and depression. Results are interpreted in light of Bayesian models, emphasizing the need to integrate motivational aspects into cognitive theory. We highlight the implications of these findings for interventions aimed at updating self-belief in psychopathology.
{"title":"On bias and balance: Updating agentic and communal self-beliefs in social anxiety and depression","authors":"Zohar Klein , Reut Zabag , Dan E. Hay , Einat Levy-Gigi , Eva Gilboa-Schechtman","doi":"10.1016/j.brat.2025.104905","DOIUrl":"10.1016/j.brat.2025.104905","url":null,"abstract":"<div><div>Cognitive models propose that biased information processing in social anxiety (SA) and depression facilitates negative and inhibits the processing of positive self-information. These biases are postulated to reinforce persistent negative views of the self. Biased updating of self-beliefs in response to valanced new information in both SA and depression is theoretically postulated. The results, however, are not fully consistent with theoretical postulations. Importantly, self-information is structured around two main domains - agency (e.g., competence, assertiveness) and communion (e.g., warmth, connectedness). These domains distinctly influence the way information about the self is processed and integrated. However, this distinction is missing from the examination of self-belief updating. The current study examined how individuals update agentic and communal self-beliefs in response to negative and positive social feedback. We employed a novel ‘SocialMirror’ paradigm in a large subclinical sample (N = 560). In this two-phase reversal learning task, participants received negative feedback followed by positive feedback on their personality traits. SA was uniquely associated with increased negative updating of agentic, but not communal, self-beliefs. Depression was uniquely associated with reduced positive updating across both domains. Notably, these findings remained evident even after statistically controlling for initial beliefs. Across the sample, updating was domain dependent, with agentic traits being less malleable. These findings suggest domain- and valence-related patterns of self-belief updating in SA and depression. Results are interpreted in light of Bayesian models, emphasizing the need to integrate motivational aspects into cognitive theory. We highlight the implications of these findings for interventions aimed at updating self-belief in psychopathology.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"195 ","pages":"Article 104905"},"PeriodicalIF":4.5,"publicationDate":"2025-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-26DOI: 10.1016/j.brat.2025.104906
Luigi A.E. Degni , Claudio Danti , Gianluca Finotti , Francesca Starita , Giuseppe di Pellegrino , Sara Garofalo
Value-based decisions are often biased by Pavlovian cues in the environment, but it remains unclear how such biases affect optimal decision-making in humans. To address this, we used a novel variant of the Pavlovian-to-Instrumental Transfer (PIT) paradigm. Participants first learned to prefer a richer option (70 % reward probability) over a poorer one (30 %) in order to maximize rewards. A baiting rule was implemented, whereby each option's reward probability increased the longer it was not selected, rendering reward matching (i.e., aligning choice proportions with reward probabilities) a close approximation of the optimal strategy. Pavlovian cues predictive of either option were then introduced during decision-making. Results showed that Pavlovian bias disrupted optimal behavior, impairing reward maximization under both nominal extinction and rewarded conditions. This effect was replicated in an independent sample. In a third experiment, weakening the cue-outcome association during Pavlovian learning reduced the bias, suggesting a causal role of cue predictiveness. Together, these findings demonstrate that Pavlovian cues can produce maladaptive choice patterns, with implications for understanding and potentially mitigating behaviors linked to impulsivity and addiction.
{"title":"Pavlovian bias instigates suboptimal choices in humans","authors":"Luigi A.E. Degni , Claudio Danti , Gianluca Finotti , Francesca Starita , Giuseppe di Pellegrino , Sara Garofalo","doi":"10.1016/j.brat.2025.104906","DOIUrl":"10.1016/j.brat.2025.104906","url":null,"abstract":"<div><div>Value-based decisions are often biased by Pavlovian cues in the environment, but it remains unclear how such biases affect optimal decision-making in humans. To address this, we used a novel variant of the Pavlovian-to-Instrumental Transfer (PIT) paradigm. Participants first learned to prefer a richer option (70 % reward probability) over a poorer one (30 %) in order to maximize rewards. A baiting rule was implemented, whereby each option's reward probability increased the longer it was not selected, rendering reward matching (i.e., aligning choice proportions with reward probabilities) a close approximation of the optimal strategy. Pavlovian cues predictive of either option were then introduced during decision-making. Results showed that Pavlovian bias disrupted optimal behavior, impairing reward maximization under both nominal extinction and rewarded conditions. This effect was replicated in an independent sample. In a third experiment, weakening the cue-outcome association during Pavlovian learning reduced the bias, suggesting a causal role of cue predictiveness. Together, these findings demonstrate that Pavlovian cues can produce maladaptive choice patterns, with implications for understanding and potentially mitigating behaviors linked to impulsivity and addiction.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"195 ","pages":"Article 104906"},"PeriodicalIF":4.5,"publicationDate":"2025-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-25DOI: 10.1016/j.brat.2025.104902
Shir Porat-Butman , Görkem Ayas , Stefanie Rita Balle , Julia Carranza-Neira , Natalia E. Fares-Otero , Alla Hemi , Billy Jansson , Antonia Lüönd , Tanja Michael , Dany Laure Wadji , Misari Oe , Roxanne M. Sopp , Tanya Tandon , Ulrich Schnyder , Monique Pfaltz , Einat Levy-Gigi
Childhood maltreatment (CM), defined as caregiver-perpetrated abuse or neglect during childhood or adolescence, is associated with enduring social dysfunction. Adults with a history of CM often maintain greater interpersonal distance from both friends and strangers, regardless of relational closeness. Predictive-processing models suggest that such impairments may stem from the development of overly precise negative beliefs about others, which are resistant to updating, even in the face of contradictory information. The current study investigated whether the ability to form and update social beliefs varies as a function of CM history, and whether belief updating moderates the association between CM and posttraumatic stress disorder (PTSD) symptoms following trauma exposure in adulthood. One hundred and eighteen participants completed a battery of questionnaires and a performance-based task assessing belief formation and updating about friends and strangers. Results indicated no CM-related differences in initial belief formation. However, as predicted, adults with a CM history showed impaired belief updating when interacting with strangers. Importantly, deficits in stranger-related belief updating moderated the relationship between CM severity and PTSD symptoms: those with poor updating showed a stronger association between CM and PTSD, while those with greater flexibility in belief updating reported low symptom levels regardless of maltreatment severity. These findings suggest that CM may disrupt adaptive belief updating in interpersonal contexts, contributing to later vulnerability to psychopathology. The results highlight the potential value of targeting social cognitive processes, particularly belief updating, in interventions aimed at improving social functioning and psychological resilience among individuals with a history of CM.
{"title":"From maltreatment to mistrust: Impaired belief updating as a mechanism linking childhood maltreatment to interpersonal and clinical outcomes","authors":"Shir Porat-Butman , Görkem Ayas , Stefanie Rita Balle , Julia Carranza-Neira , Natalia E. Fares-Otero , Alla Hemi , Billy Jansson , Antonia Lüönd , Tanja Michael , Dany Laure Wadji , Misari Oe , Roxanne M. Sopp , Tanya Tandon , Ulrich Schnyder , Monique Pfaltz , Einat Levy-Gigi","doi":"10.1016/j.brat.2025.104902","DOIUrl":"10.1016/j.brat.2025.104902","url":null,"abstract":"<div><div>Childhood maltreatment (CM), defined as caregiver-perpetrated abuse or neglect during childhood or adolescence, is associated with enduring social dysfunction. Adults with a history of CM often maintain greater interpersonal distance from both friends and strangers, regardless of relational closeness. Predictive-processing models suggest that such impairments may stem from the development of overly precise negative beliefs about others, which are resistant to updating, even in the face of contradictory information. The current study investigated whether the ability to form and update social beliefs varies as a function of CM history, and whether belief updating moderates the association between CM and posttraumatic stress disorder (PTSD) symptoms following trauma exposure in adulthood. One hundred and eighteen participants completed a battery of questionnaires and a performance-based task assessing belief formation and updating about friends and strangers. Results indicated no CM-related differences in initial belief formation. However, as predicted, adults with a CM history showed impaired belief updating when interacting with strangers. Importantly, deficits in stranger-related belief updating moderated the relationship between CM severity and PTSD symptoms: those with poor updating showed a stronger association between CM and PTSD, while those with greater flexibility in belief updating reported low symptom levels regardless of maltreatment severity. These findings suggest that CM may disrupt adaptive belief updating in interpersonal contexts, contributing to later vulnerability to psychopathology. The results highlight the potential value of targeting social cognitive processes, particularly belief updating, in interventions aimed at improving social functioning and psychological resilience among individuals with a history of CM.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"195 ","pages":"Article 104902"},"PeriodicalIF":4.5,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-24DOI: 10.1016/j.brat.2025.104900
Maximilian Blomberg , Rachel Schaper , Anahita Bonabi , Johanna Sophie Oppermann , Hilmar Zech , Wally Wünsch-Leiteritz , Timo Brockmeyer
Background
Effective treatments for anorexia nervosa (AN) are available, yet many patients do not respond to treatment or experience relapse. Cognitive bias modification aims to ameliorate cognitive biases that are assumed to contribute to the development and maintenance of AN. This study examines the efficacy of a novel mobile approach-avoidance bias modification training (ABMT) with food cues for AN.
Method
In this RCT, 90 inpatients with AN received six sessions of active or sham ABMT with food cues or no training, alongside treatment-as-usual. Primary outcome was self-reported eating disorder psychopathology; secondary outcomes included food-related approach-avoidance bias, fear of food, and BMI. Outcomes were assessed at baseline, end-of-training and at 6-month follow-up.
Results
Active ABMT did not result in greater reductions in eating disorder psychopathology. Similarly, treatment conditions did not differ regarding in change in BMI, approach-avoidance bias or fear of food, neither in the short term nor in the long term. Changes in approach-avoidance bias did not mediate training effects on any outcomes.
Conclusions
This first RCT on ABMT for AN found no superiority of active ABMT over sham or no ABMT in reducing eating disorder psychopathology. ABMT also appeared insufficient to alter food-related approach bias. Mobile ABMT with food cues in its current form does not seem to be an efficacious adjunct treatment to inpatient TAU for patients with AN. Further research may explore whether modified training protocols and personalized approaches are more promising in this regard.
Trial registration
This study's design was registered at the German Clinical Trials Register [https://trialsearch.who.int/Trial2.aspx?TrialID=DRKS00022078]
{"title":"Smartphone-based approach-avoidance bias modification training for anorexia nervosa - A randomized clinical trial","authors":"Maximilian Blomberg , Rachel Schaper , Anahita Bonabi , Johanna Sophie Oppermann , Hilmar Zech , Wally Wünsch-Leiteritz , Timo Brockmeyer","doi":"10.1016/j.brat.2025.104900","DOIUrl":"10.1016/j.brat.2025.104900","url":null,"abstract":"<div><h3>Background</h3><div>Effective treatments for anorexia nervosa (AN) are available, yet many patients do not respond to treatment or experience relapse. Cognitive bias modification aims to ameliorate cognitive biases that are assumed to contribute to the development and maintenance of AN. This study examines the efficacy of a novel mobile approach-avoidance bias modification training (ABMT) with food cues for AN.</div></div><div><h3>Method</h3><div>In this RCT, 90 inpatients with AN received six sessions of active or sham ABMT with food cues or no training, alongside treatment-as-usual. Primary outcome was self-reported eating disorder psychopathology; secondary outcomes included food-related approach-avoidance bias, fear of food, and BMI. Outcomes were assessed at baseline, end-of-training and at 6-month follow-up.</div></div><div><h3>Results</h3><div>Active ABMT did not result in greater reductions in eating disorder psychopathology. Similarly, treatment conditions did not differ regarding in change in BMI, approach-avoidance bias or fear of food, neither in the short term nor in the long term. Changes in approach-avoidance bias did not mediate training effects on any outcomes.</div></div><div><h3>Conclusions</h3><div>This first RCT on ABMT for AN found no superiority of active ABMT over sham or no ABMT in reducing eating disorder psychopathology. ABMT also appeared insufficient to alter food-related approach bias. Mobile ABMT with food cues in its current form does not seem to be an efficacious adjunct treatment to inpatient TAU for patients with AN. Further research may explore whether modified training protocols and personalized approaches are more promising in this regard.</div></div><div><h3>Trial registration</h3><div>This study's design was registered at the German Clinical Trials Register [<span><span>https://trialsearch.who.int/Trial2.aspx?TrialID=DRKS00022078</span><svg><path></path></svg></span>]</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"195 ","pages":"Article 104900"},"PeriodicalIF":4.5,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145394340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-23DOI: 10.1016/j.brat.2025.104899
Nele Assmann , Tim Kaiser , Philipp Herzog , Arnoud Arntz , Jan Philipp Klein , Eva Fassbinder , Anja Schaich
Background
Borderline personality disorder (BPD) can be treated successfully with specific psychological treatments, but there is no clear evidence of superiority of one specific treatment at the group level. Due to high heterogeneity in BPD, individual patients might benefit differently from specific treatments.
Methods
Based on a randomised trial comparing 18 months of dialectical behaviour therapy (DBT) and schema therapy (ST) for BPD, differential effectiveness was examined using causal forest analyses. Baseline variables on BPD criteria, general psychopathology, traumatic childhood experiences, rejection sensitivity, level of functioning, coping skills, schemas and medication were included to predict the Borderline Personality Disorder Severity Index (BPDSI-IV) during treatment and follow-up (24 and 30 months after start of treatment).
Results
A subgroup was identified that benefited significantly more from DBT compared to ST. This group showed a significantly greater reduction in symptoms post treatment (post-treatment difference of 5.79 BPDSI points, SMD = 0.65, p = .028), but no longer at follow-up (p = .771). The group that showed better results with DBT displayed a pattern of specific baseline characteristics: higher levels of functioning, less frequent emotional neglect and sexual abuse, more severe anxiety symptoms and more pronounced schema ’failure to achieve’. No pattern of variables was identified associated with a superiority of ST.
Conclusion
Moderators of the short-term effect of DBT versus ST were found. However, this moderator effect was no longer significant at follow-up. Identifying patient characteristics associated with differential treatment effect might be a promising way to improve BPD treatment outcomes faster.
Retrospectively registered (German Clinical Trials Register: DRKS00011534) without protocol changes.
边缘型人格障碍（BPD）可以通过特定的心理治疗成功治疗，但没有明确的证据表明一种特定的治疗方法在群体水平上具有优势。由于BPD的高度异质性，个体患者可能从特定治疗中获益不同。方法基于一项比较18个月辩证行为疗法（DBT）和图式疗法（ST）治疗BPD的随机试验，使用因果森林分析来检验差异效果。在治疗和随访期间（治疗开始后24个月和30个月），包括BPD标准、一般精神病理学、创伤性童年经历、排斥敏感性、功能水平、应对技能、图式和药物治疗等基线变量来预测边缘型人格障碍严重程度指数（BPDSI-IV）。结果发现有一个亚组从DBT中获益明显多于st，该组治疗后症状的减轻明显更大（治疗后BPDSI点差异为5.79,SMD = 0.65, p = 0.028），但在随访时不再如此（p = 0.771）。在DBT中表现出较好结果的那一组表现出特定的基线特征模式：更高的功能水平，更少的情感忽视和性虐待，更严重的焦虑症状和更明显的“失败”模式。没有发现与ST的优势相关的变量模式。结论：发现了DBT与ST的短期效果的调节因子。然而，这种调节效应在随访中不再显著。识别与不同治疗效果相关的患者特征可能是更快改善BPD治疗结果的有希望的方法。回顾性注册（德国临床试验注册：DRKS00011534），未更改方案。
{"title":"Differential effectiveness of dialectical behavioural therapy and schema therapy in patients with borderline personality disorder: a secondary analysis of a randomised clinical trial","authors":"Nele Assmann , Tim Kaiser , Philipp Herzog , Arnoud Arntz , Jan Philipp Klein , Eva Fassbinder , Anja Schaich","doi":"10.1016/j.brat.2025.104899","DOIUrl":"10.1016/j.brat.2025.104899","url":null,"abstract":"<div><h3>Background</h3><div>Borderline personality disorder (BPD) can be treated successfully with specific psychological treatments, but there is no clear evidence of superiority of one specific treatment at the group level. Due to high heterogeneity in BPD, individual patients might benefit differently from specific treatments.</div></div><div><h3>Methods</h3><div>Based on a randomised trial comparing 18 months of dialectical behaviour therapy (DBT) and schema therapy (ST) for BPD, differential effectiveness was examined using causal forest analyses. Baseline variables on BPD criteria, general psychopathology, traumatic childhood experiences, rejection sensitivity, level of functioning, coping skills, schemas and medication were included to predict the Borderline Personality Disorder Severity Index (BPDSI-IV) during treatment and follow-up (24 and 30 months after start of treatment).</div></div><div><h3>Results</h3><div>A subgroup was identified that benefited significantly more from DBT compared to ST. This group showed a significantly greater reduction in symptoms post treatment (post-treatment difference of 5.79 BPDSI points, SMD = 0.65, p = .028), but no longer at follow-up (p = .771). The group that showed better results with DBT displayed a pattern of specific baseline characteristics: higher levels of functioning, less frequent emotional neglect and sexual abuse, more severe anxiety symptoms and more pronounced schema ’failure to achieve’. No pattern of variables was identified associated with a superiority of ST.</div></div><div><h3>Conclusion</h3><div>Moderators of the short-term effect of DBT versus ST were found. However, this moderator effect was no longer significant at follow-up. Identifying patient characteristics associated with differential treatment effect might be a promising way to improve BPD treatment outcomes faster.</div><div>Retrospectively registered (German Clinical Trials Register: DRKS00011534) without protocol changes.</div></div>","PeriodicalId":48457,"journal":{"name":"Behaviour Research and Therapy","volume":"195 ","pages":"Article 104899"},"PeriodicalIF":4.5,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145418873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-22DOI: 10.1016/j.brat.2025.104901
Liav Sommerfeld , Tom Zalmenson , Amit Lazarov , Yair Bar-Haim
Social anxiety is characterized by persistent fear of social situations and has been associated with information processing biases, including aberrant memory for social information. Although social situations are rich in contextual cues, little is known about context-dependent memory processes in social anxiety. Here, context-dependent memory was studied in participants with high vs. low social anxiety. We tested whether contextual congruency between encoding and retrieval influences memory for social (faces) versus non-social (houses) stimuli. Participants (N = 231; high social anxiety n = 118, low social anxiety n = 113) completed a recognition memory task of either faces or houses presented against colored backgrounds. During a recognition test, old stimuli were presented with either encoding-congruent or incongruent background colors, along with new stimuli. Participants were asked to make old/new judgments. Memory performance was measured using sensitivity (d') scores. A significant three-way interaction between group, task, and congruency indicated that individuals with high social anxiety showed enhanced context-dependent memory specifically for faces, but not for houses. No such effect was observed in individuals with low social anxiety. These findings indicate that individuals with high social anxiety demonstrate an enhanced and specific context-dependent memory effect for social stimuli. This domain-specific memory enhancement suggests that memory biases in social anxiety manifest, at least in part, through differential processing of contextual information.
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