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 24h 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.

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.

Previous research has provided valuable insights into associations of belief updating with aspects of psychopathology. However, prior work was mostly based on laboratory studies or scenario-based tasks. Thus, applications to everyday life situations are unclear. To address this limitation, the present study employed an Ecological Momentary Assessment (EMA) design to examine change in interpersonal expectations following interpersonal experiences and its relationship with depressive symptoms, assessed once at baseline. After a baseline assessment, a non-clinical sample (N=43, age 18-66, 67% female) indicated their interpersonal expectations in the morning and actual interpersonal experiences as well as updated expectations in the evening over 18 days. Multi-level modelling shows that, consistent with associative learning models, participants updated their beliefs the more, the greater the expectation-outcome discrepancy was - irrespective of the valence of the discrepancy. When considering the valence of the expectation-outcome discrepancy, participants updated their beliefs more towards better-than-expected than towards worse-than-expected experiences, in line with the optimistic update bias. Depressive symptoms were associated with increased updating in a negative direction after worse-than-expected experiences, but not with reduced updating in a positive direction after better-than-expected experiences. These findings provide proof-of-principle evidence for investigating biased belief updating using EMA.

Responses to exposure therapy vary across individuals, emphasizing the need for a deeper understanding of its underlying mechanisms. This study examined two key processes during exposure that serve as readouts of different clinical rationales: (1) within-session fear reduction (measured as the decline from peak to end fear within an exposure exercise) and (2) threat expectancy processes (assessed via expectancy violation, expectancy change, and learning rate). Data from 516 patients with anxiety disorders who completed at least 10 exposure exercises in a clinical trial were analyzed. Results showed that expectancy measures and fear reduction were only weakly correlated within exposure exercises. While no significant differences were found in their time courses, both readouts independently predicted treatment success. Specifically, a higher learning rate and greater relative fear reduction were associated with better outcomes. These findings highlight the clinical relevance of monitoring fear reduction and expectancy-related readouts as indicators of two distinct exposure rationales - the fear reduction rationale and the threat expectancy rationale. Although it remains unclear whether they reflect separate mechanisms of change or different aspects of a shared mechanism, addressing both rationales may help optimize and personalize exposure therapy.

Health-related quality of life (HRQOL) adds important information about the quality and usefulness of interventions. It has not previously been examined in school-based indicated prevention for anxiety in adolescents. Using secondary analyses of data from a randomized controlled trial of cognitive behavioral therapy (CBT) interventions for anxious adolescents (N=302; mean age 14), we examined whether HRQOL increased during and after treatment. Additionally, we examined whether changes and pre-treatment levels in anxiety and depression symptoms predicted changes in and final levels of HRQOL. This was done using latent growth curve modeling. Results showed that the interventions increased levels of HRQOL and that the levels of HRQOL were sustained at 1-year follow-up, independent of the timing of change. Pre-treatment levels and changes in symptoms of anxiety and depression predicted the changes and final levels in HRQOL. The results indicate that the school-based indicated-preventive interventions may have benefits on HRQOL in addition to reduction in symptoms of anxiety and depression and that these benefits are associated with changes in symptoms.

A core element of EMDR therapy is that a patient recalls a traumatic memory while concurrently making horizontal eye movements. Experimental studies show that performing such tasks simultaneously (i.e., Recall+Dual-Task) reduces the memory's vividness and unpleasantness. Memory age may act as a boundary condition on this effect as older memories have been more consolidated and strengthened over time compared to more recently formed memories, making older memories less susceptible to change. To investigate this, participants (N=195) in Experiment 1 recalled an old or a new negative autobiographical memory and were randomly assigned to a Recall+Dual-Task intervention or a Recall Only intervention. Before, during, and after the intervention the memory was rated on vividness and unpleasantness. In Experiment 2 (N = 356) a follow-up rating was added one day later to test for delayed effects of memory age on intervention effectiveness. Collectively, the two experiments show that Recall+Dual-Task immediately reduces memory vividness and unpleasantness compared to Recall Only. For unpleasantness this differential effect remained one day later. However, none of the effects were moderated by memory age. Thus, these findings suggest that memory age is not a boundary condition for dual-task effectiveness and that dual-task interventions (as used in EMDR) could be similarly effective for reducing the intensity of emotional memories of different ages.

Anxiety disorders are the most prevalent mental health problems in childhood and adolescence, highlighting the importance to study their underlying mechanisms. One key process in fear reduction, particularly in exposure-based cognitive behavioral therapy, is extinction learning. While extensively studied in adults, its role in youth remains underexplored. The aim of the present study was to examine fear extinction learning and return of fear in a large sample of children and adolescents (N=274; age range 8-16 years, M=11.07, SD=2.22; 55.8% female) with separation anxiety disorder, social anxiety disorder, and specific phobia (n=217) in comparison to non-anxious controls (n=57). All children participated in a 2-day fear conditioning paradigm. Fear acquisition, extinction, and reinstatement were assessed using subjective (valence, arousal, contingency) and psychophysiological (startle) indicators of emotional reactivity. Successful differential fear acquisition could be observed in both groups. Extinction learning was also successful as the fear response to the CS+decreased. Contradicting previous findings suggesting impairment in extinction in children with anxiety disorders, we could not find differences in fear extinction learning between anxious and non-anxious children and adolescents; both groups learned to inhibit their fear response when the CS+no longer predicted the occurrence of the aversive outcome. Further research is needed to disentangle the role of fear extinction learning within childhood anxiety disorders and determine whether children with anxiety disorders generally do not show deficits in extinction learning or whether this deficit is limited to disorder specific stimuli.

Despite the remarkable progress in developing effective psychological interventions for emotional disorders, our understanding of the mechanisms driving therapeutic change remains strikingly limited. To bridge this gap, we need to refine experimental paradigms with high ecological validity and establish their clinical utility. In this study, we replicate and extend previous findings that the Trier Social Stress Test (TSST) can evoke persistent, sensory rich, and personally meaningful emotional memories. One week after the TSST, a student sample (N=146) reported greater negative valence, arousal, and lack of control in response to TSST-related versus control cues. Participants reported intrusive memories, the content of which reflects the personal relevance, sensory richness, and emotionality of the TSST memory. Re-imagining the TSST through guided imagery evoked heightened emotional responses (skin conductance, heart rate, and self-report) and participants evaluated themselves more negatively due to the TSST. These effects correlated with trait anxiety. However, comparisons to a naïve sample that only experienced the TSST through guided imagery (N=38) revealed that some findings, including changes in self-image, were not memory-induced. We conclude with concrete examples of how the paradigm can expand our toolset to further unravel mechanistic underpinnings of memory-focused interventions.

Previous research on biased expectation change has mainly focused on the mechanisms underlying the deficient processing of novel positive information at the individual level. Yet, it is less clear whether also characteristics of the person who provides new learning experiences influence the modification of negative expectations. To approach this question, we tested whether the perceived warmth and competence of a person who provides positive performance feedback influences the extent to which performance expectations change. Participants from a non-clinical sample (N=146) were randomly assigned to one of three experimental conditions which manipulated the experimenter's interpersonal behaviour in terms of warmth and competence: augmented, limited, control group (minimal physical contact). All participants received the same positive feedback for their performance in an emotion recognition test. Warmth and competence were successfully manipulated, with large effects, but this did not lead to differences in expectation change. Instead, positive post-feedback expectations were associated with low cognitive immunisation and high perceived cognitive value of the feedback across groups. The findings suggest that changing negative performance expectations through positive feedback is possible and mainly depends on the perception of the content of the feedback, while characteristics of the feedback-providing person are less relevant.