Randomized Controlled Trial on Imaginal Retraining for Problematic Alcohol Use: A Dismantling Study.

Imaginal retraining (IR) is an approach-avoidance procedure that has shown promising results in previous studies. The aim of the present study was to dismantle the efficacy of IR's components in a randomized controlled trial (RCT). We conducted a RCT with nine conditions comprising eight intervention groups and a waitlist control group (WLC). Alcohol craving (primary outcome), consumption, depressive symptoms, quality of life, subjective appraisal, and side effects were assessed online at baseline, post intervention (6 weeks), and follow-up (12 weeks). The sample consisted of 426 participants (age: M = 47.22, SD = 11.82, women: 50.5%). The intervention groups received instructions for four different components of IR (mood induction, mental avoidance of unhealthy stimuli, motor avoidance of unhealthy stimuli, approach to healthy stimuli) that were each conveyed with or without prior psychoeducation (PE). The intervention was delivered online. At total of 163 individuals (42.9%) used the intervention at least once. No group differences were found for any primary or secondary outcome after Sidák correction. Uncorrected statistics showed effects of significantly decreased alcohol consumption for the approach + PE group in the intention-to-treat and the merged motor avoidance group in the per-protocol analyses at post assessment compared with the WLC. Exploratory moderation analyses revealed that individuals with high visualization skills benefited most. The authors conclude that visualization training and motivational components may increase the efficacy and adherence of IR.

Too much of a good thing? Hand hygiene and the long-term course of contamination-related obsessive-compulsive symptoms.

Increased hygiene behavior may be a factor in the development of contamination-related obsessive-compulsive symptoms (C-OCS). We aimed at investigating (1) the course of C-OCS over 1 year after the start of the COVID-19 pandemic and (2) the effects of changes in hand hygiene (i.e., duration and frequency of handwashing) and related distress regulation on the long-term course of C-OCS. In a longitudinal study, we assessed 1,220 individuals from the German general population at the start of the COVID-19 pandemic (t1), 3 months later (t2), and 12 months later (t3). Pre-pandemic data were available in a subsample from 2014 (n = 430). A decrease in C-OCS over the first year of the pandemic emerged with a small effect size. Thirty-six percent of the participants scored above the clinical cut-off score at t1, 31% at t2, and 27% at t3. In 2014, only 11% scored above the clinical cut-off score. Hierarchical regression showed that C-OCS at t1 was the strongest predictor of a long-term increase in C-OCS. With small effect sizes, change in the duration (not frequency) of handwashing from t1 to t2, as well as the distress-reducing effect of handwashing served as additional predictors. Implications for information on hand hygiene guidelines are discussed.

Interrelations of resilience factors and their incremental impact for mental health: insights from network modeling using a prospective study across seven timepoints.

Resilience can be viewed as trajectory of stable good mental health or the quick recovery of mental health during or after stressor exposure. Resilience factors (RFs) are psychological resources that buffer the potentially negative effects of stress on mental health. A problem of resilience research is the large number of conceptually overlapping RFs complicating their understanding. The current study sheds light on the interrelations of RFs in the face of the COVID-19 pandemic as a use case for major disruptions. The non-preregistered prospective study assessed a sample of 1275 German-speaking people from February 2020 to March 2021 at seven timepoints. We measured coping, hardiness, control beliefs, optimism, self-efficacy, sense of coherence (SOC), sense of mastery, social support and dispositional resilience as RFs in February 2020, and mental health (i.e., psychopathological symptoms, COVID-19-related rumination, stress-related growth) at all timepoints. Analyses used partial correlation network models and latent growth mixture modeling (LGMM). Pre-pandemic RFs were strongly interrelated, with SOC being the most central node. The strongest associations emerged between coping using emotional support and social support, SOC and sense of mastery, and dispositional resilience and self-efficacy. SOC and active coping were negatively linked. When we examined RFs as predictors of mental health trajectories, SOC was the strongest predictor of psychopathological symptoms and rumination, while trajectories of stress-related growth were predicted by optimism. Subsequent network analyses, including individual intercepts and slopes from LGMM, showed that RFs had small to moderate associations with intercepts but were unrelated to slopes. Our findings provide evidence for SOC playing an important role in mental distress and suggest further examining SOC's incremental validity. However, our results also propose that RFs might be more important for stable levels of mental health than for adaptation processes over time. The differential associations for negative and positive outcomes support the use of multidimensional outcomes in resilience research.

The Perceived Stress Scale 2&2: a two-factorial German short version of the Perceived Stress Scale.

Background: Stress is among the leading causes for diseases. The assessment of subjectively perceived stress is essential for resilience research. While the Perceived Stress Scale (PSS) is a widely used questionnaire, a German short version of the scale is not yet available. In the current study, we developed such a short version using a machine learning approach for item reduction to facilitate the simultaneous optimization of multiple psychometric criteria. Method: We recruited 1,437 participants from an online panel, who completed the German long version of the PSS along with measures of mental health and resilience. An ant-colony-optimization algorithm was used to select items, taking reliability, and construct validity into account. Findings on validity were visualized by psychological network models. Results: We replicated a bifactor structure for the long version of the PSS and derived a two-factor German short version of the PSS with four items, the PSS-2&2. Its factors helplessness and self-efficacy showed differential associations with mental health indicators and resilience-related factors, with helplessness being mainly linked to mental distress. Conclusion: The valid and economic short version of the PSS lends itself to be used in future resilience research. Our findings highlight the importance of the two-factor structure of the PSS short versions and challenge the validity of commonly used one-factor models. In cases where the general stress factor is of interest, researchers should use the longer versions of the PSS that allow for the interpretation of total scores, while the PSS-2&2 allows of an economic assessment of the PSS factors helplessness and self-efficacy.

Determinants of individuals' objective and subjective financial fragility during the COVID-19 pandemic.

We examine determinants of the objective and subjective financial fragility of 2100 individuals across Australia, France, Germany, and South Africa during the COVID-19 pandemic. Objective financial fragility reflects individuals' (in)ability to deal with unexpected expenses, while subjective financial fragility reflects their emotional response to financial demands. Controlling for an extensive set of socio-demographics, we find that negative personal experiences during the pandemic (i.e., reduced or lost employment; COVID-19 infection) are associated with higher objective and subjective financial fragility. However, individuals' cognitive (i.e., financial literacy) as well as non-cognitive abilities (i.e., internal locus of control; psychological resilience) help to counteract this higher financial fragility. Finally, we examine the role of government financial support (i.e., income support; debt relief) and find that it is negatively related to financial fragility only for the economically weakest households. Our results have implications for public policymakers, providing levers for reducing individuals' objective and subjective financial fragility.

Open-label placebos-a systematic review and meta-analysis of experimental studies with non-clinical samples.

The use of open-label placebos (OLPs) has shown to be effective in clinical trials. We conducted a systematic review and meta-analysis to examine whether OLPs are effective in experimental studies with non-clinical populations. We searched five databases on April 15, 2021. We conducted separate analyses for self-reported and objective outcomes and examined whether the level of suggestiveness of the instructions influenced the efficacy of OLPs. Of the 3573 identified records, 20 studies comprising 1201 participants were included, of which 17 studies were eligible for meta-analysis. The studies investigated the effect of OLPs on well-being, pain, stress, arousal, wound healing, sadness, itchiness, test anxiety, and physiological recovery. We found a significant effect of OLPs for self-reported outcomes (k = 13; standardized mean difference (SMD) = 0.43; 95% CI = 0.28, 0.58; I2 = 7.2%), but not for objective outcomes (k = 8; SMD = - 0.02; 95% CI = - 0.25, 0.21; I2 = 43.6%). The level of suggestiveness of the instructions influenced the efficacy of OLPs for objective outcomes (p = 0.02), but not for self-reported outcomes. The risk of bias was moderate for most studies, and the overall quality of the evidence was rated low to very low. In conclusion, OLPs appear to be effective when examined in experimental studies. However, further research is needed to better understand the mechanisms underlying OLPs.

Therapeutic alliance in videoconferencing psychotherapy compared to psychotherapy in person: A systematic review and meta-analysis.

INTRODUCTION: Videoconferencing psychotherapy (VCP) delivers treatment to individuals with limited access to face-to-face mental healthcare. VCP's effectiveness has been demonstrated for various disorders and therapeutic interventions. However, there is contradictory evidence regarding the therapeutic alliance in VCP as compared to psychotherapy in person (PIP). This meta-analysis examines whether therapeutic alliance differs by psychotherapy's delivery format, namely VCP versus PIP. METHODS: We searched five databases for trials comparing the therapeutic alliance in VCP and PIP, wherein the therapeutic alliance was rated by either patients or therapists or both. Eighteen publications were included, and the difference between VCP and PIP was assessed. Furthermore, we tested possible moderators of the difference in therapeutic alliance between VCP and PIP by meta-regression, and we assessed the risk of bias of this meta-analysis. RESULTS: The meta-analysis revealed no statistically significant difference in the therapeutic alliance between VCP and PIP for alliance ratings by patients (SMD = -0.09; 95% CI = -0.26; 0.07) as well as by therapists (SMD = 0.04; 95% CI = -0.17; 0.25). No significant moderators were found. DISCUSSION: In this meta-analysis, VCP and PIP did not differ with respect to the therapeutic alliance as rated by either patients or therapists. Further research is required into mechanisms driving the therapeutic alliance in VCP and PIP.

Domain-Specific Greed.

Greed, the insatiable and excessive desire and striving for more even at the expense of others, may be directed toward various goods. In this article, we propose that greed may be conceptualized as a domain-specific construct. Based on a literature review and an expert survey, we identified 10 domains of greed which we operationalized with the DOmain-SPEcific Greed (DOSPEG) questionnaire. In Study 1 (N = 725), we found support for the proposed structure and convergent validity with related constructs. Bifactor-(S-1) models revealed that generic greed is differentially related to the greed domains, indicating that generic greed primarily captures a striving for money and material things. In the second study (N = 591), we found that greed domains had incremental validity beyond generic greed with regard to corresponding criteria assessed via self- and other-reports. We conclude that greed can be conceptualized as a domain-specific construct and propose an onion model reflecting this structure.

Long-term effects of imaginal retraining in overweight and obesity: A controlled study.

BACKGROUND: Imaginal retraining (IR) is a self-help technique that targets automatic approach tendencies toward appetitive stimuli. In a randomized controlled trial (RCT; N = 384), IR reduced craving for high-calorie foods after a six-week intervention period (small effect). The aim of the present study was to evaluate long-term effects of IR in this sample. METHODS: One year after baseline, participants from the initial RCT were recontacted. A visual analogue scale measuring craving, the Food Cravings Questionnaire-Trait-reduced (FCQ-T-r), the Three-Factor Eating Questionnaire, the Beck Depression Inventory, quality of life, and subjective appraisal of the intervention were assessed online. Participants were classified as users or nonusers based on self-reported usage of IR over the previous year. RESULTS: Linear-mixed models showed no significant interaction effects of time and group for any outcome (trend level effects were found for two subscales of the FCQ-T-r). Yet, higher usage of IR was associated with greater symptom reduction. Although overall subjective appraisal of the intervention was comparably good to the initial study, usage of IR and completion rate were unsatisfactory. LIMITATIONS: Main limitations of the present study include the nonrandomized group allocation and the low completion rate. CONCLUSIONS: This study did not find evidence for the long-term efficacy of IR in individuals with craving for high-calorie foods. Only upon high usage of IR, improvement was found. However, low completion rate and usage of the intervention may have resulted in a Type-II error. Future studies may consider low-intensity professional guidance to increase adherence and assess the long-term effects of IR in RCTs.

Imaginal retraining reduces craving for high-calorie food.

Imaginal retraining (IR) is a treatment derived from approach bias modification to reduce strong craving for high-calorie food. The push component (IRpush) seems to be the most effective element according to a recent dismantling trial. Conclusions derived from prior studies are limited, however, by small sample sizes and restriction of participants to women. The present study aimed to overcome these limitations and also tested a new variant of IR (3P; decoupling with the elements pull, pause, push), which has previously been found to be more effective than the standard protocol in individuals with problematic alcohol use. The study was conducted online. A total of 1,106 participants with strong craving for high-calorie food were randomized to different brief interventions of IR or a passive control group. Before and after the interventions, participants indicated their craving for high-calorie food and appraised food pictures. The main conditions of interest were IRpush and 3P. The other two experimental conditions did not contain a motor element and served as active control conditions. IRpush proved the most effective intervention and reduced craving by approximately 18%, which was significantly larger than in the passive control group. IRpush worked especially well for those with higher initial weight, higher cravings, and more dysfunctional eating behavior. The novel 3P technique significantly reduced craving across time and was especially effective for those with high BMI and craving. The study suggests that a simple self-help component of imaginal retraining, IRpush, can decrease craving for high-calorie food to a relevant extent. Future trials should elucidate whether different forms of substance-related and behavioral addictions require adapted IR or 3P protocols to increase effectiveness.

Combination of Two Behavioral Techniques Reduces Craving in Problematic Alcohol Consumption by One Third: A Randomized Controlled Trial.

INTRODUCTION: Craving alcohol is a core symptom of alcohol use disorder (AUD) and an important target for treatment. A new line of treatment for AUD aims at overriding the urge to consume alcohol by changing implicit cognitions via approach bias modification (ApBM). In a prior study, we tested a variant of ApBM called imaginal retraining, which reduced craving. As addiction and body-focused repetitive behaviors (BFRBs) share important symptoms (e.g., inability to resist urges), for the present study we merged imaginal retraining with a technique aimed at BFRB, called decoupling, to augment treatment effects. We hypothesized that the new technique, which is called 3P, would lead to a greater reduction in craving relative to (active) control conditions. METHODS: The study was conducted online. Data from 227 participants were considered. Participants were randomized to 1 out of 5 conditions. Craving for alcohol before and after the brief intervention was the primary outcome. RESULTS: Only the 3P condition lessened craving by approximately one third at an almost medium effect size (improvement: 34.5%, p = 0.003, d = 0.458). Effects were significantly larger relative to the wait-list control and two active control conditions (p's < 0.02; greater reduction than imaginal retraining at a small but nonsignificant effect size). DISCUSSION/CONCLUSION: If replicated, the combination of imaginal retraining and decoupling (3P) represents a promising, easy-to-implement self-help technique to reduce immediate craving. Long-term effects in participants with formally diagnosed AUD have not yet been investigated.

Whodunit - A novel video-based task for the measurement of jumping to conclusions in the schizophrenia spectrum.

Jumping to conclusions (JTC) is implicated in the formation and maintenance of the positive symptoms of psychosis and over the years has become a prominent treatment target. Yet, measures designed to detect JTC are compromised by a number of limitations. We aimed to address some of these shortcomings with a new video-based "Whodunit task" among participants scoring high and low on the Community Assessment of Psychic Experiences (CAPE). We recruited a large sample (N = 979) from the general population who were divided into subgroups high vs. low on psychotic-like experiences (PLE), matched for depression and background characteristics. In the Whodunit task, participants were asked to rate the likelihood that one out of six suspects was the perpetrator of a crime (deliberately ambiguous with no clear clues until the end). The primary measure was the number of sequences-to-decision (STD). In line with the hypothesis, participants scoring high on the CAPE positive subscale displayed significantly lower STD and a higher rate of JTC. Response confidence in the assessments was elevated in the PLE-High group. The number of overall decisions was also significantly elevated for the PLE-High group. No group differences were found when comparing those scoring high versus low on depression. The STD index correlated significantly with a corresponding index from another JTC task. The study presents a new paradigm for the measurement of data gathering in the schizophrenia spectrum. Speaking to its validity, the Whodunit task was correlated with another JTC measure. Future research should test abbreviated versions of the paradigm, preferably using multiple trials with differing topics/emotional themes.

Long-COVID or long before? Neurocognitive deficits in people with COVID-19.

In connection with COVID-19 disease, evidence of persisting psychiatric and neurocognitive effects is accumulating. To examine long COVID symptoms, baseline data from 2015 (i.e., before the pandemic) and follow-up data from 2021 from 428 participants were compared. Participants with COVID-19 reported more subjective neurocognitive complaints in the follow-up, but this did not correspond to the test performance. Also, greater depressive symptoms compared with the no-COVID group were reported. However, these complaints must be put into perspective when considering the baseline data, since complaints were present before the COVID infection. Thus, premorbid performance as well as psychological factors should be considered when discussing long COVID.

Activity-based working: How the use of available workplace options increases perceived autonomy in the workplace.

BACKGROUND: If companies are building offices, nowadays, they mostly realize activity-based concepts as a response to growing flexibility requirements of a digitalized society. Activity-based concepts provide multiple workplace options to employees. After moving to new workspaces, employees need to get used to the facilities and learn how to use the available workplace options. OBJECTIVE: The effectiveness of activity-based working relies on the workplace options and on employees' autonomy to use them according to their current work tasks. The present study examined the change in the use of workplace options, task-environment fit, and autonomy in the workplace after the implementation of an activity-based working concept. METHODS: The study was longitudinal with two time points (Time 1 and Time 2) that were one year apart. Data were obtained prior to the COVID-19 pandemic. The sample consisted of 153 employees working in activity-based office environments in two organizations in Germany. The average age was 45 years (SD = 11); 44% were men; and 23% had leadership responsibilities. RESULTS: The increased use of available workplace options offered in activity-based working concepts was associated with better task-environment fit, which in turn led to an increase in perceived autonomy in the workplace. CONCLUSIONS: The results support the core idea of activity-based working and revealed how this office concept unfolds its effectiveness: Having different workplace options available and using them led to a higher perceived task-environment fit, which in turn, contributed to a higher perceived autonomy in the workplace.

The long-term buffering effect of sense of coherence on psychopathological symptoms during the first year of the COVID-19 pandemic: A prospective observational study.

The COVID-19 pandemic is a major chronic stressor affecting all societies and almost all individuals. Consequently, research demonstrated a negative impact of COVID-19 on mental health in parts of the general population. However, not all people are affected equally thus making the identification of resilience factors modulating the pandemic's impact on mental health an important research agenda. One of these factors is sense of coherence (SOC), the key component of the salutogenesis framework. The current study aimed at investigating the long-term relationship between SOC and psychopathological symptoms, and the impact of COVID-19-related rumination as its moderator. The prospective observational study assessed psychopathological symptoms and SOC before the COVID-19 outbreak in Germany (February 2020) and at six critical time points during the pandemic in an online panel (n = 1,479). Bivariate latent change score models and latent growth mixture modeling were used to analyze changes in psychopathological symptoms and SOC along with their interaction and to differentiate trajectories of COVID-19-related rumination. A model allowing for unidirectional coupling from SOC to psychopathological symptoms demonstrated best fit. In the total sample, psychopathological symptoms increased significantly over time. Previous SOC predicted later changes in psychopathological symptoms, whereby a stronger SOC was associated with a decrease in symptoms over time. The same pattern of results was evident in the high-rumination (17.2%) but not in the low-rumination group (82.8%). Our findings demonstrate that SOC is an important predictor and modulator of psychopathological symptoms during the COVID-19 pandemic, particularly in those respondents that ruminate about the pandemic.

Unrealistic pessimism and obsessive-compulsive symptoms during the COVID-19 pandemic: Two longitudinal studies.

OBJECTIVE: Unrealistic pessimism (UP) is an aspect of overestimation of threat (OET) that has been associated with obsessive-compulsive disorder/symptoms (OCD/OCS). During the COVID-19 pandemic, UP may have played an important role in the course of OCD. To investigate the relationship, we conducted two longitudinal studies assuming that higher UP predicts an increase in OCS. METHOD: In Study 1, we investigated UP in the general population (N = 1,184) at the start of the pandemic asking about overall vulnerability to infection with SARS-CoV-2 and UP regarding infection and outcome of severe illness. Further, OCS status (OCS+/-) was assessed at the start of the pandemic and 3 months later. In Study 2, we investigated UP in individuals with OCD (N = 268) regarding the likelihood of getting infected, recovering, or dying from an infection with SARS-CoV-2 at the start of the pandemic and re-assessed OCS 3 months later. RESULTS: In Study 1, UP was higher in the OCS+ compared to the OCS- group, and estimates of a higher overall vulnerability for an infection predicted a decrease in OCS over time. UP regarding severe illness predicted an increase in symptoms over time. In Study 2, UP was found for a recovery and death after an infection with SARS-CoV-2, but not for infection itself. CONCLUSIONS: Exaggeration of one's personal vulnerability rather than OET per se seems pivotal in OCD, with UP being associated with OCD/OCS+ as well as a more negative course of symptomatology over the pandemic in a nonclinical sample. PRACTITIONER POINTS: Unrealistic optimism, a bias common in healthy individuals, is thought to be a coping mechanism promoting well-being in the face of danger or uncertainty. The current study extends findings that its inversion, unrealistic pessimism, may play an important role in obsessive-compulsive disorder and may also be involved in the development of the disorder. This study highlights the importance that prevention programs during a pandemic should include targeting unrealistic pessimism.

Imaginal Retraining Reduces Craving for Tobacco in 1-Year Controlled Follow-Up Study.

INTRODUCTION: Imaginal retraining is a self-help technique that adapts the principles of approach bias modification to the imagination. Imaginal retraining has been shown to reduce craving and addictive behaviours in 3 randomized controlled trials (RCTs) on problematic alcohol consumption, overweight, and tobacco use. To date, there have been no studies evaluating the long-term efficacy of the intervention. The aim of the present study was to generate first hypotheses on the long-term efficacy of imaginal retraining in smokers in a controlled 1-year follow-up study. MATERIALS AND METHODS: We recontacted the 345 participants who had taken part in an RCT on imaginal retraining for smokers 1 year later. The survey was carried out online and assessed craving for tobacco (primary outcome), smoking behaviour, well-being, and subjective appraisal. Individuals who applied the technique at least once during the previous year were categorized as the training group, whereas participants who never performed the training were categorized as the no-training group. Data were analysed using linear mixed models (LMMs). The study was preregistered as DRKS00021044. RESULTS: The completion rate was 45.5%. Less than 40% used the intervention at least once in the previous 12 months. LMM analyses showed a significant reduction in craving for tobacco for the training compared to the no-training group after 1 year. No significant group differences emerged in smoking behaviour, depressive symptoms, or quality of life. Subjective appraisal of the intervention was favorable, similar to the initial study. CONCLUSION: The present study provides preliminary support for the long-term efficacy of imaginal retraining on craving for tobacco but not on smoking behaviour, highlighting the importance of multimodal treatment concepts in smoking cessation that target a variety of maintaining factors. Future studies need to investigate the long-term efficacy of the intervention in prospective RCTs that test alternative ways of conveying the technique to improve adherence.

The day-of-invitation effect on participation in web-based studies.

Several methods have been proposed to promote participation in web-based research. Here, we examine a technique that is available at no cost: Inviting respondents per e-mail on a particular day of the week. We base our reasoning on such a day-of-invitation effect upon theories on variations in mood and work performance over the week. We conducted five experiments with large and heterogeneous samples to find out whether such effects apply for response rate (i.e., visiting the first page of a study) and retention rate (i.e., completing the study) in web-based studies. We found evidence of a small but significant day-of-invitation effect. Response rate is high at the beginning of the workweek and falls to a low on Friday. Exploratory analyses showed that this decline is higher for employed (vs. nonemployed) persons. Effects on retention rate appear to follow a less straightforward pattern. We discuss possible mechanisms that might account for the day-of-invitation effect and recommend inviting participants on Monday or Tuesday.

The impact of a tailored mindfulness-based program for resident physicians on distress and the quality of care: A randomised controlled trial.

BACKGROUND: Many resident physicians suffer from distress, which endangers their individual health and the quality of care. OBJECTIVE: To examine the impact of a tailored mindfulness-based program (MBP) for resident physicians on distress and the quality of care. METHODS: A single-centre, two-armed, longitudinal randomised controlled trial. The intervention group took part in an 8-week, tailored MBP that included a coursebook. The MBP was followed by a 4-month maintenance phase. The active control group received the coursebook for self-study. Assessments were at baseline (t0, 0 months), after the intervention (t1, 2 months), after the maintenance phase (t2, 6 months), and at follow-up (t3, 12 months). The primary outcome was a change in burnout at t2. Secondary outcomes included perceived stress, mental distress, perceived job strain, depression, anxiety, hair cortisol secretion, self-reported medical errors and third-party ratings by patients, supervisors and colleagues. RESULTS: Seventy-six participants were randomised to the intervention and 71 to the control group. The intervention group showed greater improvements in the primary outcome (burnout at t2, d = 0.32, p = 0.046), in perceived stress (d = 0.31, p = 0.046) and perceived job strain (d = 0.33, p = 0.026) at t1, and in supervisor rated empathy (d = 0.71, p = 0.037) and colleague rated attentiveness (d = 0.85, p = .006) at t2. There was no difference between groups in the other outcomes. CONCLUSION: A tailored MBP for resident physicians improved burnout and might have improved other aspects of distress and the quality of care.

Teacher Self-Efficacy and Mental Health-Their Intricate Relation to Professional Resources and Attitudes in an Established Manual-Based Psychological Group Program.

Introduction: Teaching is considered a mentally challenging occupation. Teacher self-efficacy is a personal resource which buffers the experience of stress and may be important in maintaining mental health. The preventive intervention "Manual-Based Psychological Group Program for Teachers" (MBPGPT) was applied and evaluated state-wide to improve the mental health of teachers. This study aims to investigate the intricate relation between teacher self-efficacy and mental health and their changes in the course of the intervention. Method: Using a single-group pre-/post-design, the relation between teacher self-efficacy and mental health was investigated in 742 teachers. Pre- and post-changes in teacher self-efficacy and their interaction with mental health were examined in a subsample of 171 teachers, who met the conservative inclusion criteria. In ancillary analyses, correlations with underlying changes in work-related behavior and experience patterns were analyzed to better understand the intricate link between teacher self-efficacy and mental health. Results: Teacher self-efficacy showed a significant, moderate correlation with mental health. Self-efficacy was moderately higher after the intervention than before the intervention, but independent of changes in mental health. Teacher self-efficacy was related to work-related psychological resistance and positive emotions. An increase in teacher self-efficacy was accompanied by an improvement in life satisfaction and distancing ability. A decrease in teacher self-efficacy went hand in hand with reduced experience of social support. Discussion: This study confirmed teacher self-efficacy as an important, reliable resource and its correlation with psychological resistance. The absence of a control group limits what causal conclusions can be drawn from the study. Nevertheless, self-efficacy seems to be a worthwhile goal of preventive interventions for teachers and should be promoted due to its wide-ranging implications. Suggestions for further studies and interventions are made.