A reproducible systematic map of research on the illusory truth effect

People believe information more if they have encountered it before, a finding known as the illusory truth effect. But what is the evidence for the generality and pervasiveness of the illusory truth effect? Our preregistered systematic map describes the existing knowledge base and objectively assesses the quality, completeness and interpretability of the evidence provided by empirical studies in the literature. A systematic search of 16 bibliographic and grey literature databases identified 93 reports with a total of 181 eligible studies. All studies were conducted at Western universities, and most used convenience samples. Most studies used verbatim repetition of trivia statements in a single testing session with a minimal delay between exposure and test. The exposure tasks, filler tasks and truth measures varied substantially across studies, with no standardisation of materials or procedures. Many reports lacked transparency, both in terms of open science practices and reporting of descriptive statistics and exclusions. Systematic mapping resulted in a searchable database of illusory truth effect studies (https://osf.io/37xma/). Key limitations of the current literature include the need for greater diversity of materials as stimuli (e.g., political or health contents), more participants from non-Western countries, studies examining effects of multiple repetitions and longer intersession intervals, and closer examination of the dependency of effects on the choice of exposure task and truth measure. These gaps could be investigated using carefully designed multi-lab studies. With a lack of external replications, preregistrations, data and code, verifying replicability and robustness is only possible for a small number of studies.

Experiences of online exposure-based treatment with parental support for teenagers with excessive worry

Worry is a common symptom that can become excessive and is related to several negative health outcomes. Our research group recently developed an online treatment for teenagers with excessive worry with a parallel programme for their parents. The treatment is characterized by a specific focus on exposure to uncertainty and other avoided stimuli, and includes a substantial amount of parental involvement. The aim of this study was to explore how teenagers and their parents experienced the treatment, especially how they perceived working independently with exposure tasks, parental involvement in the treatment programme, and a fixed treatment format. An experienced, independent clinical psychologist interviewed eight teenagers and nine parents in total. The verbatim transcripts were analysed with thematic analysis and two main themes emerged: ‘Seeing the worry in a new light’ and ‘Changing within a set format’, which both consisted of three subthemes. Based on the analysis, we concluded that teenagers can work actively with exposure and experience it as helpful even though it can be difficult and strange at first, and that parental involvement can be perceived as beneficial by both teenagers and their parents. While the online format placed a substantial responsibility on the families, and some would have wanted additional therapist support, working independently with one’s difficulties was acceptable. Key learning aims (1) To learn about experienced benefits and obstacles of exposure in the treatment of worry. (2) To learn about teenagers’ experiences of working independently with exposure. (3) To consider the impact of parental involvement in psychological treatments for teenagers. (4) To consider pros and cons of online treatment for teenagers and their parents. (5) To consider the use of qualitative research approaches to inform further development of psychological treatments for teenagers with excessive worry.

A Close Look Into Coping Cat: Strategies Within an Empirically Supported Treatment for Anxiety in Youth

The Coping Cat protocol has shown both efficacy and effectiveness in the treatment of youth anxiety across numerous randomized controlled trials (RCTs), leading to its designation as an empirically supported treatment. The treatment is completed in two phases. In the first phase, children are taught a series of coping skills outlined using the FEAR plan acronym. The FEAR plan is then practiced in exposure tasks during the second phase of treatment. To illustrate implementation of both phases, and highlight core treatment components (i.e., exposure, flexibility within fidelity), a case description is presented. Directions for future research are discussed.

OCD and COVID-19: a new frontier

People with obsessive compulsive disorder (OCD) are likely to be more susceptible to the mental health impact of COVID-19. This paper shares the perspectives of expert clinicians working with OCD considering how to identify OCD in the context of COVID-19, changes in the presentation, and importantly what to consider when undertaking cognitive behaviour therapy (CBT) for OCD in the current climate. The expert consensus is that although the presentation of OCD and treatment may have become more difficult, CBT should still continue remotely unless there are specific reasons for it not to, e.g. increase in risk, no access to computer, or exposure tasks or behavioural experiments cannot be undertaken. The authors highlight some of the considerations to take in CBT in light of our current understanding of COVID-19, including therapists and clients taking calculated risks when developing behavioural experiments and exposure tasks, considering viral loading and vulnerability factors. Special considerations for young people and perinatal women are discussed, as well as foreseeing what life may be like for those with OCD after the pandemic is over. Key learning aims (1) To learn how to identify OCD in the context of COVID-19 and consider the differences between following government guidelines and OCD. (2) To consider the presentation of OCD in context of COVID-19, with regard to cognitive and behavioural processes. (3) Review factors to be considered when embarking on CBT for OCD during the pandemic. (4) Considerations in CBT for OCD, including weighing up costs and benefits of behavioural experiments or exposure tasks in light of our current understanding of the risks associated with COVID-19.

That Was Easy! Expectancy Violations During Exposure and Response Prevention for Childhood Obsessive-Compulsive Disorder

Violating expectancies during exposure therapy is proposed to promote inhibitory learning and improved treatment outcomes. Because people tend to overestimate how distressing emotionally challenging situations will be, violating expectations of distress may be an intuitive way to promote treatment outcome during exposure-based cognitive-behavioral therapy (CBT). This study evaluated overpredictions of distress during exposure tasks in 33 youth with obsessive-compulsive disorder (OCD; ages 8-17) participating in CBT. Youth with more variable prediction accuracy and a higher proportion of overpredictions experienced more rapid symptom reduction, b = −0.29, p = .002. Underpredictions were less common toward the end of therapy as youth experienced less severe OCD, b = 0.12, p= .001. Findings suggest that although youth often accurately predict the intensity of exposure, overpredictions are common as well. The frequency of these overpredictions promoted treatment outcome, supporting expectancy violations as one indicator of inhibitory learning during exposure therapy.

The virtues of virtual reality in exposure therapy

SummaryVirtual reality can be more effective and less burdensome than real-life exposure. Optimal virtual reality delivery should incorporate in situ direct dialogues with a therapist, discourage safety behaviours, allow for a mismatch between virtual and real exposure tasks, and encourage self-directed real-life practice between and beyond virtual reality sessions.