Individual Differences in Neurocomputational Markers of Belief-Updating and Self-Efficacy as Predictors of Acquisition of Cognitive Therapy Skills

Abstract

Depression is a leading cause of disability worldwide, and while Cognitive Behavioral Therapy (CBT) is an effective treatment, a substantial proportion of patients do not benefit from CBT. Belief-updating is an individual’s adjustment of expectations in response to feedback, and computational models have increasingly been used to capture these mechanisms in clinical research. Self-efficacy, the confidence in one’s ability, is a well-established predictor of therapeutic engagement and skill acquisition. Yet, little is known about how these two constructs interact in shaping outcomes of CBT. This study examined whether self-efficacy moderates the relationship between belief-updating parameters, learning rate (eta), self-esteem malleability (w1), and cognitive skill acquisition. Thirty-three participants (Mage = 26.55, SD = 4.58) completed measures of self-efficacy, a computerized task, and assessments of cognitive skills before and after a cognitive restructuring intervention. Results demonstrated an increase in cognitive skill use and moderation analyses revealed that self-efficacy significantly moderated the relationship between eta and cognitive skill acquisition. Individuals with low self-efficacy showed poorer cognitive skill with increased learning rate, suggesting quickly-updating beliefs may be maladaptive when self-efficacy is low, result not seen among participants with higher self-efficacy. No moderating effect was found for w1. Results suggest that individuals with lower levels of self-efficacy combined with high belief-updating regarding expectations of social approval may have a harder time acquiring necessary cognitive therapy skills. These results highlight the potential utility of assessing self-efficacy and belief-updating parameters to optimize treatment tailoring by adapting CBT pacing, feedback style, and how skills are acquired.