Beliefs About the Malleability of Anxiety and General Emotions and Their Relation to Treatment Outcomes in Acute Psychiatric Treatment

Abstract

Beliefs about the malleability of self-attributes—mindsets—may have important relevance to clinical psychology. Individuals with growth mindsets of anxiety and general emotions (the belief that these attributes are changeable) report fewer psychological symptoms, more adaptive emotion regulation strategies, and prefer effortful treatments. However, most research has been conducted in unselected student samples, limiting understanding of clinical utility. Thus, we evaluated mindsets of anxiety and emotion in patients attending an intensive psychiatric partial hospitalization program using cognitive-behavior therapy, acceptance–commitment therapy, and dialectical-behavior therapy. Growth mindsets of anxiety and emotion were negatively correlated with psychological distress. Baseline growth mindset of anxiety, but not general emotion, predicted fewer anxiety symptoms at discharge, even after controlling for psychiatric symptoms, number of inpatient hospitalizations, and treatment expectations. Moreover, patients became significantly more growth-minded about anxiety at discharge, especially those with elevated psychiatric symptoms at baseline. Findings highlight the clinical potential of mindsets and point to intervention targets.

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References

  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th edn.). Arlington: American Psychiatric Publishing.

    Book  Google Scholar 

  2. Beer, J. S. (2002). Implicit self-theories of shyness. Journal of Personality and Social Psychology, 83, 1009–1024. https://doi.org/10.1037/0022-3514.83.4.1009.

    Article  PubMed  Google Scholar 

  3. Bergen, R. (1991). Beliefs about intelligence and achievement-related behaviors (Unpublished doctoral dissertation). University of Illinois, Urbana-Champaign.

  4. Björgvinsson, T., Kerz, S. J., Bigda-Peyton, J. S., Rosmarin, D. H., Aderka, I. M., & Neuhaus, E. C. (2014). Effectiveness of cognitive behavior therapy for severe mood disorders in an acute psychiatric naturalistic setting: A benchmarking study. Cognitive Behaviour Therapy, 43, 209–220. https://doi.org/10.1080/165060703.2014.901988.

    Article  PubMed  Google Scholar 

  5. Boden, M. T., John, O. P., Goldin, P. R., Werner, K., Heimberg, R. G., & Gross, J. J. (2012). The role of maladaptive beliefs in cognitive-behavioral therapy: Evidence from social anxiety disorder. Behaviour Research and Therapy, 50, 287–291. https://doi.org/10.1016/j.brat.2012.02.007.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Brown, T. A., White, K. S., Forsyth, J. P., & Barlow, D. H. (2004). The structure of perceived emotional control: Psychometric properties of a revised anxiety control questionnaire. Behavior Therapy, 25, 75–99. https://doi.org/10.1016/S0005-7894(04)80005-4.

    Article  Google Scholar 

  7. Burnette, J. L., O’Boyle, E. H., VanEpps, E. M., Pollack, J. M., & Finkel, E. J. (2013). Mind-sets matter: A meta-analytic review of implicit theories and self-regulation. Psychological Bulletin, 139, 655–701.

    Article  PubMed  Google Scholar 

  8. Chan, D. W. (2012). Life satisfaction, happiness, and the growth mindset of healthy and unhealthy perfectionists among Hong Kong Chinese gifted students. Roeper Review, 34, 224–233. https://doi.org/10.1080/02783193.2012.715333.

    Article  Google Scholar 

  9. Chiu, C., Hong, Y., & Dweck, C. S. (1997). Lay dispositionism and implicit theories of personality. Journal of Personality and Social Psychology, 73, 19–30.

    Article  CAS  PubMed  Google Scholar 

  10. Cury, F., Da Fonseca, D., Zahn, I., & Elliot, A. (2008). Implicit theories and IQ test performance: A sequential mediational analysis. Journal of Experimental Social Psychology, 44, 783–791. https://doi.org/10.1016/j.jesp.2007.07.003.

    Article  Google Scholar 

  11. Da Fonseca, D., Cury, F., Santos, A., Payen, V., Bounoua, L., Brisswalter, J., et al. (2009). When depression mediates the relationship between entity beliefs and performance. Child Psychiatry and Human Development, 40, 213–222. https://doi.org/10.1007/s10578-008-0122-9.

    Article  PubMed  Google Scholar 

  12. Dar-Nimrod, I., & Heine, S. J. (2011). Genetic essentialism: On the deceptive determinism of DNA. Psychological Bulletin, 137, 800–818. https://doi.org/10.1037/a0021860.

    Article  PubMed  PubMed Central  Google Scholar 

  13. De Castella, K., Goldin, P., Jazaieri, H., Heimberg, R. G., Dweck, C. S., & Gross, J. J. (2015). Emotion beliefs and cognitive behavioural therapy for social anxiety disorder. Cognitive Behaviour Therapy, 44, 128–141.

    Article  PubMed  Google Scholar 

  14. De Castella, K., Goldin, P., Jazaieri, H., Ziv, M., Dweck, C. S., & Gross, J. J. (2013). Beliefs about emotion: Links to emotion regulation, well-being, and psychological distress. Basic and Applied Social Psychology, 35, 497–505. https://doi.org/10.1080/01973533.2013.840632.

    Article  Google Scholar 

  15. De Castella, K., Platow, M. J., Tamir, M., & Gross, J. J. (2018). Beliefs about emotion: Implications for avoidance-based emotion regulation and psychological health. Cognition and Emotion, 32, 773–795.

    Article  PubMed  Google Scholar 

  16. Devilly, G. J., & Borkovec, T. D. (2000). Psychometric properties of the credibility/expectancy questionnaire. Journal of Behavior Therapy and Experimental Psychiatry, 31, 73–86. https://doi.org/10.1016/S0005-7916(00)00012-4.

    Article  CAS  PubMed  Google Scholar 

  17. Dweck, C. S. (1975). The role of expectations and attributions in the alleviation of learned helplessness. Journal of Personality and Social Psychology, 31, 674–685. https://doi.org/10.1037/h0077149.

    Article  Google Scholar 

  18. Dweck, C. S. (1999). Self-theories: Their role in motivation, personality and development. Philadelphia: Psychology Press.

    Google Scholar 

  19. Dweck, C. S., Chiu, C., & Hong, Y. (1995). Implicit theories and their role in judgments and reactions: A world from two perspectives. Psychological Inquiry, 6, 267–285.

    Article  Google Scholar 

  20. Dweck, C. S., & Leggett, E. L. (1988). A social-cognitive approach to motivation and personality. Psychological Review, 95, 256–273.

    Article  Google Scholar 

  21. Dykman, B. M. (1998). Integrating cognitive and motivational factors in depression: Initial tests of a goal-orientation approach. Journal of Personality and Social Psychology, 74, 139–158. https://doi.org/10.1037/0022-3514.74.1.139.

    Article  CAS  PubMed  Google Scholar 

  22. Eisen, S., Normand, S.-L., Belanger, A. J., Spiro, A., & Esch, D. (2004). The revised Behavior and Symptom Identification Scale (BASIS-R): Reliability and Validity. Medical Care, 42, 1230–1241.

    Article  Google Scholar 

  23. Elliot, E., & Dweck, C. (1988). Goals: An approach to motivation and achievement. Journal of Personality and Social Psychology, 71, 421–430. https://doi.org/10.10137/0022-3514.54.1.5.

    Article  Google Scholar 

  24. First, M. B., Benjamin, L. S., Gibbon, M., & Spitzer, R. L. (1997). Structured clinical interview for DSM-IV Axis II personality disorders. Washington, DC: American Psychiatric Press.

    Google Scholar 

  25. Ford, B. Q., Lwi, S. J., Gentzler, A. L., Hankin, B., & Mauss, I. B. (2018). The cost of believing emotions are uncontrollable: Youths’ beliefs about emotion predict emotion regulation and depressive symptoms. Journal of Experimental Psychology: General, 147, 1170–1190.

    Article  Google Scholar 

  26. Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85, 248–262.

    Article  Google Scholar 

  27. Harris, P. A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., & Conde, J. G. (2009). Research Electronic Data Capture (REDCap): A metadata-driven methodology and workflow process for providing translation research informatics support. Journal of Biomedical Informatics, 42, 377–381. https://doi.org/10.1016/j.jbi.2008.08.010.

    Article  PubMed  Google Scholar 

  28. Howell, A. J. (2017). Believing in change: Reviewing the role of implicit theories in psychological dysfunction. Journal of Social and Clinical Psychology, 36, 437–460.

    Article  Google Scholar 

  29. Hughes, J. S. (2015). Support for the domain specificity of implicit beliefs about persons, intelligence, and morality. Personality and Individual Differences, 86, 195–203.

    Article  Google Scholar 

  30. Kemp, J. J., Lickel, J. J., & Deacon, B. J. (2014). Effects of a chemical imbalance causal explanation on individuals’ perceptions of their depressive symptoms. Behaviour Research and Therapy, 56, 47–52. https://doi.org/10.1016/j.brat.2014.02.009.

    Article  PubMed  Google Scholar 

  31. Kertz, S. J., Bigda-Peyton, J. S., Rosmarin, D. H., & Björgvinsson, T. (2012). The importance of worry across diagnostic presentations: Prevalence, severity, and associated symptoms in a partial hospital setting. Journal of Anxiety Disorders, 26, 126–133. https://doi.org/10.1016/j.janxdis.2011.10.005.

    Article  PubMed  Google Scholar 

  32. Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617–627. https://doi.org/10.1001/archpsyc.62.6.617.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Kneeland, E. T., Dovidio, J. F., Joormann, J., & Clark, M. S. (2016a). Emotion malleability beliefs, emotion regulation, and psychopathology: Integrating affective and clinical science. Clinical Psychology Review, 45, 81–88. https://doi.org/10.1016/j.cpr.2016.03.008.

    Article  PubMed  Google Scholar 

  34. Kneeland, E. T., Nolen-Hoeksema, S., Dovidio, J. F., & Gruber, J. (2016b). Emotion malleability beliefs influence the spontaneous regulation of social anxiety. Cognitive Therapy and Research, 40, 496–509. https://doi.org/10.1007/s10608-016-9765-1.

    Article  Google Scholar 

  35. Kneeland, E. T., Nolen-Hoeksema, S., Dovidio, J. F., & Gruber, J. (2016c). Beliefs about emotion’s malleability influence state emotion regulation. Motivation and Emotion, 40, 740–749. https://doi.org/10.1007/s11031-016-9566-6.

    Article  Google Scholar 

  36. Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Lebowitz, M. S., Ahn, W. K., & Nolen-Hoeksema, S. (2013). Fixable or fate? Perceptions of the biology of depression. Journal of Consulting and Clinical Psychology, 81, 518–527.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Lebowitz, M. S., Pyun, J. J., & Ahn, W. K. (2014). Biological explanations of generalized anxiety disorder: Effects on beliefs about prognosis and responsibility. Psychiatric Services, 65, 498–503.

    Article  PubMed  Google Scholar 

  39. Miu, A. S., & Yeager, D. S. (2015). Preventing symptoms of depression by teaching adolescents that people can change: Effects of a brief incremental theory of personality intervention at 9-month follow-up. Clinical Psychological Science, 3, 726–743.

    Article  Google Scholar 

  40. Phelan, J. C., Cruz-Rojas, R., & Reiff, M. (2002). Genes and stigma: The connection between perceived genetic etiology and attitudes and beliefs about mental illness. Psychiatric Rehabilitation Skills, 6, 159–185. https://doi.org/10.1080/10973430208408431.

    Article  Google Scholar 

  41. Rapee, R. M., Craske, M. G., Brown, T. A., & Barlow, D. H. (1996). Measurement of perceived control over anxiety-related events. Behavior Therapy, 27, 279–293. https://doi.org/10.1016/S0005-7894(96)80018-9.

    Article  Google Scholar 

  42. Romero, C., Master, A., Paunesku, D., Dweck, C. S., & Gross, J. J. (2014). Academic and emotional functioning in middle school: The role of implicit theories. Emotion, 13, 227–234. https://doi.org/10.1037/a0035490.

    Article  Google Scholar 

  43. Rosenberg, E. R., Burt, K. B., Forehand, R. L., & Paysnick, A. A. (2016). Youth self-views, coping with stress, and behavioral/emotional problems: The role of incremental self-theory. Journal of Child and Family Studies, 25, 1713–1723. https://doi.org/10.1007/s10826-015-0346-9.

    Article  Google Scholar 

  44. Schleider, J. L., Abel, M. R., & Weisz, J. R. (2015). Implicit theories and youth mental health problems: A random-effects meta-analysis. Clinical Psychology Review, 35, 1–9.

    Article  PubMed  Google Scholar 

  45. Schleider, J. L., & Schroder, H. S. (2018). Implicit theories of personality across development: Impacts on coping, resilience, and mental health. In V. Ziegler-Hill & T. K. Shackelford (Eds.), The SAGE handbook of personality and individual differences. Thousand Oaks: Sage.

    Google Scholar 

  46. Schleider, J. L., & Weisz, J. R. (2016). Implicit theories relate to youth psychopathology, but how? A longitudinal test of two predictive models. Child Psychiatry and Human Development, 47, 603–617.

    Article  PubMed  Google Scholar 

  47. Schroder, H. S., Callahan, C. P., Gornik, A. E., & Moser, J. S. (in press). The fixed mindset of anxiety predicts future distress: A longitudinal study. Behavior Therapy.

  48. Schroder, H. S., Dawood, S., Yalch, M. M., Donnellan, M. B., & Moser, J. S. (2015). The role of implicit theories in mental health symptoms, emotion regulation, and hypothetical treatment choice in college students. Cognitive Therapy and Research, 39, 120–139.

    Article  Google Scholar 

  49. Schroder, H. S., Dawood, S., Yalch, M. M., Donnellan, M. B., & Moser, J. S. (2016). Evaluating the domain specificity of mental health-related mindsets. Social Psychological and Personality Science, 7, 508–520.

    Article  Google Scholar 

  50. Schroder, H. S., & Moser, J. S. (2018). Experimental evidence that incremental beliefs of anxiety promote treatment motivation. Talk presented at the 30th Annual Convention of the Association for Psychological Science.

  51. Schroder, H. S., Yalch, M. M., Dawood, S., Callahan, C. P., Donnellan, M. B., & Moser, J. S. (2017). Growth mindset of anxiety buffers the link between stressful life events and psychological distress and coping strategies. Personality and Individual Differences, 110, 23–26.

    Article  Google Scholar 

  52. Sheehan, D., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., et al. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59, 22–33.

    Google Scholar 

  53. Shih, S.-S. (2011). Perfectionism, implicit theories of intelligence, and Taiwanese eight-grade students’ academic engagement. The Journal of Educational Research, 104, 131–142. https://doi.org/10.1080/002206/70903570368.

    Article  Google Scholar 

  54. Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Lowe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166, 1092–1097. https://doi.org/10.1001/archinte.166.10.1092.

    Article  Google Scholar 

  55. Sung, G., Park, Y., Choi, T. K., & Park, S. W. (2017). Implicit theories and depression in clinical and non-clinical samples: The mediating role of experiential avoidance. Current Psychology. https://doi.org/10.1007/s12144-017-9736-z.

    Article  Google Scholar 

  56. Tamir, M., John, O. P., Srivastava, S., & Gross, J. J. (2007). Implicit theories of emotion: Affective and social outcomes across a major life transition. Journal of Personality and Social Psychology, 92, 731–744.

    Article  PubMed  Google Scholar 

  57. Valentiner, D. P., Jencius, S., Jarek, E., Gier-Lonsway, S., & McGrath, P. B. (2013). Pre-treatment shyness mindsets predicts less reduction of social anxiety during exposure therapy. Journal of Anxiety Disorders, 27, 267–271.

    Article  PubMed  Google Scholar 

  58. Valentiner, D. P., Mounts, N. S., Durik, A. M., & Gier-Lonsway, S. L. (2011). Shyness mindset: Applying mindset theory to the domain of inhibited social behavior. Personality and Individual Differences, 50, 1174–1179.

    Article  Google Scholar 

  59. Westra, H. A., Dozois, D. J. A., & Marcus, M. (2007). Expectancy, homework compliance, and initial change in cognitive-behavioral therapy for anxiety. Journal of Consulting and Clinical Psychology, 75, 363–373.

    Article  PubMed  Google Scholar 

  60. Yalch, M. M., Schroder, H. S., Dawood, S., & Donnellan, M. B. (2017). Relative effects of maladaptive traits and anxiety mindset on borderline personality disorder symptoms. Journal of Social and Clinical Psychology, 36, 285–299.

    Article  Google Scholar 

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Schroder, H.S., Kneeland, E.T., Silverman, A.L. et al. Beliefs About the Malleability of Anxiety and General Emotions and Their Relation to Treatment Outcomes in Acute Psychiatric Treatment. Cogn Ther Res 43, 312–323 (2019). https://doi.org/10.1007/s10608-018-9985-7

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Keywords

  • Mindsets
  • Growth mindset
  • Implicit theories
  • Partial hospital program