Preventing mental disorders in young adults with low self-efficacy: A randomized controlled trial

• Applicants: Professorin Dr. Eva Asselmann; Dr. Stefanie L. Kunas
• Subject Area: Personality Psychology, Clinical and Medical Psychology, Methodology
• Term: since 2024
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 534641939

Background. Low self-efficacy is a transdiagnostic risk factor for various mental disorders. Self-efficacy refers to one’s belief to be capable to show a behavior that is needed to solve a task or reach a goal successfully. In line with theoretical models and empirical findings, individuals with low self-efficacy are more likely to experience challenges as uncontrollable and threatful. Thus, they are at increased risk of developing mental disorders during sensitive periods such as young adulthood. Self-efficacy interventions have been shown to effectively promote health behavior (change), quality of life and treatment adherence in patients with severe diseases, as well as motivation and performance in students and employees. However, whether targeted self-efficacy training can prospectively prevent the onset of full-threshold anxiety, affective, and substance use disorders in young adults at increased risk for psychopathology remains an open question. Aims. This randomized-controlled trial aims to test whether a short cognitive-behavioral intervention in young adults with low self-efficacy can enhance general self-efficacy (primary outcome of the intervention efficacy) and thus prevent incident DSM-5 mental disorders in the consecutive year (primary outcome of the prevention efficacy). Additionally, we investigate whether (a) improvements in domain-specific self-efficacy lead to subsequent improvements in general self-efficacy and in turn lower psychopathological symptoms (spillover effects). Methods. Young adults (aged 18-30 years) with low self-efficacy but no mental disorder yet will be included (N = 378). The study includes a screening, an entry exam, as well as baseline, post, and 12-month follow-up assessments (plus additional course assessments in the intervention group). After baseline, participants will be randomized to an intervention or control group. The intervention group will receive group-based self-efficacy training (5 sessions à 60 minutes). The control group will also meet in groups (5 sessions à 60 minutes) but only speak about personal concerns without receiving any specific training. DSM-5 mental disorders will be assessed at study entry and follow-up with a structured diagnostic interview. Other outcomes will be captured with well-established scales and ecological momentary assessments (EMA) at baseline, post, and follow-up. Clinical outcomes include psychopathological symptoms (dimensional scores for anxiety, depression, anger, somatic symptoms, and sleep disturbances) and mental disorders (categorical DSM-5 diagnoses of anxiety, affective, and substance use disorders). Adherence and acceptability of the study protocol will be assessed. The intervention efficacy will be tested with logistic/linear regressions and multilevel analyses. Spillover effects between improvements in domain-specific/general self-efficacy and psychopathological symptoms over the course of the study will be examined using cross-lagged panel models.

• DFG Programme: Research Grants