(PS3-85) The Effect of Skill Practice on Gains in Interpersonal Skill: Considering Skillfulness and Negative Thinking in Interpersonal Contexts as Moderators

A central focus of cognitive behavioral therapy (CBT) is to help clients learn strategies to address maladaptive patterns of negative thinking. Among those with elevated social anxiety symptoms, negative thoughts are often focused on fear of embarrassment or negative evaluation. Social anxiety is among the most common comorbidities of depression, though the skills best suited to addressing negative thinking in interpersonal contexts are unclear.

In a study of 230 undergraduate students, we evaluated the benefits of two strategies for addressing negative thoughts, cognitive restructuring and positive thinking. Participants were randomized to receive instruction in one of these two approaches. We also tested baseline CBT skills and negative thinking related to interpersonal contexts as potential moderators of participants’ use of these strategies. We evaluated differences in interpersonal skill gains, including behaviors such as initiating social activities, nurturing relationships, and seeking support, after one week of practicing one of these strategies. We found no difference between cognitive restructuring and positive thinking on change in interpersonal skills. However, when considering the moderating effect of negative thinking in interpersonal contexts and baseline CBT skills on the effects of condition, we found a significant three-way interaction of condition and these two potential moderators (p = .002). The effect of cognitive restructuring skill use on interpersonal skill gains was similar regardless of negative thinking in interpersonal contexts and baseline CBT skills. However, the benefits of positive thinking skills varied strongly by negative thinking in interpersonal contexts and baseline CBT skills. Specifically, when both negative thinking in interpersonal contexts and CBT skills were high, the positive thinking condition resulted in large gains in interpersonal skills.

These findings suggest that it may be beneficial to consider factors such as baseline skills and the frequency of negative thinking focused on interpersonal contexts when making use of certain CBT skills. Though further evaluation in a sample of those with meeting criteria for depression or social anxiety will be important, these initial findings suggest the promise of providing training in positive thinking strategies for more skillful clients with elevated negative thinking in interpersonal contexts.