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Although it is an adaptive mechanism that danger usually elicits fear, it seems that fearful individuals overestimate the danger associated with their feared objects or situations. Previous research has not systematically distinguished between the estimated risk of an encounter with fear-relevant stimuli and the expected unpleasant outcomes of such encounters. Furthermore, it is not clear if biased risk perception is specific to an individual’s fear or generalized to all negative events. In an online-survey ( N = 630) we assessed the estimated risk to encounter fear-relevant stimuli and the expectations of negative outcomes of such encounters. Items contained three domains (spiders, snakes, and everyday fear triggers). In regression analyses we examined the specific associations between fear and risk estimations. In addition, we compared subgroups with specific fears and low fearful individuals. While an individual’s fear score was not related to the estimated risk of an encounter with fear-specific stimuli, it was related to an overestimation of negative outcomes in all domains. The perceived risk of aversive outcomes was most pronounced for an individual’s specific fear. Furthermore, an individual’s specific fear was most predictive of the estimated risk of a negative fear-relevant outcome. Highly fearful individuals overestimate the risk of negative outcomes of fear-relevant encounters. Specifically, they dread outcomes of encounters with their feared object. Differentiating fear-relevant components of risk perception provides insights into the cognitions which may motivate maladaptive avoidance behavior.

Stress and anxiety can both influence risk-taking in decision-making. While stress typically increases risk-taking, anxiety often leads to risk-averse choices. Few studies have examined both stress and anxiety in a single paradigm to assess risk-averse choices. We therefore set out to examine emotional decision-making under stress in socially anxious participants. In our study, individuals (N = 87) high or low in social anxiety completed an expanded variation of the Balloon Analogue Risk Task (BART). While inflating a balloon to a larger degree is rewarded, a possible explosion leads to (a) a loss of money and (b) it is followed by an emotional picture (i.e., a calm vs. an angry face). To induce stress before this task, participants were told that they would have to deliver a speech. We operationalized risk-taking by the number of pumps during inflation and its functionality by the amount of monetary gain. In addition, response times were recorded as an index of decisional conflict. Without the stressor, high socially anxious compared to low socially anxious participants did not differ in any of the dependent variables. However, under stress, the low socially anxious group took more risk and earned more money, while high socially anxious individuals remained more cautious and did not change their risk-taking under social stress. Overall, high socially anxious individuals made their decisions more hesitantly compared to low socially anxious individuals. Unexpectedly, there were no main effects or interactions with the valence of the emotional faces. This data shows that stress affects socially anxious individuals differently: in low socially anxious individuals stress fosters risk-taking, whereas high socially anxious individuals did not alter their behavior and remained risk-averse. The novel eBART is a promising research tool to examine the specific factors that influence decision-making.

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Abstract. The use of standardized patients (SPs) in the training of prospective practitioners is a well-established didactic tool in medical schools. Only recently have simulations of patients in psychotherapy been introduced into the training of psychologists. By integrating psychotherapy training into university-level master’s programs, German law now requires licensing exams for psychotherapists (i. e., Approbationsprüfung) to include an assessment of therapeutic competencies in simulated interactions with SPs. Yet, it has not been examined whether these simulations are useful for a reliable assessment of competencies in psychotherapy trainees. Also, we need to develop standardized instruments to evaluate competencies in entry-level psychotherapists. As part of a university course, we trained master’s-level students from three cohorts in clinical interviewing techniques (course title: Klinisch-psychologische Gesprächsführung). We analyzed videotaped 20-min sequences of N = 104 students while they interviewed one of N = 38 trained SPs. The students’ task was to interview the SP, conduct a brief case history, and use the interviewing skills they had learned in class. Two independent raters evaluated their psychotherapeutic competencies with an adapted version of the German Cognitive Therapy Scale (CTS). Raters evaluated students’ performance on two subscales and the total score with satisfactory interrater agreement (intraclass correlations). In general, students performed well in the interviews: They structured the sessions sufficiently, and their global psychotherapeutic competencies were satisfactory. However, the psychotherapeutic competencies of master’s students fell short of the benchmark derived from experienced psychotherapists. This pilot study provides first evidence that simulated interviews with SPs may be a reliable tool in the assessment of practical competencies in psychotherapy trainees at an early stage of their training. Moreover, we found that the CTS, which has demonstrated validity to quantify competencies of psychotherapists, is applicable and reliable in this training context as well. In sum, this suggests that simulated interviews with SPs may be useful for evaluating psychotherapeutic competencies of psychotherapy trainees.