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Zhang Y, Wang Y, Li R, Sun Z, Li Q. The Illness Perceptions and Coping Experiences of Patients with Colorectal Cancer and Their Spousal Caregivers: A Qualitative Study. Healthcare (Basel) 2024; 12:1073. [PMID: 38891148 PMCID: PMC11171850 DOI: 10.3390/healthcare12111073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/20/2024] [Accepted: 05/22/2024] [Indexed: 06/21/2024] Open
Abstract
(1) Background: Illness perception (IP) is an important psychological construct for couples dealing with cancer, which impacts health outcomes and the psychological adjustment to cancer. More research is needed to explore the traits of IP and the efforts of couples coping with cancer. Thus, this study was designed to explore the coping experiences and features of the IPs of couples dealing with cancer. (2) Methods: A total of 24 patients with colorectal cancer (CRC) and 20 spousal caregivers (SCs) participated in semi-structured interviews. All interviews were recorded digitally, transcribed, and analyzed by using an inductive thematic analysis. (3) Results: Two themes (individualized and predominant IP; IP sharing and restructuring) were developed. A preliminary framework was formulated to illustrate the relations among subthemes and the relations between themes with an adjustment of a positive IP to CRC. In this framework, based on multiple sources and factors, the natural disparities formed the IPs of the partners of couples and determined the incongruence of IPs. The effects of IP incongruence on lives under the disease guided the three directions of coping approaches (i.e., information and available support, appropriate disclosure and reflection, and leaving the CRC diagnosis behind) which were adopted by couples dealing with CRC to share and restructure the IP with their spouses for effective dyadic coping. (4) Conclusions: This study provides insights to healthcare providers into the experiences of couples dealing with CRC and the development of couple-based IP intervention programs: (a) it initially provides adequate factual knowledge for enhancing beliefs in the ability to control illness, (b) encourages illness-centered conversations and disclosure regarding thoughts and emotions for promoting positive congruence of IP between the partners of couples dealing with a hard dilemma, and (c) guides couples to perceive positive changes and explore the illness's meaning. Understanding each theme of personalized IP and adopting effective IP coping approaches can help guide couples dealing with CRC to efficiently promote constructive IP and better health outcomes.
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Affiliation(s)
| | | | | | | | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Y.Z.); (Y.W.); (R.L.); (Z.S.)
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Kołodziejczyk A, Krawczyk J, Tkaczyszyn-Mika E, Gniewczyńska J, Ziarko M, Zozulińska-Ziółkiewicz D, Pawłowski T. The Role of Metacognition in the Prediction of Depressive and Anxiety Symptoms in Chronically Ill Patients. J Clin Med 2024; 13:1306. [PMID: 38592170 PMCID: PMC10932318 DOI: 10.3390/jcm13051306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 02/18/2024] [Accepted: 02/23/2024] [Indexed: 04/10/2024] Open
Abstract
INTRODUCTION Cancer, diabetes, and heart diseases are frequent causes of depression and anxiety. The study explored the metacognitive beliefs manifested by chronically ill patients and the presence of depressive or anxiety symptoms and the predictive role of metacognition in both. METHODS A total of 254 chronically ill patients participated in the study. The Metacognitive Questionnaire was used to measure the patients' metacognitive beliefs, whereas the Hospital Anxiety and Depression Scale was applied to evaluate their psychopathological symptoms. A correlation analysis was performed to explore the relationships between metacognition and psychopathological symptoms. Regression analyses were conducted to examine the predictive role of metacognition in anxiety and depression. RESULTS The Negative Beliefs about Uncontrollability and Danger scale correlated with both anxiety and depression scales, and the Cognitive Confidence scale correlated with the depression scale. Linear regression analyses indicated that metacognitive beliefs were responsible for 32.2% of the variance of anxiety symptoms among all the chronically ill. Metacognitive beliefs accounted for 48.8% of the variance in anxiety symptoms and 36.6% in depressive symptoms among diabetes patients. CONCLUSIONS There are specific correlations between psychopathological symptoms and metacognition among chronically ill patients. Metacognitions have a moderate role in developing and sustaining anxiety and depressive symptoms.
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Affiliation(s)
- Agata Kołodziejczyk
- Division of Psychotherapy and Psychosomatic Medicine, Department of Psychiatry, Wroclaw Medical University, 50-367 Wrocław, Poland
- Lower Silesian Oncology, Pulmonology and Hematology Center, 53-413 Wroclaw, Poland
| | - Julia Krawczyk
- Department of Health and Clinical Psychology, University of Adam Mickiewicz, 60-568 Poznan, Poland
- Department and Clinic of Internal Medicine and Diabetology, Medical University of Karol Marcinkowski, 61-701 Poznan, Poland
| | | | | | - Michał Ziarko
- Department of Health and Clinical Psychology, University of Adam Mickiewicz, 60-568 Poznan, Poland
| | - Dorota Zozulińska-Ziółkiewicz
- Department and Clinic of Internal Medicine and Diabetology, Medical University of Karol Marcinkowski, 61-701 Poznan, Poland
| | - Tomasz Pawłowski
- Division of Psychotherapy and Psychosomatic Medicine, Department of Psychiatry, Wroclaw Medical University, 50-367 Wrocław, Poland
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Dursun-Yildirim Sİ, Üzar-Özçetin YS. Association of Rumination and Metacognition with Posttraumatic Growth in Parents of Children with Cancer. Semin Oncol Nurs 2024; 40:151552. [PMID: 38072688 DOI: 10.1016/j.soncn.2023.151552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/28/2023] [Accepted: 11/01/2023] [Indexed: 02/12/2024]
Abstract
OBJECTIVE The primary objective of this study was to examine the association of rumination, metacognition, and posttraumatic with growth in parents of children diagnosed with cancer. DATA SOURCES The study adopted a descriptive correlational design, and participants (N = 103) were parents of children with cancer. The study was conducted online through the social media platforms of three cancer associations. Data were collected using the Metacognitions Questionnaire-30, the Event Related Rumination Inventory, and the Posttraumatic Growth Inventory. CONCLUSION The findings revealed a positive correlation between deliberate rumination and metacognition with posttraumatic growth, while a negative correlation was observed between intrusive rumination and posttraumatic growth. Furthermore, deliberate rumination, intrusive rumination, and metacognition collectively accounted for 30% of the variance in posttraumatic growth among parents of children with cancer. These results underscore the significant influence of rumination and metacognition in facilitating posttraumatic growth in this specific population. Consequently, interventions aimed at fostering deliberate rumination hold substantial potential for promoting posttraumatic growth among parents of children diagnosed with cancer. IMPLICATIONS FOR NURSING PRACTICE This research guides nurses in addressing rumination, metacognition, and posttraumatic growth in parents of children with cancer. By adopting a holistic approach, nurses can enhance parents' well-being and resilience in the face of a child's cancer diagnosis.
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Affiliation(s)
| | - Yeter Sinem Üzar-Özçetin
- Associate Professor, University College Dublin School of Nursing, Midwifery and Health Systems, Dublin Ireland
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Cherry MG, Brown SL, Purewal R, Fisher PL. Do metacognitive beliefs predict rumination and psychological distress independently of illness representations in adults with diabetes mellitus? A prospective mediation study. Br J Health Psychol 2023; 28:814-828. [PMID: 36859760 DOI: 10.1111/bjhp.12655] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 12/13/2022] [Accepted: 02/06/2023] [Indexed: 03/03/2023]
Abstract
OBJECTIVE Adults with Diabetes Mellitus (DM) experience high levels of depression and anxiety that are not always effectively ameliorated by current therapeutic approaches. The Self-Regulatory Executive Function (S-REF) model, which underpins metacognitive therapy (MCT), posits that depression and anxiety become persistent when stored metacognitive beliefs guide an individual to respond to common thoughts and feelings in a certain way. We hypothesized that (i) metacognitive beliefs would predict depression and anxiety independently of participants' representations of their illness; and (ii) rumination would mediate independent prediction of depression and anxiety by metacognitive beliefs. DESIGN A prospective mediation study. METHODS Four hundred and forty-one adults with DM (Types 1 and 2) completed a two time-point survey. Metacognitive beliefs, illness representations and rumination were measured at baseline, and depression and anxiety measured at baseline and 6-months later. Data were analysed using structural equation modelling. Baseline illness representations, depression and anxiety were used as control variables. RESULTS A structural equation analysis showed potential mediation, by baseline rumination, of any effects of baseline metacognitive variables on 6-month distress in Type 1 and 2 diabetes samples. Significant standardized coefficients for relationships between the metacognitive latent variable and rumination were .67 (Type 1) and .75 (Type 2) and between rumination and distress of .36 and .43, respectively. These effects were independent of direct and independent effects of illness representation variables. CONCLUSIONS Findings are consistent with metacognitive beliefs playing a key role in depression and anxiety by increasing the likelihood of rumination in adults with DM. MCT may be an effective intervention for this population, subsequent to further longitudinal testing of the S-REF model.
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Affiliation(s)
- Mary Gemma Cherry
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
- Clinical Health Psychology Service, Linda McCartney Centre, Liverpool University NHS Foundation Trust, Liverpool, UK
| | - Stephen L Brown
- School of Psychology, University of New England, Armidale, NSW, Australia
| | - Rebecca Purewal
- Department of Clinical, Educational, and Health Psychology, University College London, London, UK
| | - Peter L Fisher
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
- Clinical Health Psychology Service, Linda McCartney Centre, Liverpool University NHS Foundation Trust, Liverpool, UK
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Abu-Odah H, Molassiotis A, Zhao IY, Su JJ, Allsop MJ. Psychological distress and associated factors among Palestinian advanced cancer patients: A cross-sectional study. Front Psychol 2022; 13:1061327. [PMID: 36533049 PMCID: PMC9755485 DOI: 10.3389/fpsyg.2022.1061327] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/11/2022] [Indexed: 11/05/2023] Open
Abstract
OBJECTIVE There is limited research exploring the experiences of people living with advanced cancer in the Gaza Strip (GS), Palestine. Thus, this study aimed to determine the level of psychological distress, anxiety, and depression among advanced cancer patients in the GS and identify factors associated with a high level of distress. MATERIALS AND METHODS A secondary analysis was performed using primary data from a larger study focusing on supportive care needs in advanced cancer patients in GS. Three hundred sixty-one patients agreed to participate and filled out the Distress Thermometer (DT) and the Hospital Anxiety and Depression Scale (HADS). Multivariate logistic regression was conducted to identify factors associated with high distress levels. RESULTS Over two-thirds of advanced cancer patients (70.6%) reported a high level of distress. They also reported a significantly higher distress level than patients with early cancer (96.5 vs. 3.5%; p = 0.001). About 92.8% of participants reported depression and anxiety symptoms. Physical, emotional, and practical problems were the primary sources of distress. Breast cancer patients were more likely to have psychological distress than colon and stomach cancer patients. Newly diagnosed patients had a higher level of anxiety, depression, and distress than those who had a cancer diagnosis for an extended period. CONCLUSION Patients with advanced cancer in the GS exhibited a significantly higher level of psychological distress, depression and anxiety than patients with advanced cancer elsewhere. Efforts should be made to identify psychological distress as a routine part of oncology practice. Future research should further explore the causes of psychological distress in cancer patients in conflict zones and feasible mitigation strategies.
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Affiliation(s)
- Hammoda Abu-Odah
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- Nursing and Health Sciences Department, University College of Applied Sciences (UCAS), Gaza, Palestine
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- College of Arts, Humanities and Education, University of Derby, Derby, United Kingdom
| | - Ivy Y. Zhao
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Jing Jing Su
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Matthew J. Allsop
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
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Xiao PP, Ding SQ, Duan YL, Luo XF, Zhou Y, Cheng QQ, Liu XY, Xie JF, Cheng ASK. Metacognitions associated with reproductive concerns: A cross-sectional study of young adult female cancer survivors in China. Front Psychol 2022; 13:987221. [PMID: 36237684 PMCID: PMC9552999 DOI: 10.3389/fpsyg.2022.987221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/12/2022] [Indexed: 11/30/2022] Open
Abstract
Objective Cancer and its treatments affect patients’ fertility potential. This study examined the prevalence of reproductive concerns and their relationship with metacognitions among Chinese young adult female cancer survivors (YAFCS). Methods A total of 318 YAFCS (aged 18–39) completed an online survey from March to December 2021. Participants reported sociodemographic characteristics, reproductive concerns and metacognitions. Reproductive concerns were measured using the Reproductive Concerns after Cancer scale (RCAC), and metacognitions were measured by the Short Form of Metacognitions Questionnaire (MCQ-30). We used Pearson correlation analysis to examine associations between metacognitions and reproductive concerns across multiple domains and multivariable linear regression to determine the influencing factors of reproductive concerns. Results The mean score of reproductive concern among YAFCS was 49.97 ± 12.52. A total of 57.9% of participants reported a high level of concern regarding at least one dimension of reproductive concerns, and they were most concerned about their child’s health and least concerned about partner disclosure of fertility status. We also found a moderate association between RCAC and MCQ-30 scores (r = 0.408, p < 0.001). In multivariate analyses, metacognitions, especially negative metacognitive beliefs had an impact on reproductive concerns among YAFCS (p < 0.001). Conclusion Higher reproductive concerns were associated with higher metacognitions among YAFCS, especially with negative metacognitive beliefs. Oncology professionals should pay attention to assessing reproductive concerns in patients who want to have children or who have no children. Moreover, metacognitive beliefs may be an intervention target for alleviating reproductive concerns among YAFCS.
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Affiliation(s)
- Pan Pan Xiao
- Department of Nursing, Third Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Si Qing Ding
- Department of Nursing, Third Xiangya Hospital, Central South University, Changsha, China
| | - Ying Long Duan
- Department of Emergency, Third Xiangya Hospital, Central South University, Changsha, China
| | - Xiao Fei Luo
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Yi Zhou
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Qin Qin Cheng
- Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Xiang Yu Liu
- Hunan Cancer Hospital, Health Management Center, Changsha, China
| | - Jian Fei Xie
- Department of Nursing, Third Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Jian Fei Xie,
| | - Andy SK Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
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Aydın O, Balıkçı K, Arslan Y, Ünal-Aydın P, Müezzin E, Spada MM. The Combined Contribution of Fear and Perceived Danger of COVID-19 and Metacognitions to Anxiety Levels during the COVID-19 Pandemic. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2021; 40:603-617. [PMID: 34776609 PMCID: PMC8571673 DOI: 10.1007/s10942-021-00429-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2021] [Indexed: 12/20/2022]
Abstract
Despite a wide base of research suggesting a major role for dysfunctional metacognitions in contributing to anxiety, their role in explaining psychological distress in the context of the COVID-19 pandemic remains unclear. In this study we investigated whether metacognitions would predict anxiety, while controlling for fear and perceived danger of COVID-19. A total of 862 individuals were included in this study. Participants completed sociodemographic questions, emotional state questions relating to COVID-19, the Metacognitions Questionnaire-30, and the Generalized Anxiety Disorder-7. Results showed that both negative beliefs about thoughts concerning uncontrollability and danger, and cognitive self-consciousness were significant predictors of anxiety beyond the fear and perceived danger of COVID-19. Future studies involving clinical populations are needed to investigate the longer-term impact of metacognitions in the maintenance and exacerbation of anxiety associated with the fear and perceived danger of COVID-19.
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Affiliation(s)
- Orkun Aydın
- Faculty of Arts and Social Sciences, Department of Psychology, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Kuzeymen Balıkçı
- Faculty of Science and Literature, Department of Psychology, International Final University, Nicosia, Turkish Republic of Northern Cyprus
| | - Yasin Arslan
- Faculty of Arts and Social Sciences, Department of Psychology, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Pınar Ünal-Aydın
- Faculty of Arts and Social Sciences, Department of Psychology, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Ece Müezzin
- Faculty of Arts and Social Sciences, Department of Psychology, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Marcantonio M Spada
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
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Inci H, Inci F, Ersoy S, Karatas F, Adahan D. Self-esteem, metacognition, and coping strategies in cancer patients: A case-control study. J Cancer Res Ther 2021; 17:956-962. [PMID: 34528548 DOI: 10.4103/jcrt.jcrt_618_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Self-esteem refers to a person's positive and negative attitudes towards the self, and metacognition is an upper system providing awareness and direction of events and mental functions. Coping refers to the specific and psychological efforts used to deal with stressful events or the negative effects of the agents of these. The aim of this study was to evaluate self-esteem, metacognition status and coping attitudes in patients with cancer, which is known to have severely destructive psychological effects. Materials and Methods Fifty adult cancer patients who were followed up in the medical oncology clinic between July 2018 and June 2019 and 50 age- and gender-matched healthy controls as control group were included in this study. All the participants were applied with a sociodemographic data form, the Rosenberg self-esteem scale, the Metacognition Assessment Scale, and the Copying Orientation to Problems Experienced (COPE) inventory, and their results were compared between the groups. Results The groups comprised 50% females with a median age of 58 (33-82) years. The values related to the degree of participation in discussions, problem-focused coping, active coping, planning, and state of emotional vulnerability were low in the cancer patient group compared to the control group (P < 0.005 for all). The sustaining of their self-image, feeling threatened in interpersonal relationships, and degree of daydreaming were higher, and in the metacognition tests, the positive beliefs related to anxiety, uncontrolled or dangerous negative thoughts, nonfunctional coping, religious coping, joking, reckless behavior, substance use, denial, and mental disengagement scores were higher (P < 0.05 for all). Conclusion Self-esteem was lower in cancer patients and upper level cognitive functions and problem-focused coping were determined to be worse compared to healthy controls. In the light of these results, psychosocial support given to cancer patients in this respect could contribute to quality of life and social conformity.
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Affiliation(s)
- Habibe Inci
- Department of Family Medicine, Karabuk University, Karabuk, Turkey
| | - Fatih Inci
- Department of Medical Oncology, Faculty of Medicine, Karabuk University, Karabuk, Turkey
| | - Süleyman Ersoy
- Department of Family Medicine, Ümraniye Education and Research Hospital, Istanbul, Turkey
| | - Fatih Karatas
- Department of Medical Oncology, Faculty of Medicine, Karabuk University, Karabuk, Turkey
| | - Didem Adahan
- Department of Family Medicine, Karabuk University, Karabuk, Turkey
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10
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Dodd R, Fisher PL, Makin S, Moore P, Cherry MG. The Association Between Maladaptive Metacognitive Beliefs and Emotional Distress in People Living With Amyotrophic Lateral Sclerosis. Front Psychol 2021; 12:609068. [PMID: 33716871 PMCID: PMC7953059 DOI: 10.3389/fpsyg.2021.609068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 02/03/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Approximately half of all people living with amyotrophic lateral sclerosis (ALS) experience persistent or recurrent emotional distress, yet little is known about the psychological processes that maintain emotional distress in this population. The self-regulatory executive functioning (S-REF) model specifies that maladaptive metacognitive beliefs and processes are central to the development and maintenance of emotional distress. This study explored whether maladaptive metacognitive beliefs are associated with emotional distress after controlling for demographic factors, time since diagnosis, and current level of physical functioning. DESIGN In a cross-sectional design, 75 adults with a diagnosis of ALS completed self-report questionnaires. Participants had a mean age of 60.40 years, mean duration of symptoms 63.92 months, and male:female gender ratio of 14:11. MAIN OUTCOME MEASURES Questionnaires assessed emotional distress (HADS, adapted for ALS), physical functioning (ALSFRS-R), repetitive negative thinking (RTQ-10), metacognitive beliefs (MCQ-30), and demographic factors. RESULTS Maladaptive metacognitive beliefs explained additional variance in emotional distress after controlling for age, gender, time since diagnosis, physical functioning, and repetitive negative thinking. Repetitive negative thinking partially mediated the relationships between positive and negative metacognitive beliefs and emotional distress. CONCLUSIONS These data support the utility of the metacognitive model in understanding emotional distress in people with ALS. Examination of the temporal relationship between maladaptive metacognitive beliefs and emotional distress in people living with ALS may help to guide the development of therapeutic approaches.
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Affiliation(s)
- Rachel Dodd
- Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Peter L. Fisher
- Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Selina Makin
- Salford Royal NHS Foundation Trust, Salford, United Kingdom
| | - Perry Moore
- Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
- Salford Royal NHS Foundation Trust, Salford, United Kingdom
| | - Mary Gemma Cherry
- Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
- Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom
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11
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Fisher PL, Salmon P, Heffer-Rahn P, Huntley C, Reilly J, Cherry MG. Predictors of emotional distress in people with multiple sclerosis: A systematic review of prospective studies. J Affect Disord 2020; 276:752-764. [PMID: 32736185 DOI: 10.1016/j.jad.2020.07.073] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 05/20/2020] [Accepted: 07/05/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Emotional distress (defined as any negative mood state, including anxiety, depression, trauma symptoms and global distress) is common in people with multiple sclerosis (PwMS). To develop more integrated care for PwMS requires a better understanding of causal variables underlying persistent emotional distress. This systematic review critically appraised and synthesised the findings of prospective studies investigating predictors of emotional distress in PwMS. METHOD CINAHL, Medline, and PsycINFO, were systematically searched for: i) prospective cohort studies with ≥1-month follow-up period, which; ii) evaluated baseline clinical and demographic, social and/or psychosocial predictors of emotional distress; iii) presented results for adults with MS; and iv) used validated measures to assess emotional distress. Risk of bias was assessed using an adapted version of the Newcastle-Ottawa Scale. RESULTS Thirteen studies, reported in 17 papers, were included. A wide range of outcome measures and statistical methods were used. The most reliable finding was that baseline emotional distress and stress-coping variables predicted emotional distress. Less robust support was found for income, negative cognitive illness appraisals and poor social support. No other variables often predicted emotional distress. LIMITATIONS Lack of consistency across included studies may limit confidence in the results obtained. CONCLUSIONS Little is currently known about how or why some people become and remain distressed following a diagnosis of MS, whilst others do not. However, psychological and social factors such as emotional distress and stress-coping variables appear to be important. A better understanding of the psychological factors underpinning distress in PwMS is needed.
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Affiliation(s)
- Peter L Fisher
- Department of Psychological Sciences, University of Liverpool, Whelan Building, Quadrangle, Brownlow Hill, Liverpool L69 3GB, United Kingdom; Clinical Health Psychology Service, Linda McCartney Centre, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, United Kingdom.
| | - Peter Salmon
- Department of Psychological Sciences, University of Liverpool, Whelan Building, Quadrangle, Brownlow Hill, Liverpool L69 3GB, United Kingdom; Clinical Health Psychology Service, Linda McCartney Centre, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, United Kingdom
| | - Phillip Heffer-Rahn
- Department of Psychological Sciences, University of Liverpool, Whelan Building, Quadrangle, Brownlow Hill, Liverpool L69 3GB, United Kingdom
| | - Chris Huntley
- Department of Psychological Sciences, University of Liverpool, Whelan Building, Quadrangle, Brownlow Hill, Liverpool L69 3GB, United Kingdom
| | - James Reilly
- Department of Psychological Sciences, University of Liverpool, Whelan Building, Quadrangle, Brownlow Hill, Liverpool L69 3GB, United Kingdom
| | - Mary Gemma Cherry
- Department of Psychological Sciences, University of Liverpool, Whelan Building, Quadrangle, Brownlow Hill, Liverpool L69 3GB, United Kingdom; Clinical Health Psychology Service, Linda McCartney Centre, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, United Kingdom
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12
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Capobianco L, Faija C, Husain Z, Wells A. Metacognitive beliefs and their relationship with anxiety and depression in physical illnesses: A systematic review. PLoS One 2020; 15:e0238457. [PMID: 32911486 PMCID: PMC7500039 DOI: 10.1371/journal.pone.0238457] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 08/17/2020] [Indexed: 02/06/2023] Open
Abstract
Anxiety and depression are common among patients with chronic physical illnesses
and have a significant impact on morbidity, quality of life, and health service
utilisation. Psychological treatment of anxiety and depression has small to
moderate efficacy in this group and is not commonly based on a model of causal
mechanisms. A novel approach to understanding and improving mental health
outcomes in physical illnesses is needed. One approach may be to explore the
role of metacognitive beliefs which are reliably associated with anxiety and
depression in individuals with mental health difficulties. The current
systematic review aimed to evaluate the contribution of metacognitive beliefs to
anxiety and depression across physical illnesses. Systematic searches were
conducted on Web of Science, PsychINFO, MEDLINE, Embase, and CINAHL of studies
published between 1997 and January 2019. 13 eligible studies were identified
that in sum comprised 2851 participants. Metacognitive beliefs were found to
have reliable, moderate, positive and significant associations with anxiety and
depression symptoms across a range of physical illnesses. There appeared to be
commonality and some specificity in the relationships. Negative metacognitive
beliefs concerned with uncontrollability and danger of worry were associated
with both anxiety and depression across all physical illnesses assessed, whilst
more specific associations emerged for individual medical conditions where
positive beliefs about worry, cognitive confidence and cognitive
self-consciousness were unique correlates. Negative metacognitive beliefs of
uncontrollability and danger significantly and positively predicted symptoms of
anxiety and depression after controlling for factors including age, gender,
disease factors and cognition (illness perceptions and intolerance of
uncertainty). The results suggest that the metacognitive model of psychological
disorder is applicable to psychological symptoms of anxiety and depression
across a range of chronic medical conditions, implying that metacognitive
therapy might be helpful in improving outcomes in multiple morbidities that
involve poor mental and medical health.
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Affiliation(s)
- Lora Capobianco
- Research and Innovation, Greater Manchester Mental Health NHS Foundation
Trust, Manchester, United Kingdom
- * E-mail:
| | - Cintia Faija
- Division of Nursing, Midwifery & Social Work, Faculty of Biology,
Medicine and Health, Manchester Academic Health Science Centre, The University
of Manchester, Manchester, United Kingdom
| | - Zara Husain
- Research and Innovation, Greater Manchester Mental Health NHS Foundation
Trust, Manchester, United Kingdom
| | - Adrian Wells
- Research and Innovation, Greater Manchester Mental Health NHS Foundation
Trust, Manchester, United Kingdom
- Faculty of Biology, Medicine and Health, School of Psychological
Sciences, Manchester Academic Health Science Centre, The University of
Manchester, Manchester, United Kingdom
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Lenzo V, Sardella A, Martino G, Quattropani MC. A Systematic Review of Metacognitive Beliefs in Chronic Medical Conditions. Front Psychol 2020; 10:2875. [PMID: 31998178 PMCID: PMC6965316 DOI: 10.3389/fpsyg.2019.02875] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 12/04/2019] [Indexed: 12/19/2022] Open
Abstract
Background: Psychological functioning plays an important role in medical conditions and impacts patients' quality of life. Previously, many studies have highlighted the association of metacognition to both the development and maintenance of emotional disorders. Recently, several researchers pointed out the relevant role of dysfunctional metacognitive beliefs in the context of chronic diseases. Hence, dysfunctional metacognitive beliefs could be directly related to anxiety and depression, regardless of the medical condition's expression. The aim of this systematic review was to summarize the available evidence regarding the association of metacognition with anxiety, depression, and perceived quality of life, in the context of medical conditions, according to Wells' theory. Methods: A systematic review based on electronic bibliographic databases (PsycINFO, PubMed, Scopus, Web of Science, and Web of Knowledge) of scientific literature was carried out. Studies involving patients evaluated in clinical settings were included in the analysis. Results: Our findings indicated that metacognition appears to be related to anxiety, depression, and quality of life in patients with medical chronic conditions. Therefore, dysfunctional metacognitive beliefs might be a relevant factor associated with the process of adapting to illness. Conclusions: The additional evaluation of metacognitive factors in the context of several medical chronic conditions appears valuable. Due to the rising interest in the study of metacognition, suggestions for future research have also been provided.
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Affiliation(s)
- Vittorio Lenzo
- Department of Human, Social and Health Sciences, University of Cassino and South Latium, Cassino, Italy
| | - Alberto Sardella
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Maria C Quattropani
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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14
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Ng DWL, Foo CC, Ng SSM, Kwong A, Suen D, Chan M, Or A, Chun OK, Fielding BFS, Lam WWT. The role of metacognition and its indirect effect through cognitive attentional syndrome on fear of cancer recurrence trajectories: A longitudinal study. Psychooncology 2019; 29:271-279. [PMID: 31663187 DOI: 10.1002/pon.5234] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 09/05/2019] [Accepted: 09/09/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This longitudinal study mapped distinct trajectories of fear of cancer recurrence (FCR) over 12 months among patients with breast (BC) or colorectal (CRC) cancer, and examined if metacognition, indirectly via attentional bias, intrusive thoughts and avoidance (hallmarks of cognitive attentional syndrome; CAS) predicted FCR trajectory membership. METHODS Two hundred and seventy BC (n = 163) or CRC (n = 107) patients were assessed at 8-weeks, 3-, 6-, and 12-months postsurgery on a measure of FCR (FCRI-SF). Metacognition (MCQ-30), Intrusive and Avoidant Thoughts (CIES-R) and attentional bias (dot-probe tasks) were assessed at baseline. Latent growth mixture modeling identified FCR trajectories. Fully-adjusted Multinomial Logistic Regression identified whether direct and indirect effects of metacognition through CAS determined FCR trajectory membership. RESULTS Three distinct FCR trajectories were identified, namely, low-stable (62.4%), high-stable (29.2%), and recovery (8.3%). Negative beliefs about worry, cognitive confidence, and age predicted FCR trajectories (χ2 (6) = 38.31, P<.001). Compared with Low-stable group, Recovery FCR patients held greater Negative beliefs about worry (OR = 1.13, P = .035) and High-stable FCR patients reported poorer Cognitive confidence (OR = 1.12, P = .004). The effect of Negative beliefs about worry was partially mediated by avoidance (β = .06, 95% CIs 0.03-0.12) and fully mediated by intrusive thoughts (β = .14, 95% CIs 0.08-0.20). Attentional bias did not predict FCR trajectories. CONCLUSIONS While most patients experienced low level of FCR, 3 in 10 persistently worried about cancer returning over the first 12-months postsurgery. Modifying metacognitive knowledge to interrupt maladaptive cognitive processing including intrusion and avoidance may be an effective therapeutic intervention for patients at risk of persistent FCR.
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Affiliation(s)
- Danielle W L Ng
- Centre for Psycho-Oncological Research and Training, Division of Behavioural Sciences, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
| | - Chi-Chung Foo
- Department of Surgery, The University of Hong Kong, Hong Kong, Hong Kong
| | - Simon S M Ng
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Ava Kwong
- Department of Surgery, The University of Hong Kong, Hong Kong, Hong Kong
| | - Dacita Suen
- Department of Surgery, The University of Hong Kong, Hong Kong, Hong Kong
| | - Miranda Chan
- Department of Surgery, Kwong Wah Hospital, Hong Kong Hospital Authority, Hong Kong, Hong Kong
| | - Amy Or
- Department of Surgery, Kwong Wah Hospital, Hong Kong Hospital Authority, Hong Kong, Hong Kong
| | - Oi Kwan Chun
- Department of Surgery, Kwong Wah Hospital, Hong Kong Hospital Authority, Hong Kong, Hong Kong
| | - Brenna F S Fielding
- Department of Emergency Medicine, Royal Hampshire County Hospital, Winchester, Hampshire
| | - Wendy W T Lam
- Centre for Psycho-Oncological Research and Training, Division of Behavioural Sciences, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
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15
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Anderson R, Capobianco L, Fisher P, Reeves D, Heal C, Faija CL, Gaffney H, Wells A. Testing relationships between metacognitive beliefs, anxiety and depression in cardiac and cancer patients: Are they transdiagnostic? J Psychosom Res 2019; 124:109738. [PMID: 31443817 DOI: 10.1016/j.jpsychores.2019.109738] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 05/29/2019] [Accepted: 06/09/2019] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Anxiety and depression symptoms are common in patients with physical health conditions. In the metacognitive model, beliefs about cognition (metacognitions) are a key factor in the development and maintenance of anxiety and depression. The current study evaluated if metacognitions predict anxiety and/or depression symptoms and if differential or common patterns of relationships exist across cardiac and cancer patients. METHOD A secondary data analysis with 102 cardiac patients and 105 patients with breast or prostate cancer were included. Participants were drawn from two studies, Wells et al. [1] and Cook et al. [2]. All patients reported at least mild anxiety or depression symptoms. Patients completed the Metacognitions Questionnaire 30 (MCQ-30) and the Hospital Anxiety and Depression Scale (HADS). Hierarchical linear regressions evaluated metacognitive predictors of anxiety and depression across the groups. RESULTS The results of regression analyses controlling for a range of demographics and testing for effect of illness type showed that uncontrollability and danger and positive beliefs were common and independent predictors of anxiety in both groups. There was one positive bi-variate association between metacognitive beliefs (uncontrollability and danger) and depressive symptoms. CONCLUSIONS Findings support the metacognitive model, suggesting that a common set of metacognitive factors contribute to psychological distress, particularly anxiety. Uncontrollability and danger metacognitions and positive beliefs about worry appear to make independent contributions to anxiety irrespective of type of physical illness. While metacognitive beliefs were not reliably associated with depressive symptoms this may be because the current sample exhibited low depression scores.
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Affiliation(s)
- Rebecca Anderson
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Lora Capobianco
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | | | - David Reeves
- NIHR School for Primary Care Research, Division of Population of Health, Health Services Research and Primary Care, Manchester Academic Health Science Centre, University of Manchester, UK
| | - Calvin Heal
- Centre for Biostatistics, Division of Population of Health, Health Services Research and Primary Care, Manchester Academic Health Science Centre, University of Manchester, UK
| | - Cintia L Faija
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Hannah Gaffney
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK; Centre for Biostatistics, Division of Population of Health, Health Services Research and Primary Care, Manchester Academic Health Science Centre, University of Manchester, UK
| | - Adrian Wells
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK; School of Psychological Sciences, The University of Manchester, UK.
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16
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Krok D, Telka E, Zarzycka B. Illness perception and affective symptoms in gastrointestinal cancer patients: A moderated mediation analysis of meaning in life and coping. Psychooncology 2019; 28:1728-1734. [DOI: 10.1002/pon.5157] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/14/2019] [Accepted: 06/17/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Dariusz Krok
- Institute of PsychologyUniversity of Opole Opole Poland
| | - Ewa Telka
- Department of RadiotherapyCancer Center and Institute of Oncology Gliwice Poland
| | - Beata Zarzycka
- Institute of PsychologyJohn Paul II Catholic University of Lublin Lublin Poland
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17
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McPhillips R, Salmon P, Wells A, Fisher P. Cardiac Rehabilitation Patients' Accounts of Their Emotional Distress and Psychological Needs: A Qualitative Study. J Am Heart Assoc 2019; 8:e011117. [PMID: 31433708 PMCID: PMC6585358 DOI: 10.1161/jaha.118.011117] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 03/21/2019] [Indexed: 12/14/2022]
Abstract
Background Psychological distress is prevalent among patients with cardiovascular disease and is linked to increased risk of future cardiac events. Cardiac rehabilitation (CR) is widely recommended for treating psychological distress but has been of limited benefit. This study aims to understand how distressed cardiac patients describe their emotional needs and the response of CR. Methods and Results A qualitative descriptive study was conducted with 46 patients who screened positively for anxiety and/or depression. Semi-structured interviews were held, and data were analyzed using a constant comparative approach. Patients described low mood and diverse concerns, including threat of another cardiac event, restrictions on their lives, and problems unrelated to their health. Patients described worrying constantly about these concerns, worrying about their worry, and feeling that worry was uncontrollable and harmful. Patients wanted to "get back to normal" but lacked any sense of how to achieve this and were reluctant to discuss their worries with CR staff. They hoped to recover over time, meanwhile seeking reassurance that they were responding "normally." Patients were mostly dismissive of psychological techniques used in CR. Conclusions These findings expose a conundrum. Distressed CR patients have diverse worries but do not generally want to discuss them, so they invest hopes for feeling better in time passing and reassurance. An intervention acceptable to CR patients would allow them to address diverse worries but without having to share the content of worries, would have "face validity," and would address patients' worry about worry. Metacognitive therapy is an intervention that might be suitable. Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT02420431.
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Affiliation(s)
- Rebecca McPhillips
- School of Psychological SciencesFaculty of Biology, Medicine and HealthManchester Academic Health Science CentreUniversity of ManchesterUnited Kingdom
- Department of Research and InnovationGreater Manchester Mental Health TrustManchester Academic Health Science CentreManchesterUnited Kingdom
| | - Peter Salmon
- Division of Clinical PsychologyPsychological SciencesUniversity of LiverpoolUnited Kingdom
| | - Adrian Wells
- School of Psychological SciencesFaculty of Biology, Medicine and HealthManchester Academic Health Science CentreUniversity of ManchesterUnited Kingdom
- Department of Research and InnovationGreater Manchester Mental Health TrustManchester Academic Health Science CentreManchesterUnited Kingdom
| | - Peter Fisher
- Division of Clinical PsychologyPsychological SciencesUniversity of LiverpoolUnited Kingdom
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18
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Cherry MG, Salmon P, Byrne A, Ullmer H, Abbey G, Fisher PL. Qualitative Evaluation of Cancer Survivors' Experiences of Metacognitive Therapy: A New Perspective on Psychotherapy in Cancer Care. Front Psychol 2019; 10:949. [PMID: 31118912 PMCID: PMC6506788 DOI: 10.3389/fpsyg.2019.00949] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 04/09/2019] [Indexed: 01/22/2023] Open
Abstract
Background Preliminary evidence suggests that metacognitive therapy (MCT), a brief, process-focused psychological intervention, alleviates distress in cancer survivors. In a longitudinal qualitative study nested in an open trial of MCT for cancer survivors, we explored how patients understood, experienced and applied MCT. Methods Patients received six MCT sessions. Consenting patients provided semi-structured interviews post-intervention (n = 19), and at 3- and 6-months follow-up (n = 14 and 10 respectively). Interviews were audio-recorded and transcribed. Analysis followed a constant comparison approach. Results Participants felt “overwhelmed” by worry before starting MCT and doubted that such brief therapy could help. Their accounts focused on feeling “challenged” to think differently by the psychologist. Those completing therapy were enthusiastic about it. They described having learned that thoughts are “only thoughts,” that feelings of worry or sadness are a normal part of life, and that they were in control of whether and how they engaged with thoughts. Consequently, most described a sense of freedom to live free from worry. A minority described being unable to apply MCT to certain thoughts. Two patients who withdrew before completing MCT did not describe having learned what MCT was intended to achieve. Conclusion MCT is an acceptable brief intervention for distressed cancer survivors. Feeling challenged to understand the processes maintaining their distress was central to their enthusiasm for it, irrespective of their presenting difficulties. Implications for Cancer Survivors The complexity of emotional distress in cancer survivors can potentially be addressed using a transdiagnostic model which focuses on the psychological processes which maintain distress.
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Affiliation(s)
- Mary Gemma Cherry
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
| | - Peter Salmon
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
| | - Angela Byrne
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
| | - Helen Ullmer
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
| | - Gareth Abbey
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
| | - Peter L Fisher
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
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19
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Fernie BA, Aoun A, Kollmann J, Spada MM, Nikčević AV. Transcultural, transdiagnostic, and concurrent validity of a revised metacognitions about symptoms control scale. Clin Psychol Psychother 2019; 26:471-482. [PMID: 30927302 DOI: 10.1002/cpp.2367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 03/07/2019] [Accepted: 03/22/2019] [Indexed: 12/24/2022]
Abstract
Anxiety and depression add to the burden of chronic fatigue syndrome (CFS), fibromyalgia (FM), and type 1 diabetes mellitus (T1DM). Metacognitions play a role in this distress. The metacognitions about symptoms control scale (MaSCS) measure metacognitive beliefs regarding symptoms but have weaknesses. The current study created a revised MaSCS (MaSCS-R) in English, German, and Arabic versions using CFS, FM, and T1DM samples and examined the transcultural, transdiagnostic, and concurrent validity of metacognitions about symptom control. This study used data from 563 participants clinically diagnosed with CFS (n = 124; English), FM (n = 348; German), or T1DM (n = 91; Lebanese). CFS and FM data had been used in earlier published studies but were subjected to new analyses. CFS data were used to create the English version of the MaSCS-R and FM and T1DM data for German and Arabic versions. Metacognitions about worry, anxiety, depression, and symptom severity were measured. The three MaSCS-R versions, consisting of two factors (each with four items), had adequate psychometric properties, possessing configural and metric invariance. Metacognitive factors were associated with distress and symptom severity in all three samples. Metacognitions about symptom control have transcultural, transdiagnostic, and concurrent validity.
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Affiliation(s)
- Bruce A Fernie
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.,HIV Assessment and Liaison Team, South London and Maudsley NHS Foundation Trust, London, UK
| | - Amanda Aoun
- Department of Psychology, Kingston University, Kingston upon Thames, UK
| | - Josianne Kollmann
- Department of Psychological Assessment and Health Psychology, University of Konstanz, Konstanz, Germany
| | - Marcantonio M Spada
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
| | - Ana V Nikčević
- Department of Psychology, Kingston University, Kingston upon Thames, UK
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20
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Fisher PL, Byrne A, Fairburn L, Ullmer H, Abbey G, Salmon P. Brief Metacognitive Therapy for Emotional Distress in Adult Cancer Survivors. Front Psychol 2019; 10:162. [PMID: 30766505 PMCID: PMC6365419 DOI: 10.3389/fpsyg.2019.00162] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 01/17/2019] [Indexed: 01/07/2023] Open
Abstract
Background: Adult cancer survivors often experience substantial psychological morbidity following the completion of acute cancer treatment. Unfortunately, current psychological interventions are of limited efficacy. This study explored if metacognitive therapy (MCT); a brief transdiagnostic psychological intervention was potentially efficacious and could be delivered effectively to adult cancer survivors with psychological morbidity. Methods: An open trial with 3- and 6-month follow-up evaluated the treatment effects of MCT in 27 consecutively referred individuals to a clinical psychology health service specializing in psycho-oncology. Each participant received a maximum of six 1-hour sessions of MCT. Levels of anxiety, depression, fear of cancer recurrence, post-traumatic stress symptoms, health related quality of life, and metacognitive beliefs and processes were assessed using self-report questionnaires. Results: MCT was associated with statistically significant reductions across all outcome measures which were maintained through to 6-month follow-up. In the ITT sample on the primary treatment outcome measure, the Hospital Anxiety and Depression Scale-Total, 59% of participants met recovery criteria at post-treatment and 52% at 6-month follow-up, respectively. No participants significantly deteriorated. In the completer sample (N = 20), 80% recovered at post-treatment and 70% at 6-month follow-up. MCT was acceptable to patients with approximately 75% of patients completing all treatment sessions. Conclusion: MCT, a brief transdiagnostic psychological intervention can be delivered effectively to a heterogenous group of cancer survivors with promising treatment effects. Examining the efficacy of brief MCT against the current gold standard psychological intervention would be a valuable advance toward improving the quality of life of cancer survivors.
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Affiliation(s)
- Peter L Fisher
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom.,Liverpool Clinical Health, Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom.,Psychology Service, Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom
| | - Angela Byrne
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom.,Liverpool Clinical Health, Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom.,Psychology Service, Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom
| | - Louise Fairburn
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom.,Liverpool Clinical Health, Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom.,Psychology Service, Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom
| | - Helen Ullmer
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom.,Liverpool Clinical Health, Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom.,Psychology Service, Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom
| | - Gareth Abbey
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Peter Salmon
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom.,Liverpool Clinical Health, Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom.,Psychology Service, Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom
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21
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McPhillips R, Salmon P, Wells A, Fisher P. Qualitative Analysis of Emotional Distress in Cardiac Patients From the Perspectives of Cognitive Behavioral and Metacognitive Theories: Why Might Cognitive Behavioral Therapy Have Limited Benefit, and Might Metacognitive Therapy Be More Effective? Front Psychol 2019; 9:2288. [PMID: 30662413 PMCID: PMC6328488 DOI: 10.3389/fpsyg.2018.02288] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 11/02/2018] [Indexed: 02/03/2023] Open
Abstract
Introduction: Cognitive behavioral therapy (CBT) alleviates emotional distress in mental health settings, but has only modest effects in cardiac patients. Metacognitive therapy (MCT) also alleviates depression and anxiety in mental health settings and is in its initial stages of evaluation for cardiac patients. Aim: Our objective is to compare how CBT and MCT models conceptualize cardiac patients' distress, and to explore why CBT has had limited benefit for cardiac patients and whether MCT has the potential to be more efficacious. Method: Forty-nine cardiac rehabilitation patients, who screened positively for anxiety and/or depression, provided semi-structured interviews. We analyzed transcripts qualitatively to explore the "fit" of patients' accounts of their distress with the main elements of cognitive behavioral and metacognitive theories. Four illustrative cases, representative of the diverse presentations in the broader sample, were analyzed in detail and are presented here. Results: Conceptualizing patients' distress from the perspective of CBT involved applying many distinct categories to describe specific details of patients' talk, particularly the diversity of their concerns and the multiple types of cognitive distortion. It also required distinction between realistic and unrealistic thoughts, which was difficult when thoughts were associated with the risk or consequences of cardiac events. From the perspective of MCT a single category-perseverative negative thinking-was sufficient to understand all this talk, regardless of whether it indicated realistic or unrealistic thoughts, and could also be applied to some talk that did not seem relevant from a CBT perspective. Discussion: Conceptualizing distress from the perspective of CBT presents multiple, diverse therapeutic targets, not all of which a time-limited therapy would be able to address. Given the difficulty of identifying them as unrealistic or not, thoughts about disease, death or disability may not be amenable to classic CBT techniques such as reality testing. MCT proved more parsimonious and, because it did not distinguish between realistic and unrealistic thoughts, might prove a better fit to emotional distress in cardiac patients.
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Affiliation(s)
- Rebecca McPhillips
- Faculty of Biology, Medicine and Health, School of Psychological Sciences, Manchester Academic Health Science Center, University of Manchester, Manchester, United Kingdom
- Department of Research and Innovation, Greater Manchester Mental Health Trust, Manchester Academic Health Science Center, Manchester, United Kingdom
| | - Peter Salmon
- Division of Clinical Psychology, Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Adrian Wells
- Faculty of Biology, Medicine and Health, School of Psychological Sciences, Manchester Academic Health Science Center, University of Manchester, Manchester, United Kingdom
- Department of Research and Innovation, Greater Manchester Mental Health Trust, Manchester Academic Health Science Center, Manchester, United Kingdom
| | - Peter Fisher
- Division of Clinical Psychology, Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
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22
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Castanhel FD, Liberali R. Mindfulness-Based Stress Reduction on breast cancer symptoms: systematic review and meta-analysis. EINSTEIN-SAO PAULO 2018; 16:eRW4383. [PMID: 30540032 PMCID: PMC6282865 DOI: 10.31744/einstein_journal/2018rw4383] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 06/27/2018] [Indexed: 12/30/2022] Open
Abstract
Mindfulness-Based Stress Reduction practices increase the capacity for concentration and attention, and these practices are particularly effective for people with breast cancer. To analyze the effects of the application of Mindfulness-Based Stress Reduction on breast cancer symptoms. Systematic review and meta-analysis were carried out. To find suitable studies, the PubMed/ MEDLINE database was searched using the keywords "breast cancer" and "Mindfulness-Based Stress Reduction". Studies included were published between 2013 and 2017, written in English and showed methodological quality through the PEDro scale (score greater than 3). They also presented empirical evidence, had an experimental study design (randomized or non-randomized), and had full text available. For the meta-analysis, we used a random-effects model, with standardized mean differences and 95% confidence intervals. Seven studies were included, one non-randomized and containing only an intervention group of Mindfulness-Based Stress Reduction, and six randomized including samples of two or three groups. The non-randomized study showed 6 points on the PEDro scale, the randomized studies of two groups 6 to 7 points and studies with three groups showed 7 points. In the meta-analysis of the two randomized studies, the results, although not significant, revealed a moderate effect for Mindfulness-Based Stress Reduction on the outcome of fatigue, with a mean difference of -0.42 (95%CI -0.92- -0.07; p=0.09). Mindfulness-Based Stress Reduction seems to be a promising alternative for treatment of this disease's symptoms.
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Affiliation(s)
| | - Rafaela Liberali
- Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
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23
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Fisher PL, Reilly J, Noble A. Metacognitive beliefs and illness perceptions are associated with emotional distress in people with epilepsy. Epilepsy Behav 2018; 86:9-14. [PMID: 30036766 DOI: 10.1016/j.yebeh.2018.07.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 07/05/2018] [Accepted: 07/08/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE Emotional distress is common in people with epilepsy (PWE) for which efficacious interventions are required. Developing evidence-based treatments should be based on testable models of the psychological mechanisms maintaining psychopathology. The Self-Regulatory Executive Function (S-REF) model proposes that maladaptive metacognitive beliefs and processes are central to the development and maintenance of emotional distress. Although preliminary support exists for the role of metacognitive beliefs in emotional distress in PWE, their role has yet to be tested when controlling for the contribution made by illness perceptions. METHODS Four hundred and fifty-seven PWE completed an online survey, which assessed anxiety, depression, metacognitive beliefs, illness perceptions, general demographic factors, and epilepsy characteristics. RESULTS Hierarchical regression analyses demonstrated that metacognitive beliefs and illness perceptions were both associated with anxiety and depression when controlling for the influence of demographic variables and epilepsy characteristics. However, metacognitive beliefs accounted for more variance in anxiety and depression than illness perceptions. CONCLUSION Metacognitive beliefs appear to make a greater contribution to anxiety and depression in PWE than illness perceptions. Prospective studies are now needed to establish the causal role of metacognitive beliefs in both the development and persistence of emotional distress.
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Affiliation(s)
- Peter L Fisher
- Psychological Sciences, University of Liverpool, Liverpool, United Kingdom.
| | - James Reilly
- Psychological Sciences, University of Liverpool, Liverpool, United Kingdom.
| | - Adam Noble
- Psychological Sciences, University of Liverpool, Liverpool, United Kingdom.
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24
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Wells A, McNicol K, Reeves D, Salmon P, Davies L, Heagerty A, Doherty P, McPhillips R, Anderson R, Faija C, Capobianco L, Morley H, Gaffney H, Heal C, Shields G, Fisher P. Metacognitive therapy home-based self-help for cardiac rehabilitation patients experiencing anxiety and depressive symptoms: study protocol for a feasibility randomised controlled trial (PATHWAY Home-MCT). Trials 2018; 19:444. [PMID: 30115112 PMCID: PMC6097432 DOI: 10.1186/s13063-018-2826-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 07/27/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Anxiety and depression are common among patients attending cardiac rehabilitation services. Currently available pharmacological and psychological interventions have limited effectiveness in this population. There are presently no psychological interventions for anxiety and depression integrated into cardiac rehabilitation services despite emphasis in key UK National Health Service policy. A new treatment, metacognitive therapy, is highly effective at reducing anxiety and depression in mental health settings. The principal aims of the current study are (1) to evaluate the acceptability of delivering metacognitive therapy in a home-based self-help format (Home-MCT) to cardiac rehabilitation patients experiencing anxiety and depressive symptoms and conduct a feasibility trial of Home-MCT plus usual cardiac rehabilitation compared to usual cardiac rehabilitation; and (2) to inform the design and sample size for a full-scale trial. METHODS The PATHWAY Home-MCT trial is a single-blind feasibility randomised controlled trial comparing usual cardiac rehabilitation (control) versus usual cardiac rehabilitation plus home-based self-help metacognitive therapy (intervention). Economic and qualitative evaluations will be embedded within the trial. Participants will be assessed at baseline and followed-up at 4 and 12 months. Patients who have been referred to cardiac rehabilitation programmes and have a score of ≥ 8 on the anxiety and/or depression subscales of the Hospital Anxiety and Depression Scale will be invited to take part in the study and written informed consent will be obtained. Participants will be recruited from the National Health Service in the UK. A minimum of 108 participants will be randomised to the intervention and control arms in a 1:1 ratio. DISCUSSION The Home-MCT feasibility randomised controlled trial will provide evidence on the acceptability of delivering metacognitive therapy in a home-based self-help format for cardiac rehabilitation patients experiencing symptoms of anxiety and/or depression and on the feasibility and design of a full-scale trial. In addition, it will provide provisional point estimates, with appropriately wide measures of uncertainty, relating to the effectiveness and cost-effectiveness of the intervention. TRIAL REGISTRATION ClinicalTrials.gov, NCT03129282 , Submitted to Registry: 11 April 2017.
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Affiliation(s)
- Adrian Wells
- The University of Manchester, School of Psychological Sciences, Faculty of Biology, Medicine and Health, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL UK
- Greater Manchester Mental Health NHS Foundation Trust, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL UK
| | - Kirsten McNicol
- Greater Manchester Mental Health NHS Foundation Trust, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL UK
| | - David Reeves
- The University of Manchester, NIHR School for Primary Care Research, Manchester Academic Health Science Centre, Williamson Building, Oxford Road, Manchester, M13 9PL UK
| | - Peter Salmon
- University of Liverpool, Institute of Psychology, Health and Society, Waterhouse Building, Block B, Brownlow Street, Liverpool, L69 3GL UK
- The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Prescot Street, Liverpool, L7 8XP UK
| | - Linda Davies
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Centre for Health Economics, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL UK
| | - Anthony Heagerty
- The University of Manchester, School of Medical Sciences, Core Technology Facility, Grafton Street, Manchester, M13 9NT UK
- Central Manchester Foundation Trust, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL UK
| | - Patrick Doherty
- Department of Health Sciences, University of York, Seebohm Rowntree Building, York, YO10 5DD UK
| | - Rebecca McPhillips
- Greater Manchester Mental Health NHS Foundation Trust, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL UK
| | - Rebecca Anderson
- Greater Manchester Mental Health NHS Foundation Trust, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL UK
| | - Cintia Faija
- Greater Manchester Mental Health NHS Foundation Trust, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL UK
| | - Lora Capobianco
- Greater Manchester Mental Health NHS Foundation Trust, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL UK
| | - Helen Morley
- Division of Neuroscience and Experimental Psychology, The University of Manchester, School of Biological Sciences, Oxford Road, Manchester, M13 9PL UK
| | - Hannah Gaffney
- Division of Psychology and Mental Health, The University of Manchester, School of Health Sciences, Oxford Road, Manchester, M13 9PL UK
| | - Calvin Heal
- The University of Manchester, Centre for Biostatistics, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, Manchester, M13 9PL UK
| | - Gemma Shields
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Centre for Health Economics, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL UK
| | - Peter Fisher
- University of Liverpool, Institute of Psychology, Health and Society, Waterhouse Building, Block B, Brownlow Street, Liverpool, L69 3GL UK
- The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Prescot Street, Liverpool, L7 8XP UK
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25
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Wells A, McNicol K, Reeves D, Salmon P, Davies L, Heagerty A, Doherty P, McPhillips R, Anderson R, Faija C, Capobianco L, Morley H, Gaffney H, Shields G, Fisher P. Improving the effectiveness of psychological interventions for depression and anxiety in the cardiac rehabilitation pathway using group-based metacognitive therapy (PATHWAY Group MCT): study protocol for a randomised controlled trial. Trials 2018; 19:215. [PMID: 29615092 PMCID: PMC5883514 DOI: 10.1186/s13063-018-2593-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 03/13/2018] [Indexed: 12/24/2022] Open
Abstract
Background Anxiety and depression are prevalent among cardiac rehabilitation patients but pharmacological and psychological treatments have limited effectiveness in this group. Furthermore, psychological interventions have not been systematically integrated into cardiac rehabilitation services despite being a strategic priority for the UK National Health Service. A promising new treatment, metacognitive therapy, may be well-suited to the needs of cardiac rehabilitation patients and has the potential to improve outcomes. It is based on the metacognitive model, which proposes that a thinking style dominated by rumination, worry and threat monitoring maintains emotional distress. Metacognitive therapy is highly effective at reducing this thinking style and alleviating anxiety and depression in mental health settings. This trial aims to evaluate the effectiveness and cost-effectiveness of group-based metacognitive therapy for cardiac rehabilitation patients with elevated anxiety and/or depressive symptoms. Methods/Design The PATHWAY Group-MCT trial is a multicentre, two-arm, single-blind, randomised controlled trial comparing the clinical- and cost-effectiveness of group-based metacognitive therapy plus usual cardiac rehabilitation to usual cardiac rehabilitation alone. Cardiac rehabilitation patients (target sample n = 332) with elevated anxiety and/or depressive symptoms will be recruited across five UK National Health Service Trusts. Participants randomised to the intervention arm will receive six weekly sessions of group-based metacognitive therapy delivered by either cardiac rehabilitation professionals or research nurses. The intervention and control groups will both be offered the usual cardiac rehabilitation programme within their Trust. The primary outcome is severity of anxiety and depressive symptoms at 4-month follow-up measured by the Hospital Anxiety and Depression Scale total score. Secondary outcomes are severity of anxiety/depression at 12-month follow-up, health-related quality of life, severity of post-traumatic stress symptoms and strength of metacognitive beliefs at 4- and 12-month follow-up. Qualitative interviews will help to develop an account of barriers and enablers to the effectiveness of the intervention. Discussion This trial will evaluate the effectiveness and cost-effectiveness of group-based metacognitive therapy in alleviating anxiety and depression in cardiac rehabilitation patients. The therapy, if effective, offers the potential to improve psychological wellbeing and quality of life in this large group of patients. Trial registration UK Clinical Trials Gateway, ISRCTN74643496, Registered on 8 April 2015. Electronic supplementary material The online version of this article (10.1186/s13063-018-2593-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Adrian Wells
- School of Psychological Sciences, Faculty of Biology, Medicine and Health, Rawnsley Building, Manchester Royal Infirmary, The University of Manchester, Oxford Road, Manchester, M13 9WL, UK. .,Greater Manchester Mental Health NHS Foundation Trust, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK.
| | - Kirsten McNicol
- Greater Manchester Mental Health NHS Foundation Trust, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK
| | - David Reeves
- NIHR School for Primary Care Research, Manchester Academic Health Science Centre, The University of Manchester, Williamson Building, Oxford Road, Manchester, M13 9PL, UK
| | - Peter Salmon
- Institute of Psychology, Health and Society, University of Liverpool, Waterhouse Building, Block B, Brownlow Street, Liverpool, L69 3GL, UK.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Prescot Street, Liverpool, L7 8XP, UK
| | - Linda Davies
- Centre for Health Economics, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
| | - Anthony Heagerty
- School of Medical Sciences, Core Technology Facility, The University of Manchester, Grafton Street, Manchester, M13 9NT, UK.,Central Manchester Foundation Trust, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK
| | - Patrick Doherty
- Department of Health Sciences, University of York, Seebohm Rowntree Building, York, YO10 5DD, UK
| | - Rebecca McPhillips
- Greater Manchester Mental Health NHS Foundation Trust, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK
| | - Rebecca Anderson
- Greater Manchester Mental Health NHS Foundation Trust, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK
| | - Cintia Faija
- Greater Manchester Mental Health NHS Foundation Trust, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK
| | - Lora Capobianco
- Greater Manchester Mental Health NHS Foundation Trust, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK
| | - Helen Morley
- School of Biological Sciences, Division of Neuroscience and Experimental Psychology, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Hannah Gaffney
- School of Health Sciences, Division of Psychology and Mental Health, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Gemma Shields
- Centre for Health Economics, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
| | - Peter Fisher
- Institute of Psychology, Health and Society, University of Liverpool, Waterhouse Building, Block B, Brownlow Street, Liverpool, L69 3GL, UK.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Prescot Street, Liverpool, L7 8XP, UK
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26
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Nordahl H, Nordahl HM, Vogel PA, Wells A. Explaining depression symptoms in patients with social anxiety disorder: Do maladaptive metacognitive beliefs play a role? Clin Psychol Psychother 2018; 25:457-464. [PMID: 29493054 DOI: 10.1002/cpp.2181] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 01/03/2018] [Accepted: 01/16/2018] [Indexed: 01/04/2023]
Abstract
Social anxiety disorder (SAD) is a major risk factor for developing symptoms of depression. Severity of social anxiety has previously been identified as a risk factor, and cognitive models emphasize dysfunctional schemas and self-processing as the key vulnerability factors underlying general distress in SAD. However, in the metacognitive model, depressive and other symptoms are related to metacognitive beliefs. The aim of this study was therefore to test the relative contribution of metacognitions when controlling for SAD severity and factors postulated in cognitive models. In a cross-sectional design, 102 patients diagnosed with primary SAD were included. We found that negative metacognitive beliefs concerning uncontrollability and danger and low confidence in memory emerged as the only factors explaining depressive symptoms in the regression model, suggesting that metacognitive beliefs are associated with increased depressive symptoms in SAD patients.
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Affiliation(s)
- Henrik Nordahl
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.,St. Olavs Hospital, Nidaros DPS, Trondheim University Hospital, Trondheim, Norway
| | - Hans M Nordahl
- St. Olavs Hospital, Nidaros DPS, Trondheim University Hospital, Trondheim, Norway.,Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Patrick A Vogel
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Adrian Wells
- School of Psychological Sciences, University of Manchester, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Prestwich, UK
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27
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Purewal R, Fisher PL. The contribution of illness perceptions and metacognitive beliefs to anxiety and depression in adults with diabetes. Diabetes Res Clin Pract 2018; 136:16-22. [PMID: 29203257 DOI: 10.1016/j.diabres.2017.11.029] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 11/04/2017] [Accepted: 11/28/2017] [Indexed: 12/17/2022]
Abstract
AIMS Anxiety and depression are highly prevalent in people with diabetes (PwD). The most widely used psychological model to explain anxiety and depression in PwD is the Common-Sense Model, which gives a central role to illness perceptions. The Self-Regulatory Executive Function (S-REF) model proposes metacognitive beliefs are key to understanding the development and maintenance of emotional disorders. To test the potential utility of the S-REF model in PwD, the study explored if metacognitive beliefs explained additional variance in anxiety and depression after controlling for demographic and illness perceptions. METHODS 614 adults with either Type 1 (n = 335) or Type 2 (n = 279) diabetes participated in a cross sectional online survey. All participants completed questionnaires on anxiety, depression, illness perceptions and metacognitive beliefs. RESULTS Regression analyses showed that metacognitive beliefs were associated with anxiety and depression in PwD and explained additional variance in both anxiety and depression after controlling for demographics and illness perceptions. CONCLUSIONS This is the first study to demonstrate that metacognitive beliefs are associated with anxiety and depression in PwD. The clinical implications of the study are illustrated.
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Affiliation(s)
- Rebecca Purewal
- Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Peter L Fisher
- Psychological Sciences, University of Liverpool, Liverpool, United Kingdom; Nidaros DPS, Division of Psychiatry, St. Olavs University Hospital, Trondheim, Norway.
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28
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Cook SA, Salmon P, Hayes G, Byrne A, Fisher PL. Predictors of emotional distress a year or more after diagnosis of cancer: A systematic review of the literature. Psychooncology 2018; 27:791-801. [PMID: 29318702 PMCID: PMC5873392 DOI: 10.1002/pon.4601] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 10/27/2017] [Accepted: 11/23/2017] [Indexed: 11/12/2022]
Abstract
Objective Why some people recover emotionally after diagnosis and treatment of cancer and others do not is poorly understood. To identify factors around the time of diagnosis that predict longer‐term distress is a necessary step in developing interventions to reduce patients' vulnerability. This review identified the demographic, clinical, social, and psychological factors available at or within 3 months of diagnosis that are reliable predictors of emotional distress at least 12 months later. Methods A systematic search of literature for prospective studies addressing our research question and predicting a range of distress outcomes was conducted. Thirty‐nine papers (reporting 36 studies) were subjected to narrative synthesis of the evidence. Results There was no consistent evidence that demographic, clinical, or social factors reliably predicted longer‐term distress. Of the psychological factors examined, only baseline distress (significant in 26 of 30 relevant papers; 24 of 28 studies) and neuroticism (significant in all 5 papers/studies that examined it) consistently predicted longer‐term distress. The heterogeneity of included studies, particularly in populations studied and methodology, precluded meta‐analytic techniques. Conclusions This review supports current clinical guidance advising early assessment of distress as a marker of vulnerability to persistent problems. Additionally, neuroticism is also indicated as a useful marker of vulnerability. However, the review also highlights that more sophisticated research designs, capable of identifying the psychological processes that underlie the association between these marker variables and persistent distress, are needed before more effective early interventions can be developed.
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Affiliation(s)
- Sharon A Cook
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Peter Salmon
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Gemma Hayes
- The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Angela Byrne
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Peter L Fisher
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK.,Nidaros DPS, Østmarka University Hospital, Trondheim, Norway
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29
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Heffer-Rahn P, Fisher PL. The clinical utility of metacognitive beliefs and processes in emotional distress in people with multiple sclerosis. J Psychosom Res 2018; 104:88-94. [PMID: 29275790 DOI: 10.1016/j.jpsychores.2017.11.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 11/01/2017] [Accepted: 11/25/2017] [Indexed: 12/14/2022]
Abstract
AIM Multiple sclerosis (MS) is a chronic demyelinating disease that poses significant life challenges. Depression and anxiety often occur in people with MS (PwMS). An information processing model of psychopathology, the Self-Regulatory Executive Function (S-REF) model specifies that maladaptive metacognitive beliefs play a fundamental role in the development and maintenance of distress. The model also asserts that a style of thinking known as the cognitive attentional syndrome (CAS), which consists of worry and rumination, focusing on sources of threat, and unhelpful coping responses, is common across all psychological conditions. This study investigated for the first time whether metacognitive beliefs explained additional variance in distress in PwMS, after accounting for demographic, clinical, and illness appraisal variables. METHOD One hundred and thirty-two participants with MS completed self-report questionnaires measuring distress, fatigue, pain, metacognitive beliefs, illness appraisals, and the CAS. Hierarchical regression modelling was used to test whether metacognitive beliefs accounted for distress. Mediational modelling examined if the CAS mediated the association between metacognitive beliefs and distress. RESULTS Metacognitive beliefs made a unique contribution to distress, over and above demographic and clinical variables, and illness appraisals. The CAS fully mediated the relationship between positive metacognitive beliefs and distress, and partially mediated the relationship between negative metacognitive beliefs and distress. CONCLUSIONS Metacognitive beliefs are associated with emotional distress in PwMS, and the CAS mediates this relationship. Future studies should examine if modification of metacognitive beliefs and processes in PwMS will lead to effective alleviation of emotional distress.
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Affiliation(s)
- Philip Heffer-Rahn
- Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Peter L Fisher
- Psychological Sciences, University of Liverpool, Liverpool, United Kingdom; Nidaros DPS, Division of Psychiatry, St. Olavs University Hospital, Trondheim, Norway.
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30
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Abreu C, Grilo A, Lucena F, Carolino E. Oncological Patient Anxiety in Imaging Studies: the PET/CT Example. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:820-826. [PMID: 27370917 PMCID: PMC5670194 DOI: 10.1007/s13187-016-1069-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The purpose of this study was to investigate the subjective perception of anxiety pre- and post-procedure, and explore the relationship between demographic, clinical variables and cancer patients' anxiety during a positron emission tomography/computed tomography (PET/CT) scan. Two hundred and thirty-two oncological out patients, with clinical indication for performing an 18F-2-fluoro-2-deoxy-D-glucose (18F-FDG) PET/CT scan and attending a nuclear medicine (NM) department, participated in the study. Patients' anxiety and subjective experience of PET/CT were examined using two self-report questionnaires. The pre-procedure questionnaire focused on demographic information, level of knowledge regarding the scan and subjective perception of anxiety before the procedure. The post-procedure questionnaire included the subjective perception anxiety after the procedure, information adequacy and satisfaction with the NM department. The self-reported data indicate that patients were anxious during PET/CT. Furthermore, our data revealed a significant difference between the anxiety pre-procedure and post-procedure (z = -3909, p < 0.05), in which the anxiety pre-procedure has significantly higher values. No significant correlation was found between anxiety and age of the patients, education levels, adequacy of information or satisfaction with the NM Department. Perception of anxiety post-procedure differs between gender (U = 5641, p = 0.033). In conclusion, PET/CT generated anxiety levels in oncological patients, especially before the procedure. Although patients seemed to be satisfied with information delivered by staff and with the NM Department, attention has to be focused on effective interventions strategies that help patients to reduce anxiety.
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Affiliation(s)
- Carla Abreu
- King’s College London & Guy’s and St. Thomas’ PET Centre, St. Thomas’ Hospital, Lambeth Palace Road, SE1 7EH, London, UK
| | - Ana Grilo
- Department of Social Sciences and Humanities, Scientific Area of Psychology, Higher School of Health Technology, Polytechnical Institute of Lisbon, Portugal, Av. Dom João II Lote 4.69.01, 1990-096 Lisbon, Portugal
| | - Filipa Lucena
- Scientific Area of Nuclear Medicine, Higher School of Health Technology, Polytechnical Institute of Lisbon, Portugal, Av. Dom João II Lote 4.69.01, 1990-096 Lisbon, Portugal
| | - Elisabete Carolino
- Department of Natural and Exact Sciences, Area of Mathematics, Higher School of Health Technology, Polytechnical Institute of Lisbon, Portugal, Av. Dom João II Lote 4.69.01, 1990-096 Lisbon, Portugal
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31
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Park JH, Chun M, Jung YS, Bae SH. Predictors of Psychological Distress Trajectories in the First Year After a Breast Cancer Diagnosis. Asian Nurs Res (Korean Soc Nurs Sci) 2017; 11:268-275. [PMID: 29290274 DOI: 10.1016/j.anr.2017.10.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 10/11/2017] [Accepted: 10/24/2017] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Psychological distress is a significant and ongoing problem for breast cancer. These mental health problems are often neglected as they are not always properly understood. This study was performed to explore the trajectory of psychological distress over 1 year since breast cancer surgery and to identify the associated factors for the trajectory. METHODS One hundred seventeen women who underwent surgery for breast cancer completed the psychological distress thermometer and problem lists from after surgery to 12 months after surgery. Information on their sociodemographic and clinical characteristics was also obtained. Group-based trajectory modeling was performed to identify the distinct trajectories of psychological distress. Chi-square test and logistic regression analysis were performed to determine predictors of psychological distress trajectories. RESULTS A two-group linear trajectory model was optimal for modeling psychological distress (Bayesian information criterion = -777.41). Group-based trajectory modeling identified consistently high-distress (19.4%) and low-decreasing distress (80.6%) trajectories. Old age, depression, nervousness, and pain were significant predictors of consistently high-distress trajectory. CONCLUSION Our results indicate that distinct trajectory groups can be used as a screening tool to identify patients who may be at an increased risk of psychological distress over time. Screening for psychological distress during disease diagnosis is important and necessary to identify patients who are at an increased risk of elevated distress or at risk of experiencing psychological distress over time.
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Affiliation(s)
- Jin-Hee Park
- College of Nursing·Nursing Research Institute, Ajou University, Suwon, Republic of Korea
| | - Mison Chun
- Department of Radiation Oncology, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - Yong-Sik Jung
- Department of Surgery, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - Sun Hyoung Bae
- College of Nursing·Nursing Research Institute, Ajou University, Suwon, Republic of Korea.
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32
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Anxiety and depression in people with epilepsy: The contribution of metacognitive beliefs. Seizure 2017; 50:153-159. [DOI: 10.1016/j.seizure.2017.06.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 05/15/2017] [Accepted: 06/13/2017] [Indexed: 01/02/2023] Open
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Cognitive and Metacognitive Mechanisms of Change in Metacognitive Training for Depression. Sci Rep 2017; 7:3449. [PMID: 28615651 PMCID: PMC5471213 DOI: 10.1038/s41598-017-03626-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 05/02/2017] [Indexed: 11/08/2022] Open
Abstract
Metacognitive Training for Depression (D-MCT), a low-threshold group intervention, has been shown to improve depressive symptoms. It aims at the reduction of depression by changing dysfunctional cognitive as well as metacognitive beliefs. The purpose of the present study was to investigate whether the mechanisms of change in D-MCT are cognitive (and thus primarily concern the content of cognition) or metacognitive in nature. Eighty-four outpatients with depression were included in a randomized controlled trial comparing D-MCT to an active control intervention. Level of depression, dysfunctional cognitive beliefs (DAS), and metacognitive beliefs (MCQ subscales: Positive Beliefs, Negative Beliefs, Need for Control) were assessed before (t0) and after treatment (t1). Severity of depression was also assessed 6 months later (t2). Linear regression analyses were used to determine whether change in depression from t0 to t2 was mediated by change in cognitive vs. metacognitive beliefs from t0 to t1. D-MCT's effect on change in depression was mediated by a decrease in dysfunctional metacognitive beliefs, particularly 'need for control'. Our findings underline that one of the key mechanisms of improvement in D-MCT is the change in metacognitive beliefs. The current study provides further support for the importance of metacognition in the treatment of depression.
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34
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Fisher PL, Byrne A, Salmon P. Metacognitive Therapy for Emotional Distress in Adult Cancer Survivors: A Case Series. COGNITIVE THERAPY AND RESEARCH 2017; 41:891-901. [PMID: 29104332 PMCID: PMC5656708 DOI: 10.1007/s10608-017-9862-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Many adult cancer survivors experience persistent emotional distress after completing cancer treatment. The aim of this study was to test the potential of a brief transdiagnostic psychological intervention—metacognitive therapy (MCT)—in reducing emotional distress in adult cancer survivors. A non-concurrent multiple baseline design with 3- and 6-months follow-up was used to evaluate the effects of MCT in four patients consecutively referred to a psycho-oncology service. Each patient received six 1-h sessions of MCT. Anxiety, depression, worry/rumination, fear of cancer recurrence and metacognitive beliefs were assessed using self-report questionnaires. MCT was associated with clinically significant reductions in anxiety, depression, fear of cancer recurrence, worry/rumination and metacognitive beliefs at the end of treatment, and gains were maintained in all patients to 3-months follow-up and in three out of four patients to 6-months follow-up. MCT is a promising brief transdiagnostic approach to psychological morbidity in adult survivors of cancer. Larger scale controlled trials are now required.
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Affiliation(s)
- Peter L Fisher
- Psychological Sciences, University of Liverpool, Whelan Buliding, Liverpool, L69 3GB UK.,Liverpool Psychology Cancer Service, Royal Liverpool and Broadgreen NHS Trust, Liverpool, UK.,Nidaros, Østmarka University Hospital, Trondheim, Norway
| | - Angela Byrne
- Psychological Sciences, University of Liverpool, Whelan Buliding, Liverpool, L69 3GB UK.,Liverpool Psychology Cancer Service, Royal Liverpool and Broadgreen NHS Trust, Liverpool, UK
| | - Peter Salmon
- Psychological Sciences, University of Liverpool, Whelan Buliding, Liverpool, L69 3GB UK.,Liverpool Psychology Cancer Service, Royal Liverpool and Broadgreen NHS Trust, Liverpool, UK
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35
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Donnellan C, Al Banna M, Redha N, Al Sharoqi I, Al-Jishi A, Bakhiet M, Taha S, Abdulla F. Association Between Metacognition and Mood Symptoms Poststroke. J Geriatr Psychiatry Neurol 2016; 29:212-20. [PMID: 27056067 DOI: 10.1177/0891988716640374] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 02/10/2016] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The link between metacognition and mood has been well established, particularly in other conditions with psychological comorbidity, however, there is no evidence regarding this association in the area of stroke. AIM The aim of this study was to examine the association between metacognition, based on the Self-Regulatory Executive Function model, and mood symptoms in the acute phase after stroke. METHODS One hundred thirty patients were recruited to a prospective stroke study in Bahrain, and n = 64 were assessed for mood and cognition. A neuropsychological battery of cognitive assessments included the following measures: the Mini-Mental State Examination, the Trail Making Test (A+B), and the Metacognition Questionnaire 30 (MCQ-30) for metacognition. The Hospital Anxiety and Depression Scale assessed mood symptoms, and stroke severity was measured using the National Institute of Health Stroke Severity Scale. RESULTS Total MCQ-30 scores were significantly associated with both anxiety (r = .47, P = .001) and depression (r = .54, P <. 0001). The MCQ-30 subscales' cognitive confidence, cognitive self-consciousness, and uncontrollability/danger were the specific factors to be associated with mood symptoms (P < .01). Global cognition (r =.32, P < .01), but not executive function, was significantly associated with depression only. Metacognition remained a statistically significant correlate with depression (β = .42, P < .0001) and anxiety (β = .51, P < .0001) after adjusting for education and global cognition. DISCUSSION Metacognition is a better determinant of mood symptoms after stroke, especially in regions where illiteracy levels are high in older populations, in comparison to executive function and global cognition.
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Affiliation(s)
- Claire Donnellan
- School of Medicine, Royal College of Surgeons in Ireland-Medical University of Bahrain, Busaiteen, Kingdom of Bahrain School of Postgraduate Studies, Royal College of Surgeons in Ireland-Medical University of Bahrain, Busaiteen, Kingdom of Bahrain School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - M Al Banna
- School of Postgraduate Studies, Royal College of Surgeons in Ireland-Medical University of Bahrain, Busaiteen, Kingdom of Bahrain
| | - N Redha
- School of Postgraduate Studies, Royal College of Surgeons in Ireland-Medical University of Bahrain, Busaiteen, Kingdom of Bahrain
| | - I Al Sharoqi
- Department of Clinical Neurosciences, Salmaniya Medical Complex, Salmaniya, Kingdom of Bahrain
| | - A Al-Jishi
- Department of Clinical Neurosciences, Salmaniya Medical Complex, Salmaniya, Kingdom of Bahrain
| | - M Bakhiet
- Department of Molecular Medicine, Princess Al-Jawhara Center for Genetics and Inherited Diseases, Salmaniya Kingdom of Bahrain
| | - S Taha
- Department of Molecular Medicine, Princess Al-Jawhara Center for Genetics and Inherited Diseases, Salmaniya Kingdom of Bahrain
| | - F Abdulla
- Department of Clinical Neurosciences, Salmaniya Medical Complex, Salmaniya, Kingdom of Bahrain
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Fisher PL, Cook SA, Noble A. Clinical utility of the Metacognitions Questionnaire 30 in people with epilepsy. Epilepsy Behav 2016; 57:185-191. [PMID: 26970994 DOI: 10.1016/j.yebeh.2016.02.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 02/04/2016] [Accepted: 02/05/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The Metacognitions Questionnaire 30 (MCQ-30) has been widely used to assess metacognitive beliefs and processes linked to emotional disorders. The aim of the present study was to test the utility of the MCQ-30 in assessing metacognitions in people with epilepsy. METHODS Three hundred forty-nine people with epilepsy completed the MCQ-30 and self-report measures of anxiety and depression at two time points, 12 months apart. Factor analyses and structural equation modeling were used to test the factor structure, internal consistency, and convergent validity of the MCQ-30. RESULTS Confirmatory and exploratory factor analyses supported the original five-factor structure and demonstrated that each factor had good to excellent levels of internal consistency. CONCLUSION The MCQ-30 is a robust measure of metacognitive beliefs and processes and has clinical utility in PWE.
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Affiliation(s)
- Peter L Fisher
- Psychological Sciences, University of Liverpool, Liverpool, United Kingdom.
| | - Sharon A Cook
- Psychological Sciences, University of Liverpool, Liverpool, United Kingdom.
| | - Adam Noble
- Psychological Sciences, University of Liverpool, Liverpool, United Kingdom.
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Fear of cancer recurrence: a theoretical review and novel cognitive processing formulation. J Cancer Surviv 2016; 10:663-73. [PMID: 26782171 DOI: 10.1007/s11764-015-0512-5] [Citation(s) in RCA: 144] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 12/25/2015] [Indexed: 12/16/2022]
Abstract
PURPOSE Fear of cancer recurrence (FCR) is prevalent among survivors. However, a comprehensive and universally accepted theoretical framework of FCR to guide intervention is lacking. This paper reviews theoretical frameworks previously used to explain FCR and describes the formulation of a novel theoretical framework for FCR. METHODS A systematic review of the literature was undertaken to identify conceptual frameworks or theories applied to FCR. MEDLINE, PubMED, CINAHL, AMED, PsycINFO and Web of Science were searched. Identified conceptual frameworks were reviewed for strength of evidence supporting their validity. RESULTS Of 558 papers initially identified, 16 made reference to six different conceptual frameworks relating to FCR. The most comprehensive and evidence-based theoretical approach is the Common Sense Model (CSM). Other approaches have limited evidence supporting their application to FCR. Two theoretical approaches developed in the context of emotional disorders that appear to be highly relevant to FCR: the Self-Regulatory Executive Function (S-REF) model and Relational Frame Theory were combined with the CSM to produce a novel cognitive processing account of FCR. CONCLUSIONS Few conceptual frameworks have been used consistently to guide FCR research, and not all frameworks are empirically well supported, suggesting that further discussion regarding the conceptualisation of FCR is needed. The novel theoretical framework for FCR presented highlights the multidimensional nature of FCR and the importance of cognitive processing and metacognitions in the development and maintenance of FCR. IMPLICATIONS FOR CANCER SURVIVORS The novel theoretical formulation of FCR outlined here provides a much-needed comprehensive framework to further investigate and address FCR in cancer survivors.
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Papageorgiou C. Metacognitive Theory, Therapy and Techniques: Introduction to the Special Issue. COGNITIVE THERAPY AND RESEARCH 2014. [DOI: 10.1007/s10608-014-9649-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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