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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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2
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Luca M, Eccles F, Perez Algorta G, Patti F. Illness perceptions and outcome in multiple sclerosis: A systematic review of the literature. Mult Scler Relat Disord 2022; 67:104180. [PMID: 36130458 DOI: 10.1016/j.msard.2022.104180] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/08/2022] [Accepted: 09/11/2022] [Indexed: 11/24/2022]
Abstract
According to Leventhal's self-regulation model, ill people construct personal representations of their disease, namely illness perceptions, which impact their coping strategies and the emotional response to their condition. Since these representations develop in the social environment, the individuals' perceptions may also be related to the opinions of their caregivers. This systematic review aims at synthesising and critically appraising literature pertaining the relationship between illness perceptions and outcome in persons with multiple sclerosis and their caregivers. A literature search was conducted in MEDLINE, PsycINFO, and CINAHL. Only papers with the following characteristics were included: quantitative studies; written in English or Italian; published from 1992; investigating the relationship between illness perceptions and any outcome in persons with multiple sclerosis and/or their caregivers; using validated scales assessing illness perceptions. Twenty papers were included and appraised through the 16-item Quality Assessment Tool for Studies with Diverse Designs. The quality of the papers was acceptable. Eighteen out of 20 papers reported the existence of a moderate effect size when analysing the relationship between illness perceptions and outcome, whereby "positive" perceptions (e.g. stronger beliefs of control) related to better outcomes, while "negative" ones (e.g. attribution of negative consequences to the disease) related to worse outcome.
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Affiliation(s)
- Maria Luca
- Centre for Addiction, Via Pò 2, 95031 Adrano, Italy; Division of Health Research, Faculty of Health and Medicine, Lancaster University, Bailrigg, Lancaster LA1 4YW, UK.
| | - Fiona Eccles
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Bailrigg, Lancaster LA1 4YW, UK
| | - Guillermo Perez Algorta
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Bailrigg, Lancaster LA1 4YW, UK
| | - Francesco Patti
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Via S. Sofia 78, 95125 Catania, Italy
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3
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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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Russell JK, Strodl E, Kavanagh DJ. Correlates of distress in young people with cystic fibrosis: the role of self-efficacy and metacognitive beliefs. Psychol Health 2020; 36:1497-1513. [PMID: 33370209 DOI: 10.1080/08870446.2020.1861280] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES While significantly elevated distress is repeatedly found amongst young people with cystic fibrosis, their determinants remain largely unknown. This study explored whether metacognitive beliefs and self-efficacy for emotion regulation were associated with anxiety and depression after control for physical functioning, age and gender. DESIGN Cross-sectional study using a 110-item online questionnaire. METHODS An online survey was undertaken by 147 young people with CF aged 10-18 from five countries. Associations of Hospital Anxiety and Depression Scale scores with gender, age, physical functioning, Metacognitive Beliefs Questionnaire for Children (MCQ-C) subscales and Self-Efficacy for Emotion Regulation (SE-ER) were examined using hierarchical multiple linear regressions. RESULTS Physical functioning, gender and age accounted for 31% of the variance in anxiety and 39% in depression. The MCQ-C and SE-ER added another 45% to the variance of anxiety and 32% to depression. At the final step of both analyses, physical functioning, SE-ER, MCQ-C Negative Meta-Worry and Superstition, Punishment & Responsibility contributed significantly. Older age was also significantly associated with depression. CONCLUSIONS Self-efficacy for emotion regulation, concern about worrying and shame may be particularly important foci for interventions aimed at ameliorating anxiety and depression in young people with CF.
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Affiliation(s)
- Jeremy K Russell
- Centre for Children's Health Research, Institute of Health & Biomedical Innovation, and School of Psychology & Counselling, Queensland University of Technology, Brisbane, Australia
| | - Esben Strodl
- School of Psychology & Counselling, Queensland University of Technology, Brisbane, Australia
| | - David J Kavanagh
- Centre for Children's Health Research, Institute of Health & Biomedical Innovation, and School of Psychology & Counselling, Queensland University of Technology, Brisbane, Australia
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5
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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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Faija CL, Reeves D, Heal C, Capobianco L, Anderson R, Wells A. Measuring the Cognitive Attentional Syndrome in Cardiac Patients With Anxiety and Depression Symptoms: Psychometric Properties of the CAS-1R. Front Psychol 2019; 10:2109. [PMID: 31620051 PMCID: PMC6760032 DOI: 10.3389/fpsyg.2019.02109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 08/30/2019] [Indexed: 11/13/2022] Open
Abstract
Metacognitive Therapy (MCT) is a recent treatment with established efficacy in mental health settings. MCT is grounded in the Self-Regulatory Executive Function (S-REF) model of emotional disorders and treats a negative perseverative style of thinking called the cognitive attentional syndrome (CAS), thought to maintain psychological disorders, such as anxiety and depression. The evaluation of effective psychological therapies for anxiety and depression in chronic physical illness is a priority and research in this area depends on the suitability and validity of measures assessing key psychological constructs. The present study examined the psychometric performance of a ten-item scale measuring the CAS, the CAS-1R, in a sample of cardiac rehabilitation patients experiencing mild to severe symptoms of anxiety and/or depression (N = 440). Participants completed the CAS scale, the Hospital Anxiety and Depression Scale and the Metacognitions Questionnaire 30 (MCQ-30). The latent structure of the CAS-1R was assessed using confirmatory factor analyses (CFA). In addition, the validity of the measure in explaining anxiety and depression was assessed using hierarchical regression. CFA supported a three-factor solution (i.e., coping strategies, negative metacognitive beliefs and positive metacognitive beliefs). CFA demonstrated a good fit, with a CFI = 0.988 and an RMSEA = 0.041 (90% CI = 0.017–0.063). Internal consistency was acceptable for the first two factors but low for the third, though all three demonstrated construct validity and the measure accounted for additional variance in anxiety and depression beyond age and gender. Results support the multi-factorial assessment of the CAS using this instrument, and demonstrate suitability for use in cardiac patients who are psychologically distressed.
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Affiliation(s)
- Cintia L 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
| | - David Reeves
- Manchester Academic Health Science Centre, NIHR School for Primary Care Research, The University of Manchester, Manchester, United Kingdom
| | - Calvin Heal
- Faculty of Biology, Medicine and Health, Centre for Biostatistics, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Lora Capobianco
- Faculty of Biology, Medicine and Health, School of Psychological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Foundation Trust, Manchester Royal Infirmary, Manchester, United Kingdom
| | - Rebecca Anderson
- Faculty of Biology, Medicine and Health, School of Psychological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Adrian Wells
- Faculty of Biology, Medicine and Health, School of Psychological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Foundation Trust, Manchester Royal Infirmary, Manchester, United Kingdom
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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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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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10
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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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11
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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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