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Webster L, Norman C, Jones G, Marriott M. Mediating role for metacognitive processes in the relationship between schizotypy and anxiety and depression symptoms. Cogn Neuropsychiatry 2022; 27:393-410. [PMID: 35975632 DOI: 10.1080/13546805.2022.2108388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Introduction: Depression and anxiety symptoms are highly prevalent in schizophrenia-spectrum disorders and are commonly associated with schizotypy in non-clinical samples. However, it remains unclear what factors could be contributing to the relationships between schizotypy and anxiety and depression symptoms. Using path analysis, we explored the complex interplay between schizotypy, metacognitive beliefs, cognitive insight, and symptoms of emotional distress.Methods: Self-report data of schizotypy, metacognitive beliefs, cognitive insight, depression, and anxiety symptoms were collected from 344 participants from a predominantly student sample.Results: Path analysis confirmed unique associations between schizotypy dimensions, metacognitive beliefs, and cognitive insight. Furthermore, negative beliefs about worry mediated the link between the schizotypy dimensions, unusual experiences, cognitive disorganisation, and introvertive anhedonia and both depression and anxiety symptoms. Lack of cognitive confidence also mediated the relationship between cognitive disorganisation and depression symptoms. Finally, the cognitive insight subcomponent self-reflectiveness mediated the relationship between unusual experiences and cognitive disorganisation and anxiety.Conclusions: This study significantly furthers our understanding of the complex relationship between schizotypy, metacognitive processes, and emotional distress. Our findings also provide support for interventions which modify metacognitive beliefs and self-reflectiveness, which may prove beneficial for treatment in clinical settings.
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Affiliation(s)
- Lucy Webster
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Christine Norman
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Gary Jones
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Mike Marriott
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
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Han M, Lee K, Kim M, Heo Y, Choi H. Metacognitive Rating Scale: A Study Applying a Korean Translation to Individuals with Schizophrenia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136853. [PMID: 34202408 PMCID: PMC8297169 DOI: 10.3390/ijerph18136853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/19/2021] [Accepted: 06/22/2021] [Indexed: 01/28/2023]
Abstract
Metacognition is a higher-level cognition of identifying one’s own mental status, beliefs, and intentions. This research comprised a survey of 184 people with schizophrenia to verify the reliability of the metacognitive rating scale (MCRS) with the revised and supplemented metacognitions questionnaire (MCQ) to measure the dysfunctional metacognitive beliefs of people with schizophrenia by adding the concepts of anger and anxiety. This study analyzed the data using principal component analysis and the varimax method for exploratory factor analysis. To examine the reliability of the extracted factors, Cronbach’s α was used. According to the results, reliability was ensured for five factors: positive beliefs about worry, negative beliefs about uncontrollability and danger of worry, cognitive confidence, need for control, and cognitive self-consciousness. The negative beliefs about uncontrollability and danger of worry and the need for control on anger expression, which were both added in this research, exhibited the highest correlation (r = 0.727). The results suggest that the MCRS is a reliable tool to measure the metacognition of people with schizophrenia.
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Affiliation(s)
- Mihwa Han
- Department of Nursing Science, Sunlin University, Pohang 37560, Korea;
| | - Kyunghee Lee
- College of Nursing, Keimyung University, Daegu 42601, Korea
- Correspondence: ; Tel.: +82-53-258-7664
| | - Mijung Kim
- College of Nursing, Masan University, Masan 51217, Korea;
| | - Youngjin Heo
- Industry-Academic Cooperation Foundation, Keimyung University, Daegu 42601, Korea;
| | - Hyunseok Choi
- Center for Educational Performance, Keimyung University, Daegu 42601, Korea;
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Østefjells T, Lystad JU, Berg AO, Hagen R, Loewy R, Sandvik L, Melle I, Røssberg JI. Metacognitive beliefs mediate the effect of emotional abuse on depressive and psychotic symptoms in severe mental disorders. Psychol Med 2017; 47:2323-2333. [PMID: 28397634 DOI: 10.1017/s0033291717000848] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Early trauma is linked to higher symptom levels in bipolar and psychotic disorders, but the translating mechanisms are not well understood. This study examines whether the relationship between early emotional abuse and depressive symptoms is mediated by metacognitive beliefs about thoughts being uncontrollable/dangerous, and whether this pathway extends to influence positive symptoms. METHOD Patients (N = 261) with psychotic or bipolar disorders were assessed for early trauma experiences, metacognitive beliefs, and current depression/anxiety and positive symptoms. Mediation path analyses using ordinary least-squares regressions tested if the effect of early emotional abuse on depression/anxiety was mediated by metacognitive beliefs, and if the effect of early emotional abuse on positive symptoms was mediated by metacognitive beliefs and depression/anxiety. RESULTS Metacognitive beliefs about thoughts being uncontrollable/dangerous significantly mediated the relationship between early emotional abuse and depression/anxiety. Metacognitive beliefs and depression/anxiety significantly mediated the relationship between early emotional abuse and positive symptoms. The models explained a moderate amount of the variance in symptoms (R 2 = 0.21-0.29). CONCLUSION Our results indicate that early emotional abuse is relevant to depression/anxiety and positive symptoms in bipolar and psychotic disorders, and suggest that metacognitive beliefs could play a role in an affective pathway to psychosis. Metacognitive beliefs could be relevant treatment targets with regards to depression/anxiety and positive symptoms in bipolar and psychotic disorders.
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Affiliation(s)
- T Østefjells
- NORMENT,KG Jebsen Centre for Psychosis Research,Oslo University Hospital and Institute of Clinical Medicine,University of Oslo,Oslo,Norway
| | - J U Lystad
- NORMENT,KG Jebsen Centre for Psychosis Research,Oslo University Hospital and Institute of Clinical Medicine,University of Oslo,Oslo,Norway
| | - A O Berg
- NORMENT,KG Jebsen Centre for Psychosis Research,Oslo University Hospital and Institute of Clinical Medicine,University of Oslo,Oslo,Norway
| | - R Hagen
- Department of Psychology,Norwegian University of Science and Technology,Trondheim,Norway
| | - R Loewy
- Department of Psychiatry,University of California San Francisco,San Francisco,CA,USA
| | - L Sandvik
- Oslo Centre for Biostatistics and Epidemiology,Research Support Services,Oslo University Hospital,Oslo,Norway
| | - I Melle
- NORMENT,KG Jebsen Centre for Psychosis Research,Oslo University Hospital and Institute of Clinical Medicine,University of Oslo,Oslo,Norway
| | - J I Røssberg
- NORMENT,KG Jebsen Centre for Psychosis Research,Oslo University Hospital and Institute of Clinical Medicine,University of Oslo,Oslo,Norway
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Østefjells T, Melle I, Aminoff SR, Hellvin T, Hagen R, Lagerberg TV, Lystad JU, Røssberg JI. An exploration of metacognitive beliefs and thought control strategies in bipolar disorder. Compr Psychiatry 2017; 73:84-92. [PMID: 27918949 DOI: 10.1016/j.comppsych.2016.11.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 11/17/2016] [Accepted: 11/19/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Metacognitive factors influence depression, but are largely unexplored in bipolar disorders. We examined i) differences in metacognitive beliefs and thought control strategies between individuals with bipolar disorder and controls, and ii) to what extent clinical characteristics were related to levels of metacognitive beliefs and thought control strategies in bipolar disorder. METHOD Eighty patients with bipolar disorder were assessed for age at onset of affective disorder, number of affective episodes, symptoms of mania and depression, metacognitive beliefs (MCQ-30) and thought control strategies (TCQ). Control subjects (N=166) completed MCQ-30 and TCQ. Factors impacting on metacognitive beliefs and thought control strategies were explored with multiple linear regressions. RESULTS Patients with bipolar disorder reported higher levels of unhelpful metacognitive beliefs and thought control strategies than controls. Metacognitive beliefs were mainly influenced by depressive symptoms, and age at onset of affective illness. Thought control strategies were mainly influenced by metacognitive beliefs and age at onset of affective illness. CONCLUSION Our findings suggest that metacognitive beliefs and control strategies are relevant in bipolar disorder. Depression and age at onset of affective disorder could contribute to metacognitive beliefs in bipolar disorder, and influence the use of thought control strategies. This indicates potential relationships that warrant further investigation for clinical relevance.
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Affiliation(s)
- Tiril Østefjells
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway; Department for Specialised Inpatient Treatment, Division of Mental Health and Addiction, Akershus University Hospital, 1478 Lørenskog, Norway.
| | - Ingrid Melle
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway.
| | - Sofie R Aminoff
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway; Department for Specialised Inpatient Treatment, Division of Mental Health and Addiction, Akershus University Hospital, 1478 Lørenskog, Norway.
| | - Tone Hellvin
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway.
| | - Roger Hagen
- Department of Psychology, Norwegian University of Science and Technology, 7491 Trondheim, Norway.
| | - Trine Vik Lagerberg
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway
| | - June Ullevoldsæter Lystad
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway; Institute of Clinical Medicine, Adult Psychiatry Unit, University of Oslo, 0315 Oslo
| | - Jan Ivar Røssberg
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway
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