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Kroener J, Eickholt ML, Sosic-Vasic Z. Group based metacognitive therapy for alcohol use disorder: a pilot study. Front Psychiatry 2024; 15:1375960. [PMID: 39015882 PMCID: PMC11249785 DOI: 10.3389/fpsyt.2024.1375960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 06/12/2024] [Indexed: 07/18/2024] Open
Abstract
Introduction Alcohol use disorder (AUD) is a severe clinical disorder, which has been associated with 5.3% of death worldwide. Although several treatments have been developed to improve AUD symptomatology, treatment effects were moderate, with a certain amount of patients displaying symptom deterioration after treatment termination. Moreover, outpatient treatment placements become increasingly scarce, thus necessitating more efficient treatment options. Therefore, the aim of the present study was to investigate the efficacy, feasibility, and acceptability of a newly invented, short, group based metacognitive therapy (MCT) for patients diagnosed with AUD. Method Seven patients were treated with eight sessions of group based MCT using a single case series design with an A-B replication across patients. Patients were assessed one month and one week before treatment, as well as one week and three months after treatment termination. Results Patients improved significantly and with large effect sizes regarding dysfunctional metacognitive beliefs, desire thinking/craving and depressive symptoms up to three months after treatment termination. AUD symptomatology as well as positive and negative metacognitive beliefs improved at post-treatment, but improvements could not be maintained at follow-up. All included patients completed the treatment and were highly satisfied. Conclusion The presented findings show preliminary evidence for the efficacy, feasibility, and acceptability of the implemented group based MCT treatment. Large scale randomized controlled trials (RCTs) are needed to confirm the effectiveness of the developed program for patients diagnosed with AUD.
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Affiliation(s)
- Julia Kroener
- Department of Applied Psychotherapy and Psychiatry, Christophsbad Goeppingen, Goeppingen, Germany
- Medical Department, University of Ulm, Ulm, Germany
| | - Maja Lara Eickholt
- Department of Applied Psychotherapy and Psychiatry, Christophsbad Goeppingen, Goeppingen, Germany
- Medical Department, University of Ulm, Ulm, Germany
| | - Zrinka Sosic-Vasic
- Department of Applied Psychotherapy and Psychiatry, Christophsbad Goeppingen, Goeppingen, Germany
- Medical Department, University of Ulm, Ulm, Germany
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Krzikalla C, Buhlmann U, Schug J, Kopei I, Gerlach AL, Doebler P, Morina N, Andor T. Worry Postponement From the Metacognitive Perspective: A Randomized Waitlist-Controlled Trial. CLINICAL PSYCHOLOGY IN EUROPE 2024; 6:e12741. [PMID: 39119056 PMCID: PMC11303915 DOI: 10.32872/cpe.12741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 03/19/2024] [Indexed: 08/10/2024] Open
Abstract
Background Pathological worry is associated with appraisals of worrying as uncontrollable. Worry postponement (WP) with a stimulus control rationale appears to be effective in non-clinical samples. However, preliminary research in participants with generalized anxiety disorder (GAD) does not support its efficacy in reducing negative metacognitions or worry. The aim of this study was to investigate the efficacy of WP with a metacognitive rationale. Method Participants with GAD (n = 47) or hypochondriasis (HYP; n = 35) were randomly assigned to either an intervention group (IG) or waitlist (WL). The IG received a two-session long WP intervention aiming at mainly reducing negative metacognitions concerning uncontrollability of worrying. Participants were instructed to postpone their worry process to a predetermined later time during the six days between the two sessions. Participants completed questionnaires of negative metacognitions and worry at pre-assessment, post-assessment, and follow-up. Results We observed a significant Time*Group interaction for negative metacognitions and worry. Post-hoc analyses on the total sample and separately for GAD and HYP revealed significantly lower worry scores in the treated GAD sample compared to the WL, representing the only significant effect. In the GAD group, pre-post-effect sizes were small for negative metacognitions and large for worry. Effects persisted to a four-week follow-up. Conclusion WP with a metacognitive rationale seems to be effective in reducing worry in participants with GAD. The effectiveness for HYP seems limited, possibly due to the small sample size.
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Affiliation(s)
- Clara Krzikalla
- Institute of Psychology, University of Münster, Münster, Germany
| | - Ulrike Buhlmann
- Institute of Psychology, University of Münster, Münster, Germany
| | - Janina Schug
- Institute of Psychology, University of Münster, Münster, Germany
| | - Ina Kopei
- Institute of Psychology, University of Münster, Münster, Germany
| | - Alexander L. Gerlach
- Department of Psychology, Institute of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Germany
| | - Philipp Doebler
- Department of Statistics, Technical University of Dortmund, Dortmund, Germany
| | - Nexhmedin Morina
- Institute of Psychology, University of Münster, Münster, Germany
| | - Tanja Andor
- Institute of Psychology, University of Münster, Münster, Germany
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Höller I, Spangenberg L. Study protocol for a feasibility study of microinterventions in smartphone-based assessments to reduce depressive rumination. BMJ Open 2023; 13:e076031. [PMID: 38135315 DOI: 10.1136/bmjopen-2023-076031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION Depression as well as suicidal ideation and behaviours share several precipitating and maintaining factors and are subject to the influence of overlapping constructs. One of these transdiagnostic constructs is rumination. For the treatment of rumination, a variety of interventions are already available. However, not everyone with a need receives psychotherapeutic treatment. And even if they do: implementing learnt strategies alone at home can be challenging for patients. Therefore, this study aims to test the feasibility of delivering microinterventions for the reduction of rumination in a smartphone-based setting with the goal to make these interventions accessible to a larger number of people and support their use in everyday life. METHODS AND ANALYSIS The study's design is an uncontrolled-within-group design. Participants with at least mild depressive symptoms and reported rumination will be included and recruited via outpatient clinics as well as in the general population. The aim is to recruit at least N=70 participants. Participants first undergo a short telephone screening, a baseline assessment, a 7-day smartphone-based assessment including microinterventions in case participants report rumination and a postassessment. For feasibility purposes, primary outcomes relate to participants' compliance, their evaluation of the smartphone-based assessment as well as the microinterventions delivered during the assessment. As a secondary goal, clinical utility will be examined. Clinical outcomes (eg, depressive symptoms, rumination) will be measured at baseline and postassessment. ETHICS AND DISSEMINATION The ethics committee of the institute of psychology of the university of Duisburg-Essen and University of Leipzig has approved the study. Study results will be disseminated to healthcare communities, in peer-reviewed science journals and at conferences. TRIAL REGISTRATION NUMBER DRKS00031743.
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Affiliation(s)
- Inken Höller
- Department of Clinical Psychology and Psychotherapy, Charlotte Fresenius Hochschule, Düsseldorf, Germany
- Department of Clinical Psychology and Psychotherapy, University of Duisburg-Essen, Essen, Germany
| | - Lena Spangenberg
- Department of Medical Psychology and Medical Sociology, University Leipzig, Leipzig, Germany
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Köcher LM, Schlömer-Böttner S, Christiansen H. Metacognitive Transmission Between Parents and Children in the Context of Anxiety Disorders. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01577-y. [PMID: 37501041 DOI: 10.1007/s10578-023-01577-y] [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] [Accepted: 07/18/2023] [Indexed: 07/29/2023]
Abstract
One in ten children is affected by an anxiety disorder. Current state of research shows that transgenerational transmission as well as positive (POS) and negative (NEG) metacognitive beliefs are relevant in the context of anxiety disorders in youth. We investigated whether transgenerational transmission is also evident in conjunction with POS and NEG and cross-sectionally surveyed POS, NEG, anxiety symptoms and worry in 8-16-year-old children and adolescents with anxiety disorders (n = 71) and non-clinical controls (n = 40) and one of their parents. Our results revealed significant transgenerational correlations for NEG in both samples, and for POS in the non-clinical sample only. Mediation analysis showed that children's NEG did at least partly mediate the relationship between parents' NEG and children's anxiety and worry. Children's and parents' POS did not correlate in either sample with children's anxiety and worry. Further research on the transgenerational transmission of metacognition and longitudinal data is needed.
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Affiliation(s)
- Laura Marie Köcher
- Clinical Child and Adolescent Psychology, Department of Psychology, Philipps-Universität Marburg, Frankfurter Straße 35, 35037, Marburg, Germany.
| | - Silke Schlömer-Böttner
- Psychotherapy Practice for Children and Adolescents, Alter Kirchhainer Weg 5, 35039, Marburg, Germany
| | - Hanna Christiansen
- Clinical Child and Adolescent Psychology, Department of Psychology, Philipps-Universität Marburg, Frankfurter Straße 35, 35037, Marburg, Germany
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Mavrogiorgou P, Becker S, Lee-Grimm SI, Juckel G. Embitterment and metacognition in obsessive-compulsive disorder. BMC Psychiatry 2023; 23:146. [PMID: 36890494 PMCID: PMC9997007 DOI: 10.1186/s12888-023-04642-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 02/27/2023] [Indexed: 03/10/2023] Open
Abstract
OBJECTIVE Embitterment is a persistent emotion that is known to everybody in reaction to injustice and being let down, associated with feelings of helplessness and hopelessness. People with psychiatric disorders can develop bitterness, which is to be understood as a form of reactive embitterment to the illness. The aim of this explorative study was to investigate the occurrence of embitterment in obsessive-compulsive patients compared to healthy volunteers and in the context of their metacognitions and other biographical and clinical characteristics. METHOD Following a semi-structured diagnostic interview, a number of measures were administered to 31 patients with obsessive-compulsive disorder (OCD) [ICD-10 F42.X: mean age 35.2 (SD = 10.7) years] and 31 healthy volunteers [mean age 39.1 (SD = 15.0) years]. These measures included the Post-Traumatic Embitterment Disorder questionaire (PTEDq) for measuring embitterment, the Yale-Brown Obsessive-Compulsive Scale, the Metacognition Questionnaire and other psychometric questionnaires such as the Beck Depression Inventory and the State-Trait Anxiety Inventory. RESULTS Patients with OCD scored more than three times higher (mean = 2.0, SD = 1.1) than the healthy participants in the PTEDq (mean = 0.6, SD = 0.8; p < 0.001), but the cut-off of < 2.5 for a clinically relevant embitterment disorder was not reached. Dysfunctionally distorted metacognition (MCQ-30), which is a consistent finding in OCD, as well as a generally high degree of clinical impairment were significantly cor related to the degree of embitterment. CONCLUSION Our findings suggest that embitterment as measured by PTEDq is important in patients with OCD, who are characterized by metacognitive distortions with an injustice of fate as well as a mortification of their self-image. In future, it would be necessary to screen patients with OCD not only for depressive symptoms but also specifically for feelings of embitterment in order to be able to initiate appropriate psychotherapeutic measures at an early stage.
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Affiliation(s)
- Paraskevi Mavrogiorgou
- Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital of Ruhr-University Bochum, Bochum, Germany
| | - Sarah Becker
- Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital of Ruhr-University Bochum, Bochum, Germany
| | | | - Georg Juckel
- Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital of Ruhr-University Bochum, Bochum, Germany. .,Department of Psychiatry, Ruhr-University Bochum, LWL-University Hospital, Alexandrinenstr.1, 44791, Bochum, Germany.
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Psychological interventions for generalized anxiety disorder: Effects and predictors in a naturalistic outpatient setting. PLoS One 2023; 18:e0282902. [PMID: 36897860 PMCID: PMC10004605 DOI: 10.1371/journal.pone.0282902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 02/25/2023] [Indexed: 03/11/2023] Open
Abstract
OBJECTIVE Numerous randomized controlled trials (RCTs) demonstrate the efficacy of cognitive behavioral therapy (CBT), metacognitive therapy (MCT), and methods to reduce intolerance of uncertainty (IU-CBT) in the treatment of generalized anxiety disorder (GAD). However, few studies have investigated these treatments under conditions of routine clinical care. The main objective of this study was to investigate the effectiveness of psychotherapy for GAD in an outpatient setting and to identify factors influencing treatment outcome. METHODS Fifty-nine GAD patients received naturalistic CBT (including MCT and IU-CBT) in an outpatient clinic and postgraduate training center for psychotherapy. Patients completed self-report questionnaires at the beginning and end of therapy regarding the main outcome worry as well as metacognitions, intolerance of uncertainty, depression, and general psychopathology. RESULTS Worry, negative metacognitions, intolerance of uncertainty, depression, and general psychopathology decreased significantly (p's < .001) with large effect sizes for all symptoms (d = 0.83-1.49). A reliable change in the main outcome worry was observed in 80% of patients, and recovery occurred in 23%. Higher worry scores at posttreatment were predicted by higher pretreatment scores, female sex, and less change in negative metacognitive beliefs during treatment. CONCLUSIONS Naturalistic CBT for GAD appears to be effective in routine clinical care for worry as well as depressive symptoms, with particular benefits associated with altering negative metacognitions. However, a recovery rate of only 23% is lower than the rates reported in RCTs. Treatment needs to be improved, especially for patients with more severe GAD and for women.
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The influence of alcohol on rumination and metacognitions in major depressive disorder. CLINICAL PSYCHOLOGY IN EUROPE 2022; 4:e5615. [DOI: 10.32872/cpe.5615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 09/16/2022] [Indexed: 12/24/2022] Open
Abstract
Background and Objectives
Comorbidity between major depressive disorder (MDD) and alcohol use disorder (AUD) is highly prevalent but reasons for this association are unclear. Rumination may activate metacognitive beliefs that contribute to the development and maintenance of rumination and depression. Negative metacognitions can further lead to other dysfunctional coping strategies (i.e., consumption of alcohol). We examined whether alcohol reduces (state) metacognitions, rumination and other disorder-specific processes in a group of individuals suffering from MDD.
Method
In an experiment with three randomized conditions we investigated whether the consumption of alcohol, placebo or no alcohol (orange juice) affects (meta-)cognitions, depressive symptoms and / or psychophysiological variables while participants ruminate.
Results
Voluntary rumination increased self-reported sadness, tension and rumination, tensed facial muscles and increased heart rate, but did not affect (state) metacognitions and heart rate variability. The consumption of alcohol did not influence rumination, metacognitions, depressive or psychophysiological measures.
Limitations
We recruited a depressed population but excluded pathological alcohol use due to ethical considerations.
Conclusions
We found no evidence that alcohol consumption affects rumination, metacognitions and other disorder-specific processes in MDD. However, rumination had a negative effect on various depression-specific processes, although it did not activate (negative state) metacognitions.
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Witowska J, Stolarski M, Wittmann M. Psychometric Validation of the German Adaptation of the Temporal Metacognition Scale. TIMING & TIME PERCEPTION 2022. [DOI: 10.1163/22134468-bja10070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Abstract
Temporal metacognition (TMC) is defined as the ability to consciously self-regulate cognitive focus on the past, the present, and the future by utilizing metacognitive skills, emotions, knowledge, and experience. TMC stems conceptually from the idea of a balanced time perspective — the ability to switch between time horizons — and it builds upon the major theories of metacognition. We validated the German version of the Temporal Metacognition Scale (TMCS) translated from the Polish original with n = 226 native German speakers. Confirmatory Factor Analysis supported the three-factor model obtained in the original Polish version with the following subscales: Metacognitive Temporal Control, Cognitive Reconstruction of the Past, and Goal-Oriented Metatemporal Interconnectedness. All three scales yielded acceptable internal consistency. Their correlations with the subscales of the Zimbardo Time Perspective Inventory, Deviation from the Balanced Time Perspective, and other conceptually related psychological constructs, such as personality traits, well-being, experiencing emotions, and other features of metacognition, provide evidence for the validity of the German version of the TMCS.
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Affiliation(s)
- Joanna Witowska
- Institute of Psychology, The Maria Grzegorzewska University, 02-353 Warsaw, Poland
| | - Maciej Stolarski
- Department of Psychometrics and Psychological Diagnosis, University of Warsaw, 00-183 Warsaw, Poland
| | - Marc Wittmann
- Institute for Frontier Areas in Psychology and Mental Health, 79098 Freiburg, Germany
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Mavrogiorgou P, Diop S, Turmes L, Specht C, Vanscheidt S, Seehagen S, Juckel G. Computer-based mother-infant interaction analysis and mental functioning in postpartum depression. Psychiatry Res 2022; 311:114506. [PMID: 35287041 DOI: 10.1016/j.psychres.2022.114506] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 03/06/2022] [Accepted: 03/07/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Among mothers suffering from postpartum depression (PD), 10-13% additionally experience a mother-infant interaction disturbance that causes a severe mental health risk for the infant. Besides depressive symptomology, the underlying factors promoting dysfunctional maternal interaction behavior have not yet been sufficiently investigated. Therefore, we examined potential relationships between computer-based mother-infant interaction among postpartum depressed dyads and maternal mental functioning. METHODS Mother-infant interaction was video-recorded and evaluated via a computer-based micro-interaction analysis program (INTERACT). We included only 25 hospitalized mother-infant dyads that fulfilled the diagnostic criteria of PD and tested mothers on their mental functioning (empathy, theory of mind, meta-cognition and alexithymia). RESULTS Behavioral interaction analyses indicated that mothers with PD were prone to inactive maternal behavior, less positive maternal behavior along with more rejective behavior and also disengaged affect towards the infant. Distortions in mothers' mental functioning may have had an influence on the dysfunctional patterns of mother-infant dyads. CONCLUSIONS Cognitive and social functioning could be an influencing factor on dysfunctional maternal interaction behavior. Early detection of distortions of mental processing in expectant mothers might help to inhibit the clinical manifestation of dysfunctional mother-infant bonding and negative child outcome in PD.
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Affiliation(s)
- Paraskevi Mavrogiorgou
- Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital Bochum, Alexandrinenstr. 1, 44791 Bochum, Germany
| | - Shirin Diop
- Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital Bochum, Alexandrinenstr. 1, 44791 Bochum, Germany
| | - Luc Turmes
- LWL Hospital Herten of Psychiatry, Psychotherapy and Psychosomatic, Mother-Child Unit, Im Schloßpark 20, 45699 Herten, Germany
| | - Christina Specht
- LWL Hospital Herten of Psychiatry, Psychotherapy and Psychosomatic, Mother-Child Unit, Im Schloßpark 20, 45699 Herten, Germany
| | - Simon Vanscheidt
- Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital Bochum, Alexandrinenstr. 1, 44791 Bochum, Germany
| | - Sabine Seehagen
- Ruhr University Bochum, Faculty of Psychology, Department of Developmental Psychology, Universitätsstr. 150, 44801 Bochum, Germany
| | - Georg Juckel
- Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital Bochum, Alexandrinenstr. 1, 44791 Bochum, Germany.
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Drueke B, Gauggel S, Weise L, Forkmann T, Mainz V. Metacognitive judgements and abilities in patients with affective disorders. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02838-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Abstract
Objectives
Cognitive and metacognitive deficits depict important factors in depression, but the relationship between these concepts remains to be elucidated. The present study investigated the difference between patients with depression and controls in metacognitive judgements regarding the domain of attention. Furthermore, the associations between different metacognitive abilities, depressiveness and confidence were investigated, as well as in how far the derived correlates would predict depression.
Methods
Thirty patients with a major depressive episode and 30 healthy participants were enrolled in the current study. Attention and executive functioning ability were assessed including metacognitive judgements of performance and confidence with regard to the test performance in the Stroop test. To examine further aspects related to (meta-)cognitive abilities, decentering skills, aspects of self-conscious attention, self-assessed intelligence and metacognitive beliefs, judgements and monitoring tendencies were assessed.
Results
Albeit groups’ metacognitive judgements of performance did not differ, patients indicated to be significantly less confident in their judgements. Depressive patients showed less decentering abilities compared to healthy participants and there was a significant association between decentering and confidence ratings. Moreover, depressiveness was associated with dysfunctional self-consciousness and low cognitive confidence. Finally, lower decentering skills and higher dysfunctional self-attention were the best predictors for depressiveness.
Conclusions
Results favor the assumption that patients’ metacognitive abilities regarding the domain of attention are not generally deficient. Rather, the lower confidence in their judgements and dysfunctional (meta-)cognitive abilities, like decentering, metacognitive beliefs and aspects of self-conscious attention and intelligence, seem to mirror the patients’ impairments.
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Diop S, Turmes L, Specht C, Seehagen S, Juckel G, Mavrogiorgou P. Capacities for meta-cognition, social cognition, and alexithymia in postpartum depression. Psychiatry Res 2022; 309:114430. [PMID: 35134669 DOI: 10.1016/j.psychres.2022.114430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/27/2022] [Accepted: 02/02/2022] [Indexed: 11/24/2022]
Abstract
Postpartum depression (PPD), a female-specific disorder, is the most common medical complication associated with childbirth (10-20%). The pathological relevance of emotion processing, meta-cognition, alexithymia, and social cognition to PPD is unclear. We tested 25 mothers with PPD (mean age: 30.72 ± 5.76 years) and 25 healthy mothers (mean age: 32.03 ± 3.54 years) for alexithymia (Toronto Alexithymia Scale) and evaluated cognitive empathy (Faux Pas Test), affective empathy (Interpersonal Reactivity Index), meta-cognition (Meta-Cognitions Questionnaire), sociodemographic and clinical-psychometric characteristics and personality dimensions. Mothers with PPD showed higher levels of neuroticism and more anxiety-depressive characteristics. Their metacognitive abilities were significantly altered and they more often had alexithymia. Significant correlations between alexithymia and meta-cognition, trait anxiety, and neuroticism were found. Alexithymia, neurotic personality traits, and dysfunctional meta-cognition appear more frequently in PPD women than healthy women. Social cognition abilities were not significantly altered. Alexithymia and metacognitive distortions play important roles in the pathogenesis of PPD. Dysfunctional meta-cognition, neuroticism, and alexithymia may be risk factors that should be detected early in expectant mothers to prevent the development of PPD.
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Affiliation(s)
- Shirin Diop
- Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital Bochum, Alexandrinenstr. 1, Bochum 44791, Germany
| | - Luc Turmes
- Psychotherapy and Psychosomatic Health, LWL Hospital Herten of Psychiatry, Im Schloßpark 20, Herten 45699, Germany
| | - Christina Specht
- Psychotherapy and Psychosomatic Health, LWL Hospital Herten of Psychiatry, Im Schloßpark 20, Herten 45699, Germany
| | - Sabine Seehagen
- Department of Psychology, Ruhr University Bochum, Universitätstr. 150, Bochum 44801, Germany
| | - Georg Juckel
- Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital Bochum, Alexandrinenstr. 1, Bochum 44791, Germany.
| | - Paraskevi Mavrogiorgou
- Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital Bochum, Alexandrinenstr. 1, Bochum 44791, Germany
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Do Metacognitions of Children and Adolescents with Anxiety Disorders Change after Intensified Exposure Therapy? CHILDREN 2022; 9:children9020168. [PMID: 35204889 PMCID: PMC8869889 DOI: 10.3390/children9020168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 11/17/2022]
Abstract
Metacognitive beliefs have repeatedly proven to play a role in anxiety disorders in children and adolescents, but few studies have investigated whether they change after cognitive behavioral therapy. This longitudinal intervention study explores whether positive and negative metacognitive beliefs in particular change after exposure-focused treatment, and if metacognitive changes predict reductions in anxiety symptoms. A sample of 27 children between 8 and 16 years of age with a primary diagnosis of specific phobia, separation-anxiety disorder or social phobia completed assessments of anxiety symptoms, metacognitive beliefs, worry and repetitive negative thoughts before and after 11 sessions of intensified exposure treatment. Metacognitive beliefs did not change significantly after intensified exposure, but post-hoc power analysis revealed a lack of power here. Change in negative metacognitive beliefs correlated with a change in anxiety symptoms, but did not independently contribute as a predictor variable. Differences between subsamples showed that patients with separation-anxiety disorder scored higher on negative metacognitive beliefs than those with specific or social phobia. Consideration of metacognition, and negative metacognitive beliefs in particular could help us further improve the understanding and treatment of anxiety disorders in children and adolescents and should therefore receive more attention in psychotherapy research.
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Meißner C, Weck F, Kühne F. Screening dysfunktionaler Überzeugungen bei Zwangsstörungen. PSYCHOTHERAPEUT 2020. [DOI: 10.1007/s00278-020-00410-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Zusammenfassung
Hintergrund
Dysfunktionale Überzeugungen und Bewertungen von Zwangsgedanken sind ausschlaggebend für die Entstehung und Aufrechterhaltung von Zwangsstörungen. Die reliable und valide Erfassung dieser Überzeugungen mithilfe von Screeningverfahren ist für die kognitiv-verhaltenstherapeutische Behandlung relevant.
Fragestellung
Ziel der Arbeit war die Erstellung eines Scoping review bezüglich der aktuellen Screeninginstrumenten zur Erfassung der 6 von der Obsessive Compulsive Cognitions Working Group (OCCWG) vorgeschlagenen Domänen bei Zwangsstörungen. Die Verfahren wurden systematisch nach ihrer psychometrischen Güte bewertet und in ihren Eigenschaften verglichen.
Material und Methoden
Die Literatursuche erfolgte in den Datenbanken Web of Science Core Collection, Google Scholar und PubMed. Eingeschlossen wurden deutsch- und englischsprachige Verfahren für Erwachsene (≥18 Jahre).
Ergebnisse
Es konnten 56 Studien zur Überprüfung der psychometrischen Eigenschaften von 16 Fragebogen eingeschlossen werden. Die Fragebogen erfassten alle Domänen dysfunktionaler Überzeugungen. Außerdem lagen 4 domänenübergreifende Verfahren vor, und 9 der Fragebogen waren deutschsprachig. Die Mehrzahl der Screeningverfahren wies adäquate bis gute psychometrische Werte auf. Die methodische Qualität der Studien war heterogen; methodische und statistische Verfahren nahmen über die Jahre an Komplexität zu.
Schlussfolgerung
Weiterer Forschungsbedarf besteht v. a. in der Untersuchung der Störungsspezifität und Änderungssensitivität von Screeningverfahren an klinischen Stichproben.
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Kress V, Steudte-Schmiedgen S, Kopp M, Förster A, Altus C, Schier C, Wimberger P, Kirschbaum C, von Soest T, Weidner K, Junge-Hoffmeister J, Garthus-Niegel S. The Impact of Parental Role Distributions, Work Participation, and Stress Factors on Family Health-Related Outcomes: Study Protocol of the Prospective Multi-Method Cohort "Dresden Study on Parenting, Work, and Mental Health" (DREAM). Front Psychol 2019; 10:1273. [PMID: 31263435 PMCID: PMC6584823 DOI: 10.3389/fpsyg.2019.01273] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 05/14/2019] [Indexed: 12/12/2022] Open
Abstract
The Dresden Study on Parenting, Work, and Mental Health (“DResdner Studie zu Elternschaft, Arbeit, und Mentaler Gesundheit”, DREAM) aims to prospectively investigate the relationship between parental work participation, role distribution, stress factors, and their effects on perinatal outcomes and long-term family mental and somatic health in a community sample targeting N = 4,000 individuals, i.e., 2,000 couples, expecting a child and residing in Dresden, Germany (interim sample of N = 1,410 participants, recruitment ongoing). Various questionnaires are completed at four measurement points from pregnancy to 2 years postpartum (prolongation into middle childhood planned). Applying a multi-method approach, long-term endocrinological data (analyses of hair cortisol concentrations and other endogenous hormones, “DREAMHAIR”) and qualitative interview data (regarding gender role attitudes and distribution of domestic work, child care, and paid employment; “DREAMTALK”) are obtained. In this study protocol, the theoretical background, methods, and preliminary results considering sociodemographic characteristics during pregnancy and birth-related factors at 8 weeks postpartum are presented. Additionally, there is a focus on our endocrinological sub-study DREAMHAIR. In this sub-study currently comprising N = 152 participants, i.e., 88 families (recruitment ongoing), we want to gain knowledge on the transgenerational processes of stress regulation and psychopathology in the whole family by analyzing hair cortisol concentrations in both parents and children during the course from pregnancy (or after birth regarding children) to at least 2 years postpartum. By comparing data of the community sample to a clinical sample of mothers with postpartum mental disorders, their children, and their partners during the period between admission and discharge from a mother-baby unit and post-treatment (“DREAMMBU”), the course of mothers' psychopathology, parent-infant interaction, and infant regulation disorders with special regard to long-term endocrine correlates will be examined. With previous studies neglecting the fathers or partners involved, a major advantage of DREAM is the use of a multi-method and multi-level approach by examining the whole family in a longitudinal design. Therefore, the DREAM study will contribute to a better understanding of the role of social, work, and stress factors for mental and somatic health and its long-term endocrine correlates in the natural course of becoming a family.
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Affiliation(s)
- Victoria Kress
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Susann Steudte-Schmiedgen
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany.,Institute of Biological Psychology, Faculty of Psychology of the Technische Universität Dresden, Dresden, Germany
| | - Marie Kopp
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Anke Förster
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Caroline Altus
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Caroline Schier
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Pauline Wimberger
- Department of Gynecology and Obstetrics, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Clemens Kirschbaum
- Institute of Biological Psychology, Faculty of Psychology of the Technische Universität Dresden, Dresden, Germany
| | - Tilmann von Soest
- Department of Psychology, PROMENTA Research Center, University of Oslo, Oslo, Norway
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Juliane Junge-Hoffmeister
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Susan Garthus-Niegel
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany.,Department of Child Health, Norwegian Institute of Public Health, Oslo, Norway
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Zimmermann M, Glemser M, Ertle A. Dysfunktionale Metakognitionen im Jugendalter. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2018. [DOI: 10.1026/1616-3443/a000492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Das metakognitive Modell legt nahe, dass dysfunktionale Metakognitionen für die Entwicklung und Aufrechterhaltung verschiedener emotionaler Störungen eine Rolle spielen. Diese Annahme konnte in Studien sowohl für Erwachsene als auch für Kinder und Jugendliche bestätigt werden. Fragestellung: Struktur und psychometrische Eigenschaften einer deutschen Version des Meta-cognitions Questionnaire – Adolescent Version (MCQ-A) zur Erfassung störungsrelevanter Metakognitionen wurden untersucht. Methode: Nach Erhebung von Daten an einer nicht-klinischen Stichprobe ( N = 221) wurde eine konfirmatorische Faktorenanalyse durchgeführt. Interne Konsistenz, Test-Retest-Reliabilität sowie konvergente Validität wurden ermittelt. Ergebnisse: Die Struktur der englischen Originalversion konnte repliziert werden. Die deutschsprachigen Skalen des MCQ-A weisen gute Reliabilitäts- und Validitätskennwerte auf. Schlussfolgerungen: Die vorliegende deutsche Version des MCQ-A kann vorläufig als ein reliables und valides Instrument zur Erfassung dysfunktionaler Metakognitionen betrachtet werden.
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16
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Thielsch C, Andor T, Ehring T. Assessing metacognitive beliefs about worry: validation of German versions of the Why Worry Scale II and the Consequences of Worry Scale. PeerJ 2018; 6:e5177. [PMID: 30013842 PMCID: PMC6047500 DOI: 10.7717/peerj.5177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 06/18/2018] [Indexed: 11/28/2022] Open
Abstract
Background Metacognitive beliefs have been proposed to play a key role in initiating and maintaining worry. The Why Worry-Scale-II (WW-II) and Consequences of Worry Scale (COWS) are self-report questionnaires assessing positive and negative metacognitive beliefs. The main goal of this study was to validate German versions of these two questionnaires. Method N = 603 participants completed a questionnaire battery, including the two self-report measures of metacognitive beliefs. We conducted confirmatory factor analyses, calculated internal consistencies, and examined convergent and divergent validity. In addition, the questionnaires’ power in predicting worry, repetitive negative thinking (RNT) and generalized anxiety disorder (GAD) symptoms were investigated. Results The factor structure of the original versions could be replicated for both measures. Furthermore, the translated questionnaires demonstrated excellent internal consistency and evidence of convergent and divergent validity. Importantly they also possessed predictive power in explaining worry, RNT and GAD symptoms, even over and above the Metacognitions Questionnaire-30 (MCQ-30) as the current gold standard. Conclusions Overall, our findings suggest that the WW-II and COWS show solid psychometric properties and are useful in measuring metacognitive beliefs independently from the MCQ-30.
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Affiliation(s)
- Carolin Thielsch
- Department of Psychology, University of Münster, Münster, Germany
| | - Tanja Andor
- Department of Psychology, University of Münster, Münster, Germany
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Bröcker AL, Bayer S, Stuke F, Giemsa P, Heinz A, Bermpohl F, Lysaker PH, Montag C. The Metacognition Assessment Scale (MAS-A): Results of a pilot study applying a German translation to individuals with schizophrenia spectrum disorders. Psychol Psychother 2017; 90:401-418. [PMID: 28334488 DOI: 10.1111/papt.12122] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 01/23/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Metacognition, the capacity 'to think about thinking' and thus to reflect and to master interpersonal problems on a mentalistic basis, is often impaired among patients with schizophrenia spectrum disorders and has been suggested as a potential treatment target. However, little is known about the reliability of its measurement and links with related phenomena. The aim of this study was to validate a German translation of the Metacognition Assessment Scale (MAS-A) as a measure to assess metacognition from free narratives of patients' personally relevant episodes and relationships. DESIGN AND METHODS MAS-A was applied to narratives of 22 individuals with schizophrenia spectrum disorders together with self-ratings and behavioural tests of metacognitive and related functions such as mentalizing and emotional awareness. Multi-level modelling allowed to calculate inter-rater reliability (IRR) and inter-rater agreement (IRA) and to include test results as level-2 predictors of the aggregated scorings on the MAS-A subscales in order to explore convergent validity. After considering neurocognition and symptom scores as further predictors, aggregated scorings were correlated with psychosocial functioning. RESULTS There were high IRRs and IRAs all over the ratings. None of the related measures accounted for variance in MAS-A scorings, indicating the existence of separable, non-overlapping constructs. Verbal memory and positive symptoms were significant predictors for MAS-A subscales. MAS-A, but no other measure, displayed significant associations with psychosocial functioning. CONCLUSIONS MAS-A is a reliable expert rating to assess metacognition from patients' free narratives. Considering the link to psychosocial functioning, MAS-A appears to be a promising tool for the evaluation of metacognition. PRACTITIONER POINTS MAS-A is a reliable tool to evaluate metacognitive function from narratives about emotionally relevant topics and meaningful relationships. Metacognition appears separate from neighbouring constructs such as mentalizing, ToM, or emotional awareness. MAS-A scales are significantly predicted by verbal memory and positive symptoms. Only MAS-A scales display significant associations with psychosocial functioning, and it thus is a promising tool to evaluate metacognition in psychotherapy research.
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Affiliation(s)
- Anna-Lena Bröcker
- Department of Psychiatry and Psychotherapy, Charité University Medicine Berlin, Germany
| | - Samuel Bayer
- International Psychoanalytic University Berlin (IPU), Berlin, Germany
| | - Frauke Stuke
- Department of Psychiatry and Psychotherapy, Charité University Medicine Berlin, Germany
| | - Patrick Giemsa
- Department of Psychiatry and Psychotherapy, Charité University Medicine Berlin, Germany.,Department Psychology, Medical School Brandenburg Theodor Fontane, Am Alten Gymnasium 1-3, 16186, Neuruppin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité University Medicine Berlin, Germany
| | - Felix Bermpohl
- Department of Psychiatry and Psychotherapy, Charité University Medicine Berlin, Germany
| | - Paul H Lysaker
- Roudebush VA Medical Center, Indianapolis, Indiana, USA.,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Christiane Montag
- Department of Psychiatry and Psychotherapy, Charité University Medicine Berlin, Germany
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18
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Dethier V, Heeren A, Bouvard M, Baeyens C, Philippot P. Embracing the Structure of Metacognitive Beliefs: Validation of the French Short Version of the Metacognitions Questionnaire. Int J Cogn Ther 2017. [DOI: 10.1521/ijct.2017.10.3.219] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Vincent Dethier
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Alexandre Heeren
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
- Department of Psychology, Harvard University, Cambridge, Massachusetts
| | - Martine Bouvard
- Laboratoire de Psychologie et NeuroCognition, Université de Savoie Mont Blanc, Chambéry, France
| | - Céline Baeyens
- Laboratoire Inter-universitaire de Psychologie: Personnalité, Cognition et Changement Social, Université Grenoble Alpes, UFR SHS, Grenoble, France
| | - Pierre Philippot
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
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Fink J, Hendrikx F, Stierle C, Stengler K, Jahn I, Exner C. The impact of attentional and emotional demands on memory performance in obsessive-compulsive disorder. J Anxiety Disord 2017; 50:60-68. [PMID: 28577416 DOI: 10.1016/j.janxdis.2017.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 05/11/2017] [Accepted: 05/18/2017] [Indexed: 11/20/2022]
Abstract
Lower performance on memory tests in obsessive-compulsive disorder (OCD) has been repeatedly observed. However, the origins of these performance deficits are not sufficiently explained. In this study we tested if OCD-related extensive focus of attention on thoughts (heightened self-consciousness) could be an explanatory mechanism for lower memory performance. Heightened situational self-consciousness was manipulated by instructing participants to either monitor neutral thoughts or to monitor OCD-related thoughts. We included a Behavioral Avoidance Task based on individual obsessions and compulsions to induce OCD-related thoughts. Participants were asked to perform these monitoring tasks in parallel to a taxing verbal memory task, resulting in learning under divided attention. The two conditions of learning under divided attention were compared to a single-task condition. Twenty-four participants with OCD and 24 healthy controls took part in these three learning conditions. The results indicate that in both groups memory performance deteriorated in the two conditions with divided attention compared to the single task condition. In the OCD-related thought monitoring condition (OTM) self-consciousness and Behavioral Avoidance Task-induced stress and fear were particularly increased and memory performance further deteriorated in the OCD group. This finding highlights an important and underestimated mechanism (personal involvement) which might serve to better understand lower memory performance in OCD.
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Affiliation(s)
- Jakob Fink
- University of Leipzig, Clinical Psychology and Psychotherapy, Neumarkt 9-19, 04081 Leipzig, Germany.
| | - Friederike Hendrikx
- University of Leipzig, Clinical Psychology and Psychotherapy, Neumarkt 9-19, 04081 Leipzig, Germany.
| | - Christian Stierle
- Schön-Kliniken Bad Bramstedt, Birkenweg 10, 24576 Bad Bramstedt, Germany.
| | - Katarina Stengler
- University of Leipzig, Faculty of Medicine, Semmelweisstraße 10, 04103 Leipzig, Germany.
| | - Ina Jahn
- University of Leipzig, Faculty of Medicine, Semmelweisstraße 10, 04103 Leipzig, Germany.
| | - Cornelia Exner
- University of Leipzig, Clinical Psychology and Psychotherapy, Neumarkt 9-19, 04081 Leipzig, Germany.
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20
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Do Metacognitions and Intolerance of Uncertainty Predict Worry in Everyday Life? An Ecological Momentary Assessment Study. Behav Ther 2015; 46:532-43. [PMID: 26163716 DOI: 10.1016/j.beth.2015.05.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 05/06/2015] [Accepted: 05/07/2015] [Indexed: 01/27/2023]
Abstract
Cognitive models of generalized anxiety disorder (GAD) suggest that excessive worry is due to positive and negative metacognitive beliefs and/or intolerance of uncertainty. Empirical support mainly derives from cross-sectional studies with limited conclusiveness, using self-report measures and thereby possibly causing recall biases. The aim of the present study therefore was to examine the power of these cognitive variables to predict levels of worry in everyday life using Ecological Momentary Assessment (EMA). Metacognitions and intolerance of uncertainty were assessed using well-established self-report questionnaires in 41 nonclinical participants who subsequently completed ratings on worry intensity and burden on a portable device for 1week at seven times a day once every 2hours. Results showed significant associations of negative metacognitive beliefs and intolerance of uncertainty, but not positive metacognitive beliefs, with worry in everyday life. In multilevel regression analyses, a substantial proportion of variance of everyday worry could be accounted for by negative metacognitions over and above trait worry and daily hassles. Intolerance of uncertainty likewise emerged as a valid predictor when tested in isolation, but did not explain additional variance once negative metacognitions were controlled. The findings support current cognitive models of excessive worry and highlight the role of negative metacognitions. By using EMA to assess levels of worry in everyday life, they extend earlier findings focusing exclusively on retrospective questionnaire measures.
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Thielsch C, Ehring T, Nestler S, Wolters J, Kopei I, Rist F, Gerlach AL, Andor T. Metacognitions, worry and sleep in everyday life: Studying bidirectional pathways using Ecological Momentary Assessment in GAD patients. J Anxiety Disord 2015; 33:53-61. [PMID: 26005837 DOI: 10.1016/j.janxdis.2015.04.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 04/30/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND The metacognitive model of generalized anxiety disorder proposes that negative metacognitive beliefs are crucial in the maintenance of excessive worry. Furthermore, according to the cognitive model of insomnia, worry leads to problems falling or staying asleep and poor sleep quality. In order to test the assumed causal relationships, the present study examined the time-dependent course of negative metacognition and worry as well as worry and sleep quality, using Ecological Momentary Assessment (EMA). METHOD Negative metacognitions, worry and sleep were assessed by self-report questionnaires as well as EMA in 56 GAD patients who carried a portable device for 1 week and logged sleep quality, negative metacognition and worry processes four times a day. RESULTS Metacognitions, worry and sleep were significantly correlated. Structural equation modeling using multilevel analyses showed a unidirectional relationship of negative metacognitions leading to prolonged worry processes and a bidirectional relationship of worry and sleep quality. CONCLUSIONS These findings support the theoretically derived assumptions on the relationship between negative metacognitions, worry and sleep. Implications for further research as well as clinical implications are discussed.
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Affiliation(s)
| | - Thomas Ehring
- Institute of Psychology, University of Münster, Germany; Department of Psychology, University of Munich, Germany
| | | | | | - Ina Kopei
- Institute of Psychology, University of Münster, Germany
| | - Fred Rist
- Institute of Psychology, University of Münster, Germany
| | | | - Tanja Andor
- Institute of Psychology, University of Münster, Germany
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22
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Thielsch C, Andor T, Ehring T. Metacognitions, intolerance of uncertainty and worry: An investigation in adolescents. PERSONALITY AND INDIVIDUAL DIFFERENCES 2015. [DOI: 10.1016/j.paid.2014.10.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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23
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Weber F, Hauke W, Jahn I, Stengler K, Himmerich H, Zaudig M, Exner C. Does "thinking about thinking" interfere with memory? An experimental memory study in obsessive-compulsive disorder. J Anxiety Disord 2014; 28:679-86. [PMID: 25127176 DOI: 10.1016/j.janxdis.2014.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 06/12/2014] [Accepted: 07/04/2014] [Indexed: 11/15/2022]
Abstract
Neuropsychological assessments of participants with obsessive-compulsive disorder (OCD) indicate impaired verbal memory if to be remembered material has to be organized. People with OCD also tend to focus their attention on their thoughts (heightened cognitive self-consciousness). We tested the hypothesis that cognitive self-consciousness causes verbal memory deficits by provoking a division of attention between study task and thoughts. Thirty-six participants with OCD, 36 matched healthy controls and 36 participants with major depressive disorder (MDD) learned under proactive interference in three study conditions: single-task condition, condition with heightened cognitive self-consciousness and condition with an external secondary task. Memory was impaired in the cognitive self-consciousness condition compared to both other conditions. Independent of condition, participants with OCD showed a reduced memory performance compared to healthy controls, but did not differ from participants with MDD. Our results are in line with the hypothesis that cognitive self-consciousness causes memory impairment.
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Affiliation(s)
- Friederike Weber
- Department of Clinical Psychology and Psychotherapy, University of Leipzig, Neumarkt 9-19, D-04081 Leipzig, Germany.
| | - Walter Hauke
- Psychosomatic Clinic, Schützenstraße 100, 86949 Windach, Germany
| | - Ina Jahn
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstraße 10, 04103 Leipzig, Germany
| | - Katarina Stengler
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstraße 10, 04103 Leipzig, Germany
| | - Hubertus Himmerich
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstraße 10, 04103 Leipzig, Germany
| | - Michael Zaudig
- Psychosomatic Clinic, Schützenstraße 100, 86949 Windach, Germany
| | - Cornelia Exner
- Department of Clinical Psychology and Psychotherapy, University of Leipzig, Neumarkt 9-19, D-04081 Leipzig, Germany
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25
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Barenbrügge J, Glöckner-Rist A, Rist F. Positive und negative Metakognitionen über Krankheitssorgen. PSYCHOTHERAPEUT 2013. [DOI: 10.1007/s00278-013-1016-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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