Association of Rumination and Metacognition with Posttraumatic Growth in Parents of Children with Cancer

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.

The Affect Intolerance Scale (AIS), German version: A validation study in a student and clinical sample of patients with trauma-related disorders

BACKGROUND AND OBJECTIVES

The Affect Intolerance Scale (AIS) assesses two core concepts of emotion regulation: appraisals of negative emotions as threatening and proneness to emotional avoidance. Maladaptive emotion regulation is associated with various psychopathologies. We translated and validated the AIS in a German student and clinical sample of patients with trauma-related disorders.

METHODS

340 patients, 161 with post-traumatic stress disorder and 179 with adjustment disorder, and 322 students were enrolled. We employed exploratory and confirmatory factor analyses in a cross-validation design to investigate construct validity, convergent and discriminant validity, and reliability.

RESULTS

We replicated the originally described two-factor structure in both samples. Cronbach's α was 0.947 in the student and 0.950 in the clinical sample. AIS subscales showed moderate to high correlations with convergent and low correlations with discriminant measures. AIS total scores were significantly larger in the clinical sample, controlled for gender and age.

LIMITATIONS

This study provides a unified cross-validation model in a clinical and a student sample at the cost of reduced sample sizes.

CONCLUSIONS

The AIS is a valid measure of affect intolerance with the discriminative ability to distinguish between patients with trauma-related disorders and students. Test redundancy within both sub-constructs of the AIS might lead to biased estimates but allows for increased test precision, rendering the AIS a tool suitable for individual treatment monitoring.

Comparison of the effectiveness of acceptance and commitment therapy (ACT) with metacognitive therapy (MCT) in objective cognitive information processing style of obsessive-compulsive patients (OCD)

BACKGROUND

In recent studies, the deficit in the cognitive process has been investigated as one of the etiological hypotheses in a wide range of obsessive-compulsive disorders (OCD). This study aimed to compare the effectiveness of acceptance and commitment therapy (ACT) and metacognitive therapy (MCT) on objective cognitive information processing style in obsessive-compulsive patients.

MATERIALS AND METHODS

This quasi-experimental study with a pre-test and post-test plan and a control group was conducted on 45 patients with OCD, matched with gender, age, and educational and marital status. The samples in three groups were selected using the convenience sampling method. Finally, the study participants were randomly divided into two experimental groups and one control group and assessed using Pacini and Epstein's rational experimental Inventory (REI) in two stages, pre-test, and post-test. The experimental groups received ACT and MCT weekly during eight and seven sessions and in a group.

RESULTS

The results showed that ACT and MCT are effective at a significant level in the objective cognitive information processing style of obsessive-compulsive patients (P < 0.05). The post-test results showed that the effect of ACT in changing rational processing style is more effective than MCT treatment. Also, the effect of ACT on intuitive processing style changes was greater than on MCT treatment.

CONCLUSION

The findings of this study indicate that ACT and MCT cause a significant change in intuitive style to rationalism in the thematic processing of cognitive information of obsessive-compulsive patients. According to the results, both methods of treatment improve the research variables in these patients.

The role of metacognitions in cyberbullying and cybervictimization among adolescents diagnosed with major depressive disorder and anxiety disorders: A case-control study

Cyberbullying is becoming increasingly widespread as individuals use technology more widely and frequently. Recent studies have shown a growing vulnerability for cyberbullying and cybervictimization, particularly in the adolescent population. We argue that dysfunctional metacognitions, which have been found to be prominent in various psychiatric disorders, may also play a role in predicting cyberbullying and cybervictimization over and above a variety of established factors including daily Internet use, social media use, depression and anxiety. For this purpose, we recruited 121 adolescents diagnosed with major depressive disorder (MDD) and 122 adolescents diagnosed with anxiety disorders (AD) from the child and adolescent psychiatric department of 'Çankırı State Hospital' along with age and gender matched healthy controls (n = 120). Participants completed the DSM-5 Depression and Anxiety Severity Scales, the Social Media Disorder Scale (SMDS), the Metacognitions Questionnaire for Children (MCQ-C) and the Revised Cyberbullying Inventory-II (RCBI-II). Cybervictimization scores were found to be higher in the MDD and AD groups when compared with healthy controls. Cyberbullying scores in the MDD group were higher than healthy controls. Additionally, the Superstition, Punishment and Responsibility subdimension of the MCQ-C was a significant predictor of cybervictimization in the AD group while controlling for daily Internet use, social media use and anxiety. However, metacognitions were not associated with cyberbullying in the MDD and AD groups, as well as with cybervictimization in the MDD group. We concluded that dysfunctional metacognitions may be a preventive therapeutic target in reducing the impact of cyberbullying in adolescents with AD.

Metacognitive judgements and abilities in patients with affective disorders

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.

The Combined Contribution of Fear and Perceived Danger of COVID-19 and Metacognitions to Anxiety Levels during the COVID-19 Pandemic

Despite a wide base of research suggesting a major role for dysfunctional metacognitions in contributing to anxiety, their role in explaining psychological distress in the context of the COVID-19 pandemic remains unclear. In this study we investigated whether metacognitions would predict anxiety, while controlling for fear and perceived danger of COVID-19. A total of 862 individuals were included in this study. Participants completed sociodemographic questions, emotional state questions relating to COVID-19, the Metacognitions Questionnaire-30, and the Generalized Anxiety Disorder-7. Results showed that both negative beliefs about thoughts concerning uncontrollability and danger, and cognitive self-consciousness were significant predictors of anxiety beyond the fear and perceived danger of COVID-19. Future studies involving clinical populations are needed to investigate the longer-term impact of metacognitions in the maintenance and exacerbation of anxiety associated with the fear and perceived danger of COVID-19.

The relationship between dysfunctional metacognitive beliefs and problematic social networking sites use

Social networking sites (SNSs) enrol new subscribers each day. However, problematic SNS use has undesirable effects on psychological functioning. Therefore, it is important to identify the factors that contribute to the development of problematic SNS use. Very few studies have focused on revealing the underlying mechanisms of problematic SNS use. Although many past studies have examined the relationship between metacognitive beliefs and Internet addiction, the association between metacognitive beliefs and problematic SNS use has not been adequately explored. In this study, we aimed to explore the association between metacognitive beliefs and problematic SNS use among young adults. A total of 308 individuals participated in this study. A socio-demographic data form, the Metacognitions Questionnaire-30 (MCQ-30), and Social Media Addiction Scale (SMAS) were administered. Group comparisons were performed using multivariate analysis of covariance. Pearson's correlational and multiple linear regression analyses were conducted to examine the associations between metacognitive beliefs and problematic SNS use. The SNS addicts scored higher in all of the SMAS assessments. When compared to non-addicts, SNS addicts obtained higher scores on all the subtests of the SMAS and MCQ-30 except cognitive self-consciousness. The negative beliefs about the uncontrollability and danger of worry, cognitive confidence, and need for control thoughts were associated with SMAS mood modification, relapse and conflict subdimensions. Our findings revealed that dysfunctional metacognitive beliefs are related to problematic SNS use among young adults. These findings indicate that mental health workers should consider the modification of metacognitive beliefs in the treatment of problematic SNS use.

Participant experiences of change in mindfulness-based stress reduction for anxiety disorders

AIM

To explore experiences of change among participants in a randomized clinical trial of mindfulness-based stress reduction (MBSR) for anxiety disorders.

METHOD

Semi-structured interviews were conducted to explore the subjective experiences of change for individuals with anxiety disorders after a course in MBSR. Interviews were analysed employing hermeneutic-phenomenological thematic analysis.

RESULTS

Five main themes were identified: 1) Something useful to do when anxiety appears, 2) Feeling more at ease, 3) Doing things my anxiety wouldn't let me, 4) Meeting what is there, and 5) Better-but not there yet. Most participants used what they had learned for instrumental purposes, and described relief from anxiety and an increased sense of personal agency. A few reported more radical acceptance of anxiety, as well as increased self-compassion.

CONCLUSION

Participants of MBSR both describe mindfulness as a tool to "fix" anxiety and as bringing about more fundamental change towards acceptance of their anxiety. The complexity of reported change corresponds with better handling of areas representing known transdiagnostic features of anxiety disorder, such as dysfunctional cognitive processes (including attentional biases), emotional dysregulation, avoidance behaviours, and maladaptive self-relatedness. This supports MBSR as a transdiagnostic approach to the treatment of anxiety disorders.

The influence of social cognition on ego disturbances in patients with schizophrenia

BACKGROUND

Subjects experiencing ego disturbances can be classified as a distinct subgroup of schizophrenia patients. These symptoms imply a disturbance in the ego-world boundary, which in turn implies aberrations in the perception, processing and understanding of social information. This paper provides a comparison of a group of schizophrenia patients and a group of healthy controls on a range of social-cognitive tasks. Furthermore, it analyzes the relationship between ego disturbances and social-cognitive as well as clinical variables in the schizophrenia subsample.

METHODS

Two groups - 40 schizophrenia patients and 39 healthy subjects - were compared. In the source monitoring task, subjects performed simple computer mouse movements and evaluated the partially manipulated visual feedback as either self- or other-generated. In a second step, participants indicated the confidence of their decision on a 4-point rating scale. In an emotion-recognition task, subjects had to identify 6 basic emotions in the prosody of spoken sentences. In the 'reading-the-mind-in-the-eyes' test, subjects had to infer mental states from pictures that depicted others' eyes. In an attribution task, subjects were presented with descriptions of social events and asked to attribute the cause of the event either to a person, an object or a situation. Additionally, all subjects were tested for cognitive functioning levels.

RESULTS

The schizophrenia patient group performed significantly worse on all social-cognitive tasks than the healthy control group. Correlation analysis showed that ego disturbances were related to deficits in person attribution and lower levels of confidence in the source monitoring task. Also, ego disturbances were related to higher PANSS positive scores and a higher number of hospitalizations. Stepwise regression analysis revealed that social-cognitive variables explained 48.0% of the variance in the ego-disturbance score and represented the best predictors for ego disturbances. One particular clinical variable, namely the number of hospitalizations, additionally explained 13.8% of the variance.

CONCLUSION

Our findings suggest that ego disturbances are related to deficits in the social-cognitive domain, and, to a lesser extent, to clinical variables such as the number of hospitalizations.