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Chen JH, Spada MM, Ling H, Tong KK, Wu AMS. Desire Thinking About Gambling: Assessment and Associations With Gambling Disorder and Responsible Gambling Among Chinese Gamblers. J Gambl Stud 2024:10.1007/s10899-024-10313-7. [PMID: 38758351 DOI: 10.1007/s10899-024-10313-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2024] [Indexed: 05/18/2024]
Abstract
Desire thinking, within the metacognitive model of addictive behaviors, is conceptualized as a transdiagnostic process linked to the escalation and maintenance of craving for various addictive disorders; however, its application to the understanding of gambling and the Chinese community remains at an early stage. The present study aimed to introduce desire thinking into gambling research in the Chinese context by: (1) testing the applicability of its two-factor conceptualization and assessment tool, the Desire Thinking Questionnaire (DTQ), and (2) exploring its association with dysregulated and regulated engagements in gambling (i.e., Gambling Disorder [GD] and responsible gambling [RG], respectively). We conducted a telephone survey in Macao, China, and obtained a probability sample of 837 Chinese adult past-year gamblers (48.5% men; age: M = 41.11, SD = 14.31) with a two-stage cluster random sampling method. Our data indicated the psychometric adequacy of the two-factor DTQ (i.e., verbal perseveration and imaginal prefiguration) for measuring Chinese gamblers' desire thinking about gambling. After controlling for craving and demographics, desire thinking contributed to an additional 12.1% and 18.9% variance explained in GD tendency and RG behaviors, respectively. This study provides the first empirical evidence of the utility of desire thinking and the DTQ in facilitating gambling research on Chinese gamblers. Our findings also suggest the value of incorporating desire thinking in detecting and treating GD and in promoting RG.
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Affiliation(s)
| | | | - Haofeng Ling
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macao, China
| | - Kwok Kit Tong
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macao, China
| | - Anise M S Wu
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macao, China.
- Centre for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Macao, China.
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2
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Johnson SU, Hagen R, Dammen T, Papageorgiou C. Videoconference-delivered metacognitive therapy for anxiety and depression in post-COVID-19 syndrome: A baseline-controlled single-arm pilot trial. Gen Hosp Psychiatry 2024; 88:77-78. [PMID: 38365510 DOI: 10.1016/j.genhosppsych.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/05/2024] [Accepted: 02/08/2024] [Indexed: 02/18/2024]
Affiliation(s)
- Sverre Urnes Johnson
- Department of Psychology, University of Oslo, Oslo, Norway; Modum Bad Psychiatric Hospital, Vikersund, Norway.
| | - Roger Hagen
- Department of Psychology, University of Oslo, Oslo, Norway; Modum Bad Psychiatric Hospital, Vikersund, Norway; Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Toril Dammen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway
| | - Costas Papageorgiou
- Department of Psychology, University of Oslo, Oslo, Norway; Asto Clinics, United Kingdom
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3
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Zhang Z, Wang P, Gu J, Zhang Q, Sun C, Wang P. Effect of metacognitive therapy on depression in patients with chronic disease: a protocol for a systematic review and meta-analysis. BMJ Open 2024; 14:e075959. [PMID: 38631830 PMCID: PMC11029478 DOI: 10.1136/bmjopen-2023-075959] [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: 04/19/2024] Open
Abstract
BACKGROUND Chronic diseases have a high prevalence worldwide, and patients with chronic diseases often suffer from depression, leading to a poor prognosis and a low quality of life. Metacognitive therapy is a transdiagnostic psychotherapy intervention focused on thinking patterns, with the advantages of reliable implementation effect, short intervention period and low cost. It can help patients change negative metacognition, alleviate depression symptoms, and has a higher implementation value compared with other cognitive interventions. Therefore, metacognitive therapy may be an effective way to improve the mental health of patients with chronic diseases. METHODS AND ANALYSIS CNKI, Wanfang Database, VIP Database for Chinese Technical Periodicals, Sinomed, PubMed, SCOPUS, Embase, The Cochrane Library, Web of Science and PsycINFO will be used to select the eligible studies. As a supplement, websites (eg, the Chinese Clinical Registry, ClinicalTrials.gov) will be searched and grey literature will be included. The heterogeneity and methodological quality of the eligible studies will be independently screened and extracted by two experienced reviewers. All the data synthesis and analysis (drawing forest plots, subgroup analysis and sensitive analysis) will be conducted using RevMan 5.4.1. ETHICS AND DISSEMINATION This article is a literature review that does not include patients' identifiable information. Therefore, ethical approval is not required in this protocol. The findings of this systematic review and meta-analysis will be published in a peer-reviewed journal as well as presentations at relevant conferences. PROSPERO REGISTRATION NUMBER CRD42023411105.
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Affiliation(s)
- Zirui Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Peng Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Jinjin Gu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Qiang Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Changqing Sun
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Panpan Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
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Hammersmark AT, Hjemdal O, Hannisdal M, Lending HD, Reme SE, Hodne K, Osnes K, Gjengedal R, Johnson SU. Metacognitive therapy for generalized anxiety disorders in group: A case study. J Clin Psychol 2024; 80:884-899. [PMID: 37921033 DOI: 10.1002/jclp.23615] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 09/27/2023] [Accepted: 10/15/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVES In Metacognitive therapy (MCT), homework is used, for example, to increase awareness of thoughts and thought processes, to challenge metacognitive beliefs in real-life situations, and to practice new ways of processing thoughts, feelings, and symptoms. All MCT treatment manuals include homework assignments to be given between each session. METHOD The following study provides a detailed description of the implementation of homework in a group-based MCT treatment for generalized anxiety disorder (GAD) at an outpatient clinic in Norway. The treatment described in this case consisted of 10 weekly group sessions (7 patients) lasting two hours. RESULTS This case study demonstrates that group-based MCT can be used to treat GAD and describes how the use of homework can facilitate therapeutic change. CONCLUSION Overall, the effectiveness of MCT was found to be high. Homework gives patients the opportunity to take charge of their therapy and develop a sense of responsibility for their own progress, both during and after treatment.
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Affiliation(s)
| | - Odin Hjemdal
- Diakonhjemmet Hospital, Oslo, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | | | | | - Silje E Reme
- Diakonhjemmet Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | | | | | | | - Sverre U Johnson
- Diakonhjemmet Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Modum Bad Psychiatric Hospital, Vikersund, Norway
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Peng J, Yuan S, Wei Z, Liu C, Li K, Wei X, Yuan S, Guo Z, Wu L, Feng T, Zhou Y, Li J, Yang Q, Liu X, Wu S, Ren L. Temporal network of experience sampling methodology identifies sleep disturbance as a central symptom in generalized anxiety disorder. BMC Psychiatry 2024; 24:241. [PMID: 38553683 PMCID: PMC10981297 DOI: 10.1186/s12888-024-05698-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 03/18/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND A temporal network of generalized anxiety disorder (GAD) symptoms could provide valuable understanding of the occurrence and maintenance of GAD. We aim to obtain an exploratory conceptualization of temporal GAD network and identify the central symptom. METHODS A sample of participants (n = 115) with elevated GAD-7 scores (Generalized Anxiety Disorder 7-Item Questionnaire [GAD-7] ≥ 10) participated in an online daily diary study in which they reported their GAD symptoms based on DSM-5 diagnostic criteria (eight symptoms in total) for 50 consecutive days. We used a multilevel VAR model to obtain the temporal network. RESULTS In temporal network, a lot of lagged relationships exist among GAD symptoms and these lagged relationships are all positive. All symptoms have autocorrelations and there are also some interesting feedback loops in temporal network. Sleep disturbance has the highest Out-strength centrality. CONCLUSIONS This study indicates how GAD symptoms interact with each other and strengthen themselves over time, and particularly highlights the relationships between sleep disturbance and other GAD symptoms. Sleep disturbance may play an important role in the dynamic development and maintenance process of GAD. The present study may develop the knowledge of the theoretical model, diagnosis, prevention and intervention of GAD from a temporal symptoms network perspective.
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Affiliation(s)
- Jiaxi Peng
- Mental Health Education Center, Chengdu University, 610106, Chengdu, China
| | - Shuai Yuan
- University of Amsterdam, 1018WB, Amsterdam, the Netherlands
| | - Zihan Wei
- Xijing Hospital, Air Force Medical University, 710032, Xi'an, China
| | - Chang Liu
- Brain Park, School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, 3800, Clayton, VIC, Australia
| | - Kuiliang Li
- Department of Psychology, Army Medical University, 400038, Chongqing, China
| | - Xinyi Wei
- Department of Psychology, Renmin University of China, 100000, Beijing, China
| | - Shangqing Yuan
- School of Psychology, Capital Normal University, 100089, Beijing, China
| | - Zhihua Guo
- Department of Military Medical Psychology, Air Force Medical University, 710032, Xi'an, China
| | - Lin Wu
- Department of Military Medical Psychology, Air Force Medical University, 710032, Xi'an, China
| | - Tingwei Feng
- Department of Military Medical Psychology, Air Force Medical University, 710032, Xi'an, China
| | - Yu Zhou
- Military Psychology Section, Logistics University of PAP, 300309, Tianjin, China
- Military Mental Health Services & Research Center, 300309, Tianjin, China
| | - Jiayi Li
- Military Psychology Section, Logistics University of PAP, 300309, Tianjin, China
- Military Mental Health Services & Research Center, 300309, Tianjin, China
| | - Qun Yang
- Department of Military Medical Psychology, Air Force Medical University, 710032, Xi'an, China
| | - Xufeng Liu
- Department of Military Medical Psychology, Air Force Medical University, 710032, Xi'an, China
| | - Shengjun Wu
- Department of Military Medical Psychology, Air Force Medical University, 710032, Xi'an, China.
| | - Lei Ren
- Military Psychology Section, Logistics University of PAP, 300309, Tianjin, China.
- Military Mental Health Services & Research Center, 300309, Tianjin, China.
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Nordahl H, Strand ER, Hjemdal O, Nordahl HM. Is meta-worry relevant to interpersonal problems? Testing the metacognitive model of generalized anxiety disorder in an analogue- and a clinical sample of GAD. Cogn Behav Ther 2024:1-12. [PMID: 38502149 DOI: 10.1080/16506073.2024.2331191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/08/2024] [Indexed: 03/20/2024]
Abstract
Interpersonal problems are common in individuals with generalized anxiety disorder (GAD) and improved interpersonal functioning is an important goal in treatment. In the metacognitive model of worry and generalized anxiety disorder, emotional distress and psychological dysfunction are related to two distinct types of worry. Particular emphasis is put on meta-worry which refers to "worry about worrying" or appraisal of worrying as threatening in itself. Meta-worry impairs effective mental regulation and might therefore be an important predisposition to self-regulate via others and thereof interpersonal problems. In the current study, we tested the prediction that meta-worry is uniquely associated with interpersonal problems in two samples. The first consisted of 135 individuals with analogue GAD and the second of 56 individuals with a diagnosis of GAD. Using hierarchical linear regressions controlling for anxiety, depression and worry, meta-worry showed a unique relationship with interpersonal problems in both samples. These findings indicate that meta-worry may be relevant to formulate and treat interpersonal problems in individuals with GAD.
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Affiliation(s)
- Henrik Nordahl
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Eivind R Strand
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- St. Olav`s Hospital, Nidaros DPS, Trondheim, Norway
| | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Hans M Nordahl
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Acute Psychiatry, Division of Mental Health Care, St. Olavs Hospital HF, Trondheim University Hospital, Trondheim, Norway
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Strand ER, Nordahl H. Do Patient's Interpersonal Problems Improve Following Metacognitive Therapy? A Systematic Review and Meta-Analysis. Clin Psychol Psychother 2024; 31:e2973. [PMID: 38572800 DOI: 10.1002/cpp.2973] [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: 12/23/2023] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 04/05/2024]
Abstract
Metacognitive therapy (MCT) aims to modify dysfunctional metacognitions that are thought to be universal determinants of emotional distress and psychological dysfunction more generally. MCT is an effective treatment for emotional distress symptoms, but less is known about its effect for other types of psychological problems. Interpersonal problems are common in psychological disorders and should be improved following psychotherapy. Therefore, we conducted a systematic review and meta-analysis of trials on the effects associated with MCT for interpersonal problems among adults with mental health disorders published until 15 November 2023 using PubMed, Cochrane Library and PsycNet. Trials with a minimum of 10 participants were included. A total of six studies based on five trials reported on the effectiveness of MCT for interpersonal problems and met our inclusion criteria. Two trials evaluated MCT for patients with major depressive disorders, two for patients with anxiety disorders and one for borderline personality disorder. Three of the trials were randomized controlled trials. Four of the trials reported follow-up data but varied in their time-points. The within-group effect size estimate from pretreatment to posttreatment across five trials was large (g = 0.865, 95% CI [0.512-1.218]). Our results indicate that MCT is an effective treatment for improving interpersonal problems in individuals with common mental disorders, even though the treatment is short and primarily concern improving mental regulation through modifying metacognitions. While this finding is in line with metacognitive theory, more trials evaluating personality and interpersonal functioning are needed to draw firm conclusions.
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Affiliation(s)
- Eivind R Strand
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- St. Olav's Hospital, Nidaros DPS, Trondheim, Norway
| | - Henrik Nordahl
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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8
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Lassen ER, Lia SA, Hjertaas I, Hjemdal O, Kennair LEO, Hagen R, Solem S. Patient motivation and adherence in metacognitive therapy for major depressive disorder: an observational study. Cogn Behav Ther 2024; 53:220-234. [PMID: 38047723 DOI: 10.1080/16506073.2023.2289863] [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: 07/06/2023] [Accepted: 11/24/2023] [Indexed: 12/05/2023]
Abstract
The aim of this observational study was to examine the predictive and discriminant validity of patient motivation and adherence in metacognitive therapy (MCT) for depression. Motivational development for recovered- and non-recovered patients was also investigated. Motivation in sessions 1, 4, and 7 was measured using the Motivational Interviewing Skill Code 2.5 (MISC) in a 10-session trial of MCT for depression (N = 37). Adherence was assessed with the CBT compliance measure in session 7. The Beck Depression Inventory measured treatment outcome at 3-year follow-up. Recovered patients developed significantly more change talk and taking steps, and less sustain talk, as therapy progressed, compared to non-recovered patients. Evidence of the predictive validity of motivation in sessions 1 and 4 was limited. Higher sustain talk and taking steps in session 7 were significant predictors of more and less depressive symptoms, respectively. There was a moderate-strong correlation between motivation and adherence. The results confirm the predictive value of MISC in sessions 7 of MCT for depression, and establish differential motivational development between recovered and non-recovered patients. Subsequent research should clarify the discriminant validity and temporal relationships between motivation, adherence, and other clinical variables.
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Affiliation(s)
- Espen R Lassen
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Susanne Aabel Lia
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ingrid Hjertaas
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Roger Hagen
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Research Institute, Modum Bad, Vikersund, Norway
| | - Stian Solem
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
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Capobianco L, Hann M, McManus E, Peters S, Doherty PJ, Ciotti G, Murray J, Wells A. Cardiac rehabilitation for children and young people (CardioActive): protocol for a single-blind randomised feasibility and acceptability study of a centre-based cardiac rehabilitation programme versus usual care in 11-16 years with heart conditions. BMJ Open 2024; 14:e077958. [PMID: 38401897 PMCID: PMC10895226 DOI: 10.1136/bmjopen-2023-077958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 12/14/2023] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Congenital heart conditions are among the most common non-communicable diseases in children and young people (CYP), affecting 13.9 million CYP globally. While survival rates are increasing, support for young people adjusting to life with a heart condition is lacking. Furthermore, one in three CYP with heart conditions also experiences anxiety, depression or adjustment disorder, for which little support is offered. While adults are offered cardiac rehabilitation (CR) to support their mental and physical health, this is not offered for CYP.One way to overcome this is to evaluate a CR programme comprising exercise with mental health support (CardioActive; CA) for CYP with heart conditions. The exercise and mental health components are informed by the metacognitive model, which has been shown to be effective in treating anxiety and depression in CYP and associated with improving psychological outcomes in adult CR. METHOD AND ANALYSIS The study is a single-blind parallel randomised feasibility trial comparing a CR programme (CA) plus usual care against usual care alone with 100 CYP (50 per arm) aged 11-16 diagnosed with a heart condition. CA will include six group exercise, lifestyle and mental health modules. Usual care consists of routine outpatient management. Participants will be assessed at three time points: baseline, 3-month (post-treatment) and 6-month follow-up. Primary outcomes are feasibility and acceptability (ie, referral rates, recruitment and retention rates, attendance at the intervention, rate of return and level of completion of follow-up data). Coprimary symptom outcomes (Strength and Difficulties Questionnaire and Paediatric Quality of Life) and a range of secondary outcomes will be administered at each time point. A nested qualitative study will investigate CYP, parents and healthcare staff views of CR and its components, and staff's experience of delivering CA. Preliminary health economic data will be collected to inform future cost-effectiveness analyses. Descriptive data on study processes and clinical outcomes will be reported. Data analysis will follow intention to treat. Qualitative data will be analysed using thematic analysis and the theoretical framework of acceptability. ETHICS AND DISSEMINATION Ethical approval was granted on 14 February 2023 by the Greater Manchester East Research Ethics Committee (22/NW/0367). The results will be disseminated through peer-reviewed journals, conference presentations and local dissemination. TRIAL REGISTRATION NUMBER ISRCTN50031147; NCT05968521.
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Affiliation(s)
- Lora Capobianco
- Research and Innovation, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Mark Hann
- NIHR School for Primary Care Research, Centre for Primary Care and Health Services Research, School of Health Sciences, University of Manchester, Manchester, UK
| | - Emma McManus
- Health Organisation, Policy and Economics, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Sarah Peters
- Manchester Centre for Health Psychology, School of Health Sciences, Faculty of Biology, Medicine, and Health, University of Manchester, Manchester, UK
| | | | - Giovanna Ciotti
- Department of Pedeatric Cardiology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Joanne Murray
- Shrewsbury and Telford Hospital NHS Trust, Shrewsbury, UK
| | - Adrian Wells
- Research and Innovation, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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El Houari F, El Harch I, Idrissi AJ, El Fakir S, Zarhbouch B, Souirti Z. The Scale Assessment of Executive Functions-Adult (SAEF-A): Construction of a valid ecological instrument. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-8. [PMID: 38170845 DOI: 10.1080/23279095.2023.2299916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
OBJECTIVES This study aims to validate the SAEF-A (Scale Assessment Of Executive Functions-Adult) test, a new instrument for measuring executive functions in adults. MATERIALS AND METHODS The study participants are residents of Fez-Meknes over 18 years old. Two groups were enrolled: people with epilepsy and a healthy group. We constructed the tests in all three Moroccan languages: Darija, Tamazight, and Arabic. We validated the SAEF-A test according to Bernaud's instructions compared to the BRIEF-A test. RESULTS The Alpha Cronbach and Split Half were 92% and 88%, respectively. Exploratory research results highlight five facets of perceived value. Significant convergent validation existed between the BRIEF-A subscales and the SAEF-A scale. The results show that the people with epilepsy sample can be discriminated from the healthy ones in all dimensions, except planning, with a minor difference. CONCLUSIONS The results provide good reliability and validity for the SAEF-A. It will be helpful in studies of Moroccan adults and other people.
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Affiliation(s)
- Farah El Houari
- Sociology and Psychology Laboratory, Faculty of Letters and Human Sciences Dhar Al Mahraz, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Ibtissam El Harch
- Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy of Fez, University Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Abdelkrim Janati Idrissi
- Clinical Neurosciences Laboratory, Faculty of Medicine and Pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Samira El Fakir
- Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy of Fez, University Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Benaissa Zarhbouch
- Sociology and Psychology Laboratory, Faculty of Letters and Human Sciences Dhar Al Mahraz, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Zouhayr Souirti
- Clinical Neurosciences Laboratory, Faculty of Medicine and Pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Neurology Department, Sleep Center Hassan II University Hospital, Sidi Mohamed Ben Abdellah University, Fez, Morocco
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Chahine A, El Zouki CJ, Mhanna M, Hallit S, Obeid S. Association between time perspective and metacognition among Lebanese adults: the mediating role of mindfulness. BMC Psychiatry 2023; 23:906. [PMID: 38053111 PMCID: PMC10696690 DOI: 10.1186/s12888-023-05356-w] [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] [Received: 02/15/2023] [Accepted: 11/07/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Mindfulness may serve as a component of metacognitive beliefs and can also be viewed as a form of time perspective. The interplay between time perspective and metacognitive beliefs remains understudied. Both aspects, however, display considerable stability over time and significantly influence an individual's life and well-being. Lebanon, marked by its diverse and complex history, struggles with various political, social, and economic challenges. This study offers a valuable and unprecedented opportunity to examine these connections within a distinct cultural context, shedding light on the unique experiences of the Lebanese population. Therefore, our research aims to investigate the connection between time perspective and metacognition, with a focus on the role of mindfulness as a mediator. METHODS This cross-sectional study was conducted from August to November 2022 and involved participants from various regions of Lebanon. The questionnaire included sociodemographic data and scales such as the Arabic versions of the 15-item Short Form of the Zimbardo Time Perspective Inventory, the Metacognitions Questionnaire, the Freiburg Mindfulness Inventory and the Acceptance and Action Questionnaire (AAQ-2). RESULTS Our investigation recruited 423 participants. The analysis showed that individuals with a positive stance on their past, a hedonistic present, or a future-oriented outlook exhibited heightened levels of mindfulness. This elevated state of mindfulness, in turn, demonstrated a significant link to augmented cognitive self-consciousness (An increased introspection into one's own thoughts). We also observed a direct association between a future-focused time perspective and high scores of cognitive self-consciousness. Furthermore, mindfulness emerged as a crucial mediator in the relationships between time perspectives and negative beliefs about the danger of worry. Similarly, individuals with a positive view on their past, a hedonistic present orientation, or a future-focused mindset demonstrated elevated levels of mindfulness, which was correlated with less negative beliefs about the danger of worry. Notably, a positive past perspective was directly associated with less negative views on worry and the subsequent loss of control, whereas higher future focused time perspective scores was significantly and directly associated with more negative beliefs about worry, whereas more future focused time perspective was significantly and directly associated with more negative beliefs about worry. CONCLUSION Our findings found several meaningful associations between our variables, but it primarily underscored the significance of considering distinct subcomponents within mindfulness and psychopathological metacognition that may overlap, shedding light on their differential impacts on psychological well-being. We were also able to mirror the dual pathway theory of time perspective suggested in previous studies. These insights carry notable implications for the development and refinement of mindfulness-based and metacognitive interventions, emphasizing the need for tailored approaches that consider varying time perspectives. Continued investigation in this area promises to advance our understanding of these constructs and refine their practical applications in mental health interventions and well-being enhancement strategies.
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Affiliation(s)
- Abdallah Chahine
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Christian-Joseph El Zouki
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- UFR de Médecine, Université de Picardie Jules Verne, 1 Rue des Louvels, Amiens, 80037, France
- Faculté d'Ingénierie et de Management de la Santé, 42 rue Ambroise Paré, 59120, LOOS, France
| | - Mariam Mhanna
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon.
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Li F, Yuan D, Gao C, Xiong K, Geng F, Zhang L. Validity and Reliability of the Metacognitions Questionnaire-30 (MCQ-30) among Chinese Adolescents. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01625-7. [PMID: 37917240 DOI: 10.1007/s10578-023-01625-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 11/04/2023]
Abstract
This study aimed to examine the psychometric properties of the Metacognitions Questionnaire-30 (MCQ-30) in a sample of Chinese adolescents (1382 boys, 1445 girls) aged 11 to 18 years. Confirmatory factor analysis was performed to assess factor structure, as well as, measurement invariance across demographic groups and clinical symptoms. The results of confirmatory factor analyses supported the original five-factor model. Configural, metric and scalar invariance of the five-factor model were also supported by gender, age, ethnicity, residence, parental education level, depression and anxiety status. Furthermore, all five subscales demonstrated good internal consistency (Cronbach alphas > 0.75) and test-retest reliability (intra-class correlation coefficients > 0.45). Finally, the five factors were positively related to symptoms of depression, anxiety, and irritability and negatively related to positive childhood experiences and life satisfaction, indicating excellent validity. The findings provide initial evidence that the MCQ-30 is a valid measure for use in Chinese adolescents.
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Affiliation(s)
- Fan Li
- School of Psychology, Jiangxi Normal University, 99 Ziyang Ave, Nanchang, 330022, Jiangxi, China
| | - Danyan Yuan
- School of Psychology, Jiangxi Normal University, 99 Ziyang Ave, Nanchang, 330022, Jiangxi, China
| | - Chang Gao
- School of Psychology, Jiangxi Normal University, 99 Ziyang Ave, Nanchang, 330022, Jiangxi, China
| | - Kaixin Xiong
- School of Psychology, Jiangxi Normal University, 99 Ziyang Ave, Nanchang, 330022, Jiangxi, China
| | - Fulei Geng
- School of Psychology, Jiangxi Normal University, 99 Ziyang Ave, Nanchang, 330022, Jiangxi, China
| | - Lan Zhang
- School of Psychology, Jiangxi Normal University, 99 Ziyang Ave, Nanchang, 330022, Jiangxi, China.
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13
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Fekih-Romdhane F, Azzi V, Obeid S, Gerges S, Sarray El Dine A, Malaeb D, Soufia M, Hallit S. Psychometric properties of an Arabic translation of the short form of the metacognition questionnaire (MCQ-30) in a non-clinical adult sample. BMC Psychiatry 2023; 23:795. [PMID: 37907838 PMCID: PMC10619295 DOI: 10.1186/s12888-023-05308-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 10/25/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Previous linguistic validations of the 30-item Metacognition Questionnaire (MCQ-30) have been performed in Western/Eastern populations, and no Arabic validated version exists to date for the wide Arabic-speaking populations in the Middle East-North African region and abroad. In this regard, we sought through the present study to test the psychometric properties of an Arabic translation of the MCQ-30 in a sample of Arabic-speaking community adults from Lebanon. METHODS The sample of this cross-sectional study consisted of 423 participants (mean age: 38.13 ± 11.03 years; 61.2% females). The Metacognition Questionnaire-short form, Teruel Orthorexia Scale and Emotion regulation questionnaire were used to assess metacognition, orthorexia nervosa and emotion regulation (cognitive reappraisal and expressive suppression) respectively. RESULTS Findings of Confirmatory Factor Analyses revealed that the five-factor model provided a good fit to the data. McDonald's ω coefficients ranged from 0.78 to 0.94 for the five MCQ-30 subscales, and was of 0.93 for the total score, hence supporting the adequacy of scale reliability. Results also supported configural, metric, and scalar equivalence of the five-factor model across gender groups. The MCQ-30 subscales showed patterns of correlations with the emotion regulation and disordered eating constructs in the expected directions, providing evidence of the criterion-related validity of the measure. In particular, positive emotion regulation strategies (i.e., cognitive reappraisal) were negatively correlated with cognitive self-consciousness and need to control thoughts; whereas maladaptive emotion regulation strategies (i.e., expressive suppression) showed positive correlations with lack of cognitive confidence, negative beliefs and need to control thoughts. Additionally, all metacognition dimensions (except for cognitive self-consciousness) were significantly and positively correlated with higher levels of orthorexia nervosa behaviors. CONCLUSIONS Our findings preliminarily suggest that the scale is valid, reliable, and can be recommended for use among the broad Arabic-speaking community worldwide.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi Hospital, Manouba, 2010, Tunisia.
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.
| | - Vanessa Azzi
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Sarah Gerges
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Abir Sarray El Dine
- Department of Biomedical Sciences, School of Arts and Sciences, Lebanese International University, Beirut, Lebanon
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Michel Soufia
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
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14
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Dammen T, Papageorgiou C, Lindstrøm JC, Einvik G. Metacognitions in patients with chronic obstructive pulmonary disease: a psychometric study of the metacognitions questionnaire-30. Front Psychol 2023; 14:1265102. [PMID: 37928565 PMCID: PMC10623151 DOI: 10.3389/fpsyg.2023.1265102] [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: 07/21/2023] [Accepted: 09/22/2023] [Indexed: 11/07/2023] Open
Abstract
The metacognitions questionnaire-30 (MCQ-30) was developed for the assessment of metacognitive beliefs and processes that are central components of the metacognitive model of emotional disorders. Anxiety and depression commonly occur in patients with chronic obstructive pulmonary disease (COPD). Testing such a model for anxiety and depression in patients with COPD is warranted. However, the psychometric properties of the MCQ-30 in COPD patients are unknown. Therefore, in this study we aimed to examine these properties in COPD patients. The MCQ-30 was administered to 203 COPD patients referred to a rehabilitation unit in respiratory medicine. Confirmatory factor analysis (CFA) was used to test the five-factor as well as the bi-factor models of MCQ-30. Exploratory factor analyses were also performed. Both models did not meet the criteria for an acceptable fit on Comparative Fit Index (CFI) of 0.810 and 0.858 vs. criterion of ≥0.9, but the Root Mean Square Error of Approximation (RMSEA) criterion ≤0.08 was acceptable for both models with RMSEA = 0.074 and 0.066, respectively. The factors were mostly moderately correlated (0.41-0.58) with acceptable reliability coefficients (0.73-0.87). The exploratory factor analysis identified three of the five factors originally described in the five-factor model of the MCQ-30. These data show that the factor structure of the MCQ-30 appears to differ from that of the original instrument in COPD patients and further studies are needed to confirm its validity and reliability in this patient group.
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Affiliation(s)
- Toril Dammen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Research and Innovation, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | | | - Jonas Christoffer Lindstrøm
- Department of Method Development and Analytics, Norwegian Institute of Public Health, Oslo, Norway
- Health Services Research Unit (HØKH), Akershus University Hospital, Lørenskog, Norway
| | - Gunnar Einvik
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Pulmonary Medicine, Akershus University Hospital, Lørenskog, Norway
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15
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Larionov K, Petrova E, Demirbuga N, Werth O, Breitner MH, Gebhardt P, Caldarone F, Duncker D, Westhoff-Bleck M, Sensenhauser A, Maxrath N, Marschollek M, Kahl KG, Heitland I. Improving mental well-being in psychocardiology-a feasibility trial for a non-blended web application as a brief metacognitive-based intervention in cardiovascular disease patients. Front Psychiatry 2023; 14:1138475. [PMID: 37840797 PMCID: PMC10568139 DOI: 10.3389/fpsyt.2023.1138475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 08/28/2023] [Indexed: 10/17/2023] Open
Abstract
Background Many patients with cardiovascular disease also show a high comorbidity of mental disorders, especially such as anxiety and depression. This is, in turn, associated with a decrease in the quality of life. Psychocardiological treatment options are currently limited. Hence, there is a need for novel and accessible psychological help. Recently, we demonstrated that a brief face-to-face metacognitive therapy (MCT) based intervention is promising in treating anxiety and depression. Here, we aim to translate the face-to-face approach into digital application and explore the feasibility of this approach. Methods We translated a validated brief psychocardiological intervention into a novel non-blended web app. The data of 18 patients suffering from various cardiac conditions but without diagnosed mental illness were analyzed after using the web app over a two-week period in a feasibility trial. The aim was whether a non-blended web app based MCT approach is feasible in the group of cardiovascular patients with cardiovascular disease. Results Overall, patients were able to use the web app and rated it as satisfactory and beneficial. In addition, there was first indication that using the app improved the cardiac patients' subjectively perceived health and reduced their anxiety. Therefore, the approach seems feasible for a future randomized controlled trial. Conclusion Applying a metacognitive-based brief intervention via a non-blended web app seems to show good acceptance and feasibility in a small target group of patients with CVD. Future studies should further develop, improve and validate digital psychotherapy approaches, especially in patient groups with a lack of access to standard psychotherapeutic care.
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Affiliation(s)
- Katharina Larionov
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Ekaterina Petrova
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Nurefsan Demirbuga
- Information Systems Institute, Leibniz University Hannover, Hannover, Germany
| | - Oliver Werth
- OFFIS - Institute for Information Technology, Oldenburg, Germany
| | - Michael H. Breitner
- Information Systems Institute, Leibniz University Hannover, Hannover, Germany
| | - Philippa Gebhardt
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Flora Caldarone
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - David Duncker
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | | | - Anja Sensenhauser
- University of Applied Sciences and Arts, Hochschule Hannover, Hannover, Germany
| | - Nadine Maxrath
- TU Braunschweig and Hannover Medical School, Peter L. Reichertz Institute for Medical Informatics, Hannover, Germany
| | - Michael Marschollek
- TU Braunschweig and Hannover Medical School, Peter L. Reichertz Institute for Medical Informatics, Hannover, Germany
| | - Kai G. Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Ivo Heitland
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
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16
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Dammen T, Tunheim K, Munkhaugen J, Klungsøyr O, Papageorgiou C. Attention training technique delivered in groups as treatment for anxiety and depression in patients with coronary heart disease: study protocol for a waiting-list randomized controlled trial. Front Psychol 2023; 14:1226539. [PMID: 37790218 PMCID: PMC10544325 DOI: 10.3389/fpsyg.2023.1226539] [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: 05/21/2023] [Accepted: 08/30/2023] [Indexed: 10/05/2023] Open
Abstract
Introduction Clinically significant symptoms of depression and anxiety in coronary heart disease (CHD) patients are common and associated with adverse outcomes. Psychological treatments have shown limited effectiveness and more effective treatments have been requested. Attention training technique (ATT), a component of metacognitive therapy, can potentially be effective as a stand-alone treatment for anxiety and depression. In an open study, ATT delivered face-to-face in a group format was feasible and potentially effective for improving depression and anxiety symptoms in CHD patients. The next progressive step is to test the effectiveness of ATT in a randomized controlled trial. This paper describes the methodology of this trial. Methods ATT-CHD is a randomized wait-list (WL) controlled study. Eligible CHD patients from two hospitals with Hospital Anxiety and Depression Scale (HADS)-Anxiety and/or HADS-Depression subscales scores ≥8 will be randomized into ATT (n = 32) or WL control (n = 32). After 6-8 weeks, WL patients will be allocated to ATT. Participants will be evaluated pre-, mid- and post-treatment, and at 6-months follow-up using changes in HADS as primary outcome. Secondary outcomes will be changes in psychiatric disorders, rumination, worry, type D-personality, metacognitions, insomnia, quality of life, and C-Reactive protein (CRP). Discussion To our knowledge, this will be the first WL-controlled randomized study testing the effectiveness of group-based ATT as treatment of symptoms of anxiety and depression in CHD patients. It will also explore correlations between changes in psychological distress and CRP. A qualitative analysis will reveal patients' experience with ATT including processes that may facilitate or serve as barriers to effectiveness. Recruitment into the study commenced in December 2022. Ethics and dissemination The Regional Committees for Medical and Health Research Ethics (REK), Norway has granted approval for the study (ID 52002). The trial results will be published in peer-reviewed journals. According to Norwegian legislation, the Norwegian Data Protection Authority, and the Committee of Ethics, we are not allowed to share original study data publicly. Clinical trial registration ClinicalTrials.gov, identifier NCT05621408 pre-inclusion. There were no significant changes of methods or outcomes after study start.
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Affiliation(s)
- Toril Dammen
- Department of Research and Innovation, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kristoffer Tunheim
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Medicine, Drammen Hospital, Vestre Viken Trust, Drammen, Norway
| | - John Munkhaugen
- Department of Medicine, Drammen Hospital, Vestre Viken Trust, Drammen, Norway
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Ole Klungsøyr
- Department of Research and Innovation, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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17
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Nordahl H, Anyan F, Hjemdal O. Prospective Relations Between Dysfunctional Metacognitive Beliefs, Metacognitive Strategies, and Anxiety: Results From a Four-Wave Longitudinal Mediation Model. Behav Ther 2023; 54:765-776. [PMID: 37597956 DOI: 10.1016/j.beth.2023.02.003] [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] [Received: 08/15/2022] [Revised: 01/27/2023] [Accepted: 02/09/2023] [Indexed: 02/19/2023]
Abstract
The metacognitive model of psychological disorders suggests that emotional disorders are related to maladaptive metacognitive strategies corresponding to underlying dysfunctional metacognitive beliefs. There is substantial empirical evidence supporting a role of metacognition in psychopathology, but fewer studies have evaluated the metacognitive model using longitudinal data and taken into consideration its differentiation between components and how they are hypothesized to be related to each other. Thus, more specific model evaluation is important as it relates to identifying mechanisms of disorder with a potential to provide clinical advances. In the present study, 868 participants took part in a 4-wave survey and reported on metacognitive beliefs and strategies and anxiety symptoms. Two longitudinal mediation models (forward and reversed causation) were run to test temporal precedence and bidirectional relations. The results indicated that metacognitive beliefs significantly predicted metacognitive strategies, which further predicted anxiety symptoms and mediated the indirect effect in the relationship between metacognitive beliefs and anxiety over time. The relationship between metacognitive beliefs and anxiety symptoms over time were bidirectional, but this relationship was not accounted for by metacognitive strategies. These findings largely support central predictions set forward by the metacognitive model and indicate that metacognitions play a preceding and maintaining role in anxiety.
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18
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Martin S, Strodl E. The relationship between childhood trauma, eating behaviours, and the mediating role of metacognitive beliefs. Appetite 2023; 188:106975. [PMID: 37454578 DOI: 10.1016/j.appet.2023.106975] [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: 12/19/2022] [Revised: 07/04/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023]
Abstract
Disordered eating poses a significant risk to psychological and physical health. The experience of childhood trauma has been linked to the development of disordered eating behaviours, but the causal psychological mechanisms remain unclear. The metacognitive model holds promise as a potential framework for understanding the mediating psychological processes that explain how childhood trauma may lead to disordered eating. The purpose of this study was to examine the role of metacognitive beliefs mediating the relationship between childhood trauma and disordered eating behaviours. Adults from the Australian community (N = 461) completed an online self-report survey measuring childhood maltreatment (Childhood Trauma Questionnaire - Short Form), disordered eating behaviour (Three Factor Eating Questionnaire - Revised 21), and metacognitive beliefs (Metacognitive Questionnaire 30). Hierarchical multiple regression analyses revealed no independent associations between any forms of childhood maltreatment and cognitive restraint, while childhood emotional abuse was uniquely associated with uncontrolled eating and emotional eating. Through bootstrapping tests, the mediating effect between childhood trauma and uncontrolled and emotional eating consistently involved the metacognitive beliefs that thoughts are uncontrollable and dangerous. Future longitudinal research is required to confirm causal relationships.
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Affiliation(s)
- Sarah Martin
- School of Psychology and Counselling, Queensland University of Technology, Australia
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Australia.
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19
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Dammen T, Munkhaugen J, Sverre E, Moum T, Papageorgiou C. Psychiatric disorders, rumination, and metacognitions in patients with type D personality and coronary heart disease. Nord J Psychiatry 2023; 77:540-546. [PMID: 37079379 DOI: 10.1080/08039488.2023.2182358] [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] [Received: 07/25/2022] [Revised: 01/30/2023] [Accepted: 02/14/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND Little is known regarding the prevalence of psychiatric disorders in patients with both coronary heart disease (CHD) and type D personality, and whether these patients may benefit from psychotherapy that modifies metacognitive beliefs implicated in disorder maintenance. This study explored prevalence rates among these patients and associations between type D characteristics, rumination and metacognitions. METHODS Forty-seven consecutive patients with CHD who scored positive for type D personality were included in this pre-planned study. Participants underwent structured clinical interviews for mental and personality disorders and completed questionnaires assessing rumination and metacognitions. RESULTS Mean age was 53.8 (SD 8.1) years and 21.3% were female. At least one mood disorder or anxiety disorder was found in 70.2% and 61.7% of the patients. The most common disorders were major depressive disorder (59.6%), social phobia (40.4%), and generalized anxiety disorder (29.8%). At least one personality disorder was detected in 42.6%. Only 21% reported ongoing treatment with psychotropic medication whereas none had psychotherapy. Metacognitions and rumination were significantly associated with negative affectivity (0.53-0.72, p < .001) but not social inhibition. CONCLUSION Mood and anxiety disorders were highly prevalent and relatively untreated among these patients. Future studies should test the metacognitive model for type D personality.
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Affiliation(s)
- Toril Dammen
- Department of Research and Innovation, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Behavioural Medicine, Institute of Basal Medical Sciences, University of Oslo, Oslo, Norway
| | | | - Elise Sverre
- Department of Medicine, Drammen Hospital, Drammen, Norway
| | - Torbjørn Moum
- Department of Behavioural Medicine, Institute of Basal Medical Sciences, University of Oslo, Oslo, Norway
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20
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Moller CI, Badcock PB, Hetrick SE, Rice S, Berk M, Witt K, Chanen AM, Dean OM, Gao C, Cotton SM, Davey CG. Predictors of suicidal ideation severity among treatment-seeking young people with major depressive disorder: The role of state and trait anxiety. Aust N Z J Psychiatry 2023; 57:1150-1162. [PMID: 36629043 DOI: 10.1177/00048674221144262] [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: 01/12/2023]
Abstract
OBJECTIVE Depression and suicidal ideation are closely intertwined. Yet, among young people with depression, the specific factors that contribute to changes in suicidal ideation over time are uncertain. Factors other than depressive symptom severity, such as comorbid psychopathology and personality traits, might be important contributors. Our aim was to identify contributors to fluctuations in suicidal ideation severity over a 12-week period in young people with major depressive disorder receiving cognitive behavioural therapy. METHODS Data were drawn from two 12-week randomised, placebo-controlled treatment trials. Participants (N = 283) were 15-25 years old, with moderate to severe major depressive disorder. The primary outcome measure was the Suicidal Ideation Questionnaire, administered at baseline and weeks 4, 8 and 12. A series of linear mixed models was conducted to examine the relationship between Suicidal Ideation Questionnaire score and demographic characteristics, comorbid psychopathology, personality traits and alcohol use. RESULTS Depression and anxiety symptom severity, and trait anxiety, independently predicted higher suicidal ideation, after adjusting for the effects of time, demographics, affective instability, non-suicidal self-injury and alcohol use. CONCLUSIONS Both state and trait anxiety are important longitudinal correlates of suicidal ideation in depressed young people receiving cognitive behavioural therapy, independent of depression severity. Reducing acute psychological distress, through reducing depression and anxiety symptom severity, is important, but interventions aimed at treating trait anxiety could also potentially be an effective intervention approach for suicidal ideation in young people with depression.
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Affiliation(s)
- Carl I Moller
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Paul B Badcock
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Sarah E Hetrick
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Simon Rice
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Michael Berk
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University and Barwon Health, Geelong, VIC, Australia
- The Florey Institute of Neuroscience and Mental Health and Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Katrina Witt
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Andrew M Chanen
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Olivia M Dean
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University and Barwon Health, Geelong, VIC, Australia
- The Florey Institute of Neuroscience and Mental Health and Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Caroline Gao
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Sue M Cotton
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Christopher G Davey
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
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21
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Strand ER, Hjemdal O, Anyan F, Nordahl H, Nordahl HM. Change in interpersonal problems and metacognitive beliefs as predictors of improvement in patients with generalized anxiety disorder. Clin Psychol Psychother 2023; 30:842-851. [PMID: 36797996 DOI: 10.1002/cpp.2841] [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: 12/16/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/18/2023]
Abstract
INTRODUCTION Generalized anxiety disorder (GAD) is characterized by persistent worry and anxiety, often with a chronic course. We tested the role of two suggested underlying factors in GAD, interpersonal problems and negative metacognitive beliefs, as predictors of trait-worry and trait-anxiety. METHODS The sample consisted of 56 patients with a primary diagnosis of GAD from a randomized controlled trial. We first estimated the proportion of variance lying between the higher level of the data structure to account for potential therapists' effects. Two hierarchical regression analyses were conducted testing change in interpersonal problems and negative metacognitive beliefs as predictors of change in trait-worry and trait-anxiety following treatment. Change in depression and anxiety symptoms was controlled. RESULTS Change in negative metacognitive beliefs was the strongest predictor of improvement of both trait-worry and trait-anxiety. Change in interpersonal problems was not a unique predictor of change in trait-worry but did make a significant and unique contribution to trait-anxiety. CONCLUSIONS Negative metacognitive beliefs may be important targets to improve trait-worry and trait-anxiety in GAD. Interpersonal problems may be relevant for trait-anxiety but could also be a surface marker of higher order vulnerability factors. Implications for treatment are discussed.
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Affiliation(s)
- Eivind R Strand
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Nidaros DPS, St. Olavs Hospital, Trondheim, Norway
| | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Frederick Anyan
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Henrik Nordahl
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Hans M Nordahl
- Østmarka, Division of Psychiatry, St. Olav's Hospital, Trondheim, Norway
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
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22
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Vrabel K, Johnson SU, Ebrahimi OV, Hoffart A. Anxiety and depressive symptoms among migrants during the COVID-19 pandemic in Norway: A two-wave longitudinal study. PSYCHIATRY RESEARCH COMMUNICATIONS 2023; 3:100115. [PMID: 36942153 PMCID: PMC10008811 DOI: 10.1016/j.psycom.2023.100115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/07/2023] [Accepted: 03/08/2023] [Indexed: 03/16/2023]
Abstract
This study was designed to examine the impact of the COVID-19 pandemic on the mental health of migrants living in Norway. We conducted a longitudinal two-waves survey among a sample of 574 migrants and multilevel modelling was used to analyse anxiety, health anxiety and depressive symptoms. Demographic and psychological predictors were investigated. The levels of anxiety, health anxiety and depressive symptoms among migrants decreased from the lockdown (strict social distancing protocols) to phaseout. Reductions in maladaptive coping strategies were related to parallel reductions in anxiety, health anxiety, and depression, and a reduction in loneliness was related to a reduction in depression. The results indicate that the elevated levels of anxiety, health anxiety and depressive symptoms among migrants in the first phase of the pandemic may be temporary.
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Affiliation(s)
- KariAnne Vrabel
- Department of Psychology, University of Oslo, Oslo, Norway
- Modum Bad Psychiatric Hospital, Vikersund, Norway
| | - Sverre Urnes Johnson
- Department of Psychology, University of Oslo, Oslo, Norway
- Modum Bad Psychiatric Hospital, Vikersund, Norway
| | - Omid V Ebrahimi
- Department of Psychology, University of Oslo, Oslo, Norway
- Modum Bad Psychiatric Hospital, Vikersund, Norway
| | - Asle Hoffart
- Department of Psychology, University of Oslo, Oslo, Norway
- Modum Bad Psychiatric Hospital, Vikersund, Norway
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Rawat A, Sangroula N, Khan A, Faisal S, Chand A, Yousaf RA, Muhammad N, Yousaf H. Comparison of Metacognitive Therapy Versus Cognitive Behavioral Therapy for Generalized Anxiety Disorder: A Meta-Analysis of Randomized Control Trials. Cureus 2023; 15:e39252. [PMID: 37342751 PMCID: PMC10277900 DOI: 10.7759/cureus.39252] [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] [Accepted: 05/20/2023] [Indexed: 06/23/2023] Open
Abstract
The aim of this meta-analysis is to compare the efficacy of meta-cognitive therapy (MCT) and cognitive behavioral therapy (CBT) in patients with generalized anxiety disorder (GAD). This study is reported according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic electronic literature search was conducted on April 20, 2023, to find studies reporting on the efficacy of MCT for GAD. The search keywords included "Generalized anxiety disorders," "meta-cognitive therapy," "cognitive behavior therapy," and "randomized control trials.: The following databases were searched to find relevant articles: PubMed, PsychInfo, CINAHL, and SCOPUS. Outcomes assessed in the present meta-analysis included the change in the Penn State Worry Questionnaire (PSWQ) from baseline to completion of treatment and after two years of follow-up. The PSWQ measures the trait of worry in adults. Worry is regarded as a dominant feature of GAD. Secondary outcomes assessed in this meta-analysis included symptom severity using the Beck anxiety inventory (BAI). Change in BAI was scored from baseline to completion of treatment and after two years of follow-up. A total of three studies were included in this meta-analysis. The results show that patients treated with MCT had greater reductions in PSWQ and BAI scores post-treatment and after two years of treatment, as well as higher rates of recovery compared to those treated with CBT. These findings suggest that MCT is a promising approach for treating GAD and may have advantages over traditional CBT approaches.
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Affiliation(s)
- Anurag Rawat
- Interventional Cardiology, Himalayan Institute of Medical Sciences, Dehradun, IND
| | | | - Areeba Khan
- Critical Care Medicine, United Medical and Dental College, Karachi, PAK
| | - Sana Faisal
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Ali Chand
- Medicine, Shaikh Khalifa Bin Zayed Medical and Dental College, Lahore, PAK
| | | | - Nazar Muhammad
- Psychiatry, Cornerstone Family Healthcare, New York, USA
| | - Humayoun Yousaf
- Medicine, Shaikh Khalifa Bin Zayed Medical and Dental College, Lahore, PAK
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Zhou H, Liu H, Ma X, Deng Y. The psychometric properties of positive and negative beliefs about the rumination scale in Chinese undergraduates. BMC Psychol 2023; 11:107. [PMID: 37041578 PMCID: PMC10091571 DOI: 10.1186/s40359-023-01111-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 03/06/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Rumination, a transdiagnostic factor in different psychopathological conditions, is believed to be activated and sustained by dysfunctional metacognition. The Positive Beliefs about Rumination Scale (PBRS) and the Negative Beliefs about Rumination Scale (NBRS) have been used to measure the metacognitive beliefs of rumination and have been investigated in many cultural contexts. However, it remains unclear whether these scales can work as well for the Chinese population. Therefore, this study aimed to explore the psychometric properties of the Chinese versions of these scales and to test the metacognitive model of rumination for students with different levels of depression. METHODS The PBRS and NBRS were forward-backward translated into Mandarin. In total 1,025 college students were recruited to complete a battery of web-based questionnaires. Exploratory factor analysis, confirmatory factor analysis, and correlation analysis were used to test the structure, validity, and reliability of the two scales, as well as their item correlations with rumination. RESULTS A new two-factor structure of the PBRS (rather than the original one-factor model) and a new three-factor structure of the NBRS (rather than the original two-factor model) were extracted. The goodness-of-fit indices of these two factor models showed they had a good to very good fit with the data. The internal consistency and construct validity of PBRS and NBRS were also affirmed. CONCLUSION The Chinese versions of the PBRS and the NBRS were generally shown to be reliable and valid, but their newly extracted structures fit the Chinese college students better than their original structures. These new models of PBRS and NBRS are of value to be further explored in Chinese population.
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Affiliation(s)
- Honggui Zhou
- Psychosomatic Health Research Institute, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Hong Liu
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xiaohong Ma
- Education Center for Mental Health, Central South University, Changsha, China
| | - Yunlong Deng
- Psychosomatic Health Research Institute, The Third Xiangya Hospital, Central South University, Changsha, China.
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25
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Forkmann T, Knorr A, Gerdes C, Vüst B, Hamacher D, Teismann T. Metacognitions about suicidal thoughts. J Psychiatr Res 2023; 161:199-205. [PMID: 36933446 DOI: 10.1016/j.jpsychires.2023.03.018] [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] [Received: 09/20/2022] [Revised: 02/23/2023] [Accepted: 03/08/2023] [Indexed: 03/20/2023]
Abstract
BACKGROUND Rumination about suicide has recently been identified as a risk factor for suicidal behavior. According to the metacognitive model of emotional disorders, the activation and maintenance of rumination is dependent on specific metacognitive beliefs. On this background, the current study is concerned with the development of a questionnaire to assess suicide-specific positive and negative metacognitive beliefs. METHODS Factor structure, reliability and validity of the Scales for Suicide-related Metacognitions (SSM) were investigated in two samples comprised of participants suffering from lifetime suicide ideation. Participants of sample 1 (N = 214; 81.8% female; Mage = 24.9, SDage = 4.0) took part in a single assessment using an online survey. Participants of sample 2 (N = 56; 71.4% female; Mage = 33.2, SDage = 12.2) took part in two online assessments within a two week time-period. To establish convergent validity questionnaire-based assessments of suicidal ideation, general and suicide specific rumination and depression were used. Furthermore, it was analyzed whether suicide-related metacognitions predict suicide-specific rumination cross-sectionally and prospectively. RESULTS Factor analyses revealed a two-factor structure of the SSM. Results indicated good psychometric properties, and provided evidence for construct validity and stability of the subscales. Positive metacognitions predicted concurrent and prospective suicide-specific rumination beyond the effect of suicide ideation and depression and rumination predicted concurrent and prospective negative metacognitions. CONCLUSION Taken together the results provide initial evidence that the SSM is a valid and reliable measure of suicide-related metacognitions. Furthermore, findings are in line with a metacognitive conceptualization of suicidal crises and provide first indications of factors that might be relevant for the activation and maintenance of suicide-specific rumination.
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Affiliation(s)
- Thomas Forkmann
- Department of Clinical Psychology and Psychotherapy, University of Duisburg-Essen, Germany.
| | - Anna Knorr
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Germany
| | - Christiane Gerdes
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Germany
| | - Björn Vüst
- Department of Clinical Psychology and Psychotherapy, University of Duisburg-Essen, Germany
| | - Dennis Hamacher
- Department of Clinical Psychology and Psychotherapy, University of Duisburg-Essen, Germany
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Germany
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26
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Quan H, Zettle RD. The Contribution of Psychological Inflexibility and Metacognitive Processes to Emotional Distress. J Cogn Psychother 2023; 37:63-81. [PMID: 36788002 DOI: 10.1891/jcpsy-d-21-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Process-based cognitive behavior therapy (PB-CBT) may be informed by identifying shared mechanisms of disorder linked to shared processes of therapeutic change. Repetitive negative thinking (RNT) is a molar pathogenic process common to both generalized anxiety disorder and depression. Acceptance and commitment therapy (ACT) and metacognitive therapy (MCT) offer separate models of the relationship between RNT and emotional distress. In a pair of related studies, the relative degree to which processes specific to the two models accounted for variability in levels of generalized anxiety and depression in college student samples was evaluated. Across both studies, processes of cognitive fusion and obstructed valued living within the ACT model and beliefs about the negative consequences of RNT within the MCT model were most predictive of variability in levels of emotional distress. Limitations of this project as well as implications for further research and practice of PB-CBT for disorders of emotional distress are discussed.
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Affiliation(s)
- Huan Quan
- Wichita State University, Wichita, Kansas, USA
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27
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Gori A, Topino E, Musetti A. The Relationship among Anxiety, Worry, Perceived Stress, Defense Mechanisms, and High Levels of Post-Traumatic Stress Symptoms: A Discriminant Analytic Approach. J Pers Med 2023; 13:jpm13020237. [PMID: 36836471 PMCID: PMC9966516 DOI: 10.3390/jpm13020237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/18/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) is a pathological condition that may lead to a significant deterioration in the quality of life over time. Therefore, the study of the elements that can characterize the disorder could be considered of great clinical interest and relevance. The aim of the present research was to empirically discriminate the influence of perceived stress, state anxiety, worry, and defense mechanisms (mature, neurotic, and immature) at different levels of post-traumatic stress symptoms. A sample of 1250 participants (69.5% women, 30.5% men; Mage = 34.52, SD = 11.857) completed an online survey including the Impact of Event Scale-Revised, Ten-Item Perceived Stress Scale, Penn State Worry Questionnaire, Forty Item Defense Style Questionnaire, and State-Trait Anxiety Inventory-Form X3. Data were analysed by implementing MANOVA and discriminant analysis. Results showed significant differences in the levels of perceived stress, state anxiety, and worry, as well as neurotic and immature defenses based on the levels of post-traumatic stress symptoms: F(12,2484) = 85.682, p < 0.001; Wilk's Λ = 0.430. Furthermore, these variables discriminate significant accuracy between participants who reported a mild psychological impact and those with a probable presence of PTSD, with perceived stress, which was found to be the best predictor. Classification results indicated that the original grouped cases were classified with 86.3% overall accuracy. Such findings may provide useful insight for clinical practice.
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Affiliation(s)
- Alessio Gori
- Department of Health Sciences, University of Florence, Via di San Salvi 12, Pad. 26, 50135 Firenze, Italy
- Integrated Psychodynamic Psychotherapy Institute (IPPI), Via Ricasoli 32, 50122 Florence, Italy
- Correspondence:
| | - Eleonora Topino
- Department of Human Sciences, LUMSA University of Rome, Via della Traspontina 21, 00193 Rome, Italy
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, 43121 Parma, Italy
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Machida M, Tanobe K, Lee SK, Hara S, Kumano H, Tayama J. Development and Validation of the Cognitive Attentional Syndrome Scale 1 Revised–Japanese Version
1. JAPANESE PSYCHOLOGICAL RESEARCH 2023. [DOI: 10.1111/jpr.12445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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29
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Ünal-Aydın P, Özkan Y, Öztürk M, Aydın O, Spada MM. The role of metacognitions in cyberbullying and cybervictimization among adolescents diagnosed with major depressive disorder and anxiety disorders: A case-control study. Clin Psychol Psychother 2023. [PMID: 36634222 DOI: 10.1002/cpp.2826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/06/2022] [Accepted: 01/02/2023] [Indexed: 01/13/2023]
Abstract
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.
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Affiliation(s)
- Pınar Ünal-Aydın
- Department of Psychology, Faculty of Arts and Science, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Yekta Özkan
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Afyonkarahisar University of Health Sciences, Afyonkarahisar, Turkey
| | - Masum Öztürk
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Orkun Aydın
- Department of Psychology, Faculty of Arts and Science, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Marcantonio M Spada
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
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Bruhns A, Baumeister A, Demeroutis G, Jahn H, Willenborg B, Shaffy A, Moritz S, Bücker L. A mobile-based aftercare intervention to increase self-esteem in inpatients diagnosed with depression: A randomized controlled trial. Psychother Res 2023:1-20. [PMID: 36628469 DOI: 10.1080/10503307.2022.2157226] [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: 01/12/2023] Open
Abstract
OBJECTIVE In this randomized controlled trial, we investigated the effectiveness, side effects and user satisfaction of the self-help smartphone app "MCT & More" among inpatients with a diagnosis of depression after their discharge from a psychiatric hospital over a period of 4 weeks. METHODS A total of 159 inpatients were recruited in four German psychiatric hospitals three days before hospital discharge (intervention group: n = 79; treatment as usual: n = 80). Based on the vulnerability model (low self-esteem contributes to depression), self-esteem represented the primary outcome, quality of life and depressive symptoms the secondary outcomes. RESULTS Intention-to-treat analyzes showed no statistical significance for the primary and secondary outcome parameters, except for the subscale self-competence in favor of the intervention group (with a small effect size of d = 0.35), in the context of an exploratory approach (post hoc). The more positive the attitude toward mobile-based interventions and the more positive the treatment expectations, the more frequently the app was used (r = .35, p = .008; r = .34, p = .009). CONCLUSION Further symptom reduction could not be obtained. However, the results suggest that an effect on improvement in self-competence could be achieved by low-threshold aftercare programs. Future studies should include long-term assessments to examine the impact of mobile-based aftercare on relapse.Trial registration: DRKS00022559.
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Affiliation(s)
- Alina Bruhns
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anna Baumeister
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Holger Jahn
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,AMEOS Klinikum Heiligenhafen, Heiligenhafen, Germany
| | | | - Athif Shaffy
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lara Bücker
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, 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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Castle D, Feusner J, Laposa JM, Richter PMA, Hossain R, Lusicic A, Drummond LM. Psychotherapies and digital interventions for OCD in adults: What do we know, what do we need still to explore? Compr Psychiatry 2023; 120:152357. [PMID: 36410261 PMCID: PMC10848818 DOI: 10.1016/j.comppsych.2022.152357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 08/07/2022] [Accepted: 11/14/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Despite significant advances in the understanding and treatment of obsessive compulsive disorder (OCD), current treatment options are limited in terms of efficacy for symptom remission. Thus, assessing the potential role of iterative or alternate psychotherapies is important. Also, the potential role of digital technologies to enhance the accessibility of these therapies, should not be underestimated. We also need to embrace the idea of a more personalized treatment choice, being cognisant of clinical, genetic and neuroimaging predictors of treatment response. PROCEDURES Non-systematic review of current literature on emerging psychological and digital therapies for OCD, as well as of potential biomarkers of treatment response. FINDINGS A number of 'third wave' therapies (e.g., Acceptance and Commitment Therapy, Mindfulness-Based Cognitive Therapy) have an emerging and encouraging evidence base in OCD. Other approaches entail employment of elements of other psychotherapies such as Dialectical Behaviour Therapy; or trauma-focussed therapies such as Eye Movement Desensitisation and Reprocessing, and Imagery Rescripting and Narrative Therapy. Further strategies include Danger Ideation Reduction Therapy and Habit Reversal. For these latter approaches, large-scale randomised controlled trials are largely lacking, and the precise role of these therapies in treating people with OCD, remains to be clarified. A concentrated 4-day program (the Bergen program) has shown promising short- and long-term results. Exercise, music, and art therapy have not been adequately tested in people with OCD, but may have an adjunctive role. Digital technologies are being actively investigated for enhancing reach and efficacy of psychological therapies for OCD. Biomarkers, including genetic and neuroimaging, are starting to point to a future with more 'personalised medicine informed' treatment strategizing for OCD. CONCLUSIONS There are a number of potential psychological options for the treatment of people with OCD who do not respond adequately to exposure/response prevention or cognitive behaviour therapy. Adjunctive exercise, music, and art therapy might be useful, albeit the evidence base for these is very small. Consideration should be given to different ways of delivering such interventions, including group-based, concentrated, inpatient, or with outreach, where appropriate. Digital technologies are an emerging field with a number of potential applications for aiding the treatment of OCD. Biomarkers for treatment response determination have much potential capacity and deserve further empirical testing.
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Affiliation(s)
- David Castle
- Centre for Addiction and Mental Health, 60 White Squirrel Way, Toronto, Ontario M6J 1H4, Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario M5T 1R8, Canada.
| | - Jamie Feusner
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1RB, Canada
| | - Judith M Laposa
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, 100 Stokes St., Toronto, Ontario M6J 1H4, Canada
| | - Peggy M A Richter
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Frederick W Thompson Anxiety Disorders Centre, Sunnybrook Health Sciences Centre, 2075 Bayview, Toronto, Ontario M4N 3M5, Canada
| | - Rahat Hossain
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario M5T 1R8, Canada
| | - Ana Lusicic
- Centre for Addiction and Mental Health, 60 White Squirrel Way, Toronto, Ontario M6J 1H4, Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario M5T 1R8, Canada
| | - Lynne M Drummond
- Service for OCD/ BDD, South-West London and St George's NHS Trust, Glenburnie Road, London SW17 7DJ, United Kingdom
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Wells A, Reeves D, Heal C, Fisher P, Doherty P, Davies L, Heagerty A, Capobianco L. Metacognitive therapy home-based self-help for anxiety and depression in cardiovascular disease patients in the UK: A single-blind randomised controlled trial. PLoS Med 2023; 20:e1004161. [PMID: 36719886 PMCID: PMC9888717 DOI: 10.1371/journal.pmed.1004161] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 12/21/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Anxiety and depression in cardiac rehabilitation (CR) are associated with greater morbidity, mortality, and increased healthcare costs. Current psychological interventions within CR have small effects based on low-quality studies of clinic-based interventions with limited access to home-based psychological support. We tested the effectiveness of adding self-help metacognitive therapy (Home-MCT) to CR in reducing anxiety and depression in a randomised controlled trial (RCT). METHODS AND FINDINGS We ran a single-blind, multi-centre, two-arm RCT. A total of 240 CR patients were recruited from 5 NHS-Trusts across North West England between April 20, 2017 and April 6, 2020. Patients were randomly allocated to Home-MCT+CR (n = 118, 49.2%) or usual CR alone (n = 122, 50.8%). Randomisation was 1:1 via randomised blocks within hospital site, balancing arms on sex and baseline Hospital Anxiety and Depression Scale (HADS) scores. The primary outcome was the HADS total score at posttreatment (4-month follow-up). Follow-up data collection occurred between August 7, 2017 and July 20, 2020. Analysis was by intention to treat. The 4-month outcome favoured the MCT intervention group demonstrating significantly lower end of treatment scores (HADS total: adjusted mean difference = -2.64 [-4.49 to -0.78], p = 0.005, standardised mean difference (SMD) = 0.38). Sensitivity analysis using multiple imputation (MI) of missing values supported these findings. Most secondary outcomes also favoured Home-MCT+CR, especially in reduction of post-traumatic stress symptoms (SMD = 0.51). There were 23 participants (19%) lost to follow-up in Home-MCT+CR and 4 participants (3%) lost to follow-up in CR alone. No serious adverse events were reported. The main limitation is the absence of longer term (e.g., 12-month) follow-up data. CONCLUSION Self-help home-based MCT was effective in reducing total anxiety/depression in patients undergoing CR. Improvement occurred across most psychological measures. Home-MCT was a promising addition to cardiac rehabilitation and may offer improved access to effective psychological treatment in cardiovascular disease (CVD) patients. TRIAL REGISTRATION NCT03999359.
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Affiliation(s)
- Adrian Wells
- Faculty of Biology, Medicine and Health, School of Psychological Sciences, The University of Manchester, Manchester, United Kingdom
- Research and Innovation, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
- * E-mail:
| | - David Reeves
- NIHR School for Primary Care Research, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Calvin Heal
- NIHR School for Primary Care Research, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Peter Fisher
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom
- Liverpool Clinical Health, The Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom
| | - Patrick Doherty
- Department of Health Sciences, University of York, York, United Kingdom
| | - Linda Davies
- Centre for Health Economics, Division of Population Health, Health Services Research and Primary Care, Faculty of Biology Medicine and Health, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Anthony Heagerty
- Core Technology Facility, The University of Manchester School of Medical Sciences, Manchester, United Kingdom
- Manchester University NHS Foundation Trust, Manchester Royal Infirmary, Manchester, United Kingdom
| | - Lora Capobianco
- Research and Innovation, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
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Schneider BC, Veckenstedt R, Karamatskos E, Pinho LG, Morgado B, Fonseca C, Moritz S, Jelinek L. Negative cognitive beliefs, positive metacognitive beliefs, and rumination as mediators of metacognitive training for depression in older adults (MCT-Silver). Front Psychol 2023; 14:1153377. [PMID: 37034960 PMCID: PMC10074596 DOI: 10.3389/fpsyg.2023.1153377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 03/02/2023] [Indexed: 04/11/2023] Open
Abstract
Background Metacognitive Training for Depression in older adults (MCT-Silver; www.uke.de/mct-silver) is a cognitive-behavioral based group intervention that aims at reducing depression by targeting (meta)cognitive beliefs and rumination. In the present study, it was examined whether negative cognitive beliefs, positive metacognitive beliefs and/or rumination may be implicated as mediators of MCT-Silver's effects on depression. Materials and methods We conducted a secondary analysis of a randomized controlled trial comparing MCT-Silver to an active control intervention (cognitive remediation) including 66 older adults (60 years and older) with complete baseline data. Clinician-rated (Hamilton Depression Rating Scale) and self-reported (Beck Depression Inventory-II) depression, negative cognitive beliefs (Dysfunctional Attitudes Scale-18B), positive metacognitive beliefs (positive beliefs subscale; Metacognition Questionnaire-30) and rumination (10-item Ruminative Response Scale) were assessed before (pre) and after 8 weeks of treatment (post), as well as 3 months later (follow-up). It was examined whether change in depression (pre- to follow-up) was mediated by change in negative cognitive beliefs, positive metacognitive beliefs and/or rumination (pre- to post-assessment). Results Mediation results differed for self-reported vs. clinician-rated depression. The effect of MCT-Silver on reduction in clinician-rated depression was mediated by a reduction in self-reported rumination, whereas reduction in self-reported depression was mediated by a reduction in negative cognitive beliefs. Positive metacognitive beliefs were not a significant mediator for either outcome. Conclusion The current study provides initial evidence for the roles of negative cognitive beliefs and rumination in the treatment of depression in later life with MCT-Silver. Given the divergence of findings and lack of causal precedence, mechanisms of change for MCT-Silver cannot yet be equivocally identified.
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Affiliation(s)
- Brooke C. Schneider
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- *Correspondence: Brooke C. Schneider,
| | - Ruth Veckenstedt
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Evangelos Karamatskos
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lara Guedes Pinho
- Nursing Department, University of Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, Évora, Portugal
| | | | - César Fonseca
- Nursing Department, University of Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, Évora, Portugal
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Hoffart A, Burger J, Johnson SU, Ebrahimi OV. Daily dynamics and mechanisms of anxious symptomatology in the general population: A network study during the COVID-19 pandemic. J Anxiety Disord 2023; 93:102658. [PMID: 36455414 DOI: 10.1016/j.janxdis.2022.102658] [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] [Received: 09/06/2022] [Revised: 11/15/2022] [Accepted: 11/22/2022] [Indexed: 11/24/2022]
Abstract
To understand the interplay between anxiety symptoms and their maintaining psychological processes in the population, an analysis of longitudinal within-person relationships is required. A sample of 1706 individuals completed daily measures during a 40-day period with strict mitigation protocols. Data of 1368 individuals who completed at least 30 assessments were analyzed with the multilevel vector autoregressive (mlVAR) model. This model estimates a temporal, a contemporaneous, and a between-person network. Uncontrollability of worry, generalized worry, fear of being infected, fear of significant others being infected, and threat monitoring had the highest outstrength within the temporal network, indicating that daily fluctuations in these components were the most predictive of next-day fluctuations in other components. Of specific connections, both fear of self and fear of close others being infected predicted generalized worry and threat monitoring. In turn, generalized worry and threat monitoring engaged in several positive feedback loops with other anxiety symptoms and processes. Also, intolerance of uncertainty was predictive of other components. The findings align with the mechanisms both in the metacognitive therapy (MCT) model and in the intolerance of uncertainty model of generalized anxiety disorder (GAD).
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Affiliation(s)
- Asle Hoffart
- Research Institute, Modum Bad Psychiatric Hospital, Postboks 33, N-3370 Vikersund, Norway; Department of Psychology, University of Oslo, Forskningsveien 3 A, 0373 Oslo, Norway.
| | - Julian Burger
- Department of Psychological Methods, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WT Amsterdam, the Netherlands; Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands; University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
| | - Sverre Urnes Johnson
- Research Institute, Modum Bad Psychiatric Hospital, Postboks 33, N-3370 Vikersund, Norway; Department of Psychology, University of Oslo, Forskningsveien 3 A, 0373 Oslo, Norway.
| | - Omid V Ebrahimi
- Research Institute, Modum Bad Psychiatric Hospital, Postboks 33, N-3370 Vikersund, Norway; Department of Psychology, University of Oslo, Forskningsveien 3 A, 0373 Oslo, Norway.
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Assessing Metacognitions in Compulsive Exercising: The Construction and Evaluation of the Metacognitions About Exercise Questionnaire. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2022. [DOI: 10.1007/s10942-022-00493-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Aarestad SH, Harris A, Hjemdal O, Gjengedal RGH, Osnes K, Sandin K, Reme SE, Hannisdal M, Einarsen SV. Healing the wounds of workplace bullying: Evaluating mental health and workplace participation among victims seeking treatment for common mental disorders. Work 2022; 73:1379-1391. [PMID: 36093665 PMCID: PMC9837681 DOI: 10.3233/wor-210920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Victims of workplace bullying represent a group characterised by severe negative health complaints at risk of losing their foothold in working life. To date, very few studies have investigated the effect of psychological treatment of the health-related problems often facing victims of bullying. OBJECTIVE The aim was to investigate if victims of workplace bullying suffering from common mental disorders (CMD) benefit from clinical treatment for their mental health problems at an outpatient clinic treating patients using Metacognitive or Cognitive Behavioural Therapy with work-focus. Criteria were symptom reduction and change in workplace participation. Comparisons were made between the victims of workplace bullying with CMD, a wait-list control group consisting of patients who had also been exposed to bullying yet now awaiting treatment, and other patients not exposed to bullying. METHODS The sample comprised of 405 patients from an outpatient clinic in Norway. The study used a naturalistic observational design and data was collected pre-treatment and post-treatment. RESULTS The results showed the treatment to be effective in symptom reduction for victims of bullying to a similar degree as patients otherwise not exposed to bullying. Even more, victims receiving treatment had a larger improvement compared to the wait-list control group (p < 0.001). Yet, among patients on sick leave pre-treatment, fewer victims of bullying were fully working by the end of treatment compared to the patients not exposed to workplace bullying. CONCLUSION The findings provide ground for optimism for this treatment as an efficient way of dealing with the aftermath of workplace bullying.
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Affiliation(s)
- Sarah Helene Aarestad
- Department of Psychosocial Science, University of Bergen, Bergen, Norway,Address for correspondence: Sarah Helene Aarestad, Department of Psychosocial Science, University of Bergen, Bergen, Norway. E-mail:
| | - Anette Harris
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway,Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Oslo, Norway
| | | | - Kåre Osnes
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Oslo, Norway
| | - Kenneth Sandin
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Oslo, Norway
| | - Silje E. Reme
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Marit Hannisdal
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Oslo, Norway
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Martin S, Oltra A, Del Monte J. Metacognition vulnerabilities in time of crisis: Who to protect from suicidal risk? Brain Behav 2022; 12:e2794. [PMID: 36366935 PMCID: PMC9759143 DOI: 10.1002/brb3.2794] [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] [Received: 05/19/2022] [Revised: 09/19/2022] [Accepted: 10/06/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION During stressful events, we are all trying to cope. We may not be equal depending on our emotional, psychological, and mental states. During the COVID-19 pandemic, we could try to avoid negative information processing and anxiogenics content to prevent unhealthy thinking processes. One of the processes we can observe regarding our way of thinking and its impact on our psychological well-being is Metacognition. METHODS We recruited 104 outpatients in 2018. In 2020, during the pandemic, we recruited 216 outpatients and 176 healthy controls. We assessed their level of metacognition with the MCQ30 scale together with Suicidal risk and Hopelessness. RESULTS All three groups showed significant differences, with the nonclinical sample having higher scores in MCQ30. Regression revealed the different profiles where Hopelessness was the only predictor for the clinical sample, whereas metacognition was an adjunctive predictor of suicidal risk for the nonclinical sample. CONCLUSION Our results showed that the COVID-19 crisis influenced metacognitive levels for the nonclinical sample but not for the clinical population. Moreover, Hopelessness predicted suicide risk for both populations, but Metacognition was also a predictive factor for the nonclinical sample. We conclude with the possible impact of preventive measures based on Metacognitive work that can be created out of these results.
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Affiliation(s)
- Sylvia Martin
- Psycho.TCCE, Private Practice, Nîmes, France.,Center for Research and Bioetchics, Uppsala University, Uppsala, Sweden
| | | | - Jonathan Del Monte
- Psychosocial Laboratory, Aix-Marseille and Nîmes Universities, Nîmes, France
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Trait Versus State Predictors of Emotional Distress Symptoms: The Role of the Big-5 Personality Traits, Metacognitive Beliefs, and Strategies. J Nerv Ment Dis 2022; 210:943-950. [PMID: 35764593 PMCID: PMC9742004 DOI: 10.1097/nmd.0000000000001557] [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] [Indexed: 02/04/2023]
Abstract
To enhance formulation and interventions for emotional distress symptoms, research should aim to identify factors that contribute to distress and disorder. One way to formulate emotional distress symptoms is to view them as state manifestations of underlying personality traits. However, the metacognitive model suggests that emotional distress is maintained by metacognitive strategies directed by underlying metacognitive beliefs. The aim of the present study was therefore to evaluate the role of these factors as predictors of anxiety and depression symptoms in a cross-sectional sample of 4936 participants collected during the COVID-19 pandemic. Personality traits (especially neuroticism) were linked to anxiety and depression, but metacognitive beliefs and strategies accounted for additional variance. Among the predictors, metacognitive strategies accounted for the most variance in symptoms. Furthermore, we evaluated two statistical models based on personality traits versus metacognitions and found that the latter provided the best fit. Thus, these findings indicate that emotional distress symptoms are maintained by metacognitive strategies that are better accounted for by metacognitions compared with personality traits. Theoretical and clinical implications of these findings are discussed.
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Bjørndal MT, Giæver F, Aschim BM, Gjengedal RGH, Lending HD, Bull-Hansen B, Hannisdal M, Hjemdal O. Work after mental-health-related absence: a qualitative study of perceived change after a combination of metacognitive therapy and work-focused interventions. BMC Public Health 2022; 22:2231. [PMID: 36451160 PMCID: PMC9709362 DOI: 10.1186/s12889-022-14378-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 09/19/2022] [Accepted: 10/10/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Sick leave caused by common mental health disorders (CMD) is becoming more prevalent. For most people, work is essential for good mental and physical health. It is necessary to provide treatments that facilitate return to work (RTW) and a reduction of symptoms. A qualitative study can contribute to an understanding of what makes an intervention successful. The aim of this study was to investigate how individuals who are on sick leave because of CMD perceive and handle their symptoms and their work, after completing metacognitive therapy and work-focused interventions. METHODS Semi-structured interviews were conducted with 23 participants after they had completed therapy. Thematic analysis was used to analyse the data. RESULTS Through both therapy and the process of RTW, the participants had gained increased awareness and understanding of their mental health problems and the relationship between those problems and work. Together with the sense that they were in charge of their own process of RTW, this helped to improve their self-confidence. An important part of the process was the change to new strategies and the rejection of older maladaptive ones, in relation to both mental health and work. Being open about their mental illness in the workplace could lead to support but also to the opposite, and therefore not an option for everyone. After treatment, most had returned to work and gained a more positive outlook on the future, but some had less confidence in their ability to deal with future symptoms and workplace issues. CONCLUSIONS Achieving improved self-confidence and adopting new strategies, which enabled them to change how they related to their mental problems and how they addressed their problems at work, seemed to have increased their self-efficacy. Active involvement in therapy and at work was also important, both for the process and as a way of increasing self-efficacy. This gave them renewed belief in themselves and in their ability to handle their work at present and in the future. Despite this being a manualized treatment, the participants' experience was that it was adapted to each individual, something they regarded as important.
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Affiliation(s)
- Marianne Tranberg Bjørndal
- grid.413684.c0000 0004 0512 8628Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Postboks 23 Vinderen, NO-0319 Oslo, Norway ,grid.5947.f0000 0001 1516 2393Department of Psychology, Norwegian University of Science and Technology, NO-7491 Trondheim, Norway
| | - Fay Giæver
- grid.5947.f0000 0001 1516 2393Department of Psychology, Norwegian University of Science and Technology, NO-7491 Trondheim, Norway
| | - Bente Marianne Aschim
- grid.413684.c0000 0004 0512 8628Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Postboks 23 Vinderen, NO-0319 Oslo, Norway
| | - Ragne Gunnarsdatter Hole Gjengedal
- grid.413684.c0000 0004 0512 8628Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Postboks 23 Vinderen, NO-0319 Oslo, Norway ,grid.5947.f0000 0001 1516 2393Department of Psychology, Norwegian University of Science and Technology, NO-7491 Trondheim, Norway
| | - Hilde Dallavara Lending
- grid.413684.c0000 0004 0512 8628Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Postboks 23 Vinderen, NO-0319 Oslo, Norway
| | - Bente Bull-Hansen
- grid.413684.c0000 0004 0512 8628Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Postboks 23 Vinderen, NO-0319 Oslo, Norway
| | - Marit Hannisdal
- grid.413684.c0000 0004 0512 8628Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Postboks 23 Vinderen, NO-0319 Oslo, Norway
| | - Odin Hjemdal
- grid.413684.c0000 0004 0512 8628Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Postboks 23 Vinderen, NO-0319 Oslo, Norway ,grid.5947.f0000 0001 1516 2393Department of Psychology, Norwegian University of Science and Technology, NO-7491 Trondheim, Norway
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Anyan F, Hjemdal O, Nordahl H. Testing the longitudinal effect of metacognitive beliefs on the trajectory of work ability. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03912-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
There is increasing need to identify factors that contribute to poor work ability with an aim to prevent work related problems such as sick leave and disability pension. In the Metacognitive Control System model, dysfunctional metacognitive beliefs are seen as an underlying factor in psychological vulnerability beyond disorder, and recent studies have reported that metacognitions are associated with work ability and work status. In the present study, we set out to test if there is a prospective relationship between dysfunctional metacognitions and self-assessed work ability. Individuals in working age (M = 37.19; SD = 10.31) participated in a four-timepoint self-report survey (N = 528; 75% females) separated by six weeks between each timepoint. Baseline gender differences and differences between participants by job status were conducted using t-test and one-way ANOVA, respectively. Latent growth curve with covariates assessed the impact of dysfunctional metacognitions on work ability across the four timepoints. Males reported higher work ability. Participants in fulltime job also reported higher work ability followed by those in part-time job, jobseekers, sick leave up to 12 months, and sick leave > 12 months, respectively. Dysfunctional metacognitions predicted work ability over time when controlling for gender, age, physical health status, and three common categories of emotional distress symptoms. This finding suggest that dysfunctional metacognitions are a prospective predictor of work ability beyond health status and implies that these beliefs should be targeted with a view to increasing work ability and thus potentially reduce risk for sick leave and other work-related problems.
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Nordahl H, Vollset T, Hjemdal O. An empirical test of the metacognitive model of generalized anxiety disorder. Scand J Psychol 2022; 64:263-267. [PMID: 36321682 DOI: 10.1111/sjop.12884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 10/11/2022] [Accepted: 10/18/2022] [Indexed: 11/07/2022]
Abstract
The metacognitive model of generalized anxiety disorder (GAD) places worrying, meta-worry ("worry about worry") and corresponding underlying metacognitive beliefs (i.e., beliefs about worry) as central in the maintenance of symptoms. Previous research has demonstrated significant relationships between these factors and symptoms, but no study has tested the statistical fit of this influential model including its hypothesized components and the suggested paths between them. The aim of the current study was therefore to evaluate the fit of the metacognitive model of GAD. A total of 312 participants constituting an analogue GAD sample were included in a cross-sectional study and completed self-report measures of anxiety and depression symptoms and scales relevant to the metacognitive model. Metacognitions, worry, and meta-worry in their hypothesized order provided a good model fit and explained significant and substantial variance in symptoms. These results provide further support for the metacognitive model of GAD and demonstrates separate and unique contributions from worry and meta-worry to generalized anxiety symptoms of which meta-worry was the most influential.
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Affiliation(s)
- Henrik Nordahl
- Department of Psychology Norwegian University of Science and Technology Trondheim Norway
| | - Tarjei Vollset
- Department of Psychology Norwegian University of Science and Technology Trondheim Norway
| | - Odin Hjemdal
- Department of Psychology Norwegian University of Science and Technology Trondheim Norway
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Xiao PP, Ding SQ, Duan YL, Luo XF, Zhou Y, Cheng QQ, Liu XY, Xie JF, Cheng ASK. Metacognitions associated with reproductive concerns: A cross-sectional study of young adult female cancer survivors in China. Front Psychol 2022; 13:987221. [PMID: 36237684 PMCID: PMC9552999 DOI: 10.3389/fpsyg.2022.987221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/12/2022] [Indexed: 11/30/2022] Open
Abstract
Objective Cancer and its treatments affect patients’ fertility potential. This study examined the prevalence of reproductive concerns and their relationship with metacognitions among Chinese young adult female cancer survivors (YAFCS). Methods A total of 318 YAFCS (aged 18–39) completed an online survey from March to December 2021. Participants reported sociodemographic characteristics, reproductive concerns and metacognitions. Reproductive concerns were measured using the Reproductive Concerns after Cancer scale (RCAC), and metacognitions were measured by the Short Form of Metacognitions Questionnaire (MCQ-30). We used Pearson correlation analysis to examine associations between metacognitions and reproductive concerns across multiple domains and multivariable linear regression to determine the influencing factors of reproductive concerns. Results The mean score of reproductive concern among YAFCS was 49.97 ± 12.52. A total of 57.9% of participants reported a high level of concern regarding at least one dimension of reproductive concerns, and they were most concerned about their child’s health and least concerned about partner disclosure of fertility status. We also found a moderate association between RCAC and MCQ-30 scores (r = 0.408, p < 0.001). In multivariate analyses, metacognitions, especially negative metacognitive beliefs had an impact on reproductive concerns among YAFCS (p < 0.001). Conclusion Higher reproductive concerns were associated with higher metacognitions among YAFCS, especially with negative metacognitive beliefs. Oncology professionals should pay attention to assessing reproductive concerns in patients who want to have children or who have no children. Moreover, metacognitive beliefs may be an intervention target for alleviating reproductive concerns among YAFCS.
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Affiliation(s)
- Pan Pan Xiao
- Department of Nursing, Third Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Si Qing Ding
- Department of Nursing, Third Xiangya Hospital, Central South University, Changsha, China
| | - Ying Long Duan
- Department of Emergency, Third Xiangya Hospital, Central South University, Changsha, China
| | - Xiao Fei Luo
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Yi Zhou
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Qin Qin Cheng
- Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Xiang Yu Liu
- Hunan Cancer Hospital, Health Management Center, Changsha, China
| | - Jian Fei Xie
- Department of Nursing, Third Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Jian Fei Xie,
| | - Andy SK Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
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Oversampled and undersolved: Depressive rumination from an active inference perspective. Neurosci Biobehav Rev 2022; 142:104873. [PMID: 36116573 DOI: 10.1016/j.neubiorev.2022.104873] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/12/2022] [Accepted: 09/12/2022] [Indexed: 11/22/2022]
Abstract
Rumination is a widely recognized cognitive deviation in depression. Despite the recognition, researchers have struggled to explain why patients cannot disengage from the process, although it depresses their mood and fails to lead to effective problem-solving. We rethink rumination as repetitive but unsuccessful problem-solving attempts. Appealing to an active inference account, we suggest that adaptive problem-solving is based on the generation, evaluation, and performance of candidate policies that increase an organism's knowledge of its environment. We argue that the problem-solving process is distorted during rumination. Specifically, rumination is understood as engaging in excessive yet unsuccessful oversampling of policy candidates that do not resolve uncertainty. Because candidates are sampled from policies that were selected in states resembling one's current state, "bad" starting points (e.g., depressed mood, physical inactivity) make the problem-solving process vulnerable for generating a ruminative "halting problem". This problem leads to high opportunity costs, learned helplessness and diminished overt behavior. Besides reviewing evidence for the conceptual paths of this model, we discuss its neurophysiological correlates and point towards clinical implications.
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How drug cravings affect metacognitive monitoring in methamphetamine abusers. Addict Behav 2022; 132:107341. [PMID: 35584984 DOI: 10.1016/j.addbeh.2022.107341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 04/24/2022] [Accepted: 04/24/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVE Metacognitive monitoring refers to the process in which an individual analyzes their own mental state, then monitors and adjusts cognitive activities to achieve a predetermined goal. Recent research has suggested a strong link between metacognition and drug cravings. Conversely, few studies on the impact of metacognitive monitoring on methamphetamine (MA) cravings exist. Thus, this study investigated whether drug cravings would impair MA abusers' metacognitive monitoring and explored the prediction effects of drug cravings. METHOD Seventy MA abusers from the Zhejiang Compulsory Isolation Drug Rehabilitation Center and 65 non-users from the Wenzhou Medical University were recruited for this experimental study. The judgment of learning (JOL) paradigm was used to examine metacognitive monitoring, and cue-induced pictures were used to induce MA abusers' drug cravings. Analysis of covariance (ANCOVA), partial correlation, and regression analysis were performed. RESULTS Compared with non-users, MA abusers had significantly poorer metacognitive monitoring and tended to overestimate their performance. Furthermore, there was a significant correlation between the accuracy of JOLs and drug cravings, which indicated that metacognitive monitoring was weakened by drug cravings with higher cravings imposing more severe impacts. In addition, the regression analysis suggested that drug cravings can predict metacognitive monitoring.
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Hasani H, Zarei B, Danaei Z, Mahmoudirad G. Comparing the Effect of Resilience Skills Training and Metacognitive Therapy on Job Stress in Nurses: An Experimental Study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2022; 27:377-384. [PMID: 36524134 PMCID: PMC9745846 DOI: 10.4103/ijnmr.ijnmr_59_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 12/25/2021] [Accepted: 06/28/2022] [Indexed: 03/19/2023]
Abstract
BACKGROUND Nursing is one of the stressful professions. The work-related stressful factors have affected the physical and mental health of nurses seriously. This study aimed to compare the effect of resilience skills training and metacognitive therapy on nurses' job stress. MATERIALS AND METHODS This experimental study was conducted on 54 nurses working in intensive care units and the emergency department of Valiasr Hospital, Birjand, Iran, in 2018. Selected participants were allocated via permuted block randomization into three groups: resilience skills training, metacognitive therapy, and control (n = 18 for each group). Both resilience and metacognitive therapy programs were held in eight sessions of 45-mintraining classes twice a week. The control group received no intervention. The data were collected using a demographic characteristics form and the Expanded Nursing Stress Scale (ENSS) before, immediately after, and one month after the intervention. The data were analyzed using Chi-square, Fisher's exact test, Analysis of Variance (ANOVA), and repeated measures ANOVA in the Statistical Package for Social Science (SPSS) software. RESULTS Job stress significantly decreased in both resilience (F2,51 = 123.5, p < 0.001) and metacognitive therapy (F2,51= 29.2, p = 0.002) groups over time. However, this decrease was not significantly different between the two groups (p > 0.05). Also, the control group's job stress mean score increased over time (F2,51 = 9.35, p < 0.001). CONCLUSIONS The findings suggest that both resilience skills training and metacognitive therapy can reduce the job stress of emergency and intensive care nurses. Therefore, it is recommended that both programs be taken into account by managers to reduce nurses' job stress.
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Affiliation(s)
- Halimeh Hasani
- Nursing and Midwifery College, Birjand University of Medical Sciences, Birjand, Iran
| | - Bahare Zarei
- Nursing and Midwifery College, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Danaei
- Nursing and Midwifery College, Birjand University of Medical Sciences, Birjand, Iran
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Lawson R, Carter JD, Britt E, Knowles K, Then R, Vallance J, Jenkins L, Tauamiti R. Modified metacognitive therapy for anorexia nervosa: An open trial in an outpatient setting. Int J Eat Disord 2022; 55:983-989. [PMID: 35635052 DOI: 10.1002/eat.23749] [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: 11/14/2021] [Revised: 05/12/2022] [Accepted: 05/12/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Current evidence indicates treatment for adults with anorexia nervosa (AN) requires improvement given recovery rates are low to moderate, and relapse rates are high. Metacognitive therapy (MCT) is an effective treatment for anxiety and depressive disorders. This study evaluates if MCT can be successfully modified to treat AN in a naturalistic clinical setting. METHOD Twenty-four patients with AN participated in an open trial of modified metacognitive therapy (MCT-AN). Twelve of the 24 patients (50%) completed treatment. MCT was modified to include components specific to eating disorders. The MCT-AN was delivered by clinical psychologists who had undertaken training in MCT in a specialist outpatient service. Group and single participant data analyses were undertaken on those who completed treatment. RESULTS As well as statistically significant differences from pre- to posttreatment in the group data there were also clinically significant improvements at the individual patient level for eating disorder and depressive symptoms, as well as weight. The mean number of therapy sessions was 18. DISCUSSION These findings indicate that MCT-AN may be a promising intervention in the treatment of AN, warranting further investigation. PUBLIC SIGNIFICANCE Treatment for anorexia nervosa in adults requires improvement. Research indicates that Metacognitive therapy (MCT) is an effective treatment for anxiety and depression and may be applicable to the eating disorders. This small open trial suggests that MCT can be modified successfully to treat patients with anorexia nervosa (AN). The results are preliminary and require further research to provide more evidence on the effectiveness of this treatment for AN.
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Affiliation(s)
- Rachel Lawson
- South Island Eating Disorders Service, Canterbury District Health Board, Christchurch, New Zealand
| | - Janet D Carter
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Eileen Britt
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Karen Knowles
- South Island Eating Disorders Service, Canterbury District Health Board, Christchurch, New Zealand
| | - Rebecca Then
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Joanna Vallance
- South Island Eating Disorders Service, Canterbury District Health Board, Christchurch, New Zealand
| | - Louise Jenkins
- South Island Eating Disorders Service, Canterbury District Health Board, Christchurch, New Zealand
| | - Rachel Tauamiti
- South Island Eating Disorders Service, Canterbury District Health Board, Christchurch, New Zealand
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Nordahl H, Anyan F, Hjemdal O, Wells A. The network structure of dysfunctional metacognition: Analysis of the MCQ-30. Acta Psychol (Amst) 2022; 227:103622. [PMID: 35643016 DOI: 10.1016/j.actpsy.2022.103622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 05/09/2022] [Accepted: 05/19/2022] [Indexed: 11/01/2022] Open
Abstract
The Metacognitive Control System (MCS) model gives central importance to maladaptive metacognition in psychological vulnerability and disorder. The metacognitions questionnaire 30 (MCQ-30) is widely used to assess such metacognitions and to establish their effects. Previous studies consistently demonstrate that the MCQ-30 consists of five latent factors, with some factors showing wide-ranging positive associations with symptoms and some demonstrating more specific symptom links. Questions remain concerning relationships between MCQ-items (or domains) and the most central of these outside of the latent-factor model. In the present study we set out to explore the internal structure of the MCQ-30 using network analysis and estimated two graphical Gaussian models, one with items- and one with domains, in an unselected sample (N = 1080). The robustness and stability of the networks, as well as the node predictability were assessed. Among our observations was that the items of the MCQ-30 appeared to cluster in meaningful substructures, corresponding to metacognitive theory. Furthermore, "need for control" was the most centrally placed domain, suggesting it plays an important role in the network and that its activation has a strong influence on other nodes. The theoretical and clinical implications of the current findings are discussed in light of the metacognitive model of psychological disorder.
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Shibata Y, Matsushima M, Takeuchi M, Kato M, Yabe I. Inappropriate Metacognitive Status Increases State Anxiety in Genetic Counseling Clients. Front Psychol 2022; 13:871416. [PMID: 35645862 PMCID: PMC9133628 DOI: 10.3389/fpsyg.2022.871416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/26/2022] [Indexed: 12/25/2022] Open
Abstract
Background Many genetic counseling (GC) studies have focused on anxiety status because clients of GC often feel anxious during their visits. Metacognition is known to be one of the causes of having an inappropriate thinking style. In this study, we examined the relationship between anxiety and the metacognitive status of GC clients according to their characteristics. Methods The participants were 106 clients who attended their first GC session in our hospital from November 2018 to March 2021. The survey items were the clients’ characteristics, anxiety status at the time of the visit, and metacognitive status. Results High state anxiety and high trait anxiety were observed in 34.9 and 11.3% of clients, respectively. Clients who were a relative or had a family history were significantly more likely to have high state anxiety. As for metacognitive status, only negative beliefs about thoughts concerning uncontrollability and danger were associated with having an anxiety status. Furthermore, multivariate analysis showed that negative beliefs about thoughts concerning uncontrollability and danger were an independent determinant of higher state anxiety, but not being a relative or having a family history. Metacognitive status scores were significantly lower in clients than in the control group. Conclusion State anxiety was shown to be more dependent on negative beliefs about thoughts concerning uncontrollability and danger of GC clients than their characteristics such as being a relative or having a family history. The results of this study will contribute to the development of new GC psychosocial support measures to address the anxiety of GC clients.
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Affiliation(s)
- Yuka Shibata
- Division of Clinical Genetics, Hokkaido University Hospital, Sapporo, Japan
| | - Masaaki Matsushima
- Division of Clinical Genetics, Hokkaido University Hospital, Sapporo, Japan
- Faculty of Medicine, Graduate School of Medicine, Department of Neurology, Hokkaido University, Sapporo, Japan
| | - Megumi Takeuchi
- Faculty of Medicine, Graduate School of Medicine, Department of Neurology, Hokkaido University, Sapporo, Japan
| | - Momoko Kato
- Division of Clinical Genetics, Hokkaido University Hospital, Sapporo, Japan
| | - Ichiro Yabe
- Division of Clinical Genetics, Hokkaido University Hospital, Sapporo, Japan
- Faculty of Medicine, Graduate School of Medicine, Department of Neurology, Hokkaido University, Sapporo, Japan
- *Correspondence: Ichiro Yabe,
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Changing Metacognitive Appraisal Bias in High-Worriers Through Reappraisal Training. COGNITIVE THERAPY AND RESEARCH 2022. [DOI: 10.1007/s10608-022-10297-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Abstract
Background and Objectives
Worry-related negative metacognitive beliefs about worrying maintain and predict pathological worry. For the current proof-of-principle study, we developed a computerized cognitive bias modification based—reappraisal training (RT), to modify the appraisal of negative metacognitive beliefs in a high-worrying sample. A functional and dysfunctional RT were pitted against each other to investigate whether appraisals of one’s thinking and coping changed following training. Moreover, training effects on the number of negative thoughts and interpretations of the worry content were examined.
Methods
Participants (N = 81) were trained to adopt a functional (disconfirmation of negative metacognitive beliefs) or dysfunctional (confirmation of negative metacognitive beliefs) appraisal style using a series of vignettes that had to be completed in line with the intended training direction. Changes in negative thoughts from pre- to post-RT were assessed with a behavioral state worry task, and transfer to interpretations with an open-ended stem sentence task.
Results
Findings support the use of the RT to alter a metacognitive appraisal bias, as participants receiving the functional RT reported fewer negative appraisals of one’s thinking and coping than participants in the dysfunctional RT group. Number of negative thoughts and interpretations were not directly affected by training.
Limitations
This study employed an analog sample and future research should replicate findings in a clinical sample for which negative metacognitions are more relevant.
Conclusions
These findings highlight the potential of metacognitive RT for future translational studies with (clinical) samples characterized by repetitive negative thinking and/or negative metacognitive beliefs.
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