What Comes First Metacognition or Negative Emotion? A Test of Temporal Precedence

A within-person test of the metacognitive model: Daily dynamics between metacognitive beliefs, metacognitive strategies, and negative affect

The metacognitive model of psychological disorders highlights that emotional distress is maintained by metacognitive strategies, which are related to underlying metacognitive beliefs. Considerable empirical evidence has supported the role of metacognitions in psychopathology, but few studies have examined the suggested links between metacognitive beliefs, metacognitive strategies, and symptoms within individuals. Within-person effects provide better empirical tests of theory-based hypotheses derived from clinical models as they relate to change at the individual level. Thus, the current study sought to test central predictions from the metacognitive model at the within-person level using Dynamic Structural Equation Modelling (DSEM). A sample of 222 participants gathered at convenience participated in a 26-day long assessment period where they reported daily measures of metacognitive beliefs, metacognitive strategies, and negative affect. Temporal precedence and bidirectional relations between the variables, and the possible day-to-day and within days mediation role of metacognitive strategies between metacognitive beliefs and negative affect, were tested. When controlling for previous days effects, metacognitions and negative affect (but not metacognitive strategies) predicted each other the next day, showing a reciprocal relationship. However, metacognitive strategies were significant mediators between metacognitions and negative affect within days and day-to-day. Implications and future directions based on these findings are discussed.

Effects of personality traits and mood induction on metamemory judgments and metacognitive beliefs

Although the effects of mood and personality traits on memory performance have previously been studied, their relationship to the metamemory and metacognitive processes is still unknown. In this study, we investigated the effects of mood induction (positive and negative) and personality traits (extroverted and neurotics) on metacognitive beliefs, memory confidence, the judgment of learning (JOL) and feeling of knowing (FOK) judgments during face-name recognition tasks. One hundred twenty-seven participants who met the criteria based on their extraverted and neurotic personality scores on the Big Five Personality Inventory were randomly assigned to positive and negative mood induction conditions. We found that neurotics showed lower JOL judgments and accuracy than extroverts. The interaction effect between mood and personality significantly affected JOL and FOK accuracy, indicating that while extraverts were more accurate during positive induction, neurotics were more accurate during negative induction. In addition, neurotics were underconfident in their memory and reported more negative metacognitive beliefs than extroverts. We concluded that memory and metamemory processes are distinguishable in their relationships with mood states and personality traits. Our data also showed that JOL and FOK are distinct processes that support domain-specific metacognitive judgments.

Metacognitive strategies mediate the association between metacognitive beliefs and perceived quality of life

Quality of life may be understood as a multidimensional evaluation of life circumstances in relation to values, expectations, and perceived well-being. Quality of life is thus dependent on the subjective perception of the current life situation, not only objective circumstances. According to metacognitive theory, metacognition guides the appraisal of inner experiences (i.e., thoughts and feelings) and influences how one relates to external stressors. Hence, dysfunctional metacognitive beliefs and the cognitive attentional syndrome (CAS), which includes perseverative thinking, threat monitoring and ineffective coping strategies, may negatively influence subjective quality of life. Therefore, we aimed to investigate if metacognitive beliefs and CAS strategies were associated with quality of life. A sample of 503 participants (77.1% women, mean age 41.0, SD = 11.5) completed the metacognitions questionnaire 30 (MCQ-30), the CAS-1 and the quality of life scale (QOLS). We used structural equation modelling (SEM) to estimate associations between the variables founded in metacognitive theory. The results of the SEM showed a significant direct relationship between metacognitive beliefs and quality of life. CAS strategies mediated the effect of metacognitive beliefs on quality of life. Higher level of metacognitive beliefs was associated with greater use of CAS strategies, which in turn was associated with lower quality of life. Further, more CAS strategies were associated with lower quality of life. The results support the generic metacognitive model and suggest that stronger endorsement of dysfunctional metacognitive beliefs and corresponding CAS strategies are associated with lower quality of life. This observation held even when controlling for relevant covariates and suggests that modifying metacognitive beliefs may impact on subjective quality of life.

Are you how you eat? Aspects of self-awareness in eating disorders

Eating disorders (ED) are severe psychiatric disorders characterized by dysfunctional behaviors related to eating or weight control, with profound impacts on health, quality of life, and the financial burden of affected individuals and society at large. Given that these disorders involve disturbances in self-perception, it is crucial to comprehend the role of self-awareness in their prevalence and maintenance. This literature review presents different self-awareness processes, discussing their functioning across different levels of complexity. By deconstructing this concept, we can gain a better understanding of how each facet of self and personality relates to the symptoms of these disorders. Understanding the absence or impairment of self-awareness in ED holds significant implications for diagnosis, treatment, and overall management. By recognizing and comprehending the characteristics of self-awareness, clinicians can develop tailored interventions and evidence-based treatments for individuals with ED. Furthermore, this narrative review underscores the importance of considering temperament and personality factors in the context of ED, as temperament traits and personality characteristics may interact with self-awareness processes, influencing the development and maintenance of ED. Ultimately, the results highlight the pressing need for further research on the development of effective interventions and support strategies grounded in the aspects of self-awareness mechanisms for individuals affected by these disorders.

Exploring the relationship between dysfunctional metacognitive processes and orthorexia nervosa: the moderating role of emotion regulation strategies

BACKGROUND

Dysfunctional metacognitive processes and emotional dysregulation have been widely documented in the eating disorder literature. Despite numerous research and recent consensus suggesting the categorization of orthorexia nervosa as a form of eating disorder, no previous study has examined whether aberrant metacognitive processes also correlate with orthorexia nervosa tendencies. This paper investigates potential associations between symptoms of orthorexia nervosa and dysfunctional metacognitive processes while also exploring whether such relationships may be influenced by adaptive/maladaptive emotion regulation strategies.

METHODS

We conducted a cross-sectional study in all Lebanese governorates. In total, 423 Lebanese adults completed an online questionnaire including the Teruel Orthorexia Scale, the Emotion Regulation Questionnaire, the Difficulties in Emotion Regulation Scale - 16 Item Version, and the Metacognitions Questionnaire - Short Form.

RESULTS

Higher physical activity, expressive suppression, emotion regulation difficulties, positive metacognitive beliefs about worry, and need to control thoughts were significantly associated with higher orthorexia nervosa. Additionally, the emotion regulation strategies moderated the relationships between two dysfunctional metacognitive processes and orthorexia nervosa. Specifically, cognitive self-consciousness was negatively related to orthorexia nervosa only in individuals with low (versus higher) emotion suppression (maladaptive emotion regulation strategy). In contrast, negative beliefs about worry uncontrollability and danger positively predicted orthorexia nervosa only in individuals with lower (versus high) cognitive reappraisal (adaptive emotion regulation strategy). Lower socio-economic status and having a university level of education compared to secondary level were significantly associated with lower orthorexia nervosa.

CONCLUSION

Our study provides the first empirical evidence for the existence of significant associations between dysfunctional metacognitive processes and orthorexia nervosa. It also highlights that these pathways are considerably modulated by individuals' ability to regulate their emotions adaptively versus maladaptively. Our findings thus suggest that therapies aimed at improving thought monitoring and emotional regulation may be beneficial for individuals with symptoms of orthorexia nervosa.

Prospective Relations Between Dysfunctional Metacognitive Beliefs, Metacognitive Strategies, and Anxiety: Results From a Four-Wave Longitudinal Mediation Model

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.

Metacognitive beliefs and anxiety symptoms could serve as mediators between fear of missing out and gaming disorder in adolescents

Given the vulnerability to and prevalence of emotional problems and Internet gaming disorder (IGD) in adolescents, this study aimed to test the effects of fear of missing out (FoMO) on IGD and the mediating roles of metacognitive beliefs and anxiety symptoms based on the self-regulatory executive function (S-REF) model. At a Chinese high school, 283 participants (M_age = 16.89 years old; girls = 42.0%) with past-year gaming experience voluntarily completed an anonymous paper-and-pencil questionnaire. FoMO showed significant, positive associations with IGD, anxiety symptoms, and metacognitive beliefs. Results of path analysis showed a significant direct effect of FoMO on IGD, whereas anxiety symptoms mediated the relationship between FoMO and IGD. The indirect effects of FoMO on IGD via serial mediations of three negative metacognitive beliefs (i.e., negative beliefs about worry, low cognitive confidence, and beliefs regarding need for control) and anxiety symptoms were also statistically significant. These findings demonstrated that maladaptive metacognitive beliefs and anxiety are risk-enhancing mediators in the relationship between FoMO and IGD. Therefore, metacognitive therapy, particularly for regulating those three specific significant metacognitive beliefs, is recommended for treating IGD and anxiety, especially for those with higher levels of FoMO.

The psychometric properties of positive and negative beliefs about the rumination scale in Chinese undergraduates

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.

The Role of Emotional Intelligence and Metacognition in Teachers' Stress during Pandemic Remote Working: A Moderated Mediation Model

During the COVID-19 pandemic, in adapting to social and work changes and new technological methods for remote teaching, teachers were subjected to increased work pressure, which affected their well-being and led to increased negative stress and burnout. This study was designed to test whether dysfunctional outcomes resulting from adapting to new ways of teaching via technological tools can be mitigated by the protective factors of emotional intelligence and metacognition. The study involved 604 teachers in Sicily filling out a questionnaire consisting of four different scales: (1) the Schutte Self-Report Emotional Intelligence Test (SREIT); (2) the Metacognitive Functions Screening Scale (MFSS-30); (3) the Link Burnout Questionnaire (LBQ); and (4) the Secondary Traumatic Stress Scale STSS-I. The results show that emotional intelligence mediates the relationship between certain remote work risk factors, as well as stress and burnout. In addition, metacognition was found to be a significant moderating factor in the relationship between risk factors and emotional intelligence. With regard to the United Nations' Agenda 2030 Goals, our results emphasize the importance of teachers' emotional and metacognitive skills in promoting quality of life and psychological well-being.

The metacognitive model of rumination and depression in postpartum women

OBJECTIVES

The metacognitive model of rumination and depression (Papageorgiou & Wells, 2003, Cognitive Therapy and Research, 27, 261) postulates that beliefs that perseverative negative thinking, i.e. rumination, will help solve problems contributing to rumination. However, this activates negative beliefs about the uncontrollability and social consequences of ruminations, which exacerbate depression. The metacognitive model has been well-supported but with some inconsistencies in specific pathways. It has also not yet been tested for postpartum depression (PPD). Therefore, this study aimed to examine the relations between the metacognitive model of rumination and depression when applied to PPD symptoms and to compare it with the cognitive model of depression.

DESIGN

This is a cross-sectional study.

METHOD

Postpartum mothers (N = 603) participated in an online study in their first postpartum year. They completed the Edinburgh Postnatal Depression Scale (EPDS), Postnatal Negative Thoughts Questionnaire (PNTQ), Ruminative Responses Scale (RRS), Positive Beliefs about Rumination Scale (PBRS) and Negative Beliefs about Rumination Scale (NBRS).

RESULTS

A path analysis revealed that the model had an excellent fit to the data. Specifically, positive beliefs about rumination predicted engagement in rumination that, in turn, predicted PPD, both directly and indirectly, through negative beliefs about uncontrollability and the social consequences of rumination. A cognitive model with ruminations as a partial mediator between negative postpartum thoughts and PPD symptoms also had a good fit.

CONCLUSION

The findings of this study contribute to the understanding of the cognitive and metacognitive mechanisms underlying postpartum depression, which might be similar to depression in general and have important implications for treatment strategies.

Emotion regulation and drunkorexia behaviors among Lebanese adults: the indirect effects of positive and negative metacognition

BACKGROUND

Although metacognition processes are a core feature of restrictive eating and alcohol cravings and entail an individual to control both of his/her emotions and thoughts, yet, to our knowledge, a scarcity of research has examined their potential role in drunkorexia as cognitive and emotional predictors. The following study investigates the different associations between two emotion regulation strategies (i.e. emotional suppression and cognitive reappraisal) and drunkorexia behaviors in a sample of Lebanese adults, exploring the possible indirect effects of positive and negative alcohol-related metacognitions.

METHODS

This was a cross-sectional study that enrolled 335 participants (March-July 2021).

RESULTS

Higher problematic alcohol use (beta = 5.56), higher physical activity index (beta = 0.08), higher expressive suppression (beta = 0.23), higher negative metacognitive beliefs about cognitive harm due to drinking (beta = 0.75) and higher cognitive reappraisal (beta = 0.20) were significantly associated with more drunkorexic behaviors. The positive metacognitive beliefs about cognitive self-regulation significantly mediated the association between cognitive reappraisal and drunkorexia behaviors. Both the positive metacognitive beliefs about cognitive self-regulation and the negative metacognitive beliefs about the uncontrollability of drinking significantly mediated the association between expressive suppression and drunkorexia behaviors.

CONCLUSION

This study demonstrated that emotional and metacognitive processes are associated with drunkorexia, addressing as well the mediating effect between deficient emotional regulation and risky behavioral patterns. Overall, our results would speculate that the lack of emotional and cognitive assets might enhance internal distress perceived out of control, leading individuals to indulge in maladaptive behavioral patterns for managing the underlying impairment.

'Thinking about Them is only making me feel worse'. The mediating role of metacognitive factors in the relationship between paranoia-like beliefs and psychopathology symptoms in a community sample

INTRODUCTION

Paranoia in community samples is associated with higher levels of depression, anxiety symptoms and suicidality. The metacognitive model assumes the role of metacognitive factors in these associations. Positive and negative metacognitive beliefs (PMB and NMB, respectively) and cognitive-attentional syndrome (CAS) are to mediate between paranoia-like beliefs and psychopathology symptoms. The current study is an attempt to test this prediction.

METHODS

A cross-sectional community study with n = 840 participants. We used R-GPTS's persecutory subscale to measure paranoia-like beliefs, CAS-1 for CAS and metacognitive beliefs and SCL-27-plus for psychopathology symptoms.

RESULTS

Indirect effects of PMB, CAS and NMB accounted for 22% to 56% (CI 95%) of total effects of relationships between paranoia-like beliefs and vegetative symptoms, symptoms of social phobia, agoraphobia, depression and suicidality screening.

CONCLUSIONS

We demonstrated that PMB, CAS and NMB mediate between paranoia-like beliefs and various psychopathological symptoms, as predicted by the metacognitive model of psychopathology. We also uncovered other indirect effects, including negative mediation effect of PMB on the relationship between paranoia-like beliefs and depressive symptoms and suicidality.

Validation and clinical application of the Metacognitions Questionnaire in a sample of Brazilian generalized anxiety disorder patients: the effects of different treatment interventions

INTRODUCTION

Metacognitive beliefs about worry may trigger anxiety. However, the effect of generalized anxiety disorder (GAD) treatment on metacognition has not yet been investigated.

OBJECTIVES

To validate the Metacognitions Questionnaire (MCQ-30) in a Brazilian GAD sample and verify whether different interventions reduce metacognitive beliefs.

METHOD

We recruited 180 GAD individuals and randomized them to Body in Mind Training (BMT), Fluoxetine (FLX), or an active control group (Quality of Life [QoL]) for 8 weeks. The MCQ-30 was assessed for internal consistency, was evaluated with confirmatory and exploratory factor analyses, and was tested for convergent validity with the Penn State Worry Questionnaire (PSWQ). Generalized estimating equations (GEE) were employed to analyze differences after the interventions.

RESULTS

The MCQ-30 demonstrated good internal consistency and acceptability; the original five-factor model was supported. There was a positive moderate correlation between MCQ-30 scores and worry. GEE showed a significant group x time interaction (p < 0.001). Both BMT (mean difference [MD] = -6.04, standard error [SE] = -2.39, p = 0.034) and FLX (MD = -5.78, SE = 1.91, p = 0.007) reduced MCQ-30 scores. FLX was superior to QoL, but not BMT, at weeks 5 and 8. There were no differences between BMT and QoL.

CONCLUSION

The Brazilian-Portuguese version of MCQ-30 showed good psychometric properties. Furthermore, the positive effect of FLX and BMT on metacognition suggests it may represent a potential therapeutic target.

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

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

Adult ADHD, executive function, depressive/anxiety symptoms, and quality of life: A serial two-mediator model

BACKGROUND

Adult attention-deficit/hyperactivity disorder (ADHD) is associated with impaired executive function (EF), depressive/anxiety symptoms, and poor quality of life (QoL). In this study, we aimed to investigate correlations among these variables and to build a simple or serial mediation model for exploring the mechanisms between adult ADHD and QoL.

METHODS

This was a cross-sectional study. The sample included 223 participants with ADHD and 54 healthy volunteers. Participants were required to complete the following scales: ADHD Rating Scale (ADHD-RS), Brief Version of the World Health Organization Quality of Life Scale (WHOQOL-BREF), Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A), Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS). Correlations among EF, depressive/anxiety symptoms and QoL were analyzed using Pearson correlation. The simple and serial mediation models were analyzed using PROCESS (version 3.3).

RESULTS

The correlations between EF and QoL, depressive/anxiety symptoms and QoL, and depressive/anxiety symptoms and EF were statistically significant. In ADHD adults with comorbidities, the correlation coefficients were between -0.19 and -0.47, -0.20 and -0.62, 0.28 and 0.50, respectively. In simple mediation models, EF and depressive/anxiety symptoms were significant mediators respectively between ADHD and QoL, respectively. In a serial two-mediator model, ADHD could affect QoL indirectly via EF and then via depressive/anxiety symptoms significantly.

LIMITATIONS

The average age was young, the degree of education was high, and only self-reported scales were relied on.

CONCLUSIONS

There is a mutual effect between EF and emotional symptoms. This was the first study to build a serial two-mediator model between ADHD and QoL, suggesting the importance of EF and depressive/anxiety symptoms.

Breaking the Cybernetic Code: Understanding and Treating the Human Metacognitive Control System to Enhance Mental Health

The self-regulatory executive function (S-REF) model explains the role of strategic processes and metacognition in psychological disorder and was a major influence on the development of metacognitive therapy. The model identifies a universal style of perseverative negative processing termed the cognitive attentional syndrome (CAS), comprised of worry, rumination, and threat monitoring in the development of disorder. The CAS is linked to dysfunctional metacognitions that include beliefs and plans for regulating cognition. In this paper, I extend the theoretical foundations necessary to support further research on mechanisms linking metacognition to cognitive regulation and effective treatment. I propose a metacognitive control system (MCS) of the S-REF that can be usefully distinguished from cognition and is comprised of multiple structures, information, and processes. The MCS monitors and controls activity of the cognitive system and regulates the behavior of neural networks whose activities bias the way cognition is experienced. Metacognitive information involved in the regulation of on-line processing includes metacognitive beliefs, metacognitive procedural commands, and more transient cybernetic code. Separation of the cognitive and metacognitive systems and modeling their relationship presents major implications concerning what should be done in therapy and how it should be done. The paper concludes with an in-depth consideration of methods that strengthen the psychological basis of psychotherapy and aid in understanding and applying metacognitive therapy in particular. Finally, limitations of the model and implications for future research on self-awareness, self-regulation, and metacognition are discussed.