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Isaksen CS, Hybel KA, Wolters L, Højgaard DRMA, Farrell L, Thomsen PH. Metacognition in Children and Adolescents With Obsessive-Compulsive Disorder Treated With Cognitive Behavioral Therapy. Behav Ther 2025; 56:95-109. [PMID: 39814519 DOI: 10.1016/j.beth.2024.04.011] [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: 05/18/2023] [Revised: 03/04/2024] [Accepted: 04/23/2024] [Indexed: 01/18/2025]
Abstract
According to the metacognitive theory, maladaptive metacognition is associated with the development and maintenance of emotional disorders. This study is the first to explore maladaptive metacognition in a sample of children and adolescents (7-17 years) with obsessive-compulsive disorder (OCD) in the context of cognitive behavioral therapy (CBT). A total of 114 children and adolescents were included in the study. Of these 56 were OCD patients who were assessed on metacognition (Metacognitions Questionnaire-Child Version) and OCD symptom severity (Children's Yale-Brown Obsessive Compulsive Scale) before and after 14 sessions of individual CBT. Fifty-eight children and adolescents without any psychiatric diagnoses constituted a control group and were assessed on metacognition temporally corresponding to the OCD group. Results showed that the OCD group had significantly elevated maladaptive metacognition relative to the control group, with the exception of positive beliefs about worry. The maladaptive metacognition in the OCD group was significantly reduced from pre- to posttreatment. Additionally, the reduction in the total level of maladaptive metacognition was significantly larger than that reported by the control group. However, it remained significantly elevated relative to controls at posttreatment. Furthermore, lower posttreatment OCD severity was associated with larger reductions in negative beliefs about worry, beliefs about the need to control thoughts, and cognitive self-consciousness, as well as with a higher pretreatment level of positive beliefs about worry. Overall, age group (children vs adolescents) did not moderate these results. Collectively, the results suggest that amending maladaptive metacognition in children and adolescents with OCD might be important considering the associations between reductions in maladaptive metacognition and favorable treatment outcome.
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Özkan Y, Öztürk M, Tvrtkovic S, Aydın O, Ünal-Aydın P. Exploring the associations between symptom severity, metacognition, problematic social media use and cyberbullying in treatment naïve adolescents with Attention Deficit and Hyperactivity Disorder. Addict Behav 2025; 160:108169. [PMID: 39348777 DOI: 10.1016/j.addbeh.2024.108169] [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: 06/23/2024] [Revised: 09/13/2024] [Accepted: 09/16/2024] [Indexed: 10/02/2024]
Abstract
This study investigates the relationship between ADHD symptom severity, metacognition, problematic social media use, and cyberbullying/cybervictimization in treatment-naïve adolescents. Understanding these relationships is vital for enhancing ADHD intervention strategies. Using a cross-sectional design, 97 adolescents meeting DSM-5 criteria for ADHD without any comorbidity and 97 healthy controls were assessed. Measures included the Metacognitions Questionnaire for Children, Social Media Disorder Scale, Revised Cyberbullying Inventory-II, and Revised Conners' Parent Rating Scale-Short. The comparisons were performed with independent samples' t tests and the associations were estimated by using Pearson's bivariate correlations and multiple regression analyses. Results revealed that adolescents with ADHD exhibited higher levels of dysfunctional metacognitions, problematic social media use, cyberbullying, and cybervictimization compared to controls. Regression analysis showed significant positive associations between ADHD symptoms, specific metacognitions (e.g., positive meta-worry, cognitive monitoring), and problematic social media use. This study, the first of its kind among treatment-naïve ADHD adolescents, provides valuable insights into the relationship between ADHD symptoms and particular metacognitions (i.e. positive meta-worry, cognitive monitoring) and problematic social media use. These findings contribute to a deeper understanding of ADHD in adolescence and may inform the development of targeted prevention and treatment strategies, particularly relevant given adolescents' susceptibility to social media's influence and their potential for cognitive flexibility in rehabilitation contexts.
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Affiliation(s)
- 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
| | - Selma Tvrtkovic
- Department of Psychology, Faculty of Arts and Science, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Orkun Aydın
- Department of Psychology, Faculty of Arts and Science, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Pınar Ünal-Aydın
- Department of Psychology, Faculty of Arts and Science, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
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Thingbak A, Wells A, O'Toole MS. Group metacognitive therapy for children and adolescents with anxiety and depression: A preliminary trial and test of proposed mechanisms. J Anxiety Disord 2024; 107:102926. [PMID: 39321673 DOI: 10.1016/j.janxdis.2024.102926] [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: 10/01/2023] [Revised: 08/15/2024] [Accepted: 09/04/2024] [Indexed: 09/27/2024]
Abstract
Preliminary research supports the feasibility of metacognitive therapy (MCT) in children with generalized anxiety, but the effectiveness of MCT in treating children with other anxiety and depressive disorders largely remains unknown. The purpose of this study was to investigate the effects associated with MCT in targeting symptoms of anxiety and depression in children and adolescents and to investigate mechanisms proposed by the metacognitive model. Ninety-seven participants aged 10-17 years (M = 12.9 ± 1.9, 82.5 % females) with anxiety and depressive disorders received eight sessions of group MCT. Participants were diagnostically assessed at pre- and post-treatment and completed symptom and process measures before, during, and after treatment, and again at three- and six-month follow-up. Multilevel models were conducted to investigate treatment-related and mediation effects. Results showed large reductions in total symptoms following treatment (d = 1.28). These reductions were associated with, and temporally preceded by changes in cognitive attentional syndrome (CAS), metacognitive beliefs, and self-reported attention control, but not objective attention control. Treatment gains were maintained at six-month follow-up (d = 1.18). Our results indicate that MCT may be a promising treatment for children and adolescents with anxiety and depression and provide preliminary evidence of changes in CAS, metacognition, and perceived attention control as potential drivers of treatment effects.
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Affiliation(s)
- Anne Thingbak
- Department of Psychology and Behavioral Sciences, Aarhus University, Denmark.
| | - Adrian Wells
- School of Psychological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester & Greater Manchester Mental Health NHS Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Mia Skytte O'Toole
- Department of Psychology and Behavioral Sciences, Aarhus University, Denmark
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Thingbak A, Capobianco L, Wells A, O'Toole MS. Relationships between metacognitive beliefs and anxiety and depression in children and adolescents: A meta-analysis. J Affect Disord 2024; 361:36-50. [PMID: 38815761 DOI: 10.1016/j.jad.2024.05.123] [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: 01/30/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND As hypothesized in the Self-Regulatory Executive Function (S-REF) model, metacognitive beliefs are associated with anxiety and depression in adults. An important question is the extent to which such effects are present in children and adolescents, with the implication that the model may also apply to young people. The aim of this meta-analysis was to synthesize results on the nature and magnitude of associations between metacognitive beliefs and anxiety and depression in children and adolescents. METHODS Systematic searches were conducted to identify studies that investigated: (1) group differences in metacognitive beliefs in clinical compared to non-clinical samples or (2) correlations between metacognitive beliefs and symptoms of anxiety and depression. RESULTS Forty papers were identified comprising a total sample of 9,887 participants aged 7-18 years. Meta-analyses revealed that clinical samples endorsed significantly elevated metacognitive beliefs on four out of the five domains measured (i.e., negative beliefs about worry, cognitive confidence, need for control, and cognitive self-consciousness, with the only exception being positive beliefs about worry) compared to non-clinical samples with a small to large effect (Hedges' gs = 0.45-1.22). Moreover, all five domains of metacognitive beliefs were significantly and positively correlated with symptoms of anxiety and depression of a small to large effect (rs = .24-.53). Negative beliefs about worry showed the strongest relationship with clinical status and the magnitude of symptoms. LIMITATIONS The number of studies did not allow for an evaluation of metacognitive beliefs at a disorder-specific level. CONCLUSIONS In line with the S-REF model, our findings provide evidence of robust cross-sectional relationships between metacognitions and both anxiety and depression in childhood and adolescence.
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Affiliation(s)
- Anne Thingbak
- Department of Psychology and Behavioural Sciences, Aarhus University, Denmark.
| | - Lora Capobianco
- School of Psychological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester & Greater Manchester Mental Health NHS Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Adrian Wells
- School of Psychological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester & Greater Manchester Mental Health NHS Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Mia Skytte O'Toole
- Department of Psychology and Behavioural Sciences, Aarhus University, Denmark
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Rząd Z, Rog J, Kajka N, Szewczyk P, Krukow P, Karakuła-Juchnowicz H. The efficacy of transcranial direct current stimulation in the treatment of anorexia nervosa: a randomized double-blind clinical trial. Front Psychiatry 2024; 15:1284675. [PMID: 38757134 PMCID: PMC11096801 DOI: 10.3389/fpsyt.2024.1284675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 04/12/2024] [Indexed: 05/18/2024] Open
Abstract
Background Anorexia nervosa (AN) is a life-threatening disease with a low effectiveness of treatment. The high relapse and mortality rate indicate new treatment approaches are needed. Here, we represent the protocol for randomized clinical trial (RCT) of transcranial direct current stimulation (tDCS) efficiency in the AN treatment. The main purpose of the 3-week RCT is to determine the effect of tDCS on the mental state and advances in nutritional rehabilitation in patients with AN. Methods 50 female inpatients (13-25 years old, body mass index (BMI) 17.5 kg/m2 or less) will be randomly allocated into groups: active (n=25) and sham (n=25) tDCS. Thirty 25-minute tDCS sessions (applied current at 2mA) will be given to DLPFC (F3 anode/F4 cathode) twice a day for 3 weeks on working days parallel to treatment as usual. The primary outcome measures include changes in symptoms related to eating disorders, as assessed by the Eating Attitudes Test (EAT-26), following tDCS sessions over a 3-week trial period. The secondary outcome measures include changes in: brain bioelectric activity, anthropometric measurements, mood, nutritional status, neurocognition, psychological symptoms, selected biological markers related to stress, food intake, inflammation and neurotrophins. Discussion This paper describes the evaluation of a 3-week tDCS-based intervention for AN patients. The study design was developed by a multidisciplinary research team to assess the treatment effect, taking into account various types of variables. This approach could help in better understanding the potential therapeutic tDCS strategy in AN. Clinical trial registration www.ClinicalTrials.gov, identifier NCT05814458.
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Affiliation(s)
- Zuzanna Rząd
- Department of Psychiatry, Psychotherapy and Early Intervention in Lublin, Medical University of Lublin, Lublin, Poland
| | - Joanna Rog
- Laboratory of Human Metabolism Research, Department of Dietetics, Institute of Human Nutrition Science, Warsaw University of Life Sciences (WULS-SGGW), Warsaw, Poland
| | - Natalia Kajka
- Department of Psychiatry, Psychotherapy and Early Intervention in Lublin, Medical University of Lublin, Lublin, Poland
| | - Paweł Szewczyk
- Department of Psychiatry, Psychotherapy and Early Intervention in Lublin, Medical University of Lublin, Lublin, Poland
| | - Paweł Krukow
- Department of Clinical Neuropsychiatry, Medical University of Lublin, Lublin, Poland
| | - Hanna Karakuła-Juchnowicz
- Department of Psychiatry, Psychotherapy and Early Intervention in Lublin, Medical University of Lublin, Lublin, Poland
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Quilty LC, Tempelaar W, Andrade BF, Kidd SA, Lunsky Y, Chen S, Wang W, Wong JKY, Lau C, Sedrak AB, Kelly R, Sivakumar H, Jani M, Ameis SH, Cleverley K, Goldstein BI, Felsky D, Dickie EW, Foussias G, Kozloff N, Nikolova YS, Polillo A, Diaconescu AO, Wheeler AL, Courtney DB, Hawke LD, Rotenberg M, Voineskos AN. Cognition and Educational Achievement in the Toronto Adolescent and Youth Cohort Study: Rationale, Methods, and Early Data. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:265-274. [PMID: 37979945 DOI: 10.1016/j.bpsc.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/11/2023] [Accepted: 10/30/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND Both cognition and educational achievement in youths are linked to psychosis risk. One major aim of the Toronto Adolescent and Youth (TAY) Cohort Study is to characterize how cognitive and educational achievement trajectories inform the course of psychosis spectrum symptoms (PSSs), functioning, and suicidality. Here, we describe the protocol for the cognitive and educational data and early baseline data. METHODS The cognitive assessment design is consistent with youth population cohort studies, including the NIH Toolbox, Rey Auditory Verbal Learning Test, Wechsler Matrix Reasoning Task, and Little Man Task. Participants complete an educational achievement questionnaire, and report cards are requested. Completion rates, descriptive data, and differences across PSS status are reported for the first participants (N = 417) ages 11 to 24 years, who were recruited between May 4, 2021, and February 2, 2023. RESULTS Nearly 84% of the sample completed cognitive testing, and 88.2% completed the educational questionnaire, whereas report cards were collected for only 40.3%. Modifications to workflows were implemented to improve data collection. Participants who met criteria for PSSs demonstrated lower performance than those who did not on numerous key cognitive indices (p < .05) and also had more academic/educational problems. CONCLUSIONS Following youths longitudinally enabled trajectory mapping and prediction based on cognitive and educational performance in relation to PSSs in treatment-seeking youths. Youths with PSSs had lower cognitive performance and worse educational outcomes than youths without PSSs. Results show the feasibility of collecting data on cognitive and educational outcomes in a cohort of youths seeking treatment related to mental illness and substance use.
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Affiliation(s)
- Lena C Quilty
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Wanda Tempelaar
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Brendan F Andrade
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Sean A Kidd
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Yona Lunsky
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Sheng Chen
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Wei Wang
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jimmy K Y Wong
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Chloe Lau
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychology, Western University, London, Ontario, Canada
| | - Andrew B Sedrak
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Rachel Kelly
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Harijah Sivakumar
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Melanie Jani
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Stephanie H Ameis
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Kristin Cleverley
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Benjamin I Goldstein
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Daniel Felsky
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Erin W Dickie
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - George Foussias
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Nicole Kozloff
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Yuliya S Nikolova
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Alexia Polillo
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Andreea O Diaconescu
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Anne L Wheeler
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Physiology, University of Toronto, Toronto, Ontario, Canada; Hospital for Sick Children, Neurosciences and Mental Health Program, Toronto, Ontario, Canada
| | - Darren B Courtney
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Lisa D Hawke
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Martin Rotenberg
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Aristotle N Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
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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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Temple J, Gemma Cherry M, Gray V, Jones A, Fisher P. Experience sampling methodology study of anxiety and depression in adolescents with epilepsy: The role of metacognitive beliefs and perseverative thinking. Epilepsy Behav 2024; 151:109599. [PMID: 38160577 DOI: 10.1016/j.yebeh.2023.109599] [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: 10/03/2023] [Revised: 12/10/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024]
Abstract
Emotional distress is common in young people with epilepsy (YPwE). According to the Self-Regulatory Executive Function (S-REF) model, maladaptive metacognitive beliefs and perseverative thinking are fundamental in the development and maintenance of emotional distress. As emotional distress and perseverative thinking can highly fluctuate over short intervals in YPwE, it is important to account for this variability when testing the utility of psychological models. Experience sampling methodology (ESM) was therefore used to explore the momentary relationship between metacognitive beliefs, perseverative thinking, and emotional distress in YPwE. Eighteen participants diagnosed with epilepsy (aged 12-17 years) completed the 10-day ESM period. Participants were prompted to complete the ESM assessment five times daily. The ESM assessment assessed participant's momentary levels of metacognitive beliefs, perseverative thinking (i.e., worry and rumination), and emotional distress (i.e., anxiety and depression). A series of multilevel regression analyses indicated that metacognitive beliefs were significantly positively associated with worry, rumination, anxiety and depression. After controlling for worry and rumination, respectively, metacognitive beliefs did not account for additional variance in anxiety or depression. Findings provide preliminary support for the utility of the S-REF model for emotional distress in YPwE. Metacognitive therapy, which is underpinned by the S-REF model, may be an appropriate intervention for emotional distress in YPwE. Future studies should assess the mediational relationship between metacognitive beliefs, perseverative thinking, and emotional distress using time-lagged models.
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Affiliation(s)
- James Temple
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK; Mersey Care NHS Foundation Trust, Liverpool, UK
| | - Mary Gemma Cherry
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK; Clinical Health Psychology Service, Liverpool University NHS Foundation Trust, Liverpool, UK.
| | - Victoria Gray
- Psychological Services (Paediatrics), Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Andrew Jones
- Department of Psychology, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Peter Fisher
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK; Clinical Health Psychology Service, Liverpool University NHS Foundation Trust, Liverpool, UK
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Cécillon FX, Mermillod M, Leys C, Lachaux JP, Le Vigouroux S, Shankland R. Trait Anxiety, Emotion Regulation, and Metacognitive Beliefs: An Observational Study Incorporating Separate Network and Correlation Analyses to Examine Associations with Executive Functions and Academic Achievement. CHILDREN (BASEL, SWITZERLAND) 2024; 11:123. [PMID: 38255435 PMCID: PMC10814468 DOI: 10.3390/children11010123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/09/2024] [Accepted: 01/16/2024] [Indexed: 01/24/2024]
Abstract
Trait anxiety, emotion regulation strategies, and metacognitive beliefs influence executive functions (EFs) and academic achievement. This study examines their interplay and impact on academic success. In total, 275 adolescents (10-17 years) and parents completed an online questionnaire assessing trait anxiety, emotion regulation strategies, metacognition, parent-reported behaviors related to executive functioning, and overall school average. Preliminary analyses confirmed consistency with the existing literature for each variable and their interaction. Furthermore, we conducted a network analysis among the main variables. This analysis supports the need to pay more attention to reflective variables-maladaptive emotion regulation strategies and metacognitive beliefs about worry-when studying trait anxiety. These variables were linked to problematic executive functioning in adolescents, and the latter was negatively linked to academic achievement. This study offers innovative insights by investigating relationships less explored in the scientific literature. It reveals high and significant correlations between metacognitive beliefs, maladaptive emotion regulation strategies, and trait anxiety (r > 0.500, p < 0.001) but also between these variables and both executive functioning and academic achievement. These findings offer new perspectives for research and underscore the importance of holistically examining the psychological factors related to academic success.
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Affiliation(s)
- François-Xavier Cécillon
- Laboratoire Développement Individu Processus Handicap Education, Université Lumière Lyon 2, 5, Avenue Pierre Mendès-France, 69676 Bron, Cedex, France;
| | - Martial Mermillod
- Laboratoire Psychologie et NeuroCognition, CNRS, Université Grenoble Alpes, 38000 Grenoble, France;
| | - Christophe Leys
- Faculté de Psychologie, Sciences de l’Education et Logopédie, Université Libre de Bruxelles, Avenue Franklin Roosevelt, 50—CP191, 1050 Bruxelles, Belgium;
| | - Jean-Philippe Lachaux
- Centre de Recherche en Neurosciences de Lyon, Bâtiment 452—95 Bd Pinel, 69500 Bron, France;
| | | | - Rebecca Shankland
- Laboratoire Développement Individu Processus Handicap Education, Université Lumière Lyon 2, 5, Avenue Pierre Mendès-France, 69676 Bron, Cedex, France;
- Institut Universitaire de France, 1 Rue Descartes, 75231 Paris, Cedex 05, France
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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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11
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Schultz K, Kannis-Dymand L, Jamieson D, McLoughlin LT, Loughnan S, Allen A, Hermens DF. Examining the Longitudinal Relationship Between Metacognitive Beliefs and Psychological Distress in an Adolescent Population: A Preliminary Analysis. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01611-z. [PMID: 37831288 DOI: 10.1007/s10578-023-01611-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/16/2023] [Indexed: 10/14/2023]
Abstract
Adolescence is a period marked by significant vulnerability to the onset of mental health concerns. Within adults, the metacognitive model of psychological disorders advocates for the involvement of metacognitive beliefs in the onset, and maintenance, of psychopathology. The current study aimed to assess the applicability of the metacognitive model in adolescence by exploring the relationship, as well as the trajectory, between metacognitive beliefs and psychological distress. The longitudinal prospective cohort study investigated data from a community-based sample of participants aged 12 to 13. Self-report assessment measures of metacognitive beliefs, psychological distress, and somatic distress are reported across four time-points. Baseline assessments are reported for 70 participants, which reduced to 53 participants at time-point four. Correlational analyses demonstrated a significant relationship between overall metacognition, as well as negative metacognitive beliefs, and psychological distress at each of the four time-points. Generalised Estimating Equations found a significant association between metacognitive predictors and psychological distress over the four time-points. These results indicate that negative metacognitive beliefs, positive metacognitive beliefs, metacognitive beliefs related to superstition, punishment, and responsibility, low perceived levels of cognitive confidence and cognitive self-consciousness predict psychological distress over 12 months in adolescents aged 12 to 13. The strongest longitudinal correlational structure was found for the model of negative metacognitive beliefs and psychological distress. These findings provide preliminary evidence for the positive linear relationship between metacognitive beliefs and psychological distress in adolescence. The study provides an important contribution to understanding the role of metacognitive beliefs in the aetiology and perpetuation of psychological distress in adolescence.
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Affiliation(s)
- Katie Schultz
- School of Health, University of the Sunshine Coast, Maroochydore DC, QLD, Australia
| | - Lee Kannis-Dymand
- School of Health, University of the Sunshine Coast, Maroochydore DC, QLD, Australia
| | - Daniel Jamieson
- Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia
| | - Larisa T McLoughlin
- Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia
| | - Siobhan Loughnan
- Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia
- Stillbirth Centre of Research Excellence, Mater Research Institute, South Brisbane, QLD, Australia
| | - Andrew Allen
- School of Health, University of the Sunshine Coast, Maroochydore DC, QLD, Australia.
| | - Daniel F Hermens
- Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia
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12
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Kajka N, Karakuła-Juchnowicz H, Kulik A, Szewczyk P, Hryniewicz K. Stuck in a Rut of Thought-That Is Just a Barrier: Dysfunctional Metacognitive Beliefs, Limitation on Individual Freedom and Well-Being of Adolescents during COVID-19 Lockdown. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5151. [PMID: 36982060 PMCID: PMC10049271 DOI: 10.3390/ijerph20065151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/08/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The aim of the cross-sectional study was to conduct an exploratory analysis of identifying factors related to mood, metacognitive beliefs, and limitation on individual freedom associated with lockdown restrictions during COVID-19, and to determine whether they may be relevant to the deteriorating well-being of adolescents. METHODS A total of 387 adolescents (M = 15.37; SD = 1.62): 85 with depression (DG) and 302 without any psychiatric diagnosis group (WPDG) were examined using the health survey and the CDI-2 questionnaire to assess the symptoms and severity of depression and MCQ-A to measure the intensity of dysfunctional metacognitive beliefs. RESULTS The feeling of restriction of freedom had an influence on worsened well-being in the whole group of responders OR = 4.15; p < 0.001 but was more in the DG than the WPDG (OR = 20.00; p < 0.001 vs. OR = 4.77; p < 0.001). Positive metacognitive beliefs were related to well-being (DG), but no effect was observed in the WPDG (OR = 0.88; p < 0.05 vs. OR = 1.05; p = 0.136). The lower age of the WPDG negatively impacted well-being (OR = 1.20; p < 0.05). CONCLUSIONS Dysfunctional metacognitive beliefs and the feeling of restriction of freedom are important in the deterioration of adolescents' well-being, but these factors have a stronger impact on well-being in the DG.
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Affiliation(s)
- Natalia Kajka
- 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 1 Gluska St., 20-439 Lublin, Poland
| | - Hanna Karakuła-Juchnowicz
- 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 1 Gluska St., 20-439 Lublin, Poland
| | - Agnieszka Kulik
- The Department of Psychotherapy and Health Psychology, The John Paul II Catholic University of Lublin, Al. Racławickie 14, 20-950 Lublin, Poland
| | - Paweł Szewczyk
- 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 1 Gluska St., 20-439 Lublin, Poland
| | - Konrad Hryniewicz
- Department of Marketing and Quantitative Methods, Faculty of Management and Quality Science, Gdynia Maritime University, 81-87 Morska St., 81-225 Gdynia, Poland
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13
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Wells A, Carter K, Hann M, Shields G, Wallis P, Cooper B, Capobianco L. Youth Metacognitive Therapy (YoMeta): protocol for a single-blind randomised feasibility trial of a transdiagnostic intervention versus treatment as usual in 11–16-year-olds with common mental health problems. Pilot Feasibility Stud 2022; 8:207. [PMID: 36096940 PMCID: PMC9465896 DOI: 10.1186/s40814-022-01162-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/25/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Mental health disorders in children and young people (CYP) are increasing but the provision of current evidence-based treatment for common mental health problems is limited. Treatment effects vary widely with no clear superiority of a single treatment approach. Further evaluation of contemporary and effective treatments in CYP is needed. Metacognitive therapy (MCT) has shown enhanced efficacy over ‘gold standard’ approaches in adult mental health, but so far has not been evaluated in a randomised trial of CYP. As such, we aim to assess the acceptability and feasibility of group-MCT for CYP with common mental health problems in comparison to usual treatment within Child and Adolescent Mental Health Services (CAMHS).
Method
YoMeta is a multicentre, two-arm, single-blind randomised feasibility trial comparing group-MCT to usual care in CYP with common mental health problems in CAMHS. CYP (target sample n = 100) with a common mental health problem will be recruited across at least three CAMHS services in the UK. Participants in the intervention arm will receive up to eight sessions of group-MCT delivered by a CAMHS mental health practitioner. The control arm will receive usual care in CAMHS which includes individual or group-based therapy. Feasibility will be assessed by the success of recruitment, retention, and data quality. Acceptability of the intervention will be assessed by the number of sessions attended and through qualitative interviews aimed at exploring CYP acceptability and understanding of the intervention. Symptoms of psychological distress will be assessed using the Revised Children Anxiety and Depression Scale (RCADS) at 20 weeks. We will also assess psychological well-being, symptoms of depression, metacognitive beliefs, quality of life, and measures to support economic evaluation (health status and health and social care use). Qualitative interviews will be conducted to understand practitioner’s views on training and delivery of group-MCT.
Discussion
The trial is designed to evaluate the acceptability and feasibility of group-MCT for CYP with common mental health problems. Group-MCT may aid in improving access to treatment, reduce waiting times, and improve outcomes for CYP with common mental health disorders. The study will provide important information and data to evaluate future research potential and confirm sample size estimation for a definitive large-scale RCT to test the effectiveness and cost-effectiveness of group-MCT in CYP.
Trial registration
NCT05260060; ISCTRN18335255
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14
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Pedersen H, Grønnæss I, Bendixen M, Hagen R, Kennair LEO. Metacognitions and brooding predict depressive symptoms in a community adolescent sample. BMC Psychiatry 2022; 22:157. [PMID: 35232425 PMCID: PMC8887018 DOI: 10.1186/s12888-022-03779-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/08/2022] [Indexed: 02/01/2023] Open
Abstract
Depressive symptoms are prevalent in adolescence, and girls have higher levels of depressive symptoms and depressive disorder than boys. Rumination and especially brooding, seem to be a central maintaining factor of depressive symptoms, where metacognitions about rumination play a prominent role in maintaining depressive rumination. There is a sex difference in adults in depressive disorder. The current investigation of a high school / community sample of adolescents aged 16-20 from Norway (N = 1198, 62.2% women) found that adolescent women had higher scores than men on all relevant measures: Depressive symptoms, negative and positive metacognitions, pondering, and brooding. A path model for predicting depressive symptoms showed that the major factors for both sexes were negative metacognitions and brooding. The predictors of depressive symptoms were invariant across sex and age groups, suggesting similar underlying mechanisms across these groups. The overall findings suggest that metacognitive therapy may be an efficient intervention for depressive symptoms among adolescents.
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Affiliation(s)
- Helene Pedersen
- grid.5947.f0000 0001 1516 2393Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ingrid Grønnæss
- grid.5947.f0000 0001 1516 2393Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mons Bendixen
- grid.5947.f0000 0001 1516 2393Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Roger Hagen
- grid.5947.f0000 0001 1516 2393Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway ,grid.5510.10000 0004 1936 8921Department of Psychology, University of Oslo, Oslo, Norway ,grid.5510.10000 0004 1936 8921Research institute, Modum Bad, Vikersund, Norway
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15
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Aydın O, Balıkçı K, Arslan Y, Ünal-Aydın P, Müezzin E, Spada MM. The Combined Contribution of Fear and Perceived Danger of COVID-19 and Metacognitions to Anxiety Levels during the COVID-19 Pandemic. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2021; 40:603-617. [PMID: 34776609 PMCID: PMC8571673 DOI: 10.1007/s10942-021-00429-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2021] [Indexed: 12/20/2022]
Abstract
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.
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Affiliation(s)
- Orkun Aydın
- Faculty of Arts and Social Sciences, Department of Psychology, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Kuzeymen Balıkçı
- Faculty of Science and Literature, Department of Psychology, International Final University, Nicosia, Turkish Republic of Northern Cyprus
| | - Yasin Arslan
- Faculty of Arts and Social Sciences, Department of Psychology, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Pınar Ünal-Aydın
- Faculty of Arts and Social Sciences, Department of Psychology, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Ece Müezzin
- Faculty of Arts and Social Sciences, Department of Psychology, 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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16
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Köcher LM, Schneider K, Christiansen H. Thinking about worry: A systematic review and meta-analysis on the assessment of metacognitions in children and adolescents. World J Psychiatry 2021; 11:635-658. [PMID: 34631466 PMCID: PMC8474992 DOI: 10.5498/wjp.v11.i9.635] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/04/2021] [Accepted: 07/27/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The metacognitive model of generalized anxiety disorder identifies three forms of metacognition: Positive metacognitive beliefs about worry (POS), negative metacognitive beliefs about worry (NEG), and meta-worry. Though this model was originally developed relying on adult samples, it has since been applied to children and youth in different studies, and results mostly support its validity for this group. As the roles of POS, meta-worry, and age-effects do not appear to be fully clarified for children and adolescents yet, an integration of studies on children and adolescents and the metacognitive model is both timely and worthwhile.
AIM To summarize the current research on relationships, age-effects, and measurements for POS, NEG, and meta-worry in childhood and youth.
METHODS We carried out a literature search in the electronic databases PsycINFO, PubMed, PSYNDEX, and ERIC in 2017 and updated in 2020. Empirical research in German or English language on metacognition was included with child and adolescent samples diagnosed with anxiety disorders or healthy controls if POS, NEG, or meta-worry were measured. Studies were included for meta-analysis if they reported correlations between these metacognitions and anxiety or worry. Consensus rating for eligibility was done for 20.89% of full-texts with 90.32% agreement. Risk of bias was assessed with the appraisal tool for cross-sectional studies and consensus rating of appraisal tool for cross-sectional studies for 20.83% of included studies attaining agreement of intraclass correlation = 0.898. Overall, correlations between metacognitions, anxiety and worry were calculated with RevMan 5.4.1, assuming random-effects models. Meta-regressions with mean age as the covariate were performed via the online tool MetaMar 2.7.0. PROSPERO-ID: CRD42018078852.
RESULTS Overall, k = 763 records and k = 78 additional records were identified. Of those, k = 48 studies with 12839 participants were included and of those, k = 24 studies were included for meta-analysis. Most studies showed consistent NEG correlations with worry and anxiety, as well as higher values for clinical than for non-clinical samples. POS findings were less consistent. Meta-analysis revealed large effects for NEG correlating with worry and anxiety, small to medium effects for POS correlating with worry and anxiety, as well as small to medium effects for POS correlating with NEG. Meta-regressions did not reveal mean age as a significant covariate. Meta-worry was assessed in only one study. We identified eight questionnaires and one interview-format that assess metacognition about worry in children and adolescents.
CONCLUSION POS and NEG are measurable from the age of seven upwards and correlate with anxiety and worry without influences by age. Meta-worry requires further investigation.
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Affiliation(s)
- Laura M Köcher
- Department of Psychology, University of Marburg, Marburg 35037, Germany
| | - Kai Schneider
- Department of Clinical Child and Adolescent Psychology, University of Landau, Landau 76829, Germany
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17
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Metacognitive Beliefs Predict Cognitive Behavioral Therapy Outcome in Children with Anxiety Disorders. Int J Cogn Ther 2021. [DOI: 10.1007/s41811-021-00119-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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18
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Zhou H, Dang L, Lam LW, Zhang MX, Wu AM. A cross-lagged panel model for testing the bidirectional relationship between depression and smartphone addiction and the influences of maladaptive metacognition on them in Chinese adolescents. Addict Behav 2021; 120:106978. [PMID: 33971499 DOI: 10.1016/j.addbeh.2021.106978] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 05/01/2021] [Accepted: 05/02/2021] [Indexed: 12/11/2022]
Abstract
AIMS Despite the high prevalence of both depression and smartphone addiction among Chinese adolescents, research examining their bidirectional relationship has been limited. Moreover, longitudinal research regarding the influence of maladaptive metacognitive beliefs on smartphone addiction is scarce. This 6-month longitudinal study aimed to address these research gaps by testing a cross-lagged panel model of maladaptive metacognition, depression, and smartphone addiction. METHODS Four hundred and fifty-nine Chinese high school students voluntarily completed an anonymous questionnaire at baseline, and 313 of them (36.1% male; age = 14 to 18; M = 16.88, SD = 0.62) completed the same questionnaire at follow-up. RESULTS Positive correlations were shown among depression, smartphone addiction, and maladaptive metacognition at both waves (r = 0.16 to 0.57, p < .01). The results of the cross-lagged analysis demonstrated only the prospective effect of depression on smartphone addiction (β = 0.18, p < .001) but not vice versa. Moreover, maladaptive metacognition assessed at baseline significantly predicted subsequent depression (β = 0.14, p < .01) but not smartphone addiction (p>.05). Additional path analysis showed a significant indirect effect of baseline maladaptive metacognition (0.099 [95% CI = 0.042, 0.183]) on subsequent smartphone addiction, via depression. CONCLUSIONS Findings of this study showed that the relationship between depression and smartphone addiction was unidirectional rather than bidirectional among Chinese adolescents. Specifically, depression predicted smartphone addiction, while maladaptive metacognition predicted depression. Depression also mediated the relationship between maladaptive metacognition and smartphone addiction. The findings suggest that incorporating metacognition and depression interventions into smartphone addiction prevention designs for adolescents may be beneficial.
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19
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A novel, complex systems approach to modelling risk of psychological distress in young adolescents. Sci Rep 2021; 11:9428. [PMID: 33941827 PMCID: PMC8093239 DOI: 10.1038/s41598-021-88932-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 04/12/2021] [Indexed: 11/08/2022] Open
Abstract
Adolescence is a period of significant anatomical and functional brain changes, and complex interactions occur between mental health risk factors. The Longitudinal Adolescent Brain Study commenced in 2018, to monitor environmental and psychosocial factors influencing mental health in 500 adolescents, for 5 years. Participants are recruited at age 12 from the community in Australia's Sunshine Coast region. In this baseline, cross-sectional study of N = 64 participants, we draw on the network perspective, conceptualising mental disorders as causal systems of interacting entities, to propose a Bayesian network (BN) model of lifestyle and psychosocial variables influencing chances of individuals being psychologically well or experiencing psychological distress. Sensitivity analysis of network priors revealed that psychological distress (Kessler-10) was most affected by eating behaviour. Unhealthy eating increased the chance of moderate psychological distress by 600%. Low social connectedness increased the chance of severe psychological disorder by 200%. Certainty for psychological wellness required 33% decrease in unhealthy eating behaviours, 11% decrease in low social connectedness, and 9% reduction in less physical activity. BN can augment clinician judgement in mental disorders as probabilistic decision support systems. The full potential of BN methodology in a complex systems approach to psychopathology has yet to be realised.
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20
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Russell JK, Strodl E, Kavanagh D. Use of a Social Robot in the Implementation of a Narrative Intervention for Young People with Cystic Fibrosis: A Feasibility Study. Int J Soc Robot 2021. [DOI: 10.1007/s12369-021-00765-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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21
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Ünal-Aydın P, Obuća F, Aydın O, Spada MM. The role of metacognitions and emotion recognition in problematic SNS use among adolescents. J Affect Disord 2021; 282:1-8. [PMID: 33387741 DOI: 10.1016/j.jad.2020.12.103] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 11/13/2020] [Accepted: 12/23/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Problematic social networking sites (SNS) use is associated with important psychological problems among adolescents. Nevertheless, research on the aetiology of problematic SNS use is limited. Our aim was to investigate the role of metacognitions and emotion recognition in predicting problematic SNS use during the late adolescence period. METHODS Eight hundred and sixty-one high school students were recruited for the study. Participants completed the Bergen Social Media Addiction Scale (BSMAS), the Metacognitions Questionnaire for Children (MCQ-C), and the Children's Version of Reading the Mind in the Eyes Test (RMET). RESULTS A stepwise multiple linear regression analysis showed that all subdimensions of metacognitions (positive meta-worry, negative meta-worry, superstition, punishment, and responsibility beliefs, and cognitive monitoring), but not emotion recognition, independently predicted the BSMAS total score controlling for daily SNS use. CONCLUSIONS Our findings indicate that maladaptive metacognitions are associated, independently frequency of daily SNS use, to problematic SNS use among late adolescents. Interventions targeting dysfunctional metacognitions may aid adolescents who suffer from the detrimental effects of problematic SNS use.
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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
| | - Faruk Obuća
- Department of Psychology, Faculty of Arts and Science, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - 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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22
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Dos Santos Kawata KH, Ueno Y, Hashimoto R, Yoshino S, Ohta K, Nishida A, Ando S, Nakatani H, Kasai K, Koike S. Development of Metacognition in Adolescence: The Congruency-Based Metacognition Scale. Front Psychol 2021; 11:565231. [PMID: 33488443 PMCID: PMC7815698 DOI: 10.3389/fpsyg.2020.565231] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 11/18/2020] [Indexed: 11/29/2022] Open
Abstract
Introduction Previous studies on metacognitive ability were explored using self-report questionnaires that are difficult to adequately measure and evaluate when the capacity for self-reference is undeveloped. This study aimed to validate the Congruency-based Metacognition Scale (CMS) to measure metacognition and the feeling of confidence abilities and to investigate the development of metacognition during adolescence. Methods The CMS was administered to 633 child–parent pairs in Japan (child, mean age = 16.0 years, 46.0% female; parent, mean age = 48.3 years, 94.9% mother). The CMS metacognition score was assessed based on congruency scores between the self-report of the child from a third-person perspective (3PP) and the parent’s report from the first-person perspective (1PP). The CMS self-judgment accuracy score was assessed by the congruency scores between the children’s self-report from the 1PP and 3PP. For both measures, the more distant the 3PP on the self-report was from the 1PP on the parent’s report and child self-report means low ability. An exploratory factor analysis (EFA) was conducted to examine construct validity and then a confirmatory factor analysis (CFA) was used. Criterion validity was examined by calculating Pearson’s correlation coefficients with scores on the Beck Cognitive Insight Scale (BCIS) and Autism Quotient (AQ). We used intraclass correlation and Cronbach’s alpha to examine the test–retest and internal consistency reliability. Results Based on the results of the EFA and CFA, we adopted one factor structure with five items. The CMS metacognition and CMS self-judgment accuracy showed evidence criterion validity, exhibiting significant correlations with the BCIS self-reflectiveness (r = 0.16) and self-certainty scores (r = 0.17), respectively. Regarding to the AQ, only the CMS metacognition score had significant correlations with the social skills (r = 0.22) and total scale score (r = 0.20). The test–retest reliability showed adequate (intraclass correlation coefficient 0.70–0.81 and the Cronbach’s alpha coefficient 0.63–0.59). Adolescents were found to have significantly lower metacognitive ability compared to young adults. Conclusion CMS could be a valid and reliable measure to examine metacognitive abilities for adolescents.
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Affiliation(s)
| | - Yuki Ueno
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo, Japan.,Center for Advanced School Education and Evidence-based Research (CASEER), Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Ryuichiro Hashimoto
- Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan.,Department of Language Sciences, Tokyo Metropolitan University, Tokyo, Japan.,Research Center for Language, Brain and Genetics, Tokyo Metropolitan University, Tokyo, Japan
| | - Shinya Yoshino
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo, Japan.,Graduate School of Letters, Arts and Sciences, Waseda University, Tokyo, Japan
| | - Kazusa Ohta
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo, Japan.,Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Atsushi Nishida
- Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Shuntaro Ando
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Hironori Nakatani
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo, Japan.,Department of Information Media Technology, School of Information and Telecommunication Engineering, Tokai University, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,UTokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), The University of Tokyo, Tokyo, Japan.,The International Research Center for Neurointelligence (IRCN), The University of Tokyo, Tokyo, Japan.,UTokyo Center for Integrative Science of Human Behaviour (CiSHuB), The University of Tokyo, Tokyo, Japan
| | - Shinsuke Koike
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo, Japan.,UTokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), The University of Tokyo, Tokyo, Japan.,The International Research Center for Neurointelligence (IRCN), The University of Tokyo, Tokyo, Japan.,UTokyo Center for Integrative Science of Human Behaviour (CiSHuB), The University of Tokyo, Tokyo, Japan
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23
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Russell JK, Strodl E, Kavanagh DJ. Correlates of distress in young people with cystic fibrosis: the role of self-efficacy and metacognitive beliefs. Psychol Health 2020; 36:1497-1513. [PMID: 33370209 DOI: 10.1080/08870446.2020.1861280] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES While significantly elevated distress is repeatedly found amongst young people with cystic fibrosis, their determinants remain largely unknown. This study explored whether metacognitive beliefs and self-efficacy for emotion regulation were associated with anxiety and depression after control for physical functioning, age and gender. DESIGN Cross-sectional study using a 110-item online questionnaire. METHODS An online survey was undertaken by 147 young people with CF aged 10-18 from five countries. Associations of Hospital Anxiety and Depression Scale scores with gender, age, physical functioning, Metacognitive Beliefs Questionnaire for Children (MCQ-C) subscales and Self-Efficacy for Emotion Regulation (SE-ER) were examined using hierarchical multiple linear regressions. RESULTS Physical functioning, gender and age accounted for 31% of the variance in anxiety and 39% in depression. The MCQ-C and SE-ER added another 45% to the variance of anxiety and 32% to depression. At the final step of both analyses, physical functioning, SE-ER, MCQ-C Negative Meta-Worry and Superstition, Punishment & Responsibility contributed significantly. Older age was also significantly associated with depression. CONCLUSIONS Self-efficacy for emotion regulation, concern about worrying and shame may be particularly important foci for interventions aimed at ameliorating anxiety and depression in young people with CF.
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Affiliation(s)
- Jeremy K Russell
- Centre for Children's Health Research, Institute of Health & Biomedical Innovation, and School of Psychology & Counselling, Queensland University of Technology, Brisbane, Australia
| | - Esben Strodl
- School of Psychology & Counselling, Queensland University of Technology, Brisbane, Australia
| | - David J Kavanagh
- Centre for Children's Health Research, Institute of Health & Biomedical Innovation, and School of Psychology & Counselling, Queensland University of Technology, Brisbane, Australia
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24
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Assessment of the cognitive attentional syndrome in children: an adaptation of the CAS-1. Behav Cogn Psychother 2020; 49:340-351. [PMID: 33172517 DOI: 10.1017/s135246582000082x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Research suggests that the metacognitive model is applicable to clinical child populations. However, few measures related to the model are available for younger age groups. A key concept of the model is the cognitive attentional syndrome (CAS), which encompasses the individual's worry and rumination, maladaptive coping strategies, and metacognitive beliefs. While the CAS has been successfully measured in adults, this has not yet been attempted in children. AIMS The aim of this study was to adapt a measure of the CAS for use with children and investigate the measure's associations with anxiety, worry, depression and metacognitions. METHODS Our study included 127 children with anxiety disorders aged 7-13 years. The adult measure of CAS was adapted for use with children and administered at pre- and post-treatment. We examined the correlations between variables and the ability of the CAS measure to explain variance in anxious symptomatology, as well as the measure's sensitivity to treatment change. RESULTS The adapted measure, CAS-1C, displayed strong associations with overall anxiety, depression, worry and metacognitions. The CAS-1C explained an additional small amount of variance in anxiety and worry symptoms after accounting for metacognitions, which may be due to the measure also assessing thinking styles and coping strategies. Furthermore, the measure displayed sensitivity to treatment change. CONCLUSIONS The child measure of the CAS is a brief tool for collecting information on metacognitive beliefs and strategies that maintain psychopathology according to the metacognitive model, and it can be used to monitor treatment changes in these components.
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25
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Rizvi M, Smilansky H, Porth R, Myers N, Geller D, Small BJ, McGuire JF, Wilhelm S, Storch EA. The moderating effect of age on the associations of cognitive and metacognitive beliefs with pediatric OCD symptoms. Cogn Behav Ther 2020; 50:104-120. [PMID: 33073722 DOI: 10.1080/16506073.2020.1819866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Although considerable research has highlighted the importance of cognitive and metacognitive beliefs in adult obsessive-compulsive disorder (OCD), there has been limited investigation of these beliefs in pediatric OCD. The present study investigated the clinical correlates of cognitive and metacognitive beliefs in pediatric OCD. Previous studies found positive relations between OCD symptoms and these beliefs in pediatric patients, and we hypothesized these beliefs would also be positively related to pediatric OCD symptom severity. We additionally hypothesized age would moderate these relationships in consideration of previous studies highlighting age differences in symptom presentation and self-reported beliefs. We also explored age differences in belief endorsements. Youth aged 7-17 (n = 142) diagnosed with OCD completed self-report scales to measure cognitive and meta-cognitive beliefs. OCD severity was assessed using self-report and clinician-rated measures. Pearson correlations, moderation analyses, and independent-samples t-tests were used to test our hypotheses and aims. Significant positive relationships were observed between cognitive and metacognitive beliefs and self-reported OCD severity, although age did not moderate these relationships. Age differences were found in belief endorsements. In conclusion, cognitive and metacognitive beliefs appear clinically relevant to pediatric OCD cases, and we recommend clinicians assess these beliefs and incorporate cognitive components to corresponding evidence-based treatment.
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Affiliation(s)
- Myles Rizvi
- Psychology Section, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine , Houston, TX, USA
| | - Hannah Smilansky
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School , Boston, MA, United States
| | - Rachel Porth
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School , Boston, MA, United States
| | - Nicholas Myers
- Psychiatry and Behavioral Sciences - Child and Adolescent Psychiatry, Johns Hopkins School of Medicine , Baltimore, MD, USA
| | - Daniel Geller
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School , Boston, MA, United States
| | - Brent J Small
- School of Aging Studies, University of South Florida , Tampa, FL, USA
| | - Joseph F McGuire
- Psychiatry and Behavioral Sciences - Child and Adolescent Psychiatry, Johns Hopkins School of Medicine , Baltimore, MD, USA
| | - Sabine Wilhelm
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School , Boston, MA, United States
| | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine , Houston, TX, USA
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26
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Aydın O, Güçlü M, Ünal-Aydın P, Spada MM. Metacognitions and emotion recognition in Internet Gaming Disorder among adolescents. Addict Behav Rep 2020; 12:100296. [PMID: 33364305 PMCID: PMC7752660 DOI: 10.1016/j.abrep.2020.100296] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 07/31/2020] [Accepted: 08/02/2020] [Indexed: 12/12/2022] Open
Abstract
Metacognitions and emotion recognition predict IGD in early adolescence. Re-parenting, building assertiveness skills and metacognitions modification may protect adolescents from IGD. Internet Gaming Disorder (IGD) is associated with considerable psychological distress in adolescents. However, studies which strive to shed light on the developmental background of IGD are still sparse. We aimed to examine the role of metacognitions and emotion recognition in predicting IGD during the early adolescence period. Four hundred and seventy-seven secondary school students were recruited for the study. Participants completed the Internet Gaming Disorder Test (IGDT), the Metacognitions Questionnaire for Children (MCQ-C), and the Children’s Version of Reading the Mind in the Eye Test (RMET). Correlation analyses indicated that three factors of the MCQ-C (positive meta-worry, negative meta-worry, and superstition, punishment, and responsibility) and its total score were positively correlated with the majority of factors of the IGDT. The negative factor of the RMET was positively correlated with the salience, tolerance, and relapse factors and total score of the IGDT. Daily internet use was positively correlated with all factors of the IGDT and its total score. Hierarchical regression analyses indicated that daily internet use and metacognitions (in different combinations) were significant independent predictors of IGDT factors and its total score, and that the negative factor of the RMET was a significant independent predictor of the salience and tolerance factors of IGDT and its total score. The implications of these findings are discussed.
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Affiliation(s)
- Orkun Aydın
- Department of Psychology, Faculty of Arts and Science, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Merve Güçlü
- Department of Psychology, Faculty of Arts and Science, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Pınar Ünal-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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Metakognitive und mentalisierungsbasierte Konzepte und Behandlungsmodelle: Implikationen für die Kinder- und Jugendpsychiatrie. Prax Kinderpsychol Kinderpsychiatr 2020; 69:252-271. [DOI: 10.13109/prkk.2020.69.3.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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28
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Lachat Shakeshaft Y, Lecerf T, Morosan L, Badoud DM, Debbané M. Validation of the French version of the « Meta-Cognition Questionnaire » for adolescents (MCQ-Af): Evolution of metacognitive beliefs with age and their links with anxiety during adolescence. PLoS One 2020; 15:e0230171. [PMID: 32160251 PMCID: PMC7065794 DOI: 10.1371/journal.pone.0230171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 02/23/2020] [Indexed: 12/14/2022] Open
Abstract
Introduction The Meta-Cognitions Questionnaire for Adolescents (MCQ-A) measures individual differences of metacognitive beliefs and monitoring thought to be involved in the onset and maintenance of psychological disorders, especially in those involving anxiety. This assessment tool has been employed in research and clinical settings involving French-speaking adolescents, but appropriate validation has yet to be conducted. This article aims to first validate the francophone version of the MCQ-Af using measures sensitive to the expression of anxiety, and secondly, to examine the influence of age and gender on metacognitive beliefs, anxiety and their links. Method 214 adolescents (114 females) between 13 and 17 completed the MCQ-Af (French version) as well as the Revised-Children's Manifest Anxiety Scale (R-CMAS), French version, to assess anxiety manifestations. Structural validity was examined with confirmatory factor analyses. Three models were compared to the higher order five factor model proposed in the original validation study. Internal consistency and test-retest reliability were also performed. Student’s t tests as well as simple and stepwise regressions were conducted to assess for age and gender. Results The five correlated factors retained in the original version of the MCQ were replicated, and confirmatory factor analyses yielded comparable fit indices for a covariate factor model, as well as for a bifactor model. The bifactor model was privileged for theoretical reasons. Analyses were performed on a shortened questionnaire of 27 items as 3 items (2, 12 and 14) had non-significant loadings in prior path analyses. Age and gender differences were found in specific sub-factors of the MCQ-Af; positive and negative metacognitive beliefs seem to increase with age; girls seem to score higher on the negative metacognitive beliefs and thought control dimensions. The study further reports specific links between anxiety manifestation and negative and positive metacognitive beliefs, as well as confidence in one’s memory. A modest influence of age and gender on this link was also highlighted. Conclusion The present research provides the first evidence that the MCQ-Af is a valid and reliable instrument to assess individual differences of metacognitive beliefs in French-speaking adolescents. Nevertheless, it highlights that caution should be taken in regards of 3 items in particular (items 2, 12 and 14). Furthermore, age and gender in assessed samples of adolescents might influence the scores of the different dimensions of the questionnaire.
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Affiliation(s)
- Yasmina Lachat Shakeshaft
- Developmental Clinical Psychology Unit, Faculty of Psychology and Educational Science, University of Geneva, Geneva, Switzerland
- * E-mail:
| | - Thierry Lecerf
- Differential Clinical Psychology Unit, Faculty of Psychology and Educational Science, University of Geneva, Geneva, Switzerland
| | - Larisa Morosan
- Developmental Clinical Psychology Unit, Faculty of Psychology and Educational Science, University of Geneva, Geneva, Switzerland
| | - Deborah Myriam Badoud
- Developmental Clinical Psychology Unit, Faculty of Psychology and Educational Science, University of Geneva, Geneva, Switzerland
| | - Martin Debbané
- Developmental Clinical Psychology Unit, Faculty of Psychology and Educational Science, University of Geneva, Geneva, Switzerland
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
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29
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Beaudequin D, Schwenn P, McLoughlin LT, Parker MJ, Broadhouse K, Simcock G, Boyes A, Kannis-Dymand L, Wood A, Lagopoulos J, Hermens DF. Using measures of intrinsic homeostasis and extrinsic modulation to evaluate mental health in adolescents: Preliminary results from the longitudinal adolescent brain study (LABS). Psychiatry Res 2020; 285:112848. [PMID: 32062518 DOI: 10.1016/j.psychres.2020.112848] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/03/2020] [Accepted: 02/03/2020] [Indexed: 12/11/2022]
Abstract
Adolescence is a period when complex interactions occur between mental health risk factors. The Longitudinal Adolescent Brain Study (LABS) commenced in 2018, to monitor environmental and psychosocial factors thought to influence mental health in 500 young people. Participants commence at 12 years of age, via a community-based recruitment model, and data is collected at 15 time-points over five years. This study examines demographic and psychosocial self-report data from time-point 1, for the first 50 participants. Here we investigate associations between environmental and psychosocial factors, considered as measures of intrinsic homeostasis and extrinsic modulation. Numerous strong correlations were found. Findings indicate that sleep dysfunction and social connectedness were strongly associated external modulators of intrinsic homeostasis in this sample of 12-year old participants. To successfully address the increase in mental health problems in young people, comprehensive evaluation of lifestyle and environmental risk factors is recommended in addition to medicalised approaches. Interventions to promote mental health wellbeing in young adolescents should include a focus on sleep quality and patterns and the positive and negative aspects of social connectedness.
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Affiliation(s)
- Denise Beaudequin
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Birtinya 4575, Australia.
| | - Paul Schwenn
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Birtinya 4575, Australia
| | - Larisa T McLoughlin
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Birtinya 4575, Australia
| | - Marcella J Parker
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Birtinya 4575, Australia
| | - Kathryn Broadhouse
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Birtinya 4575, Australia
| | - Gabrielle Simcock
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Birtinya 4575, Australia
| | - Amanda Boyes
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Birtinya 4575, Australia
| | - Lee Kannis-Dymand
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Birtinya 4575, Australia
| | - Andrew Wood
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Birtinya 4575, Australia
| | - Jim Lagopoulos
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Birtinya 4575, Australia
| | - Daniel F Hermens
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Birtinya 4575, Australia
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30
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Zaccari V, Aceto M, Mancini F. A Systematic Review of Instruments to Assess Guilt in Children and Adolescents. Front Psychiatry 2020; 11:573488. [PMID: 33362597 PMCID: PMC7755888 DOI: 10.3389/fpsyt.2020.573488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 10/27/2020] [Indexed: 11/22/2022] Open
Abstract
Background: Guilt feelings have received considerable attention in past psychological theory and research. Several studies have been conducted that represent a range of views and propose various implications of guilt in children and adolescents. Variations in theoretical definitions of guilt, emphasizing a lack of measurement convergence, make it difficult to derive a comprehensive definition of the construct in childhood and adolescence. Research shows substantial variability in instruments used to measure guilt in children and adolescents. Purpose: The aim is to discuss existing contributions, illustrating the empirical validity of the available instruments used to measure guilt and identifying the nature of their theoretical backgrounds among children and adolescents. Methods: A systematic search was conducted using the following databases: PsycINFO, PsycARTICLES, MEDLINE, Scopus, Web of Science, and PubMed (all years up to February 19, 2020). Search terms were compiled into three concepts for all databases: "measure," "guilt," and "childhood/adolescence." In addition, a search was conducted to detect the gray literature. Results: After removing the duplicates, a total of 1,408 records were screened, resulting in the identification of 166 full-text articles to be further scrutinized. Upon closer examination, there was consensus that 148 of those studies met the study inclusion criteria or were not retrieved. Twenty-five studies were included in the quality assessment. The data were organized on three main categories: (1) interpersonal or prosocial guilt; (2) intrapunitive guilt or that referring to an excessive sense of responsibility; (3) not specifying a theoretical construct. A great heterogeneity in psychometric evaluations and substantial variability in guilt construct emerged. The construct most represented and supported by valid instruments was interpersonal or prosocial guilt. Analysis of the gray literature showed that some instruments were not immediately available to the clinical and scientific communities. Conclusions: The studies analyzed and selected for qualitative review employed various instruments to measure guilt. Results confirmed what is widely documented in the literature about substantial variability in instruments used to measure guilt. We argue the need to develop measures that assess currently overlooked dimensions of guilt and to provide further additional information about the psychometric proprieties of the available developed instruments.
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Affiliation(s)
- Vittoria Zaccari
- Associazione Scuola di Psicoterapia Cognitiva (APC - SPC), Rome, Italy.,Department of Human Sciences, Marconi University, Rome, Italy
| | - Marianna Aceto
- Associazione Scuola di Psicoterapia Cognitiva (APC - SPC), Rome, Italy
| | - Francesco Mancini
- Associazione Scuola di Psicoterapia Cognitiva (APC - SPC), Rome, Italy.,Department of Human Sciences, Marconi University, Rome, Italy
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31
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Ginsburg GS, Pella JE, Piselli K, Chan G. Teacher Anxiety Program for Elementary Students (TAPES): intervention development and proposed randomized controlled trial. Trials 2019; 20:792. [PMID: 31888726 PMCID: PMC6937798 DOI: 10.1186/s13063-019-3863-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 10/29/2019] [Indexed: 11/10/2022] Open
Abstract
Background Excessive student anxiety is a common problem that severely impairs short- and long-term academic functioning and increases teacher burden. Reducing student anxiety has been associated with improvement in educational functioning. Because anxiety manifests daily in the classroom, teachers are in an ideal position to identify and help students manage their anxiety. Unfortunately, teachers lack the knowledge and skills to support the learning of students with excessive anxiety. The Teacher Anxiety Program for Elementary Students (TAPES), a novel teacher-administered school-home collaborative intervention, was designed to address this gap. Methods This manuscript describes the protocol for developing and evaluating TAPES. Specifically, we present a description of: (1) the intervention and theoretical model; and (2) methods for the proposed randomized controlled trial comparing TAPES to a standard professional development seminar focused on reducing student anxiety. Discussion Primary aims examine the impact of the TAPES training on teacher knowledge and skill. Secondary aims examine the impact of TAPES on student outcomes. Exploratory aims will examine mediators based on our proposed theory of change. If effective, TAPES has the potential to directly benefit teachers (improving skills) and students (reducing anxiety and improving functioning). Trial registration ClinicalTrials.gov, NCT03899948. Registered on 28 March 2019.
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Affiliation(s)
- Golda S Ginsburg
- University of Connecticut School of Medicine, 65 Kane Street Room 2033, West Hartford, CT, 06119, USA.
| | - Jeffrey E Pella
- University of Connecticut School of Medicine, 65 Kane Street Room 2033, West Hartford, CT, 06119, USA
| | - Kate Piselli
- University of Connecticut School of Medicine, 65 Kane Street Room 2033, West Hartford, CT, 06119, USA
| | - Grace Chan
- University of Connecticut School of Medicine, 65 Kane Street Room 2033, West Hartford, CT, 06119, USA.,University of Connecticut School of Medicine Department of Psychiatry, 263 Farmington Avenue, Farmington, CT, 06030-2103, USA
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Shaw ZA, Hilt LM, Starr LR. The developmental origins of ruminative response style: An integrative review. Clin Psychol Rev 2019; 74:101780. [PMID: 31739123 DOI: 10.1016/j.cpr.2019.101780] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 09/07/2019] [Accepted: 10/15/2019] [Indexed: 01/03/2023]
Abstract
Rumination has been conceptualized as a stable, trait-level response style involving repetitive and passive focus on the symptoms of distress and the possible causes and consequences of those symptoms. This theoretical review examines developmental risk factors of ruminative response style, incorporating a developmental psychopathology perspective. A model integrating these developmental factors within a conceptual framework is proposed, wherein risk factors for distress (i.e., temperamental negative affectivity, stressful environments, parenting, and genetic vulnerability) lead to engagement in rumination. We propose that when rumination is well-practiced, it will consolidate into a trait-like response style, especially among adolescents who experience cognitive control deficits. Reciprocal relationships and moderators that may contribute to the formation of a ruminative response style are also included. To understand how these factors converge and influence the formation of ruminative response styles, we review patterns of stability and change in physical and cognitive development to demonstrate that individual differences in rumination may emerge and consolidate into enduring, trait-level response styles during early adolescence.
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Affiliation(s)
- Zoey A Shaw
- Department of Clinical and Social Sciences in Psychology, University of Rochester, 491 Meliora Hall, Box 270266, Rochester, NY 14627-0266, United States of America.
| | - Lori M Hilt
- Department of Psychology, Lawrence University, 711 E. Boldt Way, SPC 24, Appleton, WI 54911, United States of America
| | - Lisa R Starr
- Department of Clinical and Social Sciences in Psychology, University of Rochester, 491 Meliora Hall, Box 270266, Rochester, NY 14627-0266, United States of America
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33
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Gini G, Marino C, Spada MM. The Role of Metacognitions and Thinking Styles in the Negative Outcomes of Adolescents' Peer Victimization. VIOLENCE AND VICTIMS 2019; 34:752-769. [PMID: 31575813 DOI: 10.1891/0886-6708.vv-d-18-00016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Psychological mechanisms that may explain the link between peer victimization and its adverse outcomes are still understudied. The current study aimed to apply the Self-Regulatory Executive Function (S-REF) model of psychopathology (Wells & Matthews, 1994, 1996) to help explain this link in a sample of adolescents. A total of 1,169 Italian adolescents (47.7% females; Mage = 15.79, SD = 1.07) completed self-report measures of peer victimization, metacognitions, thinking styles (worry and rumination), and adjustment indices (somatic symptoms, anxiety, depression). The hypothesized model based on the S-REF model was tested through path analysis. Results confirmed that peer victimization was positively associated with both positive and negative metacognitions that, in turn, were linked to worry and rumination, which were associated with higher psychological and somatic problems. The strongest indirect links were found between peer victimization and anxiety via negative metacognitions and worry, and between victimization and depression via negative metacognitions and rumination. Overall, the results support to the application of the S-REF model to peer victimization experiences during adolescence. The clinical implications of these findings are discussed.
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Affiliation(s)
- Gianluca Gini
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Claudia Marino
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
| | - Marcantonio M Spada
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
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34
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Myers SG, Solem S, Wells A. The Metacognitions Questionnaire and Its Derivatives in Children and Adolescents: A Systematic Review of Psychometric Properties. Front Psychol 2019; 10:1871. [PMID: 31551843 PMCID: PMC6737041 DOI: 10.3389/fpsyg.2019.01871] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 07/30/2019] [Indexed: 01/16/2023] Open
Abstract
Background: The Metacognitions Questionnaire (MCQ) and its derivatives have been instrumental in research examining the Self-Regulatory Executive Function Model in adults. Studies testing whether findings are applicable to children and adolescents have been increasing and several different measures adapting the MCQ for younger populations have been developed. The current study aimed to systematically review the psychometric properties of MCQ measures or derivatives used in young people (aged 18 or less), to help assess current findings in this population and to guide future research in this growing area of investigation. Method: Systematic searches were carried out on PubMed and PsycINFO of studies published up to June 2018. Additional studies were identified through Google Scholar and article references. Validity, reliability, range and responsiveness of measures were examined as well as analyses of age and gender differences on scores. Results: Forty-five articles were identified. The total sample consisted of 7,803 children and adolescents (6,922 non-clinical, 881 clinical) aged 7-18. Studies used one of seven versions of the questionnaire, five adapted from the MCQ for younger populations: (1) The Metacognitions Questionnaire-Adolescent version; (2) The Metacognitions Questionnaire-Child version; (3) The Metacognitions Questionnaire-Child Version-Revised; (4) The Metacognitions Questionnaire-Child-30; and (5) The Metacognitions Questionnaire-65 Positive Beliefs Scale Revised; and two adult versions used without adaptation: (1) The Metacognitions Questionnaire-30 and (2) The Cognitive Self Consciousness Scale-Expanded. The validity and reliability of the Metacognitions Questionnaire-Adolescent version had the most extensive support. Other questionnaires had either mixed psychometrics or promising initial findings but more limited data. Conclusions: It is recommended that studies using adolescents (age 12-18) consider using the Metacognitions Questionnaire-Adolescent version. Based on initial data, it is suggested studies using younger populations should consider the Metacognitions Questionnaire-Child-30 but further psychometric research into this and other measures is needed.
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Affiliation(s)
- Samuel G. Myers
- Division of Psychology, Bar Ilan University, Ramat-Gan, Israel
| | - Stian Solem
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Adrian Wells
- Division of Clinical and Health Psychology, The University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Prestwich, United Kingdom
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Reducing Test Anxiety in School Settings: A Controlled Pilot Study Examining a Group Format Delivery of the Attention Training Technique Among Adolescent Students. Behav Ther 2019; 50:803-816. [PMID: 31208689 DOI: 10.1016/j.beth.2018.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 12/03/2018] [Accepted: 12/04/2018] [Indexed: 01/04/2023]
Abstract
Researchers have called for the examination of test anxiety interventions that extend beyond the delivery of individual services by a trained professional. Following from conceptual models and research findings underscoring the importance of metacognitive beliefs to test anxiety, a controlled pilot study examined whether a group format delivery of the attention training technique (ATT) component of metacognitive therapy reduces test anxiety among eighth-grade students. Students completed baseline study measures and were allocated based upon class period to five sessions of ATT (n = 39) or a music listening control (n = 34) delivered within a group format during a school week. Students completed postintervention study measures on the final day of the intervention and completed follow-up study measures approximately 3 weeks following the intervention. As predicted, students receiving ATT reported less postintervention test anxiety than the control when they held stronger baseline metacognitive beliefs about worry. The patterns of findings held at the follow-up and when specifically examining the cognitive (i.e., worry) dimension of test anxiety. Study results suggest that ATT may be a viable test anxiety intervention for students holding heightened metacognitive beliefs about worry. Future directions are discussed.
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Abstract
PURPOSE OF REVIEW This review describes (a) key features of the metacognitive model as they relate to anxiety and related disorders, (b) central components of metacognitive therapy (MCT), (c) the current empirical status of MCT, (d) recent developments, (e) controversies and (f) future research directions. RECENT FINDINGS Evidence is accumulating that MCT is effective for anxiety and related disorders. Emerging evidence suggests that MCT may be effective with children and adolescents and compares well to other evidence-supported treatments such as cognitive behaviour therapy and mindfulness-based approaches. Evidence for distinct mechanisms across therapies is mixed. While MCT appears to be effective for anxiety and related disorders, more research is required to evaluate (a) efficacy and unique (vs. common) mechanisms of change compared to other therapies, (b) effectiveness for children and adolescents, (c) alternative delivery methods (e.g., via internet, group vs. individual), (d) transdiagnostic impacts and (e) applications to a broader array of disorders.
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Zimmermann M, Glemser M, Ertle A. Dysfunktionale Metakognitionen im Jugendalter. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2018. [DOI: 10.1026/1616-3443/a000492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Das metakognitive Modell legt nahe, dass dysfunktionale Metakognitionen für die Entwicklung und Aufrechterhaltung verschiedener emotionaler Störungen eine Rolle spielen. Diese Annahme konnte in Studien sowohl für Erwachsene als auch für Kinder und Jugendliche bestätigt werden. Fragestellung: Struktur und psychometrische Eigenschaften einer deutschen Version des Meta-cognitions Questionnaire – Adolescent Version (MCQ-A) zur Erfassung störungsrelevanter Metakognitionen wurden untersucht. Methode: Nach Erhebung von Daten an einer nicht-klinischen Stichprobe ( N = 221) wurde eine konfirmatorische Faktorenanalyse durchgeführt. Interne Konsistenz, Test-Retest-Reliabilität sowie konvergente Validität wurden ermittelt. Ergebnisse: Die Struktur der englischen Originalversion konnte repliziert werden. Die deutschsprachigen Skalen des MCQ-A weisen gute Reliabilitäts- und Validitätskennwerte auf. Schlussfolgerungen: Die vorliegende deutsche Version des MCQ-A kann vorläufig als ein reliables und valides Instrument zur Erfassung dysfunktionaler Metakognitionen betrachtet werden.
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Campbell B, Curran M, Inkpen R, Katsikitis M, Kannis-Dymand L. A preliminary evaluation of metacognitive beliefs in high functioning children with autism spectrum disorder. ADVANCES IN AUTISM 2018. [DOI: 10.1108/aia-08-2017-0017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Purpose
Metacognitive beliefs and processes have been found to perpetuate anxiety and depression in youth and adults. However, the presence of metacognitive beliefs in children with autism spectrum disorder is somewhat unclear and has received limited research attention to date. The purpose of this paper is to explore metacognitive beliefs in children with autism and associations with anxiety and depression.
Design/methodology/approach
In total, 23 high functioning participants (17 male and 6 female) between the ages of 8 and 12 (M=10.38) diagnosed on the autism spectrum completed the study. Participants completed the Revised Children’s Scale of Anxiety and Depression and the Metacognitions Questionnaire for Children.
Findings
Correlation analyses revealed that positive and negative metacognitive beliefs were found, as hypothesised, to be prevalent in this sample.
Originality/value
Despite methodological limitations, this is one of the first research evaluations to provide evidence for metacognitive beliefs in high functioning children with autism and comorbid anxiety or low mood.
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The efficacy of group metacognitive therapy for children (MCT-c) with generalized anxiety disorder: An open trial. J Anxiety Disord 2018; 53:16-21. [PMID: 29145078 DOI: 10.1016/j.janxdis.2017.11.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 11/08/2017] [Accepted: 11/08/2017] [Indexed: 02/07/2023]
Abstract
Metacognitive therapy is an effective treatment for anxiety disorders in adults. Studies have demonstrated that the underlying theoretical model is also supported in children. It has therefore been suggested that metacognitive therapy for children may be effective. Our study is an open trial of metacognitive therapy for children with generalized anxiety as their primary disorder. Therapy was provided in groups. Families were interviewed with the Anxiety Disorders Interview Schedule - child/parent versions. They reported on the child's anxiety levels using the Revised Childrens Anxiety and Depression Scale - child/parent versions. Children reported on metacognitive beliefs using the Metacognitions Questionnaire for Children - 30 item version. Fourty-four children aged 7-13 years (50% girls) were enrolled, and one family dropped out during treatment. Fifty percent of the children had received counseling or psychological treatment for their anxiety disorder previously. Following treatment, 86.4% of the children were free of their primary disorder and 72.7% were free of all anxiety disorders, the corresponding figures were 75% and 65.9% at 6-months follow-up. The effect sizes were large for all measures and clinically significant improvements were obtained for 70% of the children at posttest and 77% at follow-up. Our study suggests that metacognitive therapy for children with generalized anxiety disorder may be a highly promising treatment approach.
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Lønfeldt NN, Silverman WK, Esbjørn BH. A Systematic Review and Meta-analysis of the Association Between Third-Wave Cognitive Constructs and Youth Anxiety. Int J Cogn Ther 2017. [DOI: 10.1521/ijct.2017.10.2.115] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Do Mother’s Metacognitions, Beliefs, and Behaviors Predict Child Anxiety-Related Metacognitions? CHILD & YOUTH CARE FORUM 2017. [DOI: 10.1007/s10566-017-9396-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Esbjørn BH, Normann N, Lønfeldt NN, Tolstrup M, Reinholdt-Dunne ML. Exploring the relationships between maternal and child metacognitions and child anxiety. Scand J Psychol 2017; 57:201-6. [PMID: 27119255 DOI: 10.1111/sjop.12286] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 02/24/2016] [Indexed: 01/26/2023]
Abstract
Research has shown that anxiety may be transmitted through verbal information pathways, for example, when parents share their anxious cognitions with their child. Less is known about the influence of parental metacognitions, that is, beliefs regarding thoughts, on child anxiety. We explored the relations between metacognitions in mothers and their children and anxiety in the children. Our study included 111 non-clinical children aged 8 to 12 years and their mothers. Children rated their metacognitions, worry and anxiety, and mothers rated their metacognitions. Results indicated agreement between maternal and child metacognitions. Maternal metacognitions were positively associated with children's anxiety symptoms and worry, and this relation was mediated by the children's metacognitions. Our results warrant further examination of the role of parental metacognitions in child anxiety.
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Affiliation(s)
| | | | | | - Marie Tolstrup
- Department of Psychology, University of Copenhagen, Denmark
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Østefjells T, Melle I, Aminoff SR, Hellvin T, Hagen R, Lagerberg TV, Lystad JU, Røssberg JI. An exploration of metacognitive beliefs and thought control strategies in bipolar disorder. Compr Psychiatry 2017; 73:84-92. [PMID: 27918949 DOI: 10.1016/j.comppsych.2016.11.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 11/17/2016] [Accepted: 11/19/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Metacognitive factors influence depression, but are largely unexplored in bipolar disorders. We examined i) differences in metacognitive beliefs and thought control strategies between individuals with bipolar disorder and controls, and ii) to what extent clinical characteristics were related to levels of metacognitive beliefs and thought control strategies in bipolar disorder. METHOD Eighty patients with bipolar disorder were assessed for age at onset of affective disorder, number of affective episodes, symptoms of mania and depression, metacognitive beliefs (MCQ-30) and thought control strategies (TCQ). Control subjects (N=166) completed MCQ-30 and TCQ. Factors impacting on metacognitive beliefs and thought control strategies were explored with multiple linear regressions. RESULTS Patients with bipolar disorder reported higher levels of unhelpful metacognitive beliefs and thought control strategies than controls. Metacognitive beliefs were mainly influenced by depressive symptoms, and age at onset of affective illness. Thought control strategies were mainly influenced by metacognitive beliefs and age at onset of affective illness. CONCLUSION Our findings suggest that metacognitive beliefs and control strategies are relevant in bipolar disorder. Depression and age at onset of affective disorder could contribute to metacognitive beliefs in bipolar disorder, and influence the use of thought control strategies. This indicates potential relationships that warrant further investigation for clinical relevance.
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Affiliation(s)
- Tiril Østefjells
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway; Department for Specialised Inpatient Treatment, Division of Mental Health and Addiction, Akershus University Hospital, 1478 Lørenskog, Norway.
| | - Ingrid Melle
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway.
| | - Sofie R Aminoff
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway; Department for Specialised Inpatient Treatment, Division of Mental Health and Addiction, Akershus University Hospital, 1478 Lørenskog, Norway.
| | - Tone Hellvin
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway.
| | - Roger Hagen
- Department of Psychology, Norwegian University of Science and Technology, 7491 Trondheim, Norway.
| | - Trine Vik Lagerberg
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway
| | - June Ullevoldsæter Lystad
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway; Institute of Clinical Medicine, Adult Psychiatry Unit, University of Oslo, 0315 Oslo
| | - Jan Ivar Røssberg
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway
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Boysan M, Kadak MT, Tarakcioglu MC, Sertdurak ZS, Demirel OF. Psychometric Properties of Turkish versions of the Leyton Obsessional Inventory-Child Version (LOI-CV) and Obsessive Beliefs Questionnaire-Child Version (OBQ-CV). ACTA ACUST UNITED AC 2017. [DOI: 10.5455/bcp.20151203125902] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Murat Boysan
- Yuzuncu Yil University, Faculty of Arts, Department of Psychology, Van - Turkey
| | - Muhammed Tayyib Kadak
- Istanbul University, Cerrahpasa School of Medicine, Department of Child and Adolescent Psychiatry, Istanbul - Turkey
| | - Mahmut Cem Tarakcioglu
- Dr. Sadi Konuk Education and Research Hospital, Department of Child and Adolescent Psychiatry, Istanbul - Turkey
| | - Zeynep Seda Sertdurak
- Istanbul University, Cerrahpasa School of Medicine, Department of Child and Adolescent Psychiatry, Istanbul - Turkey
| | - Omer Faruk Demirel
- Istanbul University, Cerrahpasa School of Medicine, Department of Child and Adolescent Psychiatry, Istanbul - Turkey
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Simons M, Vloet TD. Emetophobia - A Metacognitive Therapeutic Approach for an Overlooked Disorder. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2016; 46:57-66. [PMID: 27685192 DOI: 10.1024/1422-4917/a000464] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Objective Emetophobia is the specific fear of vomiting that usually commences during childhood and adolescence. Cognitive behavioral therapy aims to expose patients to vomiting. In this paper, a newly developed metacognitive concept and treatment approach to this disorder is illustrated within a small case series. Methods Three adolescent girls with emetophobia were treated with metacognitive therapy (MCT). Measures of anxiety, worry, depression, and metacognitions before and after the treatment were documented. Results All patients recovered during the course of 8 to 11 sessions, and measurements of anxiety, worry, depression, and metacognitions dropped markedly. Conclusions MCT presents a valuable treatment option for emetophobia in adolescents.
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Affiliation(s)
- Michael Simons
- 1 Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, RWTH Aachen University, Germany
| | - Timo Daniel Vloet
- 1 Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, RWTH Aachen University, Germany
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Sanger KL, Dorjee D. Mindfulness training with adolescents enhances metacognition and the inhibition of irrelevant stimuli: Evidence from event-related brain potentials. Trends Neurosci Educ 2016. [DOI: 10.1016/j.tine.2016.01.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Post-traumatic stress symptom, metacognition, emotional schema and emotion regulation: A structural equation model. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2015.08.053] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Garber J, Frankel SA, Herrington CG. Developmental Demands of Cognitive Behavioral Therapy for Depression in Children and Adolescents: Cognitive, Social, and Emotional Processes. Annu Rev Clin Psychol 2016; 12:181-216. [PMID: 27019397 PMCID: PMC5441981 DOI: 10.1146/annurev-clinpsy-032814-112836] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Although some treatments for depression in children and adolescents have been found to be efficacious, the effects sizes have tended to be modest. Thus, there is considerable room to improve upon existing depression treatments. Some children may respond poorly because they do not yet have the cognitive, social, or emotional maturity needed to understand and apply the skills being taught in therapy. Therefore, treatments for depression may need to be tailored to match children's ability to both comprehend and implement the therapeutic techniques. This review outlines the steps needed for such developmental tailoring: (a) Specify the skills being taught in depression treatments; (b) identify what cognitive, social, and emotional developmental abilities are needed to attain these skills; (c) describe the normative developmental course of these skills and how to determine a child's developmental level; and (d) use this information to design an individualized treatment plan. Possible approaches to intervening include: alter the therapy to meet the child's level of development, train the child on the skills needed to engage in the therapy, or apply a dynamic assessment approach that integrates evaluation into treatment and measures children's current abilities as well as their potential.
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Affiliation(s)
- Judy Garber
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee 37203-5721; , ,
| | - Sarah A Frankel
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee 37203-5721; , ,
| | - Catherine G Herrington
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee 37203-5721; , ,
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Young R, Dagnan D, Jahoda A. Leaving school: a comparison of the worries held by adolescents with and without intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2016; 60:9-21. [PMID: 26420749 DOI: 10.1111/jir.12223] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 06/23/2015] [Accepted: 08/06/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Leaving school is an important time for adolescents, with increasing autonomy and developing adult identities. The present study sought to shed light on the content and emotional impact of worries amongst adolescents with and without intellectual disabilities (IDs) at this time of change. METHODS Twenty-five adolescents with mild to moderate IDs and 27 adolescents without IDs, aged 15 to 18 years, took part in the study. Participants' worries were elicited using a structured interview. The levels of rumination and distress related to their most salient worries were also examined, along with their self-reported levels of anxiety. RESULTS Content analysis of the interviews identified differences between the worries of the two groups of participants, with the adolescents with IDs expressing more general worries about failure and personal threat. Level of distress about worries was positively correlated with anxiety in both groups. The adolescents with IDs were significantly more anxious than their non-disabled peers. CONCLUSIONS The differences between the groups' worries may be linked to differences in life experience and expectations. Consideration should be given to the specific worries of adolescents at the stage of leaving school. Doing so may allow solutions for their concerns to be identified, thus easing distress and leading to a less stressful transition.
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Affiliation(s)
- R Young
- Institute of Health and Wellbeing, Gartnavel Royal Hospital, University of Glasgow, Glasgow, UK
| | - D Dagnan
- Cumbria Partnership NHS Trust, Cumbria, UK
| | - A Jahoda
- Institute of Health and Wellbeing, Gartnavel Royal Hospital, University of Glasgow, UK
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