File Name: emotional disorders and metacognition .zip
Affective dysregulation and psychotic experiences or symptoms often co-occur in the general population as well as in bipolar and psychotic disorders, suggesting a complex interplay. Early trauma is hypothesised to be important for the aetiology of both, and individuals with early traumatic experiences often develop disorders characterised by an admixture of affective and psychotic symptoms. Early emotional abuse seems to be particularly relevant for both disorders.
While metacognitive interventions are gaining attention in the treatment of various mental disorders, a review of the literature showed that the term is often defined poorly and used for a variety of psychotherapeutic approaches that do not necessarily pursue the same goal. We give a summary of three metacognitive interventions which were developed within a sound theoretical framework—metacognitive therapy, metacognitive training, and metacognitively-oriented integrative psychotherapies—and discuss their similarities and distinctive features. They aim to alleviate disorder-specific and individual symptoms by gaining more flexibility in cognitive processing.
The present study examines a simple model for the relationship between temperament, anxiety and maladaptive metacognition. Three temperament traits were included in the hypothesized model: emotional reactivity, perseveration and briskness. A structural equation modeling analysis supported a model in which the relationship between the three temperament traits and anxiety were fully mediated by metacognition. Dissimilar models were identified for the male and female subgroups, and also with reference to individual categories of maladaptive metacognition.
The findings support the significance of metacognition as a factor influencing the temperament-anxiety relationship. Moreover, they confirm the roles both of emotional reactivity and of perseveration, being major traits related to anxiety which also turned out to be strongly associated with metacognition. In case of the models for the categories of metacognition, emotional reactivity was associated with negative beliefs, perseveration with negative and positive beliefs, while briskness predicted anxiety independently of metacognition.
These results suggest the existence of more specific associations between temperament traits, anxiety, and various types of metacognition. Metacognition is a core concept in the metacognitive model of psychopathology and psychotherapy, a relatively new approach which has grown out of the cognitive-behavioural tradition Wells , Metacognition is defined as the aspect of cognitive processing being responsible for the monitoring, evaluation, interpretation and regulation of the content of cognitions, and also for its own organization Moses and Biard It is assumed that since metacognition fulfils an executive function with regard to cognitive processing Wells , , it also plays a contributory role in emotional regulation.
Wells and Matthews , have proposed the Self-Regulatory Executive Function S-REF model, in which dysfunctional metacognition plays a central role in the development and maintenance of major forms of emotional disorder. The authors claim that maladaptive metacognitions play a leading role in emotional regulation and are responsible for the maintenance of a specific style of cognitive processing, attention focusing and coping behaviours, together termed cognitive-attentional syndrome CAS.
Through its association with extended thinking about past or future issues rumination, worrying , the focusing of attention upon threats, and also with the selection of coping strategies such as avoidance or assurance-seeking, it has the effect of prolonging the negative emotional states being the symptoms of emotional disorders. Maladaptive metacognition and other symptoms of CAS have been found to be positively associated with various psychological constructs, such as state or trait anxiety Irak and Tosun ; Spada et al.
Hermans et al. Temperament as one of the basic factors contributing to the development of vulnerability to psychopathology, has a long history of scientific study Taylor et al.
Temperament can be viewed as a sub-class of personality traits: a relatively stable tendency to react to situations in a particular way Buss and Plomin ; Strelau Rothbart et al. Rettew et al.
Supporting such findings, behaviour genetics studies e. Dragan and Oniszczenko ; Oniszczenko and Dragan have shown that temperament traits being related to anxiety may share certain genetic underpinnings with the symptoms of anxiety disorders. The cognitive model, for example, explains this assumption in terms of information processing based on hypervigilance to threat, and also disordered interpretations Taylor et al. This model emphasises the roles of worry and avoidance: two strategies in effect serving to maintain states of anxiety, and also being consistent with such temperamental tendencies as emotional reactivity or perseveration.
Van der Heiden et al. The model included general vulnerability factors such as neuroticism and extraversion, and also specific vulnerability factors such as intolerance of uncertainty and metacognitive beliefs positive and negative.
The authors found that negative beliefs mediated the relationship between neuroticism and symptoms of GAD. Dragan et al. RTT states that temperament has the regulative function of moderating the energetic and temporal aspects of all kinds of behaviour, and that individual differences in temperament traits may be observed throughout life, from early infancy onwards however, most studies on RTT have been conducted upon adults.
A meta-analysis of the research conducted regarding RTT shows that certain of these temperament traits are associated with anxiety, and also suggests that they contribute to psychopathology Strelau and Zawadzki Emotional reactivity is defined as the tendency to react intensively to emotion-generating stimuli, and is expressed in terms of high emotional sensitivity and low emotional endurance. Perseveration is the tendency to continue and repeat behaviours, and to experience emotional states following a cessation of the stimuli evoking those behaviours or states.
Briskness is the tendency to react quickly, maintaining a high tempo in the performing of activities, and easily shifting from one behaviour to another in response to changes in surroundings. The authors assume that metacognitively directed emotional regulation develops during the process of interaction between dispositional and situational factors. It therefore follows that certain temperament traits may serve as a constitutional basis during this process.
An individual becomes prone to psychopathology as a result of the development of maladaptive metacognition, being shaped by unfavourable constitutional characteristics and experiences. Thus, the effects of genetically determined temperament may be transmitted as a result of the nature of volitional mental control processes.
For example, emotional reactivity may lead to the development of specific metacognitive strategies aimed at coping with intense emotions. Maladaptive metacognitions learned throughout development, for instance positive beliefs about worry e.
An undifferentiated trait such as emotional reactivity thus effectively becomes channelled, as a result of being metacognitively directed towards manifesting in certain ways such as persistent worrying, or the sustained dysfunctional appraisal of internal mental processes , into a vulnerability to pathological anxiety. To date, the relationship between RTT traits, anxiety and metacognition has been tested in just one study. The primary purpose of the present study, given that metacognitive theory refers primarily to psychopathology, was to evaluate the role of metacognition as a potential mediator of the relationship between RTT temperament traits and anxiety, in a clinical sample, and employing the structural equation modeling SEM approach.
In line with the literature e. Strelau and Zawadzki ; Dragan et al. Moreover, in order to examine more specific associations, the proposed model was tested separately in groups of males and females, and also with reference to various categories of maladaptive metacognition.
In line with the theoretical assumptions of the S-REF model, stating that maladaptive metacognition is universal among emotional disorders, participants were recruited from among psychiatric patients diagnosed with a range of anxiety disorders. Ultimately, a total sample of participants were recruited, all of whom were undergoing treatment at three Warsaw-area State health service psychiatric inpatient clinics treating patients with anxiety and stress-related disorders.
One of the admission criteria of these clinics was the ability to participate in psychotherapy. Their diagnoses had been made prior to their current hospitalization, and had been verified by psychiatric interview in the course of their latest pre-hospitalization assessment. The most prevalent diagnosis was mixed anxiety and depressive disorder The sample contained The participants were most often married The proportion in employment amounted to More than half of the sample The participants were informed of the objectives and procedure, and also gave their informed consent prior to the study.
In the course of the psychological assessment, a battery of measures was administered to participants, including the following questionnaires:. This questionnaire includes six dimensions, in line with RTT: briskness, perseveration, sensory sensitivity, emotional reactivity, endurance and activity.
In line with the theoretical assumptions made, the study focussed on the three dimensions relating to temperament traits: emotional reactivity ER , briskness BR and perseveration PE. FCB-TI has good psychometric parameters, e. Cronbach alphas ranging from.
In the current study, Cronbach alphas for the three subscales analysed were as follows: for ER. State anxiety X-I is a measure of current symptoms, whereas trait anxiety X-II is a relatively stable personality trait.
In line with the theoretical assumptions underlying the current study, the objective was to predict the anxiety state as opposed to trait anxiety, with the aim of assessing current anxiety symptoms and reducing the conceptual and measurement overlap with the more stable, personality and temperamental dimensions being assessed. The Metacognitions Questionnaire MCQ Wells and Cartwright-Hatton measures individual differences in the metacognitive beliefs, judgments and monitoring tendencies considered important in the metacognitive model of psychopathology.
The original version of MCQ displays good psychometric properties Spada et al. The Polish version of the scale also has good psychometric properties e. Cronbach alphas for the subscales ranged from. In order to test the relationship between temperament traits, maladaptive metacognition and anxiety, the structural equation modeling technique SEM was employed, with the use of the generalized least squares GLS method. In SEM, the proposed hypothesised model is evaluated for its goodness of fit with the actual observations in the sample data Byrne The Sobel test was used to determine if the observed mediation effects are significant.
Comparisons of means by gender revealed statistically significant differences in negative beliefs about thoughts concerning uncontrollability and danger, and also in emotional reactivity in both cases, females scored significantly higher. Correlations were calculated between the general index of metacognitions, the individual subscales of metacognitions, state anxiety level, as well as the three temperament traits. Of the three temperament traits two—emotional reactivity and briskness—were correlated both with maladaptive metacognitions and with anxiety emotional reactivity correlated positively, briskness negatively.
In connection with the third trait—perseveration—no such result was observed: it was positively correlated with metacognitions, but not with anxiety.
The proposed structural model of the variables being tested did not fit the data well, either for the whole sample, or for the subgroups of males and females, or in the case of individual categories of metacognition. Standardized estimates are reported. Due to theoretical considerations, correlations between measurement errors for temperament traits were permitted.
They all fall within acceptable ranges, suggesting a good fit of the model. The three paths—between each of the three temperament traits and anxiety: ER-anxiety, PE-anxiety and BR-anxiety—turned out to be statistically non-significant, and were therefore not included in the final model. Structural equation model with the standardized path coefficients between three temperament traits, maladaptive metacognition, and anxiety.
Note : e error. The models identified for the male and female groups with reference to the general index of metacognitions are depicted in Fig.
The ER-anxiety path was not significant and was not included in the final model. In the model identified for females, only one temperament trait was included, namely emotional reactivity. The ER-anxiety path was not significant and was not included in the final model; this implies full mediation of metacognition. Structural equation models with the standardized path coefficients identified for the male and female groups.
ER emotional reactivity, BR briskness; a model identified for male group, b model identified for female group. All of them suggest a very good fit for the models. A similar model was identified for self-consciousness. For cognitive confidence, the model identified appears quite different. Two of the three RTT traits were included: emotional reactivity and briskness. In the case of the next model identified—for negative beliefs regarding uncontrollability and danger—two traits were included: emotional reactivity and perseveration.
In the current study we tested a relatively simple model in which, using maladaptive metacognition as an intervening variable, we attempted to clarify the relationships between state anxiety and three RTT traits. The results show metacognition being a significant mediator of the relationship between the three RTT traits and state anxiety, for the entire sample.
The results of the SEM analysis indicate that a significant mediation effect for metacognition was observed in two out of the three temperament traits: emotional reactivity and perseveration. Namely, effects of full mediation were observed in the identified model Fig. This fact was further confirmed in the models identified separately for the male and female subgroups Fig. These results can be interpreted with reference to earlier research by van der Heiden et al.
Moreover, a comparison of the results from the current study and van der Heiden et al.
Metacognition is " cognition about cognition", " thinking about thinking", " knowing about knowing", becoming "aware of one's awareness " and higher-order thinking skills. The term comes from the root word meta , meaning "beyond", or "on top of". Metamemory , defined as knowing about memory and mnemonic strategies, is an especially important form of metacognition. This higher-level cognition was given the label metacognition by American developmental psychologist John H. Flavell The term metacognition literally means 'above cognition', and is used to indicate cognition about cognition, or more informally, thinking about thinking.
Setting the Stage: Metacognition and Cognitive Therapy. The Self-Regulatory Executive Function (S-REF) Model. Metacognition and Emotional Disorder.
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Anxiety and depression are common among patients with chronic physical illnesses and have a significant impact on morbidity, quality of life, and health service utilisation. Psychological treatment of anxiety and depression has small to moderate efficacy in this group and is not commonly based on a model of causal mechanisms. A novel approach to understanding and improving mental health outcomes in physical illnesses is needed. One approach may be to explore the role of metacognitive beliefs which are reliably associated with anxiety and depression in individuals with mental health difficulties. The current systematic review aimed to evaluate the contribution of metacognitive beliefs to anxiety and depression across physical illnesses.
Yafteh Lorestan University of Medical Sciences. Remember me Create Account Reset Password. The relationship between metacognitive beliefs and anxiety and depression disorder.
Он ни за что не установил бы переключатель, позволяющий действовать в обход… - Стратмор заставил. - Она не дала ему договорить. Бринкерхофф почти физически ощущал, как интенсивно работают клеточки ее мозга. - Помнишь, что случилось в прошлом году, когда Стратмор занимался антисемитской террористической группой в Калифорнии? - напомнила. Бринкерхофф кивнул. Это было одним из крупнейших достижений Стратмора. С помощью ТРАНСТЕКСТА, взломавшего шифр, ему удалось узнать о заговоре и бомбе, подложенной в школе иврита в Лос-Анджелесе.
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Emotional Disorders and Metacognition: Innovative Cognitive Therapy. Author(s):. Adrian Wells. First published:1 January Print ISBN