Metapoznanie nasila depresję poprzez cechę lęku: badania w populacji osób zdrowych psychicznie
Keywords:
depresja; lęk; metapoznanie; analiza mediacji
Abstract
Wyniki dotychczasowych badań wskazują, że nieadaptacyjne przekonania metapoznawcze mogą być przyczyną objawów psychopatologicznych w postaci nadmiernego lęku i depresji. Ponadto ostatnie badania pokazują również, że lęk może nasilać objawy depresji. W naszym badaniu kwestionariuszowym sprawdzaliśmy hipotezę, czy czynnik lęku może być mediatorem zależności między nieprawidłowymi przekonaniami metapoznawczymi a objawami depresyjnymi u osób zdrowych. W badaniach udział wzięło 208 osób zdrowych, które odpowiadały na pytania Kwestionariusza Przekonań Metapoznawczych (MCQ), Inwentarza Stanu i Cechy Lęku (STAI) i Skali Depresji Becka (BDI). W celu zbadania zależności między lękiem jako mediatorem a metapoznaniem i objawami depresji wykorzystano analizę mediacji. Na podstawie badań stwierdzono, że czynniki, takie jak pozytywne przekonania o zamartwianiu się, negatywne przekonania o myślach odnoszących się do braku kontroli i zagrożenia, niska pewność poznawcza, negatywne przekonania dotyczące konsekwencji braku kontroli nad myślami oraz samoświadomość poznawcza, były zależne od poziomu lęku związanego z nasileniem objawów depresji. Ponadto analiza mediacji wskazała, że jedynie przekonania o pewności poznawczej miały bezpośredni wpływ na nasilenie się objawów depresji.
References
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Wells, A., & Cartwright-Hatton, S. (2004). A short form of the Metacognitions Questionnaire: Properties of the MCQ-30. Behaviour Research and Therapy, 42(4), 385-396.
Wells, A., Fisher, P., Myers, S., Wheatley, J., Patel, T., & Brewin, C. R. (2009). Metacognitive therapy in recurrent and persistent depression: A multiple-baseline study of a new treatment. Cognitive Therapy and Research, 33(3), 291-300.
Wells, A., & Matthews, G. (1996). Modelling cognition in emotional disorder: The S-REF model. Behaviour Research and Therapy, 34(11), 881-888.
Wittchen, H. U. (1996). Critical issues in the evaluation of comorbidity of psychiatric disorders. The British Journal of Psychiatry, 168, 9-16.
Wittchen, H. U., Kessler, R. C., Pfister, H., Höfler, M., & Lieb, R. (2000). Why do people with anxiety disorders become depressed? A prospective‐longitudinal community study. Acta Psychiatrica Scandinavica, 102(406), 14-23.
Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361-370.
Beck, A. T., & Alford, B. A. (2009). Depression: Causes and treatment (2nd ed.). Philadelphia: University of Pennsylvania Press.
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 562(4), 53-63.
Beekman, A. T., de Beurs, E., van Balkom, A. J., Deeg, D. J., van Dyck, R., & van Tilburg, W. (2000). Anxiety and depression in later life: Co-occurrence and communality of risk factors. American Journal of Psychiatry, 157(1), 89-95.
Carson, R. C., Butcher, J. N., & Mineka, S. (1998). Abnormal psychology and modern life (10th ed.). New York: Longman.
Cartwright-Hatton, S., & Wells, A. (1997). Beliefs about worry and intrusions: The Meta- -Cognitions Questionnaire and its correlates. Journal of Anxiety Disorders, 11(3), 279-296.
Cox, B. J., Enns, M. W., & Larsen, D. K. (2001). The continuity of depression symptoms: Use of cluster analysis for profile identification in patient and student samples. Journal of Affective Disorders, 65(1), 67-73.
Gawęda, Ł., Cichoń, E., & Szczepanowski, R. (2015). Dysfunctional meta-cognitive beliefs mediate the relation between temperament traits and hallucination-proneness in non-clinical population. Psychiatry Research, 229(3), 1047-1051.
Gawęda, Ł., & Kokoszka, A. (2014). Meta-cognitive beliefs as a mediator for the relationship between Cloninger’s temperament and character dimensions and depressive and anxiety symptoms among healthy subjects. Comprehensive Psychiatry, 55(4), 1029-1037.
Hayes, A. F. (2012). PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling. [White paper]. Retrieved from http://www. afhayes.com/public/process2012.pdf
Hayes, A. F., Preacher, K. J., & Myers, T. A. (2011). Mediation and the estimation of indirect effects in political communication research. In E. P. Bucy & H. R. Lance (Eds.), Sourcebook for political communication research: Methods, measures, and analytical techniques (pp. 434-465). New York: Routledge.
Kessler, R. C., McGonagle, K. A., Zhao, S., Nelson, C. B., Hughes, M., . . . & Kendler, K. S. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the National Comorbidity Survey. Archives of General Psychiatry, 51(1), 8-19.
Papageorgiou, C. i Wells, A. (1999). Process and meta‐cognitive dimensions of depressive and anxious thoughts and relationships with emotional intensity. Clinical Psychology & Psychotherapy, 6(2), 156-162.
Papageorgiou, C., & Wells, A. (2001). Metacognitive beliefs about rumination in recurrent major depression. Cognitive and Behavioral Practice, 8(2), 160-164.
Papageorgiou, C., & Wells, A. (2003). An empirical test of a clinical metacognitive model of rumination and depression. Cognitive Therapy and Research, 27(3), 261-273.
Parnowski, T., & Jernajczyk, W. (1976). Inwentarz Depresji Becka w oceniena stroju osób zdrowych i chorych na choroby afektywne [Beck’s Depression Inventory in the rating of mood in normal subjects and in patients with affective disturbances]. Psychiatria Polska, 11, 417-421.
Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments, & Computers, 36(4), 717-731.
Sosnowski, T., Wrześniewski, K., Jaworoska, A., & Ferenc, D. (2002). STAI – Inwentarz Stanu i Cechy Lęku [STAI – State–Trait Anxiety Inventory]. Warsaw, PL: Polish Psychological Association.
Spada, M. M., Mohiyeddini, C., & Wells, A. (2008a). Measuring metacognitions associated with emotional distress: Factor structure and predictive validity of the Metacognitions Questionnaire 30. Personality and Individual Differences, 45(3), 238-242.
Spada, M. M., Nikčević, A. V., Moneta, G. B., & Wells, A. (2008b). Metacognition, perceived stress, and negative emotion. Personality and Individual Differences, 44(5), 1172-1181.
Spielberger, C. D., Gorssuch, R. L., Lushene, P. R., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the State–Trait Anxiety Inventory. Menlo Park, CA: Consulting Psychologists Press.
Varese, F., & Bentall, R. P. (2011). The metacognitive beliefs account of hallucinatory experiences: A literature review and meta-analysis. Clinical Psychology Review, 31(5), 850-864.
Wells, A. (2000). Emotional disorders and metacognition: Innovative cognitive therapy. Chich-ester. United Kingdom: Wiley.
Wells, A. (2009). Metacognitive therapy for anxiety and depression. New York: Guilford Press.
Wells, A., & Cartwright-Hatton, S. (2004). A short form of the Metacognitions Questionnaire: Properties of the MCQ-30. Behaviour Research and Therapy, 42(4), 385-396.
Wells, A., Fisher, P., Myers, S., Wheatley, J., Patel, T., & Brewin, C. R. (2009). Metacognitive therapy in recurrent and persistent depression: A multiple-baseline study of a new treatment. Cognitive Therapy and Research, 33(3), 291-300.
Wells, A., & Matthews, G. (1996). Modelling cognition in emotional disorder: The S-REF model. Behaviour Research and Therapy, 34(11), 881-888.
Wittchen, H. U. (1996). Critical issues in the evaluation of comorbidity of psychiatric disorders. The British Journal of Psychiatry, 168, 9-16.
Wittchen, H. U., Kessler, R. C., Pfister, H., Höfler, M., & Lieb, R. (2000). Why do people with anxiety disorders become depressed? A prospective‐longitudinal community study. Acta Psychiatrica Scandinavica, 102(406), 14-23.
Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361-370.
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