Metacognition increases the severity of depression through trait anxiety in a nonclinical population
Keywords:
depression; anxiety; metacognition; mediation analysis
Abstract
Previous studies show that maladaptive metacognitive beliefs may constitute the psychopathological core of anxiety and depression. Recent findings also indicate that anxiety exacerbates the severity of depression. We investigated the hypothesis that anxiety mediates the relationship between faulty metacognitive beliefs and depressive symptoms in normal subjects. Two hundred and eight normal participants completed the Metacognitions Questionnaire (MCQ), the State-Trait Anxiety Inventory(STAI), and the Beck Depression Inventory (BDI). We performed mediation analysis to explore the relationships between metacognition, depression, and trait anxiety as a mediator. Our study showed that positive beliefs about worry, negative beliefs about uncontrollability and danger, low cognitive confidence, and negative beliefs about the need to control thoughts, and cognitive self-consciousness were mediated by the level of anxiety associated withthe severity of depression. Moreover, the mediation analysis indicated that only cognitive confidence beliefs directly influenced the intensity of depressive symptoms.
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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