Metacognitive Beliefs Uniquely Contribute to Interpersonal Problems: A Test Controlling for Adult Attachment, Big-5 Personality Traits, Anxiety, and Depression.

Henrik Nordahl,Odin Hjemdal,Adrian Wells

doi:10.3389/fpsyg.2021.694565

Abstract

Interpersonal difficulties are common across psychological disorders and are a legitimate target of treatment. Psychotherapeutic models differ in their understanding of interpersonal problems and how these problems are formulated and treated. It has been suggested that they are both the cause and effect of emotional distress symptoms, that they result from early attachment experiences, and that they are related to personality dimensions. However, the metacognitive model of psychopathology predicts that emotion disorder symptoms and interpersonal problems are linked to a common set of factors involving dysfunctional metacognition. In support of this view, metacognitive therapy has substantially reduced interpersonal problems in patients with anxiety and depression even though interpersonal problems are not directly targeted, indicating a role for metacognitive change. Nevertheless, the relationship between interpersonal problems and metacognitive beliefs remains underexplored, and the statistical control of emotion symptoms, personality, and attachment is important in substantiating any metacognition effects. The aim of the present study was therefore to test metacognitive beliefs as statistical predictors of interpersonal problems while controlling for anxiety/depression, adult attachment, and the Big-5 personality dimensions. In a cross-sectional study, 296 participants completed a battery of self-report questionnaires. We found that positive- and negative-metacognitive beliefs, cognitive confidence, and cognitive self-consciousness accounted for significant and unique variance in interpersonal problems together with avoidant attachment and conscientiousness when the overlap between all predictors was controlled. These findings support the notion that metacognitive beliefs are relevant to interpersonal problems with the potential implication that metacognitive therapy could have particularly broad effects on both emotion disorder symptoms and interpersonal problems.

Highlights

IntroductionInterpersonal problems are central to personality disorders (Hopwood et al, 2013; Wilson et al, 2017) and are common in axis-I disorders including anxiety disorders (Eng and Heimberg, 2006; Cain et al, 2010; Tonge et al, 2020), posttraumatic stress (Elmi and Clapp, 2021), obsessive compulsive disorder (Solem et al, 2015), eating disorders (Hartmann et al, 2010; Arcelus et al, 2013), and major depressive disorder (Bird et al, 2018)
Gender and age entered as a block were non-significant as predictors, and neither of them accounted for unique variance in interpersonal problems
To the authors’ knowledge, this is the first study to investigate metacognitive beliefs as statistical predictors of interpersonal problems and to evaluate their relative contribution when controlling for gender/age, anxiety, depression, adult attachment, and the Big-5 personality dimensions

Summary

Introduction

Interpersonal problems are central to personality disorders (Hopwood et al, 2013; Wilson et al, 2017) and are common in axis-I disorders including anxiety disorders (Eng and Heimberg, 2006; Cain et al, 2010; Tonge et al, 2020), posttraumatic stress (Elmi and Clapp, 2021), obsessive compulsive disorder (Solem et al, 2015), eating disorders (Hartmann et al, 2010; Arcelus et al, 2013), and major depressive disorder (Bird et al, 2018) They are frequent complaints in those seeking psychotherapy (Horowitz et al, 1988) and predict less improvement in therapy and greater dropout (Hilbert et al, 2007; Renner et al, 2012; Dinger et al, 2013; Quilty et al, 2013; McEvoy et al, 2014; Newman et al, 2017). More nuanced analyses of the relationships between the Big-5 and interpersonal problems indicate that the personality dimensions are consistently associated with interpersonal functioning even at the facet level, and it has been argued that integrating personality profiles with profiles of interpersonal functioning can facilitate personality assessment (Du et al, 2020)

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