Cognitive Confidence Research Articles

Assessing the Effects of Depressed Mood and Cognitive Control Training on Memory Confidence and Accuracy Following Repeated Checking

Studies show that repeated checking leads to memory distrust in healthy controls. Additionally, the extent of this reduction in memory confidence has been associated with executive control. Utilizing a 2 × 2 design, we examine the role of mood and cognitive training targeting executive control on memory distrust following repeated checking. Participants were 69 individuals with depressed (n = 32) or euthymic (n = 37) mood. Memory distrust following a repeated checking task was assessed before and after 3 sessions of a computerized cognitive training program or a control task. Consistent with previous studies, participants reported reduced meta-memory following repeated checking. Although participants with depressed mood reported lower overall cognitive confidence at a trend level, the effect of repeated checking on memory distrust was not potentiated by depressed mood in our study. A reduction in memory distrust following repeated checking was found over time; however, this effect was not dependent on cog...

Does aging affect source monitoring and cognitive confidence in schizophrenia? Preliminary results

This study tested the influence of aging on source-monitoring and cognitive confidence deficits in schizophrenia. Younger (n=13) and older (n=10) schizophrenia patients were compared with younger (n=17) and older (n=10) healthy controls in the source-monitoring task. These preliminary results suggest that age negatively influences old/new item recognition, but not source monitoring, in both groups. Age has a negative impact on subjective confidence, but no interaction between group and age was found.

The relative contribution of metacognitions and attentional control to the severity of gambling in problem gamblers

The present study explored the relationship between metacognitions, attentional control, and the severity of gambling in problem gamblers. One hundred and twenty six problem gamblers completed the Depression Anxiety Stress Scales 21, the Meta-Cognitions Questionnaire 30, the Attentional Control Scale, and the Problem Gambling Severity Index. Results revealed that negative affect, four out of five metacognitions factors (positive beliefs about worry, negative beliefs about thoughts concerning danger and uncontrollability, cognitive confidence and beliefs about the need to control thoughts), and all attentional control factors (focusing, shifting and flexible control of thought) were correlated, in the predicted directions, with the severity of gambling. The same metacognitions were also found to be correlated, in the predicted directions, with attention focusing, however only negative beliefs about thoughts concerning danger and uncontrollability and cognitive confidence were found to be correlated with attention shifting and flexible control of thought. A hierarchical regression analysis showed that beliefs about the need to control thoughts were the only predictor of the severity of gambling controlling for negative affect. Overall these findings support the hypotheses and are consistent with the metacognitive model of psychological dysfunction. The implications of these findings are discussed.

Abstract T MP83: Simulation Based Medical Education For Incoming Neurology Trainees to Improve Hospital Stroke Emergency Performance

INTRODUCTION: An ED-based “stroke code” demands timely decision making and prioritization of tasks by the stroke team neurologist while coordinating care with ED staff, radiology and pharmacists. Simulation-based medical education (SBME) focuses on obtaining clinical skills belonging to the psychomotor, cognitive and affective domains. SBME is superior to the traditional style of medical education and has shown improved outcomes of knowledge, skills and behaviors and moderate effects for patient-related outcomes in other emergency based scenarios including ACLS and procedure-based learning. HYPOTHESIS: To describe the rationale and design for a novel hospital based stroke simulation. SBME can improve stroke code efficiency particularly for inexperienced stroke team members. METHODS: Six incoming PG2 neurology residents participated in a pilot study using a high fidelity patient simulation of an acute ED-based stroke code at week 1 and 3 of orientation. The trainee independently managed every step from activation of the stroke pager including a focused patient assessment, ordering and interpreting labs and imaging, managing common obstacles, staffing with the on-call attending, working with ancillary staff and appropriate treatment as indicated. Residents completed an affective survey, pre- and post-test cognitive assessment and debriefing with feedback, as well as real time checklist and review of videotaped assessment of their performance. RESULTS: Subjects showed a 16.1% improvement in the cognitive assessment from week 1 to week 3 (p=0.02). The affective survey showed residents were moderate to highly confident in their ability to perform a history and physical prior to participation, yet they had low confidence utilizing the NIHSS and managing medications for acute stroke in the ED prior to participation. CONCLUSION: SBME can facilitate the acquisition of technical and non-technical skills such as leadership, team work, communication, situational awareness, decision-making, cognizance of personal limitations important for patient safety and a learning cycle of debriefing and feedback. Post-test and affective survey results demonstrate improvements in the cognitive domain and resident confidence respectively.

A diary study of the phenomenology and persistence of compulsions

Background and objectivesResearch on the persistence of compulsions has found that, when making the decision to stop a compulsion, people with OCD weigh sensory and memory information as more important than external criteria. At the same time, research has also found that repetition of behaviour has a deleterious effect on memory, sensory and cognitive confidence. These findings have important treatment implications but they are almost exclusively laboratory based. This study sought to examine compulsions as they occur in vivo using a structured diary format. Methods22 People with a principal diagnosis of OCD completed measures of memory, sensory and cognitive confidence and used a structured diary to report on three compulsive episodes a day for three days. ResultsDespite repetition, a sense of certainty or the “right” feeling was achieved in over half of the compulsive episodes. The outcome of compulsive episodes was not influenced by distress over the obsession, nor was distress associated with negative beliefs about obsessions. Episodes in which certainly was not achieved were characterized by greater repetitions, greater memory, cognitive and sensory doubt and less certainty that the compulsion had been done properly. LimitationsThe sample size was modest, checking compulsions were over-represented and data were based on retrospective self-report, albeit 2-h on average. ConclusionsConsistent with laboratory studies, repetition has insidious effects on the persistence of compulsions. However, compulsions yielded a sense of certainty half the time, despite repetitions.

METACOGNITION AND HAPPINESS: THE MEDIATING ROLE OF PERCEIVED STRESS

IntroductionThis research aims to investigate mediating role of perceived stress between metacognition and happiness. It is based on innovative idea that metacognitive beliefs or experiences may sometimes lead to persistent and maladaptive forms of coping, and therefore relationship between perceived stress and emotion (in context of present study, happiness was preferred as an emotion) would be mediated by metacognitions. There is a considerable research gap in this area except for a few research studies (e.g., Wells, 1995). Previous studies have examined relationship between individual dimensions of metacognition and psychological disorders such as anxiety (Sheikh et al., 2013), depression (Papageorgiou & Wells, 2003; Wells, 2009; Yilmaz, 2007), hypochondriasis (Bouman & Meijer, 1999; Buwalda, Bouman, & Van Duijn, 2008), obsessive-compulsive symptoms (Mohammadkhani, 2013; Wells & Papageorgiou, 1998; Yilmaz, Gencoz, & Wells, 2008), pathological worry (Cartwright-Hatton & Wells, 1997; Wells & Carter, 2001; Yilmaz, Gencoz, & Wells, 2008), post-traumatic stress disorder (Holeva, Tarrier, & Wells, 2001), psychosis (Morrison, Wells, & Nothard, 2000), problem drinking (Spada & Wells, 2005; Spada, Zandvoort, & Wells, 2007), and test-anxiety (Spada, Nikcevic, Moneta, & Ireson, 2006). However, issue of how perceived stress mediates between metacognition and happiness has not been tested.In this paper, I start by explaining concepts of metacognition, stress and happiness, and continue with presentation of hypotheses of this research in relation to study aim. Next, I present methods of study followed by results. In final section, I discuss study findings in association with related literature.MetacognitionMetacognition has been a very popular term in psychology since 1970s and it was presented by Flavell (1979); he defined metacognition as and about cognitive phenomena (p.906). Metacognition refers to knowledge, processes, and strategies that appraise, monitor, and control (Flavell, 1979; Wells, 2000). Other definitions widely accepted in literature are about and about cognition (Brown 1987; Garner & Alexander, 1989; Jacops & Paris, 1987, Wellman (1985).From a clinical psychology perspective, metacognition is defined as the psychological structures, knowledge, events, and processes that are involved in control, modification, and interpretation of thinking itself (Wells & Cartwright-Hatton, 2004, p. 385). In cognitive psychology, metacognition can be defined as stable knowledge or beliefs about one's own cognitive system, and knowledge about factors that affect functioning of system; regulation and awareness of current state of cognition, and appraisal of significance of thought and memories (Wells, 1995, p. 302). However, meta-cognition does not have only positive structures but also negative ones (Saricam & Akin, 2015). The metacognitive model of psychopathology is based on theoretical account named Self-Regulatory Executive Function (S-REF, Wells & Matthews, 1994). The S-REF model describes mechanisms of problematic information processing that ultimately results in emotional disorders. The S-REF theory conceptualizes multiple metacognitive factors as control mechanisms of information processing that influences development and persistence of psychological disorders. In literature, it was observed that S-REF theory has affected development of current disorder specific models and treatment procedures of GAD, obsessions, depression, PTSD, and social phobia (Papageorgiou & Wells, 2003; Holeva, Tarrier, & Wells, 2001; Wells, 2000).Wells and Cartwright-Hatton (2004) declared metacognition as composed of five correlated but conceptually distinct sub-dimensions: 1) Positive Beliefs about Worry, which assesses extent to which a person believes that ruminative thinking is useful; 2) Negative Beliefs about Worry Concerning Uncontrollability and Danger, which measures extent to which a person thinks that ruminative thinking is dangerous and uncontrollable; 3) Lack of Cognitive Confidence, assessing confidence in attention and memory; 4) Beliefs about Need to Control Thoughts; and 5) Cognitive Self-consciousness, which measures tendency to monitor one's own thoughts and focus attention inwards. …

Differential memory effects for encoding and retrieving disorder-relevant contents in relation to checking

Background and objectivesObsessive-compulsive (OC) checkers have been shown to be impaired in memory. However, when encoding OC-related material, OC checkers exhibit superior recall. This study aims to investigate emotion-related memory performance in relation to checking using newly developed OC-specific material. Additionally, metacognitive characteristics such as cognitive confidence were considered. MethodIn a sample of 63 participants (including 26 participants with obsessive-compulsive disorder), immediate and delayed recall for neutral stories and for OC-specific stories containing checking- and washing-related content were assessed. Regression analyses were applied to investigate the relationship to checking symptoms. The influence of metacognitive characteristics on recall was also examined. ResultsHigher checking was related to significantly better memory performance for a checking-related story as compared to two neutral stories. However, higher checking was also related to higher rates of forgetting of the OC-specific material over the delay period. Rates of forgetting in relation to checking were mediated by cognitive confidence. Diagnostic status was not predictive of any outcome variables. LimitationsThe use of typical and not idiosyncratic verbal material may limit the ecological validity of these findings. ConclusionsIn relation to high checking, different disorder-related cognitive and affective processes seem to interfere with memory encoding and retrieval at different stages. Metacognitive therapy methods might address these processes and thereby lead to a reduction of both cognitive impairment and OC symptoms.

P.6.b.009 High-risk alcohol relapse scale is a good instrument for predicting long-term abstinence after an episode of alcoholic hepatitis

Previous studies suggest that temperament and character may impact depression and anxiety through dysfunctional cognition. This study targets the mediating role of meta-cognitive beliefs in the relationship between Cloninger’s temperament and character dimensions and symptoms of depression and anxiety.One hundred and sixty-one healthy subjects filled out Cloninger’s Temperament Character Inventory (TCI), a Metacognitions Questionnaire (MCQ), the Beck Depression Inventory (BDI) and the State and Trait Anxiety Inventory (STAI). Correlation and mediation analyses according to Baron and Kenny’s method were performed.Harm avoidance (HA) and self-directedness (SD) were related to depression and anxiety. HA was related to negative beliefs about uncontrollability of thoughts and to beliefs about cognitive confidence. SD was associated with the same types of meta-cognitive beliefs and with general negative beliefs. Cooperativeness (CO) was related to positive beliefs about worry, beliefs about cognitive confidence and to general negative beliefs. Self-transcendence (ST) was related to all types of meta-cognitive beliefs. Mediation analysis revealed that the relationship between HA and depression and anxiety is partially mediated by certain types of meta-cognitive beliefs. The same results were obtained for the relationship between SD and depression and anxiety. General negative beliefs fully mediated the relationship between CO and depression and the relationship between ST and anxiety.Meta-cognitive beliefs mediate the relationship between temperament and character dimension and depressive and anxiety symptoms, thus providing further evidence for the meta-cognitive theory of emotional disorders as presented by Wells and Matthews (Behav Res Ther 1996;32:867-870).

A Prospective Study of the Association of Metacognitive Beliefs and Processes with Persistent Emotional Distress After Diagnosis of Cancer.

Two hundred and six patients, diagnosed with primary breast or prostate cancer completed self-report questionnaires on two occasions: before treatment (T1) and 12 months later (T2). The questionnaires included: the Hospital Anxiety and Depression Scale; Impact of Events Scale; the Metacognitions Questionnaire-30 (MCQ-30) and the Illness Perceptions Questionnaire-revised. A series of regression analyses indicated that metacognitive beliefs at T1 predicted between 14 and 19 % of the variance in symptoms of anxiety, depression and trauma at T2 after controlling for age and gender. For all three outcomes, the MCQ-30 subscale ‘negative beliefs about worry’ made the largest individual contribution with ‘cognitive confidence’ also contributing in each case. For anxiety, a third metacognitive variable, ‘positive beliefs about worry’ also predicted variance in T2 symptoms. In addition, hierarchical analyses indicated that metacognitive beliefs explained a small but significant amount of variance in T2 anxiety (2 %) and T2 depression (4 %) over and above that explained by demographic variables, T1 symptoms and T1 illness perceptions. The findings suggest that modifying metacognitive beliefs and processes has the potential to alleviate distress associated with cancer.

Overconfidence across world regions

In this paper we compare nine world regions (based on samples from 33 nations) in their performance on a cognitive ability test and confidence ratings obtained from the items of the same test. Our results indicate that differences between the world regions are greater on accuracy measures than they are on confidence ratings. Consequently, overconfidence is strongly pronounced within the world regions that have lower scores on measures of cognitive ability. Commonly observed overconfidence can be seen as a defense mechanism that cushions a person from experiencing negative feelings due to failure. Relatedly, at the national level, overconfidence can be interpreted as a means to preserving common dignity.

Individual differences in decision-making and the role of cognitive confidence

The present study focused on identifying the generality of decision-making and whether preceding judgement accuracy and confidence were significant predictors of such behaviour. 116 undergraduate psychology students completed four cognitive ability tests and a personality questionnaire. All items were accompanied with confidence ratings and the decision to accept or reject ones answer. A consistent pattern of positive intercorrelations between decision-making indices suggested a more general decision-making factor. That is, despite some sensitivity to varying cognitive requirements, individuals demonstrated consistent tendencies to accept or reject their answers, relative to others. General Accuracy and Confidence factors also emerged and, after controlling for each other, were positively related to these general tendencies. Personality was not a consistent predictor of any indices. Implications are that individual differences in decision-making exist and are somewhat accounted for by stable differences in Ability and Confidence.

Comparison of Meta-Cognitive Beliefs with Regard to Depressed, Obsessive-Compulsive and Normal Individuals

The main purpose of the present study was to investigate and compare the meta-cognitive beliefs of three groups consisting of depressed, obsessive-compulsive and normal individuals. This expost facto study was carried out on 174 individuals (58 depressed, 58 obsessive-compulsive, and 58 normal). The depressed and obsessive-compulsive patients were selected from psychological clinics in central and southern Tehran using purposive sampling. The normal group was randomly selected from the staff of the related clinics. Participants completed three questionnaires including the Beck Depression Inventory-II (BDI-II), the Maudsley Obsessive-Compulsive Inventory (MOCI), and the Meta-CognitionsQuestionnaire-30 (MCQ-30). The MANOVA test was used to analyze the statistical data. There were significant differences between the mean scores with regard to the meta-cognitive beliefs in normal individuals and in patients with depression or obsessive-compulsive disorders. Furthermore, with regard to cognitive confidence and cognitive self-consciousness subscales, there were significant differences between depressed and obsessive-compulsive patients. The mean scores of these two subscales were higher in obsessive-compulsive patient, in comparison with depressed individuals. There was no significant difference between the depressed and obsessive-compulsive groups regarding the three subscales of positive beliefs about worry, uncontrollability and need to control thoughts.

Meta-cognitive beliefs as a mediator for the relationship between Cloninger’s temperament and character dimensions and depressive and anxiety symptoms among healthy subjects

BackgroundPrevious studies suggest that temperament and character may impact depression and anxiety through dysfunctional cognition. This study targets the mediating role of meta-cognitive beliefs in the relationship between Cloninger’s temperament and character dimensions and symptoms of depression and anxiety. MethodOne hundred and sixty-one healthy subjects filled out Cloninger’s Temperament Character Inventory (TCI), a Metacognitions Questionnaire (MCQ), the Beck Depression Inventory (BDI) and the State and Trait Anxiety Inventory (STAI). Correlation and mediation analyses according to Baron and Kenny’s method were performed. ResultsHarm avoidance (HA) and self-directedness (SD) were related to depression and anxiety. HA was related to negative beliefs about uncontrollability of thoughts and to beliefs about cognitive confidence. SD was associated with the same types of meta-cognitive beliefs and with general negative beliefs. Cooperativeness (CO) was related to positive beliefs about worry, beliefs about cognitive confidence and to general negative beliefs. Self-transcendence (ST) was related to all types of meta-cognitive beliefs. Mediation analysis revealed that the relationship between HA and depression and anxiety is partially mediated by certain types of meta-cognitive beliefs. The same results were obtained for the relationship between SD and depression and anxiety. General negative beliefs fully mediated the relationship between CO and depression and the relationship between ST and anxiety. ConclusionsMeta-cognitive beliefs mediate the relationship between temperament and character dimension and depressive and anxiety symptoms, thus providing further evidence for the meta-cognitive theory of emotional disorders as presented by Wells and Matthews (Behav Res Ther 1996;32:867-870).

The association between metacognitions, the obsessive compulsive symptom dimensions and hoarding: A focus on specificity

In recent year’s metacognitive theories – particularly the self-regulatory executive function model proposed by Wells and colleagues – have emerged as a potentially useful perspective from which to extend current cognitive-behavioral models for the mood and anxiety disorders. Metacognitions refer to different beliefs individuals endorse about their thoughts, internal states, and effective coping strategies. Research has linked these attitudes to obsessive compulsive symptoms (OCS), yet it remains unclear whether there may be a differential association with the different OCS dimensions and hoarding. The current study aimed to investigate the specific relationships between the OCS dimensions, hoarding, and metacognitions controlling for general distress. The sample (N=160) was comprised of young adults at a large university in Germany. Although all symptom types were significantly linked with the various metacognitions assessed (all p’s<.05), a series of linear regression analyses provided support for more nuanced and particular relationships. The analyses conducted allowed us to examine the specificity of any associations, by factoring out any shared variance between the different OCS dimensions and hoarding. Results revealed that (1) positive beliefs about worry were significantly associated with obsessions and ordering; (2) negative beliefs about uncontrollability were significantly associated with obsessions and checking; (3) cognitive confidence was significantly associated with ordering and hoarding; (4) beliefs about the need to control thoughts were significantly associated with obsessions, ordering, and hoarding; and (5) cognitive self-consciousness was significantly linked with obsessions and ordering. Additional analyses were conducted to examine the relationships between metacognitions, hoarding-specific beliefs, and hoarding symptoms. Results are discussed from the perspective of current theoretical models of OCD and hoarding and future directions are also highlighted.

Metacognition and negative emotions in clinical practice. A preliminary study with patients with bowel disorder

In the past few years psychological characteristics in patients with organic bowel disorder have been poorly considered. However recent studies underline that psychological features increase gastrointestinal symptoms. The aim of this study is to investigate metacognition and emotions in patients with organic bowel disorder and functional bowel disorder. 33 outpatients with organic diagnosis and 28 outpatients with functional diagnosis were assessed with MCQ-30, ANPS and Brief-Cope; moreover stress was evaluated in all outpatients. Results revealed that two groups show the same psychological disturbances and there are no differences between organic patients and functional patients. Statistical analysis indicated significant relations between dysfunctional metacognitive beliefs and negative emotions. Specifically, Beliefs of Uncontrollability and Danger (UD) are significantly related to Fear, Anger and Sadness . Moreover Fear and Anger are significantly related to stress; dysfunctional metacognitive beliefs are related to coping strategies. Beliefs of UD are related to Using Emotional Support; Positive Beliefs (PB) are related to Planning, while Cognitive Confidence (CC) is related to Self-Blame. Unexpectedly results are higher in patients with organic diagnosis. Our results suggest to reconsider psychological influences in patients with organic diagnosis of gastrointestinal disease. Keywords: Metacognition; Inflammatory bowel diseases; Functional gastrointestinal disorders; Emotions; Coping;

Metacognitive beliefs in unipolar and bipolar depression: A comparative study

Aims: The purpose of this study was to perform a comparative investigation of metacognitive beliefs regarding pathological worry in patients with unipolar and bipolar depressive disorder. Methods: Those subjects with acute depressive episodes among patients diagnosed with major depressive disorder (unipolar) or bipolar disorder on the basis of DSM-IV diagnostic criteria (unipolar n = 51, bipolar n = 45), and healthy controls (n = 60), were included in the study. Participants were administered the Meta-Cognitions Questionnaire (MCQ-30) in order to determine metacognitive beliefs. The relationship between metacognitive beliefs and anxiety severity, depression severity and self-esteem in the unipolar and bipolar patients groups was then examined. Results: Scores for negative beliefs about worry concerning uncontrollability and danger and for beliefs about the need to control thoughts were higher in both the unipolar and bipolar depression groups than in the healthy controls (P < 0.05). Lack of cognitive confidence scores were higher in the bipolar group than in the healthy controls (P < 0.05). Metacognitive beliefs (to a greater extent in parameters in the bipolar group) were correlated with anxiety level, depression level and self-esteem in both patient groups. Conclusion: In addition to metacognitive beliefs known to be associated with ruminations in unipolar and bipolar depression, metacognitive beliefs can also be seen in association with worry. Worry-associated metacognitive beliefs should be the subject of focus in the identification of metacognitive beliefs in depression patients and in metacognitive therapy in these patients.

The role of metacognitive beliefs in the proneness to hallucinations and delusions: An analysis across clinical and non‐clinical populations

This study explored specific and differential effects of metacognitive beliefs on proneness to both hallucinations and delusions in a general population sample, including a control for the alternate symptom. The study then examined whether similar findings were reproduced in a sample of people with psychotic disorders. Linear and hierarchical regressions were used to determine the role of metacognitive beliefs in the proneness to symptoms, whilst ANCOVAs analysed group differences. Participants were recruited to a non-clinical sample (N = 133) and a psychosis sample (N = 100). Both groups completed the Launay-Slade Hallucinations Scale-Revised (Laroi et al., ; Eur. Psychiatry, 19, 15), the Peters Delusions Inventory (Peters et al., ; Schizophr. Bull., 25, 553), and the Metacognitions Questionnaire-30 (Wells & Cartwright-Hatton, ; Behav. Res. Ther., 42, 385). Metacognitions were predictive of both hallucination- and delusion-proneness in the non-clinical sample. Controlled analyses in the non-clinical sample revealed specific effects: low cognitive confidence (CC) predicted hallucination-proneness, whilst negative beliefs about the uncontrollability and danger of thoughts (NBUD) predicted delusion-proneness. Mean ratings on NBUD, low CC, and need to control thoughts were elevated in the psychosis sample; however, after controlling for comorbid symptoms, no metacognitive belief predicted symptom-specific vulnerability in the clinical sample. The pattern of findings provided little support for Morrison's theoretical model of symptom-proneness. Metacognitive beliefs may be related to sub-acute vulnerability to psychosis symptoms; however, the specificity of the relationship between individual metacognitive beliefs and positive psychosis symptoms appeared no longer significant in psychosis patients. The possibility that these metacognitive beliefs are evoked by psychotic experiences, rather than primarily functioning as a driver of them, warrants greater attention. Metacognitive beliefs appear at least equally associated with delusion-proneness as hallucination-proneness. Negative metacognitive beliefs appear more central to delusion-proneness than hallucination-proneness in the general population. When controlling for alternate symptom, no individual metacognitive belief appears reliably able to predict symptom-proneness in psychosis patients. Consistent with existing literature on metacognitions in psychosis, this study adopted a cross-sectional design, meaning we were unable to determine the causal direction of the observed associations between metacognitive beliefs and symptom-proneness. Although a strength of this study design was its control for alternate psychotic symptoms, we did not control for non-psychotic symptoms, particularly, anxiety and depression. The symptom measures used were developed primarily for assessment of psychosis-proneness within the general population; thus, their use by people with established psychosis may have been less sensitive to clinical manifestations of these phenomena.

Metacognitive beliefs in adolescents with an at‐risk mental state for psychosis

The self-regulatory executive function model suggests that metacognitive beliefs play a role in all forms of psychological disorder, including psychosis. However, our understanding of these beliefs and their relationship with symptoms in adolescents with an at-risk mental state (ARMS) for psychosis is limited. The Metacognitions Questionnaire short form (MCQ-30) was administered to 31 adolescents with an identified ARMS. Scores were subsequently compared to a control group of 76 adolescents drawn from a community population. As predicted, ARMS patients scored significantly higher on metacognition subscales, with negative beliefs (F = 42.97, P = 0.001), cognitive confidence (F = 17.11, P = 0.001) and need for control (F = 22.48, P = 0.001) subscales of the MCQ-30 distinguishing them from the comparison group. The finding that metacognitive beliefs are significantly elevated in comparison to a community sample of adolescents is in keeping with previous adult-orientated research. Possible implications for clinical practice are discussed.

Metacognitions, worry and attentional control in predicting OSCE performance test anxiety

This study investigated the applicability of the self-regulatory executive functioning (S-REF) model to performance test anxiety (PTA) in objective structured clinical examinations (OSCEs). Specifically, it examined the relative contributions of metacognitive beliefs, trait worry and attentional control to PTA. A cross-sectional design was used. Immediately prior to their formative Communication for Clinical Practice OSCE, 240 Year 1 medical students completed the following self-report questionnaires: the Metacognitions Questionnaire-30 (MCQ-30); the Penn State Worry Questionnaire (PSWQ); the Attentional Control Scale (ACS), and the Performance Test Anxiety questionnaire (PTA). Univariate analysis indicated that female students scored significantly more highly than male students on the MCQ-30 subscale for negative beliefs about the uncontrollability and danger of worry, the MCQ-30 subscale for cognitive confidence and the PSWQ subscale for trait worry. Partial correlations (controlling for gender) showed that metacognitions, worry and attentional control were significantly correlated with PTA. Multiple regression analyses showed that worry and negative beliefs about the uncontrollability and danger of worry were independent predictors of PTA in both male and female students, whereas attention focus was an independent predictor only in male students. The findings support predictions derived from the S-REF model that metacognitive beliefs, trait worry and attentional control processes underlie the onset and maintenance of PTA.

Metacognitive differences between elderly and adult outpatients with generalized anxiety disorder

PurposeThe metacognitive model of generalized anxiety disorder in young adults involves positive beliefs about worrying and negative beliefs concerning the uncontrollability and the dangers of worrying. Many older adults are believed to have a decline and less control over their memory. Thus, metamemory should be another cause in elder patients with generalized anxiety disorder. The aim of the study was to investigate the metacognitive constructs of elder patients with generalized anxiety disorder. MethodThirty-three elder patients and 38 young adults with generalized anxiety disorder and 37 healthy elder individuals from Turkey enrolled in the study. All participants were asked to fill out the Meta-cognitions questionnaire, the Beck Depression Inventory (BDI) and Anxiety Inventory (BAI). ResultsThe mean anxiety score in young patients was significantly higher than both elder patient and healthy groups (P<0.0001, for both). The total MCQ-30 score was significantly high in elder patients than healthy controls (P=0.002) while it was insignificant between elder and young patients (P=0.976). The mean negative belief sub score was significantly higher in elder patients than healthy elder controls (P<0.0001). Cognitive confidence was significantly higher in elder patients than elder controls (P=0.024). ConclusionFor the first time we compared metacognitive differences between older patients with generalized anxiety and healthy elders. Impairments in two domains, that were different from metacognitive model of anxiety in young adults, as cognitive confidence and need to control of thoughts, seem to contribute in the development of anxiety that may be attributed as a result of aging.