1. Dysfunctional Meta-Cognitive Beliefs Across Psychopathologies: A Meta-Analytic Review
Xiaoqi Sun, Suzanne H. So, Chen Zhu, Patrick W. Leung
Background
Method
Meta-cognitive beliefs, or “beliefs about beliefs” refer to the knowledge about the course and outcome of one's cognition (Wells, 2000).
The Self-Regulatory Executive Function (S-REF) model (Wells & Matthews, 1996) suggests that dysfunctional meta-cognitive beliefs contribute to the development of mental disorders via increasing negative appraisals and problematic coping behaviors.
Aims & Objectives
To compare aspects of dysfunctional meta-cognitive beliefs between patients with various psychiatric disorders and healthy controls.
To compare the strength of associations between aspects of dysfunctional meta-cognitive beliefs and specific psychopathologies.
Identification
Eligibility
Included
586 records identified through key term search
Psycinfo (n=296)
Medline (n=62)
PubMed (n=228)
586 records checked
155 duplicates removed
431 articles assessed for eligibility based on title and abstract
347 records excluded:
Topic irrelevant to metacognitive beliefs or psychopathology (n=120);
Case study (n=3), review (n=9), book chapter (n=42), dissertation (n=5), abstract (n=2) or protocol (n=2);
Lack of psychiatric patient group (n=108) or healthy control group (n=51).
Non-adult sample: (n=5)
40 articles excluded:
Topic irrelevant to metacognitive beliefs or psychopathology (n=10);
Clinical samples with multiple or mixed diagnoses (n=5);
Lack of sufficient data to calculate effect size (n=2);
Case study (n=1), review (n=1);
Lack of psychiatric patient group (n=17) or healthy control group (n=3);
No English full-text (n=1)
44 of studies included in quantitative synthesis
6 additional records identified through other sources
47 of studies included in meta-analysis
3 overlapped samples removed
84 articles assessed for eligibility based on full-text
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5 types of dysfunctional meta-cognitive beliefs on MCQ (Cartwright-Hatton & Wells,1997)
e.g. ‘Worrying helps me cope’
Positive beliefs about worry (PB)
e.g. ‘When I start worrying, I cannot stop’
Negative beliefs about the uncontrollability & danger of thoughts (U/D)
e.g. ‘I have a poor memory’
Cognitive confidence (CC)
e.g. ‘Not being able to control my thoughts is a sign of weakness’
Negative beliefs about need to control thought (SPR)
e.g. ‘I think a lot about my thoughts’
Cognitive self-consciousness (CSC)
Results
Overall effect sizes:
Psychiatric patients reported more dysfunctional meta-cognitive beliefs than healthy controls. Effects were significant on all 5 subscores, with sizes from moderate (PB, hedges’ g=0.49; CC, hedges’ g=0.78; CSC, hedges’ g=0.75) to large (U/D, hedges’ g=1.52; SPR, hedges’ g=1.19).
Diagnostic subgroup analyses: PB
U/D CC
(K=5)
(K=5)
(K=6)
(K=1)
(K=8)
(K=11)
(K=38)
(K=5)
(K=8)
(K=1)
(K=4)
(K=7)
(K=11)
(K=38)
(K=7)
(K=1)
(K=4)
(K=7)
(K=1)
(K=11)
(K=1)
(K=37)
SPR
CSC
Conclusions:
All aspects of dysfunctional meta-cognitive beliefs were more marked in psychiatric patients (across diagnoses) than healthy controls.
Significant differences across diagnoses were observed in effect sizes for U/D and CSC. U/D was more marked in GAD, while CSC was more marked in OCD & anorexia nervosa (AN).
(K=5)
(K=7)
(K=1)
(K=4)
(K=8)
(K=10)
(K=37)
(K=5)
(K=6)
(K=1)
(K=4)
(K=14)
(K=11)
(K=43)
Copyright © 2016 Xiaoqi Sun,