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The role of metacognitive beliefs in determining the impact of anomalous experiences: a comparison of help-seeking and non-help-seeking groups of people experiencing psychotic-like anomalies

Published online by Cambridge University Press:  12 November 2008

C. M. C. Brett
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, London, UK
L. C. Johns*
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, London, UK
E. P. Peters
Affiliation:
Department of Psychology, King's College London, Institute of Psychiatry, London, UK
P. K. McGuire
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, London, UK
*
*Address for correspondence: L. C. Johns, D.Phil., PO 77, Department of Psychology, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK. (Email: [email protected])

Abstract

Background

Current psychological models of psychotic symptoms suggest that metacognitive beliefs impact on an individual's appraisal of anomalous experiences, and thereby influence whether these lead to distress and become clinical symptoms. This study examined the relationship between maladaptive metacognitive beliefs, anomalous experiences, anomaly-related distress, anxiety and depression and diagnostic status.

Method

The Metacognitions Questionnaire (MCQ), Symptom Checklist 90 – Revised, and Appraisals of Anomalous Experiences interview were administered to 27 people diagnosed with a psychotic disorder, 32 people meeting At Risk Mental State (ARMS) criteria, 24 people with psychotic-like experiences but no need for care, and 32 healthy volunteers.

Results

The two clinical groups scored higher than non-patient controls and individuals experiencing psychotic-like anomalies with no need for care on most subscales of the MCQ, particularly the ‘general negative beliefs about thoughts’ (NEG) subscale. However, most group differences became non-significant when anxiety and depression were controlled for. Few relationships were found between the MCQ subscales and psychotic-like anomalies and anomaly-related distress. Cognitive/attentional difficulty was the only type of anomaly to be significantly associated with maladaptive metacognitive beliefs. Anomaly-related distress was associated with only the NEG subscale of the MCQ.

Conclusions

Maladaptive metacognitive beliefs, as measured by the MCQ, appear to be related more to elevated levels of general psychopathology in psychotic and at-risk groups than to the presence of, and distress associated with, psychotic experiences. Processes by which metacognitions may impact upon the need for care are discussed.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2008

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References

Baker, CA, Morrison, AP (1998). Cognitive processes in auditory hallucinations: attributional biases and metacognition. Psychological Medicine 28, 11991208.Google Scholar
Brett, CMC, Peters, EP, Johns, LC, Tabraham, PA, Valmaggia, L, McGuire, PK (2007). The Appraisals of Anomalous Experiences interview (AANEX): a multi-dimensional measure of psychological responses to anomalies associated with psychosis. British Journal of Psychiatry 191 (Suppl. 51), S23S30.CrossRefGoogle Scholar
Broome, MR, Woolley, JB, Tabraham, P, Johns, LC, Bramon, E, Murray, GK, Pariante, C, McGuire, PK, Murray, RM (2005). What causes the onset of psychosis? Schizophrenia Research 79, 2334.Google Scholar
Cartwright-Hatton, S, Wells, A (1997). Beliefs about worry and intrusions: the meta-cognitions questionnaire and its correlates. Journal of Anxiety Disorders 11, 279296.Google Scholar
Derogatis, LR (1983). SCL-90-R: Administration, Scoring, and Procedures Manual, 2nd ed. Clinical Psychometric Research: Towson, MD.Google Scholar
Freeman, D, Garety, PA (2003). Connecting neurosis and psychosis: the direct influence of emotion on delusions and hallucinations. Behaviour Research and Therapy 41, 923947.Google Scholar
Garcia-Montes, JM, Cangas, A, Perez-Alvarez, M, Hidalgo, AM, Gutierrez, O (2005). Influence of metacognitive variables on paranoid ideation. International Journal of Clinical and Health Psychology 5, 463469.Google Scholar
Garety, PA, Bebbington, P, Fowler, D, Freeman, D, Kuipers, E (2007). Implications for neurobiological research of cognitive models of psychosis: a theoretical paper. Psychological Medicine 37, 13771391.Google Scholar
Garety, PA, Kuipers, E, Fowler, D, Freeman, D, Bebbington, PE (2001). A cognitive model of the positive symptoms of psychosis. Psychological Medicine 31, 189195.Google Scholar
Larøi, F, Van der Linden, M (2005). Metacognitions in proneness towards hallucinations and delusions. Behaviour Research and Therapy 43, 14251441.Google Scholar
Linney, YM, Peters, ER (2007). The psychological processes underlying thought interference in psychosis. Behaviour Research and Therapy 45, 27262741.Google Scholar
Lobban, F, Haddock, G, Kinderman, P, Wells, A (2002). The role of metacognitive beliefs in auditory hallucinations. Personality and Individual Differences 32, 13511363.Google Scholar
Morrison, AP (2001). The interpretation of intrusions in psychosis: an integrative cognitive approach to hallucinations and delusions. Behavioural and Cognitive Psychotherapy 29, 257276.Google Scholar
Morrison, AP, Baker, CA (2000). Intrusive thoughts and auditory hallucinations: a comparative study of intrusions in psychosis. Behaviour Research and Therapy 38, 10971106.Google Scholar
Morrison, AP, Bentall, RP, French, P, Walford, L, Kilcommons, A, Knight, A, Kreuz, M, Lewis, SW (2002). A randomised controlled trial of early detection and cognitive therapy for preventing transition to psychosis in high risk individuals: study design and interim analysis of transition rate and psychological risk factors. British Journal of Psychiatry 181 (Suppl. 43), 7884.CrossRefGoogle Scholar
Morrison, AP, French, P, Wells, A (2007). Metacognitive beliefs across the continuum of psychosis: comparisons between patients with psychotic disorders, patients at ultra-high risk and non-patients. Behaviour Research and Therapy 45, 22412246.CrossRefGoogle ScholarPubMed
Morrison, AP, Wells, A (2003). A comparison of metacognitions in patients with hallucinations, delusions, panic disorder, and non-patient controls. Behaviour Research and Therapy 41, 251256.CrossRefGoogle ScholarPubMed
Morrison, AP, Wells, A, Nothard, S (2000). Cognitive factors in predisposition to auditory and visual hallucinations. British Journal of Clinical Psychology 39, 6778.Google Scholar
Phillips, LJ, Yung, AR, McGorry, PD (2000). Identification of young people at risk of psychosis: validation of Personal Assessment and Crisis Evaluation Clinic intake criteria. Australian and New Zealand Journal of Psychiatry 34 (Suppl.), s164s169.Google Scholar
Schutte, NS, Malouff, JM (1995). Sourcebook of Adult Assessment Strategies. Plenum Press: New York.Google Scholar
Stirling, J, Barkus, E, Lewis, S (2007). Hallucination proneness, schizotypy and meta-cognition. Behaviour Research and Therapy 45, 14011408.Google Scholar
Svirskis, T, Korkeila, J, Heinimaa, M, Huttunen, J, Ilonen, R, Riskari, T, McGlashan, T, Salokangas, R (2005). Axis-I disorders and vulnerability to psychosis. Schizophrenia Research 75, 439446.CrossRefGoogle ScholarPubMed
Wells, A (1997). Cognitive Therapy of Anxiety Disorders. Wiley: Chichester, UK.Google Scholar
Wells, A, Matthews, G (1994). Attention and Emotion: A Clinical Perspective. Lawrence Erlbaum Associates: Hillsdale, NJ.Google Scholar
Wells, A, Matthews, G (1996). Modelling cognition in emotional disorder: the S-REF model. Behaviour Research and Therapy 34, 881888.CrossRefGoogle ScholarPubMed
Yung, AR, Phillips, LJ, McGorry, PD, McFarlane, CA, Francey, S, Harrigan, S, Patton, GC, Jackson, HJ (1998). Prediction of psychosis: a step towards indicated prevention of schizophrenia. British Journal of Psychiatry 172 (Suppl. 33), S14S20.Google Scholar