Dysfunctional metacognitions in anorexia nervosa

School of Psychological Science, La Trobe University, Bundoora, Victoria 3086, Australia.
Eating and weight disorders: EWD (Impact Factor: 0.79). 03/2011; 16(1):e49-55. DOI: 10.1007/BF03327521
Source: PubMed


The aim was to compare women with anorexia nervosa (AN) and without AN in terms of dysfunctional metacognitions.
167 Australian women with AN (N=74; mean age 24.3 yrs) and without AN (N=93; mean age 27.3 yrs) completed the Metacognitions Questionnaire-30.
Multivariate analyses revealed that relative to controls, AN patients had higher scores on metacognitive dysfunction: they exhibited low confidence in their cognitive competence, reported obsessively monitoring and striving to control their thoughts, and held negative beliefs about the danger of worrying. Furthermore, this was not due to starvation effects. However, patients did not exhibit significantly more positive beliefs about worry than controls once body mass index had been controlled.
Metacognitive dysfunction may play a key role in the maintenance of AN; therefore, metacognitive therapy may be usefully applied to its treatment.

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    • "Previous studies have not investigated the relative impor - tance of the MCQ - 30 subscales . However , McDermott and Rushford ( 2011 ) found that the need for control and negative metacognitive be - liefs were the two subscales that differentiated the most between ano - rectic patients and controls . This metacognitive belief is central in the metacognitive model as it is activated by worry and rumination and its associated symptoms . "
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    ABSTRACT: Objective: The aim of the study was to compare a clinical sample with eating disorders to different control samples on self-report measures of metacognition and eating disorder symptoms, in order to investigate the role of metacognition in eating disorders. Method: The clinical group consisted of 53 female patients with eating disorders who completed the Metacognitions Questionnaire-30 and the Eating Disorder Examination Questionnaire 6.0. One-hundred and fifty women who served as a control group completed the questionnaires as an Internet survey. This control group was divided into three groups based on self-reported history of eating and psychiatric problems (N=47), other psychiatric problems (N=37), or no such problems (healthy controls: N=66). Results: The clinical group scored significantly higher on dysfunctional metacognition than healthy controls, especially on "negative beliefs about uncontrollability and danger", "need to control thoughts", and total MCQ-30 score. Eating disorder symptomatology was positively correlated with metacognition. Metacognition explained 51% of the variance in eating disorder symptoms after controlling for age and BMI, with "need to control thoughts" as the most important factor. Conclusion: Metacognitive beliefs may be central in understanding eating disorders, and metacognitive treatment strategies could be a promising approach in developing new psychological treatments for eating disorders.
    Eating Behaviors 11/2014; 16. DOI:10.1016/j.eatbeh.2014.10.019 · 1.58 Impact Factor
    • "This instrument was originally developed in order to assess positive and negative metacognitions with regard to worrying. However, it has since been used to investigate metacognitions in other populations as well, such as OCD (Solem, Haland, Vogel, Hansen, & Wells, 2009) or anorexia nervosa (McDermott & Rushford, 2011). The MCQ-30 has five subscales, each including six items. "
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    ABSTRACT: Five types of intervention may be of special relevance and in consequence have been included in treatments targeting generalized anxiety disorder (GAD) symptomology: metacognitive therapy targeting both negative and positive metacognitions concerning worrying; fear imagery exposure, based on the avoidance theory of worrying; interventions developed to increase tolerance of uncertainty; relaxation exercises; and finally, treatment modules focusing on negative problem orientation. This chapter first describes the diagnostic procedures most helpful for the preparation of treatment and then the treatment modules. All these modules have been included in manualized treatments, which have been evaluated with regard to their efficacy in a number of RCTs. The chapter presents an overview of the evidence for the efficacy of variations of this cognitive-behavioral treatment (CBT). Applied relaxation is one of the most regularly used components within standard CBTs for GAD. Besides cognitive-behavioral therapy and psychodynamic psychotherapy, pharmacotherapy offers another evidence-based treatment option for GAD.
    The Wiley Handbook of Anxiety Disorders, 04/2014: pages 1003-1037; , ISBN: 9781118775356
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    • "In line with this logic, several extant AN-treatments are more concerned with altering the cognitions and behaviors giving rise to AN symptoms than with supporting need satisfaction, tackling experiential avoidance, or boosting internal change motivation. Results from some studies show that such approaches are promising; for example, metacognitive therapy " may hold great therapeutic potential for AN " (Wells, 2000; McDermott & Rushford, 2011). In addition , treatment process studies also show direct links between cognitive change and treatment response. "
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    ABSTRACT: Objective: Anorexia nervosa (AN) is a debilitating and often chronic and treatment-resistant disorder. Despite decades of theoretical progress and research, many questions remain with regard to the psychological mechanisms explaining why and how some AN patients respond to treatment whereas others do not. Based on the premise that the broader, noneating disorders psychotherapy research literature, and particularly the common factors literature, can inform AN treatment development efforts, we review a set of selected psychological change mechanisms and describe how they might be relevant in the context of AN treatment response. Specifically, we suggest that a systematic consideration of constructs such as basic psychological needs, expectancies, the therapeutic alliance, experiential avoidance, and patient motivation for change might help illuminate how patients do or do not benefit from AN treatment. We briefly describe an ongoing multicenter trial in which the constructs introduced here are being measured on a weekly basis and are examined as potential mediators of treatment response. The article aims to contribute to the AN literature by introducing a set of potentially important change constructs that we think ought to be studied in greater depth by AN researchers.
    Journal of Clinical Psychology 07/2013; 69(7). DOI:10.1002/jclp.21945 · 2.12 Impact Factor
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