Article

Metacognitive therapy for generalized anxiety disorder: an open trial.

University of Manchester, Academic Division of Clinical Psychology, Rawnsley Building, MRI, Manchester M13 9WL, UK.
Journal of Behavior Therapy and Experimental Psychiatry (Impact Factor: 2.23). 10/2006; 37(3):206-12. DOI: 10.1016/j.jbtep.2005.07.002
Source: PubMed

ABSTRACT Generalized anxiety disorder (GAD) responds only modestly to existing cognitive-behavioural treatments. This study investigated a new treatment based on an empirically supported metacognitive model [Wells, (1995). Metacognition and worry: A cognitive model of generalized anxiety disorder. Behavioural and Cognitive Psychotherapy, 23, 301-320; Wells, (1997). Cognitive therapy of anxiety disorders: A practice manual and conceptual guide. Chichester, UK: Wiley]. Ten consecutive patients fulfilling DSM-IV criteria for GAD were assessed before and after metacognitive therapy, and at 6, and 12-month follow-up. Patients were significantly improved at post-treatment, with large improvements in worry, anxiety, and depression (ESs ranging from 1.04-2.78). In all but one case these were lasting changes. Recovery rates were 87.5% at post treatment and 75% at 6 and 12 months. The treatment appears promising and controlled evaluation is clearly indicated.

Download full-text

Full-text

Available from: Adrian Wells, Apr 20, 2015
1 Follower
 · 
220 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: 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.Method Thirty-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).Conclusion For 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.
    European geriatric medicine 06/2013; 4(3):150–153. DOI:10.1016/j.eurger.2012.12.001 · 0.55 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Worry has been implicated in increasing the levels of distress associated with persecutory delusions. It may partly cause this distress via the impediment of emotional processing of upsetting experiences. The clinical implication is that enhancing emotional processing of paranoid experiences will reduce distress. We therefore piloted a new brief intervention-the Emotional Processing and Metacognitive Awareness (EPMA)-on 12 patients with persistent persecutory delusions. The intervention was predominately influenced by written emotional disclosure and lasted for three sessions. The delusions were assessed at baseline, preintervention and postintervention and during a one-month follow-up. It was found that EPMA particularly reduced levels of delusion distress, and this was maintained at follow-up. The effect sizes were large but were likely overestimated given the absence of a control group and assessments that were not blind. These preliminary findings suggest that simply encouraging patients to talk, in the right way, about their delusions can be beneficial.
    The Journal of nervous and mental disease 09/2011; 199(9):653-8. DOI:10.1097/NMD.0b013e318229cfa8 · 1.81 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Worry is a common phenomenon in children and adolescents, with some experiencing excessive worries that cause significant distress and interference. The metacognitive model of generalized anxiety disorder (Wells 1995, 2009) was developed to explain cognitive processes associated with pathological worry in adults, particularly the role of positive and negative beliefs about worry. This review evaluates the application of the model in understanding child and adolescent worry. Other key issues reviewed include the link between cognitive and metacognitive development and worry, and the measurement of worry and metacognitive worry in young people. Implications of these findings and directions for future research are discussed.
    Clinical Child and Family Psychology Review 03/2010; 13(2):151-63. DOI:10.1007/s10567-010-0065-0 · 4.75 Impact Factor