Adrian Wells

Adrian Wells
The University of Manchester · School of Psychological Sciences

BSc (hons), MSc, PhD

About

356
Publications
183,476
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
31,634
Citations
Introduction
Adrian Wells currently works at the School of Psychological Sciences, The University of Manchester. Adrian does research in Abnormal Psychology, Behavioural Science and Clinical Psychology. One of his current NIHR funded projects is 'Metacognitive Therapy for Anxiety and Depression in People undergoing Cardiac Rehabilitation '.
Additional affiliations
August 1995 - present
Manchester Mental Health and Social Care Trust
Position
  • Consultant Clinical Psychologist
June 1995 - present
The University of Manchester
Position
  • Professor of Clinical and Experimental Psychopathology

Publications

Publications (356)
Article
Full-text available
Background Anxiety and depression contribute to poorer physical and mental health outcomes in cardiac patients. Psychological treatments are not routinely offered in cardiac care and have mixed and small effects. We conducted a series of studies under the PATHWAY research programme aimed at understanding and improving mental health outcomes for pat...
Article
Full-text available
The Metacognitive Control System (MCS) model gives central importance to maladaptive metacognition in psychological vulnerability and disorder. The metacognitions questionnaire 30 (MCQ-30) is widely used to assess such metacognitions and to establish their effects. Previous studies consistently demonstrate that the MCQ-30 consists of five latent fa...
Article
Background: One in three cardiovascular disease (CVD) patients experience significant anxiety and depression. Current psychological interventions have limited efficacy in reducing such symptoms and are offered as a face-to-face intervention that may be a barrier to accessing treatment. We evaluated the feasibility and acceptability of delivering a...
Chapter
Written by internationally recognized experts, this comprehensive CBT clinician's manual provides disorder-specific chapters and accessible pedagogical features. The cutting-edge research, advanced theory, and attention to special adaptations make this an appropriate reference text for qualified CBT practitioners, students in post-graduate CBT cour...
Article
Full-text available
Cognitive models of social anxiety give prominence to dysfunctional schemas about the social self as the key underlying factors in maladaptive self-processing strategies and social anxiety symptoms. In contrast, the metacognitive model argues that beliefs about cognition represent a central belief domain underlying psychopathology and cognitive sch...
Article
Full-text available
Background Common mental disorders such as depression and anxiety are major contributors to the global burden of disease. Affected individuals suffer reduced quality of life, impaired functioning and reduced capacity to work. Maintaining employment is an important determinant for health and wellbeing, and the economic impact of depression and anxie...
Article
Full-text available
The current study aimed to examine the relationship between metacognitive beliefs about suicidal ideation and the content and process of suicidal ideation. This was to examine the potential contribution of the Self-Regulatory Executive Function (S-REF) model (Wells and Matthew, 2015) to suicidal ideation. Twenty-seven participants completed both tr...
Article
Full-text available
Objective Metacognitive therapy (MCT) and cognitive–behavior therapy (CBT) are effective treatments for generalized anxiety disorder. In this study, we followed-up patients who had previously participated in a randomized controlled trial of MCT compared against CBT. Method We collected 9-year follow-up data on 39 out of 60 original patients (i.e.,...
Article
Full-text available
Interpersonal difficulties are common across psychological disorders and are a legitimate target of treatment. Psychotherapeutic models differ in their understanding of interpersonal problems and how these problems are formulated and treated. It has been suggested that they are both the cause and effect of emotional distress symptoms, that they res...
Article
Full-text available
Background Cardiac rehabilitation (CR) is a programme of care offered to people who recently experienced a cardiac event. There is a growing focus on home-based formats of CR and a lack of evidence on preferences for psychological care in CR. This pilot study aimed to investigate preferences for delivery attributes of a psychological therapy interv...
Article
Full-text available
Objective Depression and anxiety are up to three times more prevalent in cardiac patients than the general population and are linked to increased risks of future cardiac events and mortality. Psychological interventions for cardiac patients vary in content and are often associated with weak outcomes. A recent treatment, metacognitive therapy (MCT)...
Article
Full-text available
Background: Depression and anxiety in cardiovascular disease are significant, contributing to poor prognosis. Unfortunately, current psychological treatments offer mixed, usually small improvements in these symptoms. The present trial tested for the first time the effects of group metacognitive therapy (MCT; 6 sessions) on anxiety and depressive s...
Article
A relationship between rumination and suicidal ideation is well-evidenced. A role for thought suppression has also been suggested but under-explored. The present study assessed the relative contribution of rumination and a range of thought control strategies in the understanding of suicidal ideation, within the theoretical framework of the self-reg...
Article
Full-text available
Background: COVID 19 is still presenting a clear and dynamic global threat. The United Kingdom remains one of the hardest hit countries from the pandemic. In January 2021 parliament announced that the UK will be entering a full national lockdown. This paper explores what effect lockdown measures had on rates of deliberate self-harm presentations to...
Article
Background Bipolar Disorder (BD) is a severe mental disease with a considerable reduction in life quality and high mortality. Self-management interventions and Cognitive behavior therapy (CBT) are the most widely investigated psychological treatments for BD. However, recovery rates are low and only small to moderate effect sizes have been found. Me...
Article
Full-text available
Anxiety and depression are common among patients with chronic physical illnesses and have a significant impact on morbidity, quality of life, and health service utilisation. Psychological treatment of anxiety and depression has small to moderate efficacy in this group and is not commonly based on a model of causal mechanisms. A novel approach to un...
Article
Full-text available
Introduction: Cardiac rehabilitation (CR) is offered to reduce the risk of further cardiac events and to improve patients' health and quality of life following a cardiac event. Psychological care is a common component of CR as symptoms of depression and/or anxiety are more prevalent in this population, however evidence for the cost-effectiveness o...
Article
Full-text available
Publications reporting discrete choice experiments of healthcare interventions rarely discuss whether patient and public involvement (PPI) activities have been conducted. This paper presents examples from the existing literature and a detailed case study from the National Institute for Health Research-funded PATHWAY programme that comprehensively i...
Article
Background This study investigated the psychometric properties of a Chinese version of the short form of Metacognitions Questionnaire (MCQ-30), which is an effective tool to assess metacognitive beliefs that have been linked to mental disturbance/disorder. We also tested whether metacognition factors would correlate with Internet gaming disorder (I...
Article
Full-text available
Background Anxiety and depression are common in cardiac rehabilitation (CR) patients. However, CR programs which incorporate psychological techniques achieve modest reductions in emotional distress. More efficacious interventions that can be easily integrated within services are required. A promising alternative to current psychological interventio...
Article
Full-text available
The evaluation of effective psychological therapies for anxiety and depression in cardiac patients is a priority, and progress in this area depends on the suitability and validity of measures. Metacognitive Therapy is a treatment with established efficacy in mental health settings. It postulates that anxiety and depression are caused by dysfunction...
Article
Full-text available
In the last forty years therapy outcomes for depression have remained the same with approximately 50% of patients responding to treatments. Advances are urgently required. We hypothesised that a recent treatment, metacognitive therapy (MCT), might be more effective, by targeting mental control processes that directly contribute to depression. We as...
Article
Full-text available
The self-regulatory executive function (S-REF) model explains the role of strategic processes and metacognition in psychological disorder and was a major influence on the development of metacognitive therapy. The model identifies a universal style of perseverative negative processing termed the cognitive attentional syndrome (CAS), comprised of wor...
Article
Full-text available
A major challenge in the treatment of depression has been high relapse rates following treatment. The current study reports results from a 3-year follow-up of patients treated with metacognitive therapy (MCT). Thirty-four of the 39 patients enrolled in the original study attended assessment (participation rate of 87%). There were large reductions i...
Article
Full-text available
The Self-Regulatory Executive Function model predicts that emotional symptoms and metacognition can causally affect each other. Crucially, for the model metacognition must cause emotion disorder symptoms. Therefore, in time-series data involving repeated measurements, metacognitions should predict subsequent changes in emotion. 265 participants com...
Article
The self-regulatory executive function model is the basis of metacognitive therapy and proposes that psychological disorders are caused by maladaptive beliefs about thinking (metacognitive beliefs) and a perseverative negative thinking style associated with them, named the cognitive attentional syndrome (CAS). The CAS-1 was devised and has been use...
Article
Work ability is a prospective predictor of sick leave, disability pension and unemployment, and has been defined as the balance between human resources and the demands of work, taking into consideration that illness is not equivalent to work disability. In the present study we set out to explore predictors of work ability in a sample of individuals...
Article
Full-text available
Background: Common mental disorders such as depression and anxiety frequently co-occur and may share etiological mechanisms. The metacognitive model is based on the principle that there are common pathological mechanisms across disorders that account for comorbidity and therefore can be conceptualized in one generic model. A central prediction of...
Article
Full-text available
Background: The Metacognitions Questionnaire (MCQ) and its derivatives have been instrumental in research examining the Self-Regulatory Executive Function Model in adults. Studies testing whether findings are applicable to children and adolescents have been increasing and several different measures adapting the MCQ for younger populations have been...
Article
Full-text available
Metacognitive Therapy (MCT) is a recent treatment with established efficacy in mental health settings. MCT is grounded in the Self-Regulatory Executive Function (S-REF) model of emotional disorders and treats a negative perseverative style of thinking called the cognitive attentional syndrome (CAS), thought to maintain psychological disorders, such...
Article
Full-text available
This paper reports the 1-year follow-up results from a randomized controlled trial (RCT), which examined the efficacy of metacognitive therapy (MCT) for unipolar depression compared to a waiting condition. Thirty-nine patients with major depression were offered MCT and were divided into two conditions; immediate MCT with 10 weekly sessions or a wai...
Article
Full-text available
Background: Metacognitive therapy (MCT) is a modern approach with demonstrated efficacy in current major depressive disorder (MDD). The treatment aims to modify thinking styles of rumination and worry and their underlying metacognitions, which have been shown to be involved in the initiation and perpetuation of MDD. We hypothesized that metacogniti...
Article
Full-text available
Metacognitive therapy (MCT) is proving to be an effective and brief treatment for anxiety disorders and depression, but there are no investigations of its feasibility and effect on primary personality disorders. We conducted a baseline controlled phase II trial of MCT on a group of patients with Borderline personality disorder all reporting early t...
Article
Full-text available
Objective: Comorbidity is common among anxiety and depression. Transdiagnostic treatment approaches have been developed to optimize treatment and offer a more unified approach suitable for individuals with comorbidities. Metacognitive therapy (MCT) is a transdiagnostic therapy for psychological disorder and is based on the metacognitive model. The...
Article
Full-text available
In the metacognitive model, attentional control and metacognitive beliefs are key transdiagnostic mechanisms contributing to psychological disorder. The aim of the current study was to investigate the relative contribution of these mechanisms to symptoms of anxiety and depression in children with anxiety disorders and in non-clinical controls. In a...
Article
Full-text available
Background Psychological distress is prevalent among patients with cardiovascular disease and is linked to increased risk of future cardiac events. Cardiac rehabilitation ( CR ) is widely recommended for treating psychological distress but has been of limited benefit. This study aims to understand how distressed cardiac patients describe their emot...
Article
Full-text available
Objective: Anxiety and depression symptoms are common in patients with physical health conditions. In the metacognitive model, beliefs about cognition (metacognitions) are a key factor in the development and maintenance of anxiety and depression. The current study evaluated if metacognitions predict anxiety and/or depression symptoms and if differ...
Article
Full-text available
Operators of Unmanned Aerial Systems (UAS) face a variety of stress factors resulting from both the cognitive demands of the work and its broader social context. Dysfunctional metacognitions including those concerning worry may increase stress vulnerability, whereas personality traits including hardiness and grit may confer resilience. The present...
Article
Full-text available
Vulnerability to psychological disorder can be assessed with constructs such as trait anxiety and neuroticism which among others are transdiagnostic risk factors. However, trait-anxiety and related concepts have been criticised because they don't illuminate the etiological mechanisms of psychopathology. In contrast, the metacognitive (S-REF) model...
Article
Full-text available
Introduction: Cognitive behavioral therapy (CBT) alleviates emotional distress in mental health settings, but has only modest effects in cardiac patients. Metacognitive therapy (MCT) also alleviates depression and anxiety in mental health settings and is in its initial stages of evaluation for cardiac patients. Aim: Our objective is to compare how...
Article
Full-text available
Alcohol Use Disorder (AUD) is a debilitating condition with serious adverse effects on health and psycho-social functioning. The most effective psychological treatments for AUD show moderate efficacy and return to dysregulated alcohol use after treatment is still common. The aim of the present study was to evaluate Metacognitive Therapy (MCT) as ap...
Article
Full-text available
Cognitive-behavior therapy (CBT), delivered in an individual or group format, is the recommended treatment of choice for Obsessive-Compulsive Disorder (OCD), but no studies have benchmarked the outcomes for group CBT in real-world clinical settings. The first aim of this evaluation was to benchmark the outcomes for group CBT in a sample of 125 pati...
Article
Full-text available
Background: Major depressive Disorder (MDD) is a severe mental disorder associated with considerable disability and high costs. Over the last decades, various psychotherapies for MDD have been developed and researched, among others Behavioral Activation (BA) and Metacognitive Therapy (MCT). MCT and BA target different maintaining factors of MDD and...
Article
We examined the efficacy of a brief CBT (bCBT) in 53 patients with social anxiety disorder (SAD). Patients were randomized to either bCBT plus treatment as usual (N = 27) or TAU only (N = 26). Seven sessions of bCBT (Wells and Papageorgiou in Behavior Research and Therapy, 39, 713–720, 2001), were delivered. The primary self-report outcome was the...
Article
Full-text available
Background Cognitive–behavioural therapy (CBT) is the treatment of choice for generalised anxiety disorder (GAD), yielding significant improvements in approximately 50% of patients. There is significant room for improvement in the outcomes of treatment, especially in recovery. Aims We aimed to compare metacognitive therapy (MCT) with the gold stan...
Article
Full-text available
The Attention Training Technique (ATT) was developed with the aim of reducing self-focused attention and increasing executive control as part of metacognitive therapy. So far there is a paucity of data on the neurophysiological effects of ATT. In the present study we tested for specific effects to determine if attention control components of ATT el...
Article
Full-text available
Background: Anxiety and depression are common among patients attending cardiac rehabilitation services. Currently available pharmacological and psychological interventions have limited effectiveness in this population. There are presently no psychological interventions for anxiety and depression integrated into cardiac rehabilitation services desp...
Article
Full-text available
A 41-year-old female with schizo-affective disorder presenting with an eight-year history of auditory hallucinations participated in a single case treatment study (A-B-A-B-A-C-B) of the effects of the Attention Training Technique (ATT). No antipsychotic medication was prescribed in this case following a serious adverse reaction in the past. The aim...
Article
Full-text available
Metacognitive therapy (MCT) has shown promising outcomes across disorders, but, currently, little is known about the mechanisms of change in MCT as well as their specificity compared to those of cognitive behavioral therapy (CBT). The main purpose of this study was to examine the within-person relationships between features of the cognitive attenti...
Article
Full-text available
Aim The Metacognitions Questionnaire‐30 (MCQ‐30) has been used to assess metacognitive beliefs in a range of mental health problems. The aim of this study is to assess the validity of the MCQ‐30 in people at risk for psychosis. Methods One hundred eighty‐five participants meeting criteria for an at risk mental state completed the MCQ‐30 as part of...
Article
In the current study, we investigate the neuronal correlates of the Attention Training Technique (ATT), a psychotherapeutic intervention used in metacognitive therapy to enhance flexible cognitive control and ameliorate rumination. We adapted the ATT in a neuroscientific attention paradigm in order to investigate the effects of its components: sele...
Article
Background Common mental disorders are associated with significant economic, social, and personal costs that are primarily incurred through loss of work status. Psychological interventions based on cognitive‐behavioural therapy have been implemented to enhance return to work (RTW), but have not proved sufficiently successful. According to the metac...
Article
Full-text available
Patients may be offered cardiac rehabilitation (CR), a supervised programme often including exercises, education and psychological care, following a cardiac event, with the aim of reducing morbidity and mortality. Cost-constrained healthcare systems require information about the best use of budget and resources to maximise patient benefit. We aimed...
Article
Full-text available
Cognitive behavioural therapy (CBT) is the treatment of choice for Social anxiety disorder (SAD). However, factors additional to those emphasised in CBT are the primary cause of psychological disorder according to the metacognitive model. Metacognitive Therapy (MCT) aims to target a perseverative thinking style named the cognitive attentional syndr...
Article
Full-text available
Poor social functioning has been found to be present in those at risk for psychosis. This study aimed to examine metacognitive beliefs as potential predictors of structured activity (measure of social functioning) in those with an At Risk Mental State (ARMS). Regression and correlation analyses were conducted. The sample included 109 young people....
Article
Full-text available
Background: Anxiety and depression are prevalent among cardiac rehabilitation patients but pharmacological and psychological treatments have limited effectiveness in this group. Furthermore, psychological interventions have not been systematically integrated into cardiac rehabilitation services despite being a strategic priority for the UK Nationa...