Cognitive and metacognitive predictors of symptom improvement following treatment for social anxiety disorder: A secondary analysis from a randomized controlled trial

Nordahl Henrik; Nordahl Hans M.; Hjemdal Odin; Wells Adrian

摘要

>Cognitive therapy for social anxiety disorder (SAD) based on the Clark and Wells model emphasizes negative beliefs about the social self and self‐consciousness as central causal factors. However, Wells' metacognitive model proposes that metacognitive beliefs are central to pathology universally. The relative importance of cognitive and metacognitive beliefs in the treatment of SAD is therefore an important research question. This study examined change in negative cognitive and negative metacognitive beliefs as independent correlates of symptom improvement in 46 SAD patients undergoing evidence‐based treatments. Both types of beliefs decreased during treatment. However, change in metacognitive belief was the only consistent independent predictor across all outcomes and change in cognitive beliefs did not significantly predict outcomes when change in self‐consciousness was controlled. The implication of this finding is that metacognitive change might be more important than cognitive belief change in symptom outcome and recovery in SAD.

Key Practitioner Message > <list style="bulleted" xml:id="cpp2083-list-0001"> <listItem xml:id="cpp2083-li-0001">Cognitive and metacognitive beliefs decreased during treatment of SAD.</listItem> <listItem xml:id="cpp2083-li-0002">Change in self‐consciousness predicted symptom improvement.</listItem> <listItem xml:id="cpp2083-li-0003">Change in metacognition predicted symptom improvement over change in cognition.</listItem> <listItem xml:id="cpp2083-li-0004">Change in metacognition was a more reliable predictor than change in cognition.</listItem> </list> </section> </span> <span class="z_kbtn z_kbtnclass hoverxs" style="display: none;">展开▼</span> </div> <div class="translation abstracttxt"> <span class="zhankaihshouqi fivelineshidden" id="abstract"> <span>机译：</span><Abstract XMLNS =“http://www.wiley.com/namespaces/wiley”type =“main”xml：lang =“en”> <sectioneded =“no”xml：id =“cpp2083-sec-1001” > >基于克拉克和井模型的社交焦虑症（悲伤）的认知治疗强调社会自我和自我意识作为中央因果区的负面信。然而，Wells的元认知模型提出了代理认知信念普遍地是病理学的核心。因此，认知和元认知信念在悲伤治疗中的相对重要性是一个重要的研究问题。本研究检测了负面认知和消极元认知信念的变化，作为46例患者进行循证治疗的症状改善的独立相关性。在治疗期间，这两种类型的信念都减少了。然而，元认知信念的变化是所有结果的唯一一致的独立预测因素，并且认知信念的变化在控制自我意识的变化时没有显着预测结果。这种发现的含义是元认知变化可能比症状结果和悲伤恢复的认知信念变化更重要。</ p> </段> <部分编号=“否”XML：ID =“CPP2083-SEC-2001 “> <标题类型=”main“>密钥从业者消息</ title> > <l列表样式=”bulleted“xml：id =”cpp2083-list-0001“> <listitem xml：id =”cpp2083-li- 0001“>治疗悲伤期间的认知和元认知信念减少。</ listitem> <listitem xml：id =”cppp2083-li-0002“>自我意识的变化预测症状改进。</ listitem> <listitem xml：id = “CPP2083-LI-0003”>元记录的变化预测认知变化的症状改善。</ listitem> <listitem xml：id =“cppp2083-li-li-0004”>元认知的变化是比认知的变化更可靠的预测。 </ listitem> </ list> </ p> </部分> </span> <span class="z_kbtn z_kbtnclass hoverxs" style="display: none;">展开▼</span> </div> </div> <div class="record"> <h2 class="all_title" id="enpatent33" >著录项</h2> <ul> <li> <span class="lefttit">来源</span> <div style="width: 86%;vertical-align: text-top;display: inline-block;"> <a href='/journal-foreign-16678/'>《Clinical Psychology & Psychotherapy》</a> <b style="margin: 0 2px;">|</b><span>2017年第6期</span><b style="margin: 0 2px;">|</b><span>共7页</span> </div> </li> <li> <div class="author"> <span class="lefttit">作者</span> <p id="fAuthorthree" class="threelineshidden zhankaihshouqi"> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Nordahl Henrik&option=202" target="_blank" rel="nofollow">Nordahl Henrik;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Nordahl Hans M.&option=202" target="_blank" rel="nofollow">Nordahl Hans M.;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Hjemdal Odin&option=202" target="_blank" rel="nofollow">Hjemdal Odin;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Wells Adrian&option=202" target="_blank" rel="nofollow">Wells Adrian;</a> </p> <span class="z_kbtnclass z_kbtnclassall hoverxs" id="zkzz" style="display: none;">展开▼</span> </div> </li> <li> <div style="display: flex;"> <span class="lefttit">作者单位</span> <div style="position: relative;margin-left: 3px;max-width: 639px;"> <div class="threelineshidden zhankaihshouqi" id="fOrgthree"> <p>Department of PsychologyNorwegian University of Science and TechnologyNorway;</p> <p>Department of Mental HealthNorwegian University of Science and TechnologyNorway;</p> <p>Department of PsychologyNorwegian University of Science and TechnologyNorway;</p> <p>School of Psychological SciencesUniversity of ManchesterManchester UK;</p> </div> <span class="z_kbtnclass z_kbtnclassall hoverxs" id="zhdw" style="display: none;">展开▼</span> </div> </div> </li> <li > <span class="lefttit">收录信息</span> <span style="width: 86%;vertical-align: text-top;display: inline-block;"></span> </li> <li> <span class="lefttit">原文格式</span> <span>PDF</span> </li> <li> <span class="lefttit">正文语种</span> <span>eng</span> </li> <li> <span class="lefttit">中图分类</span> <span><a href="https://www.zhangqiaokeyan.com/clc/5893.html" title="医学心理学">医学心理学;</a></span> </li> <li class="antistop"> <span class="lefttit">关键词</span> <p style="width: 86%;vertical-align: text-top;"> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=beliefs&option=203" rel="nofollow">beliefs;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=metacognition&option=203" rel="nofollow">metacognition;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=metacognitive beliefs&option=203" rel="nofollow">metacognitive beliefs;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=social anxiety disorder&option=203" rel="nofollow">social anxiety disorder;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=social phobia&option=203" rel="nofollow">social phobia;</a> </p> <div class="translation"> 机译：信仰;元记高;元认知信念;社交焦虑症;社会恐惧症; 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路英智</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=马秀青&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">,马秀青</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=张勤峰&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor">,张勤峰</a> <span> <a href="/conference-cn-7015/" target="_blank" rel="nofollow" class="tuijian_authcolor"> . 中国第九届森田疗法学术大会暨天津市心理卫生协会2012学术年会 </a> <span> <span> . 2012</span> </span> </div> </li> <li> <div> <b>7. </b><a class="enjiyixqcontent" href="/academic-degree-domestic_mphd_thesis/020313430853.html">元认知干预技术中布置训练任务对社交恐怖症治疗效果的影响</a> <b>[A] </b> <span> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=许相媛&option=202" target="_blank" rel="nofollow" class="tuijian_auth tuijian_authcolor"> . 许相媛</a> <span> . 2012</span> </span> </div> </li> </ul> <ul style="display: none;"> <li> <div> <b>1. </b><a class="enjiyixqcontent" href="/patent-detail/06120108195365.html">随着时间推移从经综合处理和分析后的数据信号推导出重大变化属性以预测常规预测因子的未来变化的系统及方法</a> <b>[P]</b> . <span> 中国专利： CN105706125A </span> <span> . 2016-06-22</span> </div> </li> <li> <div> <b>2. </b><a class="enjiyixqcontent" href="/patent-detail/06120103612478.html">细胞因子BPI在制备伴认知障碍的2型糖尿病治疗药物中的应用</a> <b>[P]</b> . <span> 中国专利： CN111184857A </span> <span> . 2020-05-22</span> </div> </li> <li> <div> <b>3. </b><a class="enjiyixqcontent" href="/patent-detail/06130422981979.html">COMPOUND, PHARMACEUTICAL COMPOSITION, METHOD FOR THE TREATMENT, PREVENTION OR IMPROVEMENT OF ONE OR MORE DISEASE SYMPTOMS MEDIATED BY BETA ADRENERGIC RECEPTOR, METHOD FOR TREATING, PREVENTING OR IMPROVING ONE OF THE MORE SYMPTOMS OF A SELECTED EMERGENCY DISEASE. , ANXIETY DISORDER, HYPERTRODISM, TREMOR, GLAUCOMA, HYPERTENSION, CORONARY ARTERY DEVIATION GRAFT, CHRONIC STABLE ANGINA, ATRIAL ARRHYTHM, VARIZES, ESOPHAGIC, SANCTUARY, DRYING, STERATING, STERATING AFTER RECENT MYOCARDIUM INFARCTION AND ANY DISORDER IMPROVED BY BETA ADRENERGIC RECEPTOR MODULES AND METHOD FOR MODULAR BETA ADRENERGIC RECEPTOR ACTIVITY</a> <b>[P]</b> . <span> 外国专利：  BRPI0711221A2 </span> <span> . 2012-03-13</span> </div> <p class="zwjiyix translation" style="max-width: initial;height: auto;word-break: break-all;white-space: initial;text-overflow: initial;overflow: initial;"> <span>机译：化合物，药物组合物，贝塔肾上腺素能受体介导的一种或多种疾病症状的治疗，预防或改善的方法，治疗，预防或改善所选急症的一种以上症状的方法。，变态，变长，变长，变长，变长，变长，变长，变长，变长，变长，变长了用于模块化的Beta肾上腺素受体活性 </span> </p> </li> <li> <div> <b>4. </b><a class="enjiyixqcontent" href="/patent-detail/06130417736561.html">Anthrax derivatives; pharmaceutical ingredients containing these substances, and as inhibitors of phosphoric acid 10A (PDE10A), used in the treatment of nervous system disorders, schizophrenia, cognitive disorders related to schizophrenia, bipolar disorders, depression Cognitive impairment cognitive impairment behavioral disorder associated with Alzheimer's Disease Obesity Huntington's disease and anxiety disorder</a> <b>[P]</b> . <span> 外国专利：  CL2013003731A1 </span> <span> . 2014-10-10</span> </div> <p class="zwjiyix translation" style="max-width: initial;height: auto;word-break: break-all;white-space: initial;text-overflow: initial;overflow: initial;"> <span>机译：炭疽衍生物;包含这些物质的药物成分，以及作为磷酸10A抑制剂（PDE10A），用于治疗神经系统疾病，精神分裂症，与精神分裂症有关的认知障碍，双相情感障碍，抑郁症与阿尔茨海默氏病肥胖症相关的认知障碍认知障碍行为障碍亨廷顿舞蹈症疾病和焦虑症 </span> </p> </li> <li> <div> <b>5. </b><a class="enjiyixqcontent" href="/patent-detail/06130432810987.html">In view of their capability to antagonize the actions of neurokinins by blocking the neurokinin receptors, and in particular antagonizing the actions of substance P by blocking the NK1 receptor, the compounds according to the invention are useful as a medicine, in particular in the prophylactic and therapeutic treatment of neurokinin-mediated conditions, such as, for instance CNS disorders, in particular depression, anxiety disorders, stress-related disorders, sleep disorders, cognitive disorders, personality disorders, schizoaffective disorders, eating disorders, neurodegenerative diseases, addiction disorders, mood disorders, sexual dysfunction, pain and other CNS-related conditions; inflammation; allergic disorders; emesis; gastrointestinal disorders, in particular irritable bowel syndrome (IBS); skin disorders; vasospastic diseases; fibrosing and collagen diseases; disorders related to immune enhancement or suppression and rheumatic diseases and body weight control.</a> <b>[P]</b> . <span> 外国专利：  EA009217B1 </span> <span> . 2007-12-28</span> </div> <p class="zwjiyix translation" style="max-width: initial;height: auto;word-break: break-all;white-space: initial;text-overflow: initial;overflow: initial;"> <span>机译：考虑到它们通过阻断神经激肽受体来拮抗神经激肽的作用，特别是通过阻断NK1受体来拮抗P物质的作用的能力，根据本发明的化合物可用作药物，特别是在预防和治疗中。治疗神经激肽介导的疾病，例如中枢神经系统疾病，尤其是抑郁症，焦虑症，与压力有关的疾病，睡眠障碍，认知障碍，人格障碍，精神分裂性障碍，进食障碍，神经退行性疾病，成瘾障碍，情绪疾病，性功能障碍，疼痛和其他中枢神经系统相关疾病;炎;过敏性疾病呕吐胃肠道疾病，特别是肠易激综合症（IBS）;皮肤疾病;血管痉挛性疾病;纤维化和胶原蛋白疾病;与免疫增强或抑制，风湿性疾病和体重控制有关的疾病。 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