The Association of Metacognitive Beliefs With Emotional Distress After Diagnosis of Cancer
The Association of Metacognitive Beliefs With Emotional Distress After Diagnosis of Cancer
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DOI：
10.1037/hea0000096
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发表时间：
2015-03-01
影响因子：
4.2
通讯作者：
Fisher, Peter
中科院分区：
文献类型：
--
作者：
Cook, Sharon A.;Salmon, Peter;Fisher, Peter
目的：癌症诊断后出现情绪困扰是正常的，对于大多数人来说，情绪困扰会随着时间的推移而减少。然而，极少数癌症患者会出现持续或反复出现的情绪困扰症状，需要帮助。心理健康领域开发的模型——自我调节执行功能模型（S-REF）指出，适应不良的元认知信念和过程（包括持续的担忧）是理解为什么此类情绪问题持续存在的关键。这项横断面研究首次探讨了癌症人群的元认知信念是否与情绪困扰相关，以及这种关系是否由担忧介导，正如 S-REF 模型所预测的那样。方法：229 名参与者在原发性乳腺癌或前列腺癌诊断后 3 个月内和治疗前完成了自我报告问卷，测量焦虑、抑郁、创伤后应激障碍 (PTSD) 症状、元认知信念、担忧和疾病感知。结果：回归分析表明，元认知信念与焦虑、抑郁和创伤后应激障碍（PTSD）症状相关，并解释了在控制年龄、性别和疾病认知后这些结果的额外差异。结构方程模型与元认知信念通过驱动担忧直接和间接引起和维持痛苦这一理论得出的横截面假设是一致的。结论：这些发现提供了有希望的第一个证据，证明 S-REF 模型可能有效地应用于癌症。需要进一步的研究来确定这些发现的预测和临床效用。
Objective: Emotional distress after a diagnosis of cancer is normal and, for most people, will diminish over time. However, a significant minority of patients with cancer experience persistent or recurrent symptoms of emotional distress for which they need help. A model developed in mental health, the self-regulatory executive function model (S-REF), specifies that maladaptive metacognitive beliefs and processes, including persistent worry, are key to understanding why such emotional problems persist. This cross-sectional study explored, for the first, time whether metacognitive beliefs were associated with emotional distress in a cancer population, and whether this relationship was mediated by worry, as predicted by the S-REF model. Method: Two hundred twenty-nine participants within 3 months of diagnosis of, and before treatment for, primary breast or prostate cancer completed self-report questionnaires measuring anxiety, depression, posttraumatic stress disorder (PTSD) symptoms, metacognitive beliefs, worry, and illness perceptions. Results: Regression analysis showed that metacognitive beliefs were associated with symptoms of anxiety, depression, and PTSD, and explained additional variance in these outcomes after controlling for age, gender, and illness perceptions. Structural equation modeling was consistent with cross-sectional hypotheses derived from the theory that metacognitive beliefs cause and maintain distress both directly and indirectly by driving worry. Conclusions: The findings provide promising first evidence that the S-REF model may be usefully applied in cancer. Further study is required to establish the predictive and clinical utility of these findings.