Bailey_Wells_Manuscript_BRAT_revised_Final.doc

The moderator effect in this instance was not

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misinterpretation-time 1) on Y (health anxiety-time 2) by M (dysfunctional beliefs-time 1). The moderator effect in this instance was not significant B = 0.0257, 95% CI [-0.01, 0.06], t = 1.467, p = .1453. However the subscale “Likelihood of contracting or having an illness’ (HCQ-L)” was borderline significant as a moderator (B = 0.128, 95% CI [0.00, 0.25], t = 1.98, p = .050), suggesting that a limited range of cognitive beliefs might also impact on the
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Metacognition and Health Anxiety: A prospective Study.19 relationship between misinterpretation and health anxiety. However, true moderation by such cognitions is not central to cognitive conceptualisations which typically view schemas as giving rise to misinterpretations which then lead to health anxiety. Thus, the relationship between cognition, misinterpretation and health anxiety may require further elaboration. 3.4. Regression analysis including the interaction term. A further hierarchical regression analysis was undertaken to ascertain whether the interaction between metacognitive beliefs and catastrophic mis-interpretation explained additional variance in the equation, when controlling for all other variables. The same steps as the first regression analysis were employed only this time we added the interaction effect on the last step. On this occasion the interaction effect made a significant (p < .05) contribution to health anxiety at time 2 and explained an additional 2% of the variance, when controlling for the other variables. In the final step of the equation three variables prospectively predicted health anxiety and made a unique and statistically significant contribution to symptoms at time 2. As expected health anxiety at Time 1 emerged as the strongest predictor of health anxiety (β= . 41, p < .001), the other two predictors were; beliefs that thoughts are uncontrollable (β= .25, p < .01) and the interaction term (β= .17, p < .05). 4. Discussion This is the first study to test if metacognitive beliefs predict health anxiety six months later, when controlling for important personality variables and cognitive factors. The study builds on earlier cross-sectional data and demonstrates several theoretically consistent bi-variate prospective correlates of health anxiety. However, the regression models show that metacognition was the only unique prospective predictor of subsequent health anxiety scores. In these analyses, cognitive and personality factors did not explain unique
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Metacognition and Health Anxiety: A prospective Study.20 variance in later health anxiety. Furthermore, testing of reciprocal associations between metacognition and health anxiety across time revealed that the relationship between metacognition and health anxiety was uni-directional: metacognition appears to cause health anxiety but not vice-versa. The two metacognition dimensions that made independent contributions were Beliefs about biased thinking (e.g. ‘If I think positively about physical symptoms I will be caught off guard’), and beliefs that thoughts are uncontrollable (e.g. ‘I cannot have peace of mind so long as I have physical symptoms’). This result is in line with the metacognitive model
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