Anxiety and depression in people with epilepsy_the contribution of metacognitive beliefs.doc

Negative metacognitive beliefs about the

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Negative metacognitive beliefs about the uncontrollability of worry are considered centrally important in the S-REF model [16-18] because, if patients believe that worry is uncontrollable, they will not attempt to control it. It should be noted that positive metacognitive beliefs alone are not pathognomonic as many people hold positive metacognitive beliefs about the usefulness of worry. However, the S-REF model specifies that ‘positive’ metacognitive beliefs about the benefits of engaging with, or acting on, negative thoughts and feelings will increase the likelihood that an individual will use the CAS’ counterproductive coping strategies such as worry. In summary, the S-REF model predicts that the relationship between positive metacognitive beliefs and emotional distress (anxiety and depression) will be fully mediated by worry. Negative metacognitive beliefs about the uncontrollability and danger of perseverative thinking are distressing themselves, but also serve to further maintain distress by driving continued use of the worry; that is the relationship between negative metacognitive beliefs and distress is partially mediated by worry. There is extensive evidence supporting the role of metacognitive beliefs in anxiety and depression in mental health [19-22] and physical health populations [23-25]. The overarching objective of this study was to evaluate, for the first time, the potential of the S-REF model to explain anxiety and depression in PWE. To do this, we first tested if 5
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metacognitive beliefs explained additional variance in anxiety and depression after accounting for demographic variables, comorbid physical/psychiatric illnesses, epilepsy characteristics and the number and perceived side effects of anti-epileptic medication. We then tested whether the aforementioned predictions made by the S-REF model about the nature of the mediational relationships between metacognitive beliefs, worry and emotional distress (anxiety and depression) were supported by data from PWE on these measures. 2. Methods 2.1. Study design and participants Participants were PWE affiliated with the British Epilepsy Association (Epilepsy Action) and had been recruited as part of a larger cohort study. To be eligible to participate the person returning the questionnaire needed to confirm that they were ≥16 years old, that they had been diagnosed with epilepsy (of any type) for at least one year, and that they were able to provide informed consent and independently complete questionnaires in English. The purpose of the larger study was to examine how similar ratings of patient outcomes made by patients themselves were to those made by their informal carers. Full recruitment details have previously been described [10]. In brief, a total of 3866 people were randomly selected by the British Epilepsy Association by computer from their database and sent a postal invite. Those agreeable to participation were asked to return a completed questionnaire using a prepaid envelope. The
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  • Fall '19
  • The Road, Selective serotonin reuptake inhibitor, Major depressive disorder

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