Köcher Laura Marie, Pflug Verena, Schneider Silvia, Christiansen Hanna
Clinical Child and Adolescent Psychology, Department of Psychology, Philipps-Universität Marburg, 35032 Marburg, Germany.
Mental Health Research and Treatment Center, Ruhr-Universität Bochum, 44787 Bochum, Germany.
Children (Basel). 2022 Jan 28;9(2):168. doi: 10.3390/children9020168.
Metacognitive beliefs have repeatedly proven to play a role in anxiety disorders in children and adolescents, but few studies have investigated whether they change after cognitive behavioral therapy. This longitudinal intervention study explores whether positive and negative metacognitive beliefs in particular change after exposure-focused treatment, and if metacognitive changes predict reductions in anxiety symptoms. A sample of 27 children between 8 and 16 years of age with a primary diagnosis of specific phobia, separation-anxiety disorder or social phobia completed assessments of anxiety symptoms, metacognitive beliefs, worry and repetitive negative thoughts before and after 11 sessions of intensified exposure treatment. Metacognitive beliefs did not change significantly after intensified exposure, but post-hoc power analysis revealed a lack of power here. Change in negative metacognitive beliefs correlated with a change in anxiety symptoms, but did not independently contribute as a predictor variable. Differences between subsamples showed that patients with separation-anxiety disorder scored higher on negative metacognitive beliefs than those with specific or social phobia. Consideration of metacognition, and negative metacognitive beliefs in particular could help us further improve the understanding and treatment of anxiety disorders in children and adolescents and should therefore receive more attention in psychotherapy research.
元认知信念已多次被证明在儿童和青少年焦虑症中发挥作用，但很少有研究调查它们在认知行为治疗后是否会发生变化。这项纵向干预研究探讨了在以暴露为重点的治疗后，积极和消极的元认知信念是否会发生变化，以及元认知变化是否能预测焦虑症状的减轻。27名年龄在8至16岁之间、初步诊断为特定恐惧症、分离焦虑症或社交恐惧症的儿童样本，在接受11次强化暴露治疗前后，完成了焦虑症状、元认知信念、担忧和重复性消极思维的评估。强化暴露后，元认知信念没有显著变化，但事后功效分析表明这里缺乏统计学功效。消极元认知信念的变化与焦虑症状的变化相关，但作为预测变量并不能独立发挥作用。子样本之间的差异表明，分离焦虑症患者在消极元认知信念上的得分高于特定恐惧症或社交恐惧症患者。考虑元认知，尤其是消极元认知信念，可能有助于我们进一步提高对儿童和青少年焦虑症的理解和治疗，因此在心理治疗研究中应受到更多关注。
