Executive Control Deficits Potentiate the Effect of Maladaptive Metacognitive Beliefs on Posttraumatic Stress Symptoms

Abstract

The metacognitive model and recent preliminary research suggests that metacognitive beliefs (i.e., beliefs about thinking) may be particularly important for understanding the pathogenesis of posttraumatic stress (PTS). The metacognitive model also suggests that deficits in executive control (i.e., metacognitive control) may increase the impact of metacognitive beliefs on PTS symptoms. Trauma-exposed adult participants (N = 469), recruited through an online crowdsourcing website, completed a battery of measures assessing the constructs of interest. As predicted, deficits in executive control strengthened the positive association between metacognitive beliefs and PTS symptoms. This effect was found in relation to positive (e.g., “Worrying will keep me safe”), but not negative (e.g., “My thoughts are uncontrollable”), metacognitive beliefs. Supplemental analyses, indicated that the interaction between positive metacognitive beliefs and executive control significantly predicted all PTS cluster scores (i.e., Intrusion, Cognition, Arousal, Avoidance). Taken together, results support the proposal that executive control deficits potentiate the effect of metacognitive beliefs on PTS symptoms. Intervention strategies designed to strengthen executive control (e.g., the attention training technique) may be useful in treating individuals with PTS.

The relationship of peritraumatic distress and dissociation with beliefs about memory following natural disasters

“…These findings extend the limited research into the association of metacognitions with PTSD symptoms following a traumatic event (Bardeen & Fergus, 2018;Bennett & Wells, 2010;Fergus & Bardeen, 2017;Halligan et al, 2003;Jelinek et al, 2013;Michael et al, 2007;Takarangi et al, 2017). The results supported the first hypothesis that predicted that high peritraumatic experience would be associated with higher levels of PTSD symptoms.…”

“…These findings align with literature that has established peritraumatic distress and dissociation both as key predictors of PTSD The second and third hypotheses similarly gained support, with participants who reported a high, compared with low, level of either positive or negative metacognitive beliefs about memory reporting higher levels of PTSD symptoms. These findings extend the limited research into the association of metacognitions with PTSD symptoms following a traumatic event (Bardeen & Fergus, 2018;Bennett & Wells, 2010;Fergus & Bardeen, 2017;Halligan et al, 2003;Jelinek et al, 2013;Michael et al, 2007;Takarangi et al, 2017). Notably, whereas past studies suggested that negative metacognitive beliefs had stronger relationships to outcomes (Bardeen & Fergus, 2018;Bennet & Wells, 2010;Fergus & Bardeen, 2017;Jelinek et al, 2013), the present study found similar effect sizes for positive and negative metacognitive beliefs about the memory.…”

“…Further, differences in the trauma type investigated in previous research necessitate caution in making direct comparison between studies. Past studies have investigated the displacement of children during WWII (Jelinek et al, 2013), traumatic nursing placements (Bennett & Wells, 2010), and diverse traumatic events relevant to individual participants (Bardeen & Fergus, 2018;Fergus & Bardeen, 2017). The natural disasters investigated in the current study, especially earthquakes, pose a threat of recurrence and continued disruption, which may lead individuals to believe that recovering a complete memory of the event would be helpful for future protection.…”

“…Few studies have examined the influence of metacognitions in the development of PTSD symptoms following trauma (Bardeen & Fergus, 2018;Bennett & Wells, 2010;Dunmore, Clark, & Ehlers, 2001;Fergus & Bardeen, 2017;Jelinek, Wittekind, Kellner, Moritz, & Muhtz, 2013;Takarangi, Smith, Strange, & Flowe, 2017). Ehlers et al have conducted several studies investigating the role of metacognitive beliefs; that is, negative appraisals about initial PTSD symptoms and emotions and their association with PTSD outcomes.…”

Metacognitive Therapy for Posttraumatic Stress Disorder in Youth: A Feasibility Study

“…Further, Bennett and Wells (2010) found evidence that metacognitive beliefs about the trauma memory (e.g., the belief that gaps in the memory mean I am not normal), but not memory disorganization within the trauma narrative, positively predicted significant variance in posttraumatic stress symptoms. Further, Bardeen and Fergus (2018) found that deficits in executive control strengthened the positive association between metacognitive beliefs and posttraumatic stress symptoms. Wells (2009) emphasizes that the processes of the CAS are maladaptive in that they increase and maintain threat perceptions and block emotional processing.…”