Journal article
The metacognitive model of post-traumatic stress disorder and metacognitive therapy for post-traumatic stress disorder: A systematic review
Clinical Psychology and Psychotherapy, Vol.29(1), pp.131-146
2022
PMID: 34155731
Abstract
The metacognitive model of post-traumatic stress disorder (PTSD) implicates meta-cognitive beliefs, meta-memory beliefs and metacognitive control strategies in perpetuating and maintaining symptoms of PTSD. Despite this expanding area of research, the evidence for the metacognitive model of PTSD has not been reviewed. A systematic review according to the PRISMA statement was conducted. Searches across MEDLINE, PubMed and PsycNET, as well as reference lists of the included studies (2004 to March 2020), yielded 221 records. Two independent reviewers screened articles, which were included where the impact of the constructs of interest on PTSD symptoms was investigated within the framework of the metacognitive model for PTSD. Eighteen articles were included in the review. Eleven studies were determined to have good methodological robustness. Metacognitive therapy for PTSD demonstrated reductions in symptoms from pretreatment to post-treatment, which were maintained at follow-up. Predictors of greater PTSD symptom severity included metacognitive beliefs, meta-memory beliefs, and worry, punishment, thought suppression, experiential avoidance, and rumination. Overall, support was found for the validity of the metacognitive model of PTSD. K E Y W O R D S metacognitive beliefs, meta-memory, PTSD, situational processing strategies, thought control strategies 1 | INTRODUCTION Internationally, over 67% of the population will be exposed to trauma, where 3.21% of individuals will develop post-traumatic stress disorder (PTSD; Dückers et al., 2016). The metacognitive model of PTSD by Wells and Sembi (2004a) suggests that the normal emotional processing of a traumatic event can be disrupted by dysfunctional beliefs about thinking (metacognitive beliefs) and dysfunctional beliefs about the traumatic memory (meta-memory beliefs). Wells (2009) describes positive beliefs about worry—referred to from here as positive metacognitive beliefs—which include beliefs about the usefulness of worry, rumination and monitoring threat (e.g., 'Worrying helps me cope'; Wells & Cartwright-Hatton, 2004). Negative metacognitive beliefs are those beliefs about the uncontrollability of thoughts (e.g., 'When I start worrying, I cannot stop') and the danger of thoughts (e.g., 'My worrying is dangerous for me'). Bennett and Wells (2010) further describe positive meta-memory beliefs (e.g., 'I must try to remember all of the details of the trauma so that I can understand why me') and negative meta-memory beliefs (e.g., 'gaps in my memory for the event are preventing me from getting over it'). These meta-memory beliefs perpetuate the cyclical and maladaptive processing of the memory (Wells & Sembi, 2004a). In other theoretical models of PTSD, memory is conceptualized as disorganized and fragmented, and addressing the trauma memory is central within therapy (Brewin et al., 1996; Ehlers & Clark, 2000). However, the metacognitive model of PTSD proposes that metacognitive beliefs
Details
- Title
- The metacognitive model of post-traumatic stress disorder and metacognitive therapy for post-traumatic stress disorder: A systematic review
- Authors
- Renee L Brown (Author) - University of the Sunshine Coast, Queensland, School of Health and Behavioural Sciences - LegacyAndrew Wood (Author) - University of the Sunshine Coast, Queensland, School of Health and Behavioural Sciences - LegacyJanet D Carter (Author) - University of CanterburyLee Kannis‐Dymand (Corresponding Author) - University of the Sunshine Coast, Queensland, School of Health and Behavioural Sciences - Legacy
- Publication details
- Clinical Psychology and Psychotherapy, Vol.29(1), pp.131-146
- Publisher
- John Wiley & Sons Ltd.
- Date published
- 2022
- DOI
- 10.1002/cpp.2633
- ISSN
- 1099-0879
- PMID
- 34155731
- Organisation Unit
- University of the Sunshine Coast, Queensland; Thompson Institute; School of Health - Psychology; School of Health and Behavioural Sciences - Legacy; Sustainability Research Cluster
- Language
- English
- Record Identifier
- 99548407802621
- Output Type
- Journal article
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- Psychology, Clinical
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