Generalized Anxiety Disorder: Does the Emotion Dysregulation Model Predict Symptoms Beyond the Metacognitive Model?

A systematic review of the relationship between generic and specific metacognitive beliefs and emotion dysregulation: A metacognitive model of emotion dysregulation

“…Metacognitive beliefs were measured with the Metacognitions Questionnaire Short Form‐30 (Wells & Cartwright‐Hatton, 2004) in 12 studies (Akbari, 2017; Akbari et al, 2021; Deleurme et al, 2022; Laghi et al, 2018; Leahy et al, 2019; Mansueto et al, 2022, study 1; Mansueto et al, 2022, study 2; Mazloom et al, 2016; Mohammadkhani et al, 2020; Palmieri et al, 2023b; Salguero et al, 2019; Spada & Marino, 2017), with the Positive Alcohol Metacognitions Scale (Spada et al, 2008) and the Negative Alcohol Metacognitions scale (Spada et al, 2008) in three studies (Azzi et al, 2022; Dragan, 2015; Ottonello et al, 2019), with the Metacognitions about Smoking Questionnaire (Nikčević et al, 2015) in one study (Poormahdy et al, 2022), with the Metacognitions about Smartphone Use Questionnaire in one study (Akbari et al, 2023) with the Distraction Scale of the Online Cognition Scale (Davis et al, 2002) and the Schouten's scale (Schouten et al, 2007) in one study (Casale et al, 2016), with the Beliefs about Emotions Questionnaire (Manser et al, 2012) in one study (Manser et al, 2012), and with the Emotion Beliefs Questionnaire (Becerra et al, 2020) in one study (Rogier et al, 2022). Emotion dysregulation was measured with the Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004) in eleven studies (Akbari, 2017; Casale et al, 2016; Dragan, 2015; Laghi et al, 2018; Mansueto et al, 2022, study 1; Mansueto et al, 2022, study 2; Mazloom et al, 2016; Ottonello et al, 2019; Palmieri et al, 2023b; Poormahdy et al, 2022; Salguero et al, 2019), with the Difficulties in Emotion Regulation Scale Short‐Form (Kaufman et al, 2016) in one study (Ottonello et al, 2019), with the Emotion Regulation Questionnaire (Gross & John, 2003) in three studies (Akbari et al, 2021, 2023; Azzi et al, …”

“…The aforementioned studies showed statistically significant positive correlations between positive beliefs about worry (Mansueto et al, 2022), positive metacognitive beliefs about internet use (Casale et al, 2016) and emotion dysregulation ( r values ranging from 0.20 to 0.31). Moreover, a higher endorsement of positive beliefs about worry has been found to be associated with sub‐components of emotion dysregulation, that is, a greater expression of negative emotions and emotional reactions to experiences ( r values ranging from 0.09 to 0.18), but not with a greater expression of positive emotions (Deleurme et al, 2022).…”

“…Although studies included in the present review provide evidences about the possible association between metacognitive beliefs and emotion dysregulation, some issues are still unclear: (a) due to the conflicting findings, whether a higher endorsement of dysfunctional metacognitive beliefs is mostly associated with specific subcomponents of the emotion dysregulation than others (Azzi et al, 2022;Dragan, 2015;Leahy et al, 2019); (b) only one study (Deleurme et al, 2022) explored the associations between metacognitive beliefs and greater expression of positive emotion, showing no significant associations between them; however, the paucity of studies in this field does not allow to draw any conclusion regarding the association between metacognitive beliefs and dysregulation of positive emotion (Weiss et al, 2015); (c) due to the conflicting findings (Akbari et al, 2021;Azzi et al, 2022;Mansueto et al, 2022), whether specific metacognitive beliefs may be more critical than other in enchaining dysfunctional emotion regulation strategies; (d) a partially unexpected result is the negative associations observed in both nonclinical and clinical samples between cognitive self-consciousness (i.e., the tendency to monitor one's own thoughts and focuses attention inwards, e.g., 'I pay close attention to the way my mind works') and emotion dysregulation (Mansueto et al, 2022), suggesting that cognitive self-consciousness may be associated with greater ease in emotion regulation (Mansueto et al, 2022). A possible explanation for this result may lie with literature suggesting that, compared with other metacognitive beliefs, cognitive self-consciousness tends to be negatively associated with some problematic tendencies as inhibitory behaviour tendency or lower impulsivity (Efrati et al, 2021);…”

“…Nine studies were run on non-clinical samples (i.e., university students and general population) (Akbari, 2017, Akbari et al, 2021Akbari et al, 2023;Casale et al, 2016;Deleurme et al, 2022;Manser et al, 2012;Mansueto et al, 2022, study 1;Rogier et al, 2022;Salguero et al, 2019), seven studies on clinical samples (i.e., patients under psychotherapy, outpatients seeking psychological treatment, outpatients with eating disorders, participants with nicotine dependence, alcohol dependence inpatients and drinkers) (Azzi et al, 2022;Dragan, 2015;Leahy et al, 2019;Mansueto et al, 2022, study 2;Ottonello et al, 2019;Palmieri et al, 2023b;Poormahdy et al, 2022), and four studies were run on adolescent samples (Laghi et al, 2018;Mazloom et al, 2016;Mohammadkhani et al, 2020;Spada & Marino, 2017).…”

“…All selected studies had a cross-sectional design. Six studies were conducted in Italy (Casale et al, 2016;Laghi et al, 2018;Mansueto et al, 2022;Palmieri et al, 2023b;Rogier et al, 2022;Spada & Marino, 2017), six studies in Iran (Akbari, 2017;Akbari et al, 2021Akbari et al, , 2023Mazloom et al, 2016;Mohammadkhani et al, 2020;Poormahdy et al, 2022), one study in United Kingdom (Manser et al, 2012), one study in Poland (Dragan, 2015), one in the United States of America (Leahy et al, 2019), one study in Spain (Salguero et al, 2019), one study in Lebanon (Azzi et al, 2022) and one study in Canada (Deleurme et al, 2022).…”