Are experiences of psychosis associated with unhelpful metacognitive coping strategies? A systematic review of the evidence
Abstract
This review investigated whether unhelpful metacognitive coping strategies, such as attentional biases, worry, rumination, and thought control, are associated with experiences of psychosis. These processes, known collectively as the Cognitive Attentional Syndrome (CAS), form a central tenet of the Self‐Regulatory Executive Function model. Three research questions based on assumptions underlying the CAS were addressed. It was predicted that processes of (a) self‐focused processing, (b) negative perseverative thinking (worry and rumination), and (c) counterproductive thought control would be associated with experiences of psychosis. A comprehensive search of the literature identified 51 eligible studies: 17 investigated self‐focused attention, 25 investigated perseverative processing (worry: n = 18; rumination: n = 10), and 9 investigated thought control strategies. Findings indicated that unhelpful metacognitive coping strategies associated with the CAS are related to experiences of psychosis and appear to share important relationships with distress. Implications for future research and clinical practice are discussed.
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Rumination has been suggested as an underlying mechanism for triggering and maintaining depression, anxiety and psychotic symptoms.
“Rumination, which is characterised by repetitive thoughts about negative personal experiences, has been suggested as an underlying mechanism for triggering and maintaining depression, anxiety and psychotic symptoms.10,11”
From Dispositional Mindfulness and Psychotic Symptoms in Schizophrenia Spectrum Disorders: The Mediating Roles of Rumination and Negative Emotion (2022) · cites this paper as [10]
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- Authors
- Sellers, R., Wells, A., & Morrison, A. P.
- Affiliations
- University of Manchester (GB)
- Division of Psychology and Mental Health, School of Health Sciences University of Manchester Manchester UK
- Corresponding author
- Sellers, Rachel
- Venue
- Clinical Psychology & Psychotherapy
- Publisher
- Wiley
- Published
- 2017-08-23
- Volume
- 25
- Issue
- 1
- Pages
- 31-49
- ISSN
- 1063-3995 (ISSN-L)
- 1099-0879
- OpenAlex
- W2750324265
- Cited by
- 32
- References
- 113
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 4 · 2023: 8 · 2022: 4 · 2021: 3 · 2020: 5 · 2019: 2 · 2018: 2 · 2017: 1
- FWCI
- 0.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Psychology & Psychotherapy (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- psychosis, cognitive attentional syndrome, Self-Regulatory Executive Function model, attentional bias, worry, rumination, thought control, perseverative thinking, self-focus
- MeSH terms
- Metacognition, Attentional Bias, Rumination, Cognitive, Adaptation, Psychological, Humans, Psychotic Disorders
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