Anxiety and depression in people with epilepsy: The contribution of metacognitive beliefs
Open accessAbstract
Purpose Anxiety and depressive disorders frequently occur in people with epilepsy (PWE). An information processing model of psychopathology, the Self-Regulatory Executive Function (S-REF) model specifies that maladaptive metacognitive beliefs and processes play a fundamental role in the development and maintenance of anxiety and depression. This study explored whether metacognitive beliefs would explain additional variance in anxiety and depression after accounting for demographics, physical and/or psychiatric illnesses, epilepsy characteristics and medication issues. The mediational relationships between metacognitive beliefs, worry and anxiety and depression, predicted by the metacognitive model were also explored, METHODS: Three hundred and forty-nine PWE participated in an online survey and completed self-report questionnaires measuring anxiety, depression, metacognitive beliefs and worry. Participants also provided information on epilepsy characteristics, demographics, comorbid physical and/or psychiatric illnesses, number of, and perceived side effects of, anti-epileptic medication.Results Regression analysis showed that metacognitive beliefs were associated with symptoms of anxiety, depression, and explained additional variance in these outcomes after accounting for the control variables. Furthermore, the fundamental tenet of the metacognitive model was supported; the relationship between negative metacognitive beliefs about uncontrollability and danger of worry and anxious and depressive symptoms was partially mediated by worry.Conclusion This is the first study to demonstrate that metacognitive beliefs and processes contribute to anxiety and depression beyond variables often associated with emotional distress in PWE. Further research is required to test if modification of metacognitive beliefs and processes using metacognitive therapy would effectively alleviate anxiety and depression in PWE.
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Ten of the thirteen included papers conducted hierarchical regressions evaluating which metacognitive beliefs subscales were independent predictors of anxiety, depression, and/or overall distress.
“Ten of the thirteen included papers [41, 45–47, 49, 50, 52, 53, 58, 61] conducted hierarchical regressions evaluating which metacognitive beliefs subscales were independent predictors of anxiety, depression, and/or overall distress.”
From Metacognitive beliefs and their relationship with anxiety and depression in physical illnesses: A systematic review (2020) · cites this paper as [61]
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- Authors
- Fisher, P. L., & Noble, A. J.
- Affiliations
- University of Liverpool (GB)
- Corresponding author
- Fisher, Peter L.
- Venue
- Seizure
- Publisher
- Elsevier BV
- Published
- 2017-08
- Volume
- 50
- Pages
- 153-159
- ISSN
- 1059-1311 (ISSN-L)
- OpenAlex
- W2649901218
- Cited by
- 41
- References
- 49
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2023: 4 · 2022: 6 · 2021: 3 · 2020: 11 · 2019: 5 · 2018: 2 · 2017: 2
- FWCI
- 7.08
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Seizure (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Epilepsy Action
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- epilepsy, anxiety, depression, metacognitive beliefs, worry, Self-Regulatory Executive Function model, metacognition, mediation, metacognitive therapy, psychiatric comorbidity
- MeSH terms
- Metacognition, Anxiety, Depression, Epilepsy, Female, Humans, Male, Middle Aged, Models, Psychological, Psychiatric Status Rating Scales, Surveys and Questionnaires, Stress, Psychological
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