Investigating the role of metacognitive beliefs in post-traumatic stress disorder (PTSD)

Hett, Danielle ORCID: 0000-0003-1575-5409 (2020). Investigating the role of metacognitive beliefs in post-traumatic stress disorder (PTSD). University of Birmingham. Ph.D.

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Following exposure to a traumatic event, some people will develop a mental health condition called post-traumatic stress disorder (PTSD). One novel approach to the prevention of PTSD explored in this thesis, is the shaping of healthy metacognitive beliefs—which refer to the beliefs we have about our own cognition. The metacognitive model of PTSD proposes that maladaptive metacognitive beliefs heighten vulnerability to PTSD. This thesis explored the role of metacognitive beliefs in the development of PTSD; specifically testing their causal role. Second, it examined the relationship between metacognitive beliefs and meta-awareness (i.e., awareness of one’s cognition)—a relatively understudied, yet important, topic in PTSD. Third, it investigated the links between voluntary and involuntary memory for analogue trauma, specifically examining how the details that people remember about a trauma may link to the development of PTSD symptoms.

Study 1 (pilot), investigated the causal role of healthy metacognitive beliefs in PTSD symptoms, using the cognitive bias modification (CBM) and trauma film paradigms. A novel CBM training protocol, named CBMMetacog, was developed in this thesis to test the causal role of healthy metacognitive beliefs in PTSD. The CBMMetacog training was designed to target maladaptive metacognitive beliefs in line with the metacognitive model of PTSD. In Study 1, participants received CBMMetacog training—to increase healthy metacognitive beliefs—immediately following analogue trauma and their metacognitive beliefs and PTSD symptoms were measured over time. Study 2 aimed to explore how maladaptive metacognitive beliefs increase vulnerability to PTSD. This eye-tracking study investigated whether maladaptive metacognitive beliefs affect the way people encode a traumatic event using the trauma film paradigm. Study 3 assessed the causal role of healthy metacognitive beliefs in the primary prevention of PTSD symptoms. Here, CBMMetacog training was administered immediately prior to analogue trauma. Study 4 was the main CBM study. It replicated and extended Study 3, by examining whether increasing healthy metacognitive beliefs lead participants to become more meta-aware of their intrusions. Chapter 8 combined data from Studies 1, 3 and 4, to investigate the effects of CBMMetacog training on people’s voluntary memory for analogue trauma—namely, the voluntary recall of central and peripheral details about a distressing event. The associations between these memory details and PTSD symptoms were also explored.

This thesis has demonstrated, for the first time, some early evidence for the causal link between metacognitive beliefs and PTSD symptoms. Overall, these finding have implications for the primary prevention of PTSD and suggest that targeting metacognitive beliefs in the development of preventative approaches to PTSD may be a crucial next step

Type of Work: Thesis (Doctorates > Ph.D.)
Award Type: Doctorates > Ph.D.
Licence: All rights reserved
College/Faculty: Colleges (2008 onwards) > College of Life & Environmental Sciences
School or Department: School of Psychology
Funders: None/not applicable
Subjects: B Philosophy. Psychology. Religion > BF Psychology


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