An observational treatment study of metacognition in anxious-depression
Prior studies have found metacognitive biases are linked to a transdiagnostic dimension of anxious-depression, manifesting as reduced confidence in performance. However, previous work has been cross-sectional and so it is unclear if under-confidence is a trait-like marker of anxious-depression vulne...
Main Authors: | , , , , , , , , , , |
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eLife Sciences Publications Ltd
2023-10-01
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Online Access: | https://elifesciences.org/articles/87193 |
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author | Celine Ann Fox Chi Tak Lee Anna Kathleen Hanlon Tricia XF Seow Kevin Lynch Siobhán Harty Derek Richards Jorge Palacios Veronica O'Keane Klaas Enno Stephan Claire M Gillan |
author_facet | Celine Ann Fox Chi Tak Lee Anna Kathleen Hanlon Tricia XF Seow Kevin Lynch Siobhán Harty Derek Richards Jorge Palacios Veronica O'Keane Klaas Enno Stephan Claire M Gillan |
author_sort | Celine Ann Fox |
collection | DOAJ |
description | Prior studies have found metacognitive biases are linked to a transdiagnostic dimension of anxious-depression, manifesting as reduced confidence in performance. However, previous work has been cross-sectional and so it is unclear if under-confidence is a trait-like marker of anxious-depression vulnerability, or if it resolves when anxious-depression improves. Data were collected as part of a large-scale transdiagnostic, four-week observational study of individuals initiating internet-based cognitive behavioural therapy (iCBT) or antidepressant medication. Self-reported clinical questionnaires and perceptual task performance were gathered to assess anxious-depression and metacognitive bias at baseline and 4-week follow-up. Primary analyses were conducted for individuals who received iCBT (n=649), with comparisons between smaller samples that received antidepressant medication (n=82) and a control group receiving no intervention (n=88). Prior to receiving treatment, anxious-depression severity was associated with under-confidence in performance in the iCBT arm, replicating previous work. From baseline to follow-up, levels of anxious-depression were significantly reduced, and this was accompanied by a significant increase in metacognitive confidence in the iCBT arm (β=0.17, SE=0.02, p<0.001). These changes were correlated (r(647)=-0.12, p=0.002); those with the greatest reductions in anxious-depression levels had the largest increase in confidence. While the three-way interaction effect of group and time on confidence was not significant (F(2, 1632)=0.60, p=0.550), confidence increased in the antidepressant group (β=0.31, SE = 0.08, p<0.001), but not among controls (β=0.11, SE = 0.07, p=0.103). Metacognitive biases in anxious-depression are state-dependent; when symptoms improve with treatment, so does confidence in performance. Our results suggest this is not specific to the type of intervention. |
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issn | 2050-084X |
language | English |
last_indexed | 2024-03-11T18:51:06Z |
publishDate | 2023-10-01 |
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spelling | doaj.art-bc1e941667f8405ab05ec1d458871c362023-10-11T11:26:12ZengeLife Sciences Publications LtdeLife2050-084X2023-10-011210.7554/eLife.87193An observational treatment study of metacognition in anxious-depressionCeline Ann Fox0https://orcid.org/0000-0003-1740-3765Chi Tak Lee1Anna Kathleen Hanlon2Tricia XF Seow3https://orcid.org/0000-0002-5930-8929Kevin Lynch4Siobhán Harty5Derek Richards6https://orcid.org/0000-0003-0871-4078Jorge Palacios7Veronica O'Keane8Klaas Enno Stephan9https://orcid.org/0000-0002-8594-9092Claire M Gillan10https://orcid.org/0000-0001-9065-403XSchool of Psychology, Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, IrelandSchool of Psychology, Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, IrelandSchool of Psychology, Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, IrelandWellcome Centre for Human Neuroimaging, University College London, London, United KingdomSchool of Psychology, Trinity College Dublin, Dublin, IrelandSilverCloud Science, SilverCloud Health Ltd, Dublin, IrelandSchool of Psychology, Trinity College Dublin, Dublin, Ireland; SilverCloud Science, SilverCloud Health Ltd, Dublin, IrelandSchool of Psychology, Trinity College Dublin, Dublin, Ireland; SilverCloud Science, SilverCloud Health Ltd, Dublin, IrelandDepartment of Psychiatry, Trinity College Dublin, Dublin, Ireland; Tallaght Hospital, Trinity Centre for Health Sciences, Tallaght University Hospital, Dublin, IrelandTranslational Neuroimaging Unit (TNU), Institute for Biomedical Engineering, University of Zurich, Zurich, Switzerland; Max Planck Institute for Metabolism Research, Cologne, GermanySchool of Psychology, Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland; Global Brain Health Institute, Trinity College Dublin, Dublin, IrelandPrior studies have found metacognitive biases are linked to a transdiagnostic dimension of anxious-depression, manifesting as reduced confidence in performance. However, previous work has been cross-sectional and so it is unclear if under-confidence is a trait-like marker of anxious-depression vulnerability, or if it resolves when anxious-depression improves. Data were collected as part of a large-scale transdiagnostic, four-week observational study of individuals initiating internet-based cognitive behavioural therapy (iCBT) or antidepressant medication. Self-reported clinical questionnaires and perceptual task performance were gathered to assess anxious-depression and metacognitive bias at baseline and 4-week follow-up. Primary analyses were conducted for individuals who received iCBT (n=649), with comparisons between smaller samples that received antidepressant medication (n=82) and a control group receiving no intervention (n=88). Prior to receiving treatment, anxious-depression severity was associated with under-confidence in performance in the iCBT arm, replicating previous work. From baseline to follow-up, levels of anxious-depression were significantly reduced, and this was accompanied by a significant increase in metacognitive confidence in the iCBT arm (β=0.17, SE=0.02, p<0.001). These changes were correlated (r(647)=-0.12, p=0.002); those with the greatest reductions in anxious-depression levels had the largest increase in confidence. While the three-way interaction effect of group and time on confidence was not significant (F(2, 1632)=0.60, p=0.550), confidence increased in the antidepressant group (β=0.31, SE = 0.08, p<0.001), but not among controls (β=0.11, SE = 0.07, p=0.103). Metacognitive biases in anxious-depression are state-dependent; when symptoms improve with treatment, so does confidence in performance. Our results suggest this is not specific to the type of intervention.https://elifesciences.org/articles/87193metacognitionconfidenceanxious-depressiontransdiagnosticiCBTantidepressant |
spellingShingle | Celine Ann Fox Chi Tak Lee Anna Kathleen Hanlon Tricia XF Seow Kevin Lynch Siobhán Harty Derek Richards Jorge Palacios Veronica O'Keane Klaas Enno Stephan Claire M Gillan An observational treatment study of metacognition in anxious-depression eLife metacognition confidence anxious-depression transdiagnostic iCBT antidepressant |
title | An observational treatment study of metacognition in anxious-depression |
title_full | An observational treatment study of metacognition in anxious-depression |
title_fullStr | An observational treatment study of metacognition in anxious-depression |
title_full_unstemmed | An observational treatment study of metacognition in anxious-depression |
title_short | An observational treatment study of metacognition in anxious-depression |
title_sort | observational treatment study of metacognition in anxious depression |
topic | metacognition confidence anxious-depression transdiagnostic iCBT antidepressant |
url | https://elifesciences.org/articles/87193 |
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