Carolin Thielsch1, Thomas Ehring2, Steffen Nestler3, Janina Wolters3, Ina Kopei3, Fred Rist3, Alexander L Gerlach4, Tanja Andor3. 1. Institute of Psychology, University of Münster, Germany. Electronic address: CarolinThielsch@uni-muenster.de. 2. Institute of Psychology, University of Münster, Germany; Department of Psychology, University of Munich, Germany. 3. Institute of Psychology, University of Münster, Germany. 4. Institute of Psychology, University of Cologne, Germany.
Abstract
BACKGROUND: The metacognitive model of generalized anxiety disorder proposes that negative metacognitive beliefs are crucial in the maintenance of excessive worry. Furthermore, according to the cognitive model of insomnia, worry leads to problems falling or staying asleep and poor sleep quality. In order to test the assumed causal relationships, the present study examined the time-dependent course of negative metacognition and worry as well as worry and sleep quality, using Ecological Momentary Assessment (EMA). METHOD: Negative metacognitions, worry and sleep were assessed by self-report questionnaires as well as EMA in 56 GAD patients who carried a portable device for 1 week and logged sleep quality, negative metacognition and worry processes four times a day. RESULTS: Metacognitions, worry and sleep were significantly correlated. Structural equation modeling using multilevel analyses showed a unidirectional relationship of negative metacognitions leading to prolonged worry processes and a bidirectional relationship of worry and sleep quality. CONCLUSIONS: These findings support the theoretically derived assumptions on the relationship between negative metacognitions, worry and sleep. Implications for further research as well as clinical implications are discussed.
BACKGROUND: The metacognitive model of generalized anxiety disorder proposes that negative metacognitive beliefs are crucial in the maintenance of excessive worry. Furthermore, according to the cognitive model of insomnia, worry leads to problems falling or staying asleep and poor sleep quality. In order to test the assumed causal relationships, the present study examined the time-dependent course of negative metacognition and worry as well as worry and sleep quality, using Ecological Momentary Assessment (EMA). METHOD: Negative metacognitions, worry and sleep were assessed by self-report questionnaires as well as EMA in 56 GAD patients who carried a portable device for 1 week and logged sleep quality, negative metacognition and worry processes four times a day. RESULTS: Metacognitions, worry and sleep were significantly correlated. Structural equation modeling using multilevel analyses showed a unidirectional relationship of negative metacognitions leading to prolonged worry processes and a bidirectional relationship of worry and sleep quality. CONCLUSIONS: These findings support the theoretically derived assumptions on the relationship between negative metacognitions, worry and sleep. Implications for further research as well as clinical implications are discussed.
Authors: Abigail L Barthel; Megan A Pinaire; Joshua E Curtiss; Amanda W Baker; Mackenzie L Brown; Susanne S Hoeppner; Eric Bui; Naomi M Simon; Stefan G Hofmann Journal: J Affect Disord Date: 2020-09-02 Impact factor: 4.839