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Assessment of the cognitive attentional syndrome in children: an adaptation of the CAS-1

Published online by Cambridge University Press:  11 November 2020

Nicoline Normann Open the ORCID record for Nicoline Normann [Opens in a new window] ,
Marie Louise Reinholdt-Dunne ,
Martin Stolpe Andersen  and
Barbara Hoff Esbjørn Open the ORCID record for Barbara Hoff Esbjørn [Opens in a new window]
Nicoline Normann*
Affiliation:
Department of Psychology, University of Copenhagen, Denmark
Marie Louise Reinholdt-Dunne
Affiliation:
Department of Psychology, University of Copenhagen, Denmark
Martin Stolpe Andersen
Affiliation:
Department of Psychology, University of Copenhagen, Denmark
Barbara Hoff Esbjørn
Affiliation:
Department of Psychology, University of Copenhagen, Denmark
*
*Corresponding author. Email: [email protected]
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Abstract

Background:

Research suggests that the metacognitive model is applicable to clinical child populations. However, few measures related to the model are available for younger age groups. A key concept of the model is the cognitive attentional syndrome (CAS), which encompasses the individual’s worry and rumination, maladaptive coping strategies, and metacognitive beliefs. While the CAS has been successfully measured in adults, this has not yet been attempted in children.

Aims:

The aim of this study was to adapt a measure of the CAS for use with children and investigate the measure’s associations with anxiety, worry, depression and metacognitions.

Methods:

Our study included 127 children with anxiety disorders aged 7–13 years. The adult measure of CAS was adapted for use with children and administered at pre- and post-treatment. We examined the correlations between variables and the ability of the CAS measure to explain variance in anxious symptomatology, as well as the measure’s sensitivity to treatment change.

Results:

The adapted measure, CAS-1C, displayed strong associations with overall anxiety, depression, worry and metacognitions. The CAS-1C explained an additional small amount of variance in anxiety and worry symptoms after accounting for metacognitions, which may be due to the measure also assessing thinking styles and coping strategies. Furthermore, the measure displayed sensitivity to treatment change.

Conclusions:

The child measure of the CAS is a brief tool for collecting information on metacognitive beliefs and strategies that maintain psychopathology according to the metacognitive model, and it can be used to monitor treatment changes in these components.

Keywords

child anxietychild depressionmetacognitionregulation strategiescoping
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 49 , Issue 3 , May 2021 , pp. 340 - 351
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020

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References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th edn).Google Scholar
Bacow, T. L., Pincus, D. B., Ehrenreich, J. T., & Brody, L. R. (2009). The metacognitions questionnaire for children: development and validation in a clinical sample of children and adolescents with anxiety disorders. Journal of Anxiety Disorders, 23, 727–736. https://doi.org/10.1016/j.janxdis.2009.02.013 CrossRefGoogle Scholar
Björnsson, C. H. (1968). Läsbarhet: hur skall man som författare nå fram till läsarna? Stockholm, Sweden: Bokförlaget Liber.Google Scholar
Capobianco, L., Reeves, D., Morrison, A. P., & Wells, A. (2018). Group metacognitive therapy vs. mindfulness meditation therapy in a transdiagnostic patient sample: a randomised feasibility trial. Psychiatry Research, 259, 554–561. https://doi.org/10.1016/j.psychres.2017.11.045 CrossRefGoogle Scholar
Cartwright-Hatton, S., Mather, A., Illingworth, V., Brocki, J., Harrington, R., & Wells, A. (2004). Development and preliminary validation of the Meta-cognitions Questionnaire – Adolescent Version. Journal of Anxiety Disorders, 18, 411–422. https://doi.org/10.1016/S0887-6185(02)00294-3 CrossRefGoogle ScholarPubMed
Cartwright-Hatton, S., & Wells, A. (1997). Beliefs about worry and intrusions: the Meta-Cognitions Questionnaire and its correlates. Journal of Anxiety Disorders, 11, 279–296. https://doi.org/10.1016/s0887-6185(97)00011-x CrossRefGoogle ScholarPubMed
Chorpita, B. F., Tracey, S. A., Brown, T. A., Collica, T. J., & Barlow, D. H. (1997). Assessment of worry in children and adolescents: an adaptation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 35, 569–581. https://doi.org/10.1016/S0005-7967(96)00116-7 CrossRefGoogle ScholarPubMed
Chorpita, B. F., Yim, L., Moffitt, C., Umemoto, L. A., & Francis, S. E. (2000). Assessment of symptoms of DSM-IV anxiety and depression in children: a revised child anxiety and depression scale. Behaviour Research and Therapy, 38, 835–855. https://doi.org/10.1016/S0005-7967(99)00130-8 CrossRefGoogle ScholarPubMed
Ellis, D. M., & Hudson, J. L. (2010). The metacognitive model of generalized anxiety disorder in children and adolescents. Clinical Child and Family Psychology Review, 13, 151–163. https://doi.org/10.1007/s10567-010-0065-0 CrossRefGoogle ScholarPubMed
Ellis, D. M., & Hudson, J. L. (2011). Test of the metacognitive model of generalized anxiety disorder in anxiety-disordered adolescents. Journal of Experimental Psychopathology, 2, 28–43. https://doi.org/10.5127/jep.011910 CrossRefGoogle Scholar
Esbjørn, B. H., Normann, N., Christiansen, B. M., & Reinholdt-Dunne, M. L. (2018). The efficacy of group metacognitive therapy for children (MCT-c) with generalized anxiety disorder: an open trial. Journal of Anxiety Disorders, 53, 16–21. https://doi.org/10.1016/j.janxdis.2017.11.002 CrossRefGoogle Scholar
Esbjørn, B. H., Normann, N., & Reinholdt-Dunne, M. L. (2015). Adapting metacognitive therapy to children with generalised anxiety disorder: suggestions for a manual. Journal of Contemporary Psychotherapy, 45, 159–166. https://doi.org/10.1007/s10879-015-9294-3 CrossRefGoogle ScholarPubMed
Esbjørn, B. H., Reinholdt-Dunne, M. L., Caspersen, I. D., Christensen, L. B., & Chorpita, B. F. (2013a). Penn State Worry Questionnaire: findings from normative and clinical samples in Denmark. Journal of Psychopathology and Behavioral Assessment, 35, 113–122. https://doi.org/10.1007/s10862-012-9320-7 CrossRefGoogle Scholar
Esbjørn, B. H., Sømhovd, M. J., Holm, J. M., Lønfeldt, N. N., Bender, P. K., Nielsen, S. K., & Reinholdt-Dunne, M. L. (2013b). A structural assessment of the 30-item Metacognitions Questionnaire for Children and its relations to anxiety symptoms. Psychological Assessment, 25, 1211–1219. https://doi.org/10.1037/a0033793 CrossRefGoogle ScholarPubMed
Esbjørn, B. H., Sømhovd, M. J., Turnstedt, C., & Reinholdt-Dunne, M. L. (2012). Assessing the Revised Child Anxiety and Depression Scale (RCADS) in a national sample of Danish youth aged 8–16 Years. PLoS One, 7, e37339. https://doi.org/10.1371/journal.pone.0037339 CrossRefGoogle Scholar
Fergus, T. A., Bardeen, J. R., & Orcutt, H. K. (2012). Attentional control moderates the relationship between activation of the cognitive attentional syndrome and symptoms of psychopathology. Personality and Individual Differences, 53, 213–217. https://doi.org/10.1016/j.paid.2012.03.017 CrossRefGoogle Scholar
Fergus, T. A., Valentiner, D. P., McGrath, P. B., Gier-Lonsway, S., & Jencius, S. (2013). The cognitive attentional syndrome: examining relations with mood and anxiety symptoms and distinctiveness from psychological inflexibility in a clinical sample. Psychiatry Research. https://doi.org/10.1016/j.psychres.2013.04.020 CrossRefGoogle Scholar
Field, A. (2013). Discovering Statistics Using IBM SPSS Statistics (4th edn). Sage.Google Scholar
Flavell, J. H., Green, F. L., Flavell, E. R., Harris, P. L., & Astington, J. W. (1995). Young children’s knowledge about thinking. Monographs of the Society for Research in Child Development, i–113.CrossRefGoogle Scholar
Hoffart, A., Johnson, S. U., Nordahl, H. M., & Wells, A. (2018). Mechanisms of change in metacognitive and cognitive behavioral therapy for treatment-resistant anxiety: the role of metacognitive beliefs and coping strategies. Journal of Experimental Psychopathology. https://doi.org/10.1177/2043808718787414 CrossRefGoogle Scholar
Hutton, P., Morrison, A. P., Wardle, M., & Wells, A. (2013). Metacognitive therapy in treatment-resistant psychosis: a multiple-baseline study. Behavioural and Cognitive Psychotherapy, 42, 166–185. https://doi.org/10.1017/S1352465812001026 CrossRefGoogle ScholarPubMed
Kowalski, J., & Dragan, M. (2019). Cognitive-attentional syndrome – the psychometric properties of the CAS-1 and multi-measure CAS-based clinical diagnosis. Comprehensive Psychiatry, 91, 13–21. https://doi.org/10.1016/j.comppsych.2019.02.007 CrossRefGoogle ScholarPubMed
Lønfeldt, N. N., Silverman, W. K., & Esbjørn, B. H. (2017). A systematic review and meta-analysis of the association between third-wave cognitive constructs and youth anxiety. International Journal of Cognitive Therapy, 10, 115–137. https://doi.org/10.1521/ijct.2017.10.2.115 CrossRefGoogle Scholar
Menard, S. (2002). Applied Logistic Regression Analysis. Sage University Papers Series on Quantitative Applications in the Social Sciences, 07-106. Sage. https://doi.org/10.4135/9781412983433 CrossRefGoogle Scholar
Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28, 487–495. https://doi.org/10.1016/0005-7967(90)90135-6 CrossRefGoogle ScholarPubMed
Nordahl, H., & Wells, A. (2017). Testing the metacognitive model against the benchmark CBT model of social anxiety disorder: Is it time to move beyond cognition? PLoS One, 12, e0177109. https://doi.org/10.1371/journal.pone.0177109 CrossRefGoogle ScholarPubMed
Nordahl, H., & Wells, A. (2018). Metacognitive therapy for social anxiety disorder: an A–B replication series across social anxiety subtypes. Frontiers in Psychology, 9. https://doi.org/10.3389/fpsyg.2018.00540 CrossRefGoogle ScholarPubMed
Nordahl, H., & Wells, A. (2019). Measuring the cognitive attentional syndrome associated with emotional distress: psychometric properties of the CAS-1. International Journal of Cognitive Therapy, 12, 292–306. https://doi.org/10.1007/s41811-019-00056-4 CrossRefGoogle Scholar
Normann, N., & Morina, N. (2018). The efficacy of metacognitive therapy: a systematic review and meta-analysis. Frontiers in Psychology, 9. https://doi.org/10.3389/fpsyg.2018.02211 CrossRefGoogle ScholarPubMed
Pillow, B. H. (2008). Development of children’s understanding of cognitive activities. Journal of Genetic Psychology, 169, 297–321. https://doi.org/10.3200/gntp.169.4.297-321 CrossRefGoogle ScholarPubMed
Silverman, W. K., & Albano, A. M. (1996). The Anxiety Disorders Interview Schedule for Children for DSM-IV: (Child and Parent Versions). Psychological Corporation.Google Scholar
Simons, M., & Kursawe, A.-L. (2019). Metacognitive therapy for posttraumatic stress disorder in youth: a feasibility study. Frontiers in Psychology, 10. https://doi.org/10.3389/fpsyg.2019.00264 CrossRefGoogle ScholarPubMed
Simons, M., Schneider, S., & Herpertz-Dahlmann, B. (2006). Metacognitive therapy versus exposure and response prevention for pediatric obsessive-compulsive disorder. A case series with randomized allocation. Psychotherapy and Psychosomatics, 75, 257–264. https://doi.org/10.1159/000092897 CrossRefGoogle ScholarPubMed
Wechsler, D. (2010). Wechsler Intelligence Scale for Children –Fourth Edition (WISC-IV). Danish version. Vejledning Del 1. NCS Pearson, Inc.Google Scholar
Wells, A. (1995). Meta-cognition and worry: a cognitive model of generalized anxiety disorder. Behavioural and Cognitive Psychotherapy, 23, 301–320. http://dx.doi.org/10.1017/S1352465800015897 CrossRefGoogle Scholar
Wells, A. (2009). Metacognitive Therapy for Anxiety and Depression. Guilford Press.Google Scholar
Wells, A. (2013). Advances in metacognitive therapy. International Journal of Cognitive Therapy, 6, 186–201. https://doi.org/10.1521/ijct.2013.6.2.186 CrossRefGoogle Scholar
Weng, L.-J. (2004). Impact of the number of response categories and anchor labels on coefficient alpha and test-retest reliability. Educational and Psychological Measurement, 64, 956–972. https://doi.org/10.1177/0013164404268674 CrossRefGoogle Scholar
White, J. A., & Hudson, J. L. (2016). The metacognitive model of anxiety in children: towards a reliable and valid measure. Cognitive Therapy and Research, 40, 92–106. https://doi.org/10.1007/s10608-015-9725-1 CrossRefGoogle Scholar
Wildt, A. R., & Mazis, M. B. (1978). Determinants of scale response: label versus position. Journal of Marketing Research, 15, 261–267. https://doi.org/10.2307/3151256 CrossRefGoogle Scholar
Wilson, C., & Hughes, C. (2011). Worry, beliefs about worry and problem solving in young children. Behavioural and Cognitive Psychotherapy, 39, 507–521. https://doi.org/10.1017/s1352465811000269 CrossRefGoogle ScholarPubMed
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