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How negative automatic thoughts trigger Chinese adolescents’ social anxiety: The mediation effect of meta-worry

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Abstract

Theoretical and empirical evidence has found that negative automatic thoughts (ATs) are vital in the occurrence of social anxiety in youth population; however, the mechanism is rarely investigated in Chinese adolescents. This study aimed to discover the mediating mechanism of meta-worry (including meta-worry belief and frequency) on negative automatic thoughts and social anxiety in Chinese adolescents. Cross-sectional research design was used. Three hundred and fifty-seven adolescents were recruited to complete measures of meta-worry, social anxiety, negative automatic thoughts, depression, and demographic information. After controlling for depression, we found that meta-worry frequency mediated partially the relation between negative automatic thoughts and social anxiety in adolescents. In addition, participants’ age moderated the relation between negative automatic thoughts and meta-worry frequency. Our results shed the light on the metacognitive therapy in adolescents. Results are informative for metacognitive therapy suggesting that it could be more effective by targeting changes in the frequency of thoughts rather than changes in meta-worry beliefs.

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References

  • Aderka, I. M., Hofmann, S. G., Nickerson, A., Hermesh, H., Gilboa-Schechtman, E., & Marom, S. (2012). Functional impairment in social anxiety disorder. Journal of Anxiety Disorders, 26, 393–400. https://doi.org/10.1016/j.janxdis.2012.01.003

    Article  PubMed  Google Scholar 

  • Alfano, C. A., Beidel, D. C., & Turner, S. M. (2002). Cognition in childhood anxiety: Conceptual, methodological, and developmental issues. Clinical Psychology Review, 22(8), 1209–1238. https://doi.org/10.1016/S0272-7358(02)00205-2

    Article  PubMed  Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5). American Psychiatric Publishing

  • 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(6), 727–736. https://doi.org/10.1016/j.janxdis.2009.02.013

    Article  PubMed  Google Scholar 

  • Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173

    Article  PubMed  Google Scholar 

  • Beck, J. (2011). Cognitive behavior therapy: Basics and beyond. Guilford Press

  • Benedetto, L., Blasi, D., Di, & Pacicca, P. (2014). Worry and meta-cognitive beliefs in childhood anxiety disorders. Mediterranean Journal of Clinical Psychology, 1(3). https://doi.org/10.6092/2282-1619/2013.1.932

  • Cheng, S. P., & Wang, L. P. (2007). Relationship between anxiety and metacognitive of college student. Chinese Journal of Clinical Psychology, 15(1), 46–50. https://doi.org/10.3969/j.issn.1005-3611.2007.01.017

    Article  Google Scholar 

  • Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In R. G. Heimberg, M. R. Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social phobia: Diagnosis, assessment and treatment. Guilford Press

  • Cummings, C. M., Caporino, N. E., & Kendall, P. C. (2014). Comorbidity of anxiety and depression in children and adolescents: 20 years after. Psychological Bulletin, 140, 816–845. https://doi.org/10.1037/a0034733

    Article  PubMed  Google Scholar 

  • Dush, D. M., Hirt, M. L., & Schroeder, H. E. (1989). Self-statement modification in the treatment of child behaviour disorders: A meta-analysis. Psychological Bulletin, 106, 97–106

    Article  PubMed  Google Scholar 

  • 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(2), 151–163. https://doi.org/10.1007/s10567-010-0065-0

    Article  PubMed  Google Scholar 

  • Fehm, L., Beesdo, K., Jacobi, F., & Fiedler, A. (2008). Social anxiety disorder above and below the diagnostic threshold: Prevalence, comorbidity and impairment in the general population. Social Psychiatry and Psychiatric Epidemiology, 43(4), 257–265. https://doi.org/10.1007/s00127-007-0299-4

    Article  PubMed  Google Scholar 

  • Fisak, B., Mentuccia, M., & Przeworski, A. (2014). Meta-worry in adolescents: Examination of the psychometric properties of the meta-worry questionnaire in an adolescent sample. Behavioural & Cognitive Psychotherapy, 42(4), 491–496. https://doi.org/10.1017/S1352465813000374

    Article  Google Scholar 

  • Flavell, J. H., Green, F. L., & Flavell, E. R. (1998). The mind has a mind of its own: Develo** knowledge about mental uncontrollability. Cognitive Development, 13(1), 127–138. https://doi.org/10.1016/s0885-2014(98)90024-7

    Article  Google Scholar 

  • Gkika, S., Wittkowski, A., & Wells, A. (2017). Social cognition and metacognition in social anxiety: A systematic review. Clinical Psychology & Psychotherapy, 25(1), 10–30. https://doi.org/10.1002/cpp.2127

    Article  Google Scholar 

  • Gross, C., & Hen, R. (2004). The developmental origins of anxiety. Nature Reviews Neuroscience, 5(7), 545–552. https://doi.org/10.1038/nrn1429

    Article  PubMed  Google Scholar 

  • Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. The Guilford Press

  • Heeren, A., Wong, Q. J. J., Ceschi, G., Moulds, M. L., & Philippot, P. (2014). Probing the structural validity of the self-beliefs in Social Anxiety Scale (SBSA): Adaptation and validation in a French‐speaking community sample. Canadian Journal of Behavioural Science/Revue Canadienne des Sciences du Comportement, 46(4), 506–513. https://doi.org/10.1037/a0035295

    Article  Google Scholar 

  • Hodson, K. J., McManus, F. V., Clark, D. M., & Doll, H. (2008). Can Clark and Wells’ (1995) cognitive model of social phobia be applied to young people? Behavioural and Cognitive Psychotherapy, 36(4), 449–461. https://doi.org/10.1017/S13524658080044

    Article  Google Scholar 

  • Holzman, J. B., Valentiner, D. P., & McCraw, K. S. (2014). Self-focused attention and post‐event processing: Relevance to social performance anxiety and social interaction anxiety. Journal of Cognitive Psychotherapy, 28(1), 72–82. https://doi.org/10.1891/0889‐8391.28.1.72

    Article  PubMed  Google Scholar 

  • Iancu, I., Bodner, E., Joubran, S., Lupinsky, Y., & Barenboim, D. (2015). Negative and positive automatic thoughts in social anxiety disorder. Israel Journal of Psychiatry & Related Sciences, 52(2), 129–136

    Google Scholar 

  • Kang, Z. H. (2005). The preliminary construction of the scale for college student’s metacognitive ability (Doctoral dissertation). Shanxi University

  • Keles Altun, I., Uysal, E., & Ozkorumak Karagüzel, E. (2017). Differences between autogenous and reactive obsessions in terms of metacognitions and automatic thoughts. Neuropsychiatric Disease and Treatment, 13, 2977–2985. https://doi.org/10.2147/ndt.s151083

    Article  PubMed  PubMed Central  Google Scholar 

  • Knappe, S., Sasagawa, S., & Creswell, C. (2015). Developmental epidemiology of social anxiety and social phobia in adolescents. Social Anxiety and Phobia in Adolescents (pp. 39–70). Springer International Publishing

  • Kuhn, D. (1999b). Metacognitive development. In L. Balter, & C. S. Tamis-LeMonda (Eds.), Child psychology: A handbook of contemporary issues (pp. 259–286). Psychology Press

  • Kuhn, D. (2000a). Adolescence: Adolescent thought processes. In A. E. Kazdin (Ed.), Encyclopedia of psychology (1 vol., pp. 52–59). Oxford University Press

  • Kuhn, D. (2000). Metacognitive development. Current Directions in Psychological Science, 9, 178–181. https://doi.org/10.1111/1467-8721.00088

    Article  Google Scholar 

  • Kuhn, D. (2000c). Theory of mind, metacognition, and reasoning: A life-span perspective. In J. R. Mitchell, & P. Riggs (Eds.), Children’s reasoning and the mind (pp. 301–326). Psychology Press

  • Kovacs, M. (1992). Children’s depression inventory manual. Multi-Health Systems

  • La Greca, A. M., Dandes, S. K., Wick, P., Shaw, K., & Stone, W. L. (1988). Development of the social anxiety scale for children: Reliability and concurrent validity. Journal of Clinical Child Psychology, 17(1), 84–91. https://doi.org/10.1207/s15374424jccp1701_11

    Article  Google Scholar 

  • Leigh, E., & Clark, D. M. (2018). Understanding social anxiety disorder in adolescents and improving treatment outcomes: Applying the cognitive model of clark and wells (1995). Clinical Child and Family Psychology Review, 21(3), 388–414. https://doi.org/10.1007/s10567-018-0258-5

  • Loscalzo, Y., Giannini, M., & Miers, A. C. (2017). Social anxiety and interpretation bias: Examining clinical and subclinical components in adolescents. Child and Adolescent Mental Health, 23, 169–176. https://doi.org/10.1111/camh.12221

    Article  PubMed  Google Scholar 

  • Merikangas, K. R., He, J., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., & Swendsen, J. (2010). Lifetime prevalence of mental disorders in US adolescents: Results from the National Comorbidity Study-Adolescent Supplement (NCSA). Journal of American Academy of Child and Adolescent Psychiatry, 49, 980–989. https://doi.org/10.1016/j.jaac.2010.05.017

    Article  Google Scholar 

  • Miers, A. C., Blöte, A. W., Bögels, S. M., & Westenberg, P. M. (2008). Interpretation bias and social anxiety in adolescents. Journal of Anxiety Disorders, 22(8), 1462–1471. https://doi.org/10.1016/j.janxdis.2008.02.010

    Article  PubMed  Google Scholar 

  • Normann, N., Lønfeldt, N. N., Reinholdt-Dunne, M. L., & Esbjørn, B. H. (2016). Negative thoughts and metacognitions in anxious children following CBT. Cognitive Therapy & Research, 40(2), 188–197. https://doi.org/10.1007/s10608-015-9740-2

    Article  Google Scholar 

  • Papageorgiou, C., & Wells, A. (1999). Process and metacognitive dimensions of depressive and anxious thoughts and relationships with emotional intensity. Clinical Psychology and Psychotherapy, 2(199905), 156–162. https://doi.org/10.1002/(SICI)1099-0879)6:23.0.CO;2-A

    Article  Google Scholar 

  • Payne, S., Bolton, D., & Perrin, S. (2011). A pilot investigation of cognitive therapy for generalized anxiety disorder in children aged 7–17 years. Cognitive Therapy and Research, 35(2), 171–178. https://doi.org/10.1007/s10608-010-9341-z

    Article  Google Scholar 

  • Rapee, R. M., & Heimberg, R. G. (1997). A cognitive–behavioral model of anxiety in social phobia. Behaviour Research and Therapy, 35(8), 741–756. https://doi.org/10.1016/S0005-7967(97)00022-3

    Article  PubMed  Google Scholar 

  • Ruscio, A. M., Brown, T. A., Chiu, W. T., Sareen, J., Stein, M. B., & Kessler, R. C. (2008). Social fears and social phobia in the United States: Results from the National Comorbidity Survey Replication. Psychological Medicine, 38(1), 15–28. https://doi.org/10.1017/S0033291707001699

    Article  PubMed  Google Scholar 

  • Ryum, T., Kennair, L. E. O., Hjemdal, O., Hagen, R., Halvorsen, J., & Solem, S. (2017). Worry and metacognitions as predictors of anxiety symptoms: A prospective study. Frontiers in Psychology, 8. https://doi.org/10.3389/fpsyg.2017.00924

  • Schniering, C. A., & Rapee, R. M. (2002). Development and validation of a measure of children’s automatic thoughts: The children’s automatic thoughts scale. Behaviour Research and Therapy, 40(9), 1091–1109. https://doi.org/10.1016/S0005-7967(02)00022-0

    Article  PubMed  Google Scholar 

  • Simon, N. M. (2009). Generalized anxiety disorder and psychiatric comorbidities such as depression, bipolar disorder, and substance abuse. Journal of Clinical Psychiatry, 70(suppl 2), 10–14. https://doi.org/10.4088/JCP.s.7002.02

    Article  PubMed  Google Scholar 

  • Sun, L., Rapee, R. M., Tao, X., Yan, Y., Wang, S., Xu, W., et al. (2015). Psychometric properties of the children’s automatic thoughts scale (CATS) in Chinese adolescents. Child Psychiatry & Human Development, 46, 600–608. https://doi.org/10.1007/s10578-014-0500-4

    Article  Google Scholar 

  • Vasey, M. W., & Daleiden, E. L. (1994). Worry in children. In D. Graham, & F. Tallis (Eds.), Worrying: Perspectives on theory, assessment and treatment (pp. 185–207). Wiley

  • Wells, A., & Matthews, G. (1994). Attention and emotion: A clinical perspective. Lawrence Erlbaum, 35(3). https://doi.org/10.1016/S0005-7967(97)85199-6

  • Wells, A. (1994). Attention and the control of worry. In G. C. L. Davey, & F. Tallis (Eds.), Worrying: Perspectives on theory, assessment and treatment. Wiley

  • Wells, A. (1995). Meta-cognition and worry: A cognitive model of generalized anxiety disorder. Behavioural & Cognitive Psychotherapy, 23(3), 301–320. https://doi.org/10.1017/S1352465800015897

    Article  Google Scholar 

  • Wells, A. (2002). Worry, metacognition, and gad: Nature, consequences, and treatment. Journal of Cognitive Psychotherapy, 16(2), 179–192. https://doi.org/10.1891/jcop.16.2.179.63994

    Article  Google Scholar 

  • Wells, A. (2005). The metacognitive model of gad: Assessment of meta-worry and relationship with DSM-IV generalized anxiety disorder. Cognitive Therapy and Research, 29(1), 107–121. https://doi.org/10.1007/s10608-005-1652-0

    Article  Google Scholar 

  • Wells, A. (2008). Metacognitive Therapy for Anxiety and Depression. Guilford Press

    Google Scholar 

  • Westenberg, P. M., Drewes, M. J., Goedhart, A. W., Siebelink, B. M., & Treffers, P. D. A. (2004). A developmental analysis of self-reported fears in late childhood through mid-adolescence: Social-evaluative fears on the rise? Journal of Child Psychology and Psychiatry, 45(3), 481–495. https://doi.org/10.1111/j.1469-7610.2004.00239.x

    Article  PubMed  Google Scholar 

  • Westenberg, P. M., Gullone, E., Bokhorst, C. L., Heyne, D. A., & King, N. J. (2007). Social evaluation fear in childhood and adolescence: Normative developmental course and continuity of individual differences. British Journal of Developmental Psychology, 25, 471–483. https://doi.org/10.1348/026151006X173099

    Article  Google Scholar 

  • Wong, Q. J. J., & Moulds, M. L. (2011). A new measure of the maladaptive self-beliefs in social anxiety: Psychometric properties in a non‐clinical sample. Journal of Psychopathology and Behavioral Assessment, 33(2), 273–284. https://doi.org/10.1007/s10862‐010‐9208‐3

    Article  Google Scholar 

  • Yu, D., & Li, X. (2000). Preliminary use of the Children’s Depression Inventory in China. Chinese Mental Health Journal, 14(4), 225–227. https://doi.org/10.3321/j.issn:1000-6729.2000.04.003

    Article  Google Scholar 

  • Yu, M., Xu, W., **e, Q., Zhu, Y., Chasson, G. S., & Wang, J. (2017). Automatic thoughts as a predictor of internalizing and externalizing problems in Chinese adolescents: A test of the cognitive content-specificity hypothesis with age effects. Scandinavian Journal of Psychology, 58(5), 351–358. https://doi.org/10.1111/sjop.12373

    Article  PubMed  Google Scholar 

  • Yu, M., Zhou, H., Wang, M., & Tang, X. (2020). The heterogeneity of social anxiety symptoms among Chinese adolescents: Results of latent profile analysis. Journal of Affective Disorders, 274, 935–942. https://doi.org/10.1016/j.jad.2020.06.003

    Article  PubMed  Google Scholar 

  • Zhao, X. Jr, Lynch, J. G., & Chen, Q. (2010). Reconsidering Baron and Kenny: Myths and truths about mediation analysis. Journal of Consumer Research, 37(2), 197–206. https://doi.org/10.1086/651257

  • Zhou, X., Xu, Q., Inglés, C. J., Hidalgo, M. D., & La Greca, A. M. (2008). Reliability and validity of the Chinese version of the Social Anxiety Scale for Adolescents. Child Psychiatry and Human Development, 39(2), 185–200. https://doi.org/10.1007/s10578-007-0079-0

    Article  PubMed  Google Scholar 

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Funding

This research was supported by the National Science Foundation of China [Grant No. 32171073], Humanities and Social Science Fundation of Ministry of Education of China [No. 21YJC190020], and China Postdoctoral Science Foundation [Grant No. 2020M672919].

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Correspondence to Dingguo Gao.

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Meng Yu and Fangyan Lv contributed equally to this work and share first authorship.

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Yu, M., Lv, F., Liu, Z. et al. How negative automatic thoughts trigger Chinese adolescents’ social anxiety: The mediation effect of meta-worry. Curr Psychol 42, 21489–21498 (2023). https://doi.org/10.1007/s12144-022-03229-1

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