A meta-analysis of metacognitive beliefs as implicated in the self-regulatory executive function model in clinical psychosis

This meta-analysis investigated whether the five metacognitive beliefs implicated in the Self-Regulatory Executive Function (S-REF) model (Wells and Matthews, 1994; Wells and Matthews, 1996) are elevated in people with clinical psychosis compared to people with emotional disorder and non-psychiatric controls. The review followed guidance set-out in the PRISMA statement. Primary analyses compared summary effect sizes on each sub-scale of the Metacognitions Questionnaire (MCQ) for people with psychosis and non-psychiatric controls; and people with psychosis and people with emotional disorder. Eleven eligible studies were identified comprised of 568 psychosis participants, 212 emotional disorder participants and 776 non-psychiatric controls. Findings indicated that people with psychosis had higher scores on all sub-scales of the MCQ compared to non-psychiatric controls; and higher scores on the positive beliefs about worry sub-scale compared to people with emotional disorder. This suggests metacognitive beliefs may be associated with the presence of psychological disorder and distress in general, rather than specific diagnoses. Implications for models of psychosis and treatment are discussed.