Perfectionism in patients with eating disorders: The role of metacognitive beliefs and repetitive negative thinking

Stress generation and subsequent repetitive negative thinking link poor executive functioning and depression

BACKGROUND AND OBJECTIVE

Poor executive functioning (EF) has been consistently linked to depression, but questions remain regarding mechanisms driving this association. The current study tested whether poor EF is linked to depression symptoms six weeks later via dependent stressors (model 1) and stressors perceived to be uncontrollable (model 2) at week two (W2) and repetitive negative thinking (RNT) at W4 during early COVID-19 in college students.

DESIGN

This was a longitudinal study with four timepoints spanning six weeks (April-June 2020).

METHODS

Participants (N = 154) completed online questionnaires measuring EF, dependent stress frequency, stress controllability appraisals, brooding rumination, worry, and depression.

RESULTS

Supporting model 1, poorer baseline EF predicted higher dependent stress frequency at W2; W2 dependent stress frequency, in turn, predicted increases in W4 RNT, which predicted increases in W6 depression. Model 2 was not supported: Baseline EF did not predict W2 perceived stress uncontrollability, which did not predict W4 RNT; however, W4 RNT predicted increases in W6 depression.

LIMITATIONS

The sample was relatively small and EF was measured using only self-reports.

CONCLUSIONS

Findings supported a model in which poor EF conferred risk for depression via dependent stress and subsequent RNT, highlighting these processes as risk mechanisms for depression.

Exploring the associations between symptom severity, metacognition, problematic social media use and cyberbullying in treatment naïve adolescents with Attention Deficit and Hyperactivity Disorder

This study investigates the relationship between ADHD symptom severity, metacognition, problematic social media use, and cyberbullying/cybervictimization in treatment-naïve adolescents. Understanding these relationships is vital for enhancing ADHD intervention strategies. Using a cross-sectional design, 97 adolescents meeting DSM-5 criteria for ADHD without any comorbidity and 97 healthy controls were assessed. Measures included the Metacognitions Questionnaire for Children, Social Media Disorder Scale, Revised Cyberbullying Inventory-II, and Revised Conners' Parent Rating Scale-Short. The comparisons were performed with independent samples' t tests and the associations were estimated by using Pearson's bivariate correlations and multiple regression analyses. Results revealed that adolescents with ADHD exhibited higher levels of dysfunctional metacognitions, problematic social media use, cyberbullying, and cybervictimization compared to controls. Regression analysis showed significant positive associations between ADHD symptoms, specific metacognitions (e.g., positive meta-worry, cognitive monitoring), and problematic social media use. This study, the first of its kind among treatment-naïve ADHD adolescents, provides valuable insights into the relationship between ADHD symptoms and particular metacognitions (i.e. positive meta-worry, cognitive monitoring) and problematic social media use. These findings contribute to a deeper understanding of ADHD in adolescence and may inform the development of targeted prevention and treatment strategies, particularly relevant given adolescents' susceptibility to social media's influence and their potential for cognitive flexibility in rehabilitation contexts.

Stress, repetitive negative thinking, and mental health in Chilean university students: an ecological momentary assessment study

Background

Mental disorders in university students are a growing attention problem in the international community due to their high prevalence and serious consequences. One possible reason is university students' difficulties in coping with stress. Repetitive negative thinking (RNT) is a transdiagnostic process that, when combined with stress, can lead to the development of various disorders. We aim to determine the effect of stress and RNT on predicting various mental health syndromes in university students across 7 days.

Method

Prospective observational study using Momentary Ecological Assessment (EMA) with the OURMIND Mobile App. On day one, 238 university students responded to the SCL-90R questionnaire for symptoms of depression, anxiety, hostility, obsession, psychoticism, paranoia, somatization, and interpersonal sensitivity; RNT styles questionnaires, RRS for rumination and negative reflection, PSWQ for worry; SISCO-II for term academic stress, and sociodemographic. EMA consisted of five assessments a day for 6 days; each time, the students answered items about academic and non-academic stress (EMA-stress), reactive RNT duration and intrusiveness (EMA-RNT process), and reactive RNT rumination, reflection, and worry (EMA-RNT content). On day eight, symptoms were re-assessed. Seven hierarchical stepwise linear regression models were used to test the predictive power of the study variables in the development of SCL-90R symptoms.

Results

When comparing models, adding baseline symptoms increased the models' predictive power in all symptom groups. In most cases, including EMA-stress generated greater predictive power, except for paranoia and interpersonal sensitivity. Adding the EMA-RNT process increased the prediction of paranoia and obsessive symptoms; for hostility symptoms, RNT styles increased predictive power. For the final regression models, considering the initial symptoms, the EMA-RNT process predicted the progression of symptoms in six out of eight groups, while EMA-non-academic stress predicted the remaining two. Additionally, living with other relatives or friends was a predictor of depressive symptoms.

Discussion

The stress of university life impacts the development of psychiatric symptoms in university students. These results provide evidence of RNT as a transdiagnostic process in several syndromic groups. Universal preventive programs should consider the impact of academic and non-academic stress on university students' mental health. Targeting RNT would also benefit selective preventive interventions.

The Mediating Role of Emotion Dysregulation in the Association Between Perfectionism and Eating Psychopathology Symptoms

INTRODUCTION

This study explored the possible mediating role of emotion dysregulation in the association between perfectionism and eating psychopathology symptoms.

METHOD

One hundred forty-two outpatients with eating disorders (EDs) were enrolled. Perfectionism, emotion dysregulation, ED psychopathology, anxious and depressive symptoms were assessed. Correlation, mediation and 95% bias corrected and accelerated (BCa CI) bootstrapped analyses were run.

RESULTS

Emotion dysregulation was found to mediate the association between concern over mistakes perfectionism and restraint (indirect effect: 0.093, BCa CI: 0.001-0.02, adjusted R2 = 0.3324, p < 0.001), shape concern (indirect effect: 0.0130, BCa CI: 0.004-0.03, adjusted R2 = p < 0.001) and weight concern (indirect effect: 0.0142, BCa CI: 0.004-0.03, adjusted R2 = 0.2986, p < 0.001).

CONCLUSION

Among ED outpatients, emotion dysregulation may be involved in the association between concern over mistakes perfectionism and persistence of eating psychopathology symptoms. Emotion dysregulation could be considered as possible therapeutic target to reduce the persistence, and severity, of eating psychopathology symptoms among ED patients with concern over mistakes perfectionism.