A Study of The Relationship Between Metacognitions and Dissociation in Combat Stress Veterans.

Title: A study of the relationship between metacognitive beliefs and thought control strategies, and symptoms of dissociation in combat stress veterans. Objective: The main aims of the study were to investigate the hypothesis that perseverative metacognitive processes mediate the relationship between anxiety and dissociation, and have an impact on post-traumatic stress disorder. Design: A cross-sectional questionnaire design was employed to achieve these aims. Setting and participants: 107 participants were recruited from a combat stress mental welfare charity. Visitors at the centre and postal members were approached and invited to volunteer to take part in the study. Main Outcome Measures: Measures of metacognition included the Metacognitions Questionnaire and the Thought Control Questionnaire, and outcome measures included the Dissociative Experiences Scale (II), the State-Trait Anxiety Inventory and the Impact of Events Scale - Revised version. Results: Standard multiple regression revealed a pattern of metacognitive beliefs and thought control strategies associated with dissociation independently of anxiety and other variables. These included beliefs about the danger and uncontrollability of thoughts, low cognitive confidence, and use of punishment and re-appraisal as thought control strategies. Conclusions While these fail to replicate previous findings about the role of worry in psychopathology, they do support a role for self-focused perseverative metacognitive processing in maintaining symptoms of dissociation