The contribution of illness perceptions and metacognitive beliefs to anxiety and depression in adults with diabetes

Abstract

Aims: Anxiety and depression are highly prevalent in people with diabetes (PwD). The most widely used psychological model to explain anxiety and depression in PwD is the Common-Sense Model, which gives a central role to illness perceptions. The Self-Regulatory Executive Function (S-REF) model proposes metacognitive beliefs are key to understanding the development and maintenance of emotional disorders. To test the potential utility of the S-REF model in PwD, the study explored if metacognitive beliefs explained additional variance in anxiety and depression after controlling for demographic and illness perceptions.

Methods: 614 adults with either Type 1 (n = 335) or Type 2 (n = 279) diabetes participated in a cross sectional online survey. All participants completed questionnaires on anxiety, depression, illness perceptions and metacognitive beliefs.

Results: Regression analyses showed that metacognitive beliefs were associated with anxiety and depression in PwD and explained additional variance in both anxiety and depression after controlling for demographics and illness perceptions.

Conclusions: This is the first study to demonstrate that metacognitive beliefs are associated with anxiety and depression in PwD. The clinical implications of the study are illustrated.

Keywords: Anxiety; Depression; Diabetes; Illness perceptions; Metacognitive beliefs.