Journal of affective disorders · 2025
Network analysis of emotional disorders with and without comorbid personality disorders: Symptom, metacognition, and repetitive thinking patterns.
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De Francesco Stefano, Caselli Gabriele, Giani Ludovica, Ocera Alessandro, Scaini Simona, Buattini Matilde, Piron Rossana, Fanfoni Marta, Giuri Simona, Nordahl Hans Morten, Sassaroli Sandra, Ruggiero Giovanni Maria
Аннотация
INTRODUCTION: Emotional Disorders (EDs) with and without comorbid personality disorder (ED-PD vs. ED-noPD) show distinct symptom patterns. ED-PDs involve pervasive, ego-syntonic traits, whereas ED-noPD conditions are more ego-dystonic. This study examined whether these differences extend to the interplay between metacognitive processes, repetitive negative thinking, and symptoms.
METHODS: 962 Italian-speaking adults (mean age = 36.9; 336 males, 626 females) seeking treatment at our outpatients' service (inTHERAPY) participated. Of these, 653 had a primary ED (mainly depressive or anxiety disorders), and 309 had a comorbid PD. Participants completed assessments of repetitive negative thinking styles, metacognitive beliefs, symptoms, and psychosocial functioning. A network analysis was conducted on the total sample and by subgroup, assessing Bridge Expected Influence and network invariance.
RESULTS: Negative metacognitive beliefs about danger and uncontrollability of thoughts, depressive symptoms and depressive rumination were central in both groups. In the ED-noPD group, Negative metacognitive beliefs about danger and uncontrollability of worry exerted the strongest influence, whereas in the ED-PD group, depressive rumination emerged as the most central feature. Bridge connections revealed that depressive rumination and cognitive self-consciousness acted as key links in ED-PD, possibly reinforcing ego-syntonicity. However, no significant structural differences emerged between networks.
CONCLUSION: Findings indicate that the structure linking symptoms, repetitive negative thinking, and metacognitive beliefs is broadly similar in ED-PD and ED-noPD. Yet, the specific bridge patterns in ED-PD may reflect stronger ego-syntonicity, underscoring the importance of interventions targeting self-focused attention and metacognitive awareness in this subgroup.
METHODS: 962 Italian-speaking adults (mean age = 36.9; 336 males, 626 females) seeking treatment at our outpatients' service (inTHERAPY) participated. Of these, 653 had a primary ED (mainly depressive or anxiety disorders), and 309 had a comorbid PD. Participants completed assessments of repetitive negative thinking styles, metacognitive beliefs, symptoms, and psychosocial functioning. A network analysis was conducted on the total sample and by subgroup, assessing Bridge Expected Influence and network invariance.
RESULTS: Negative metacognitive beliefs about danger and uncontrollability of thoughts, depressive symptoms and depressive rumination were central in both groups. In the ED-noPD group, Negative metacognitive beliefs about danger and uncontrollability of worry exerted the strongest influence, whereas in the ED-PD group, depressive rumination emerged as the most central feature. Bridge connections revealed that depressive rumination and cognitive self-consciousness acted as key links in ED-PD, possibly reinforcing ego-syntonicity. However, no significant structural differences emerged between networks.
CONCLUSION: Findings indicate that the structure linking symptoms, repetitive negative thinking, and metacognitive beliefs is broadly similar in ED-PD and ED-noPD. Yet, the specific bridge patterns in ED-PD may reflect stronger ego-syntonicity, underscoring the importance of interventions targeting self-focused attention and metacognitive awareness in this subgroup.