Evaluating the Specific Role of Dysfunctional Metacognitive Beliefs and Testing a Metacognitive Model of Emotional Distress in Patients with Type 1 Diabetes Mellitus.

Elevated emotional distress is common in patients with type 1 diabetes mellitus (T1DM), and alleviating psychological problems is important as they may interfere with adherence to T1DM treatment regiments and poor glycaemic regulation. One way to understand and treat emotional distress is to formulate them as linked to self-regulatory strategies and their underlying metacognitive beliefs as proposed by the Self-regulatory Executive Functioning (S-REF) model. We aimed to evaluate the role of dysfunctional metacognitions in diabetes-related emotional distress beyond general emotional distress and to test the statistical fit of a metacognitive model in a sample consisting of 218 adults with T1DM. Dysfunctional metacognitive beliefs were significantly and positively associated with emotional distress symptoms. Beliefs about the need to control thoughts and cognitive self-consciousness showed a unique association with diabetes-related emotional distress even when controlling for general emotional distress symptoms. A metacognitive model specified by dysfunctional metacognitive beliefs, metacognitive strategies (brooding), and general and diabetes-related emotional distress fitted the data well. The metacognitive model of psychological disorders is relevant to formulate and possibly treat different types of emotional distress symptoms in patients with T1DM with the implication that a feasibility trial of metacognitive therapy is warranted.