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We have previously discussed metacognitions in insomnia. In this article we specifically address metacognitions in chronic fatigue syndrome. It has been said that metacognitions are a better predictor of symptom severity than anxiety and depression and that there is a potential application of the metacognitive model of psychological disorder to understanding chronic fatigue syndrome (Maher-Edwards et. al, 2011).

Metacognitions can be defined as stable knowledge or beliefs about one’s own cognitive system

Metacognitions have been divided into two broad sets of beliefs in the self-regulatory executive function (S-REF) model:

  1. Negative beliefs concerning the significance, controllability, and danger of particular types of thoughts (e.g., “it is bad to think thought X” or “I need to control thought X”)
  2. Positive beliefs about coping strategies that impact on mental states (such as “worrying will help me get things sorted out in my mind” or “brooding will help me solve the problem”).

The paper hypothesises that metacognitions (negative beliefs about thoughts concerning uncontrollability, cognitive confidence, and beliefs about the need to control thoughts) would predict symptom severity in chronic fatigue syndrome independently of negative emotions. Results revealed that these three dimensions of metacognitions were consistently and positively correlated with symptom severity.

Metacognitions In Chronic Fatigue Syndrome – A Summary

From a therapeutic perspective, the present findings suggest that the techniques and principles of metacognitive therapy may be helpful in managing, or in reducing, symptom severity in chronic fatigue syndrome. Metacognitive therapy modifies the beliefs that individuals have about their thoughts and introduces flexible and alternative ways of relating to mental events.

Examples of this include the modification of beliefs through restructuring exercises and the facilitation of skills that promote a direct change in aspects of the cognitive attentional syndrome (for instance, interventions aimed at modifying attentional control or interrupting rumination and worry).

Patients are helped to regain flexibility in thinking so that they can continue with positive goal-directed behaviors and disengage from the unhelpful features of the cognitive attentional syndrome in response to unwanted inner events.