title: The Role of Metacognitions in Expressed Emotion and Distress: A Study on Caregivers of Persons with First-Episode Psychosis.
abstract: BACKGROUND
  In first-episode psychosis, the family is considered an important part in the recovery process. This is often accompanied by significant distress, which is acknowledged in numerous studies. However, little is known about the psychological factors involved.
  
  
  METHODS
  One hundred and twenty-seven caregivers of persons with first-episode psychosis completed a series of questionnaires aimed at investigating the contribution of expressed emotion and metacognitions to caregiver distress.
  
  
  RESULTS
  Linear mixed model analysis found that emotional over-involvement and metacognitions independently predicted caregiver distress. Mediation analysis using bootstrapping showed that emotional over-involvement could be seen as mediating the effect of metacognitions on distress.
  
  
  CONCLUSIONS
  The current study is a first step towards understanding the role of metacognitions in caregiver distress, thus opening up for the possibility of using interventions from 'contextual behaviour therapies'. Implications and future studies are discussed.
  
  
  CONCLUSIONS
  This study is the first attempt to address caregiver concerns from the perspective of contextual cognitive behavioural therapy. The metacognitive framework for caregiver distress in first-episode psychosis may help develop new therapeutic interventions to better support families. The study proposes a psychological understanding of emotional over-involvement and caregiver distress.
authors.affiliation: Early Psychosis Intervention Center, Zealand Region Psychiatry Roskilde, Roskilde, Denmark.|Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Jens Einar
authors.initials: JE
authors.lastname: Jansen
authors.affiliation: Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Susanne
authors.initials: S
authors.lastname: Harder
authors.affiliation: Early Psychosis Intervention Center, Zealand Region Psychiatry Roskilde, Roskilde, Denmark.|Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Ulrik Helt
authors.initials: UH
authors.lastname: Haahr
authors.affiliation: Early Psychosis Intervention Center, Zealand Region Psychiatry Roskilde, Roskilde, Denmark.
authors.forename: Hanne-Grethe
authors.initials: HG
authors.lastname: Lyse
authors.affiliation: Early Psychosis Intervention Center, Zealand Region Psychiatry Roskilde, Roskilde, Denmark.
authors.forename: Marlene Buch
authors.initials: MB
authors.lastname: Pedersen
authors.affiliation: Psychiatric Research Unit, Zealand Region Psychiatry Roskilde, Roskilde, Denmark.|Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Trauelsen
authors.affiliation: Psychiatric Research Unit, Zealand Region Psychiatry Roskilde, Roskilde, Denmark.|Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.|Department of Psychology and Educational Studies, Roskilde University, Roskilde, Denmark.
authors.forename: Erik
authors.initials: E
authors.lastname: Simonsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D019260:Expressed Emotion / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D000067489:Metacognition / Q000502:physiology*; D008875:Middle Aged; D011618:Psychotic Disorders / Q000523:psychology*; D013315:Stress, Psychological / Q000503:physiopathology / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Caregivers; Contextual Behaviour Therapies; Distress; Emotional Over-involvement; First-episode Psychosis; Metacognition