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CC BY 4.0 · Indian J Med Paediatr Oncol 2023; 44(04): 398-407
DOI: 10.1055/s-0043-1768050
Review Article

Metacognitive Processes in Cancer: A Review

Rekha Rashmi 
1   Centre for Health Psychology, University of Hyderabad, Hyderabad, India
,
Chhakchhuak Vanlalhruaii
1   Centre for Health Psychology, University of Hyderabad, Hyderabad, India
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Abstract

When diagnosed with cancer, the patients and their family go through emotional turmoil across the different phases: diagnosis, assessment, treatment, and aftercare, which decrease their quality of life and well-being. Previously, many studies have highlighted the association of metacognition with the development and maintenance of mental health conditions. Several recent studies have pointed out the significant role of dysfunctional metacognitive beliefs in the context of chronic disease. Thus, the present study aims to explore the role of metacognitive processes in cancer. The researchers conducted a narrative review of literature using PubMed, Semantic Scholar, and Science Direct. A total of 31 articles were selected and analyzed. This review article established that patients with cancer and caregivers experience metacognitive beliefs, which are associated with emotional distress, and the effectiveness of metacognitive therapy in reducing distress. This study also provides insight into the broader scope to advance research in this field.

Keywords

metacognition - cancer - chronic medical conditions


Publication History

Article published online:
24 April 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Baker L. Metacognition. In: Peterson P, Baker E, McGaw B. eds. International Encyclopaedia of Education. 3rd ed.. Amsterdam: Elsevier; 2010: 204-210
    Google Scholar
  • 2 Flavell JH. Metacognitive Aspects of Problem Solving. Resnick LR. ed. Mahwah, NJ: Lawrence Erbaum; 1976
    Google Scholar
  • 3 Aurah CM, Koloi-Keaikitse S, Isaacs C, Finch H. The role of metacognition in everyday problem solving among primary students in Kenya. Probl Educ 21st Century 2011; 30: 9-21
    Google Scholar
  • 4 Basu S, Dixit S. Role of metacognition in explaining decision-making styles: a study of knowledge about cognition and regulation of cognition. Pers Individ Dif 2022; 185: 111318
    CrossrefGoogle Scholar
  • 5 Yeung N, Summerfield C. Metacognition in human decision-making: confidence and error monitoring. Philos Trans R Soc Lond B Biol Sci 2012; 367 (1594): 1310-1321
    CrossrefPubMedGoogle Scholar
  • 6 Choy SC, Cheah PK. Teacher perceptions of critical thinking among students and its influence on higher education. Int J Teach Learn High Educ 2009; 20 (02) 198-206
    Google Scholar
  • 7 Matthews G, Hillyard EJ, Campbell SE. Metacognition and maladaptive coping as components of test anxiety. Clin Psychol Psychother 1999; 6 (02) 111-125
    CrossrefGoogle Scholar
  • 8 Hagen R, Hjemdal O, Solem S. et al. Metacognitive therapy for depression in adults: a waiting list randomized controlled trial with six months follow-up. Front Psychol 2017; 8: 31
    CrossrefPubMedGoogle Scholar
  • 9 Papageorgiou C, Wells A. Metacognitive beliefs about rumination in recurrent major depression. Cognit Behav Pract 2001; 8 (02) 160-164
    CrossrefGoogle Scholar
  • 10 Wells A. Metacognitive Therapy for Anxiety and Depression. New York, NY: Guilford press; 2011
    Google Scholar
  • 11 Capobianco L, Faija C, Husain Z, Wells A. Metacognitive beliefs and their relationship with anxiety and depression in physical illnesses: a systematic review. PLoS One 2020; 15 (09) e0238457
    CrossrefPubMedGoogle Scholar
  • 12 Lenzo V, Sardella A, Martino G, Quattropani MC. A systematic review of metacognitive beliefs in chronic medical conditions. Front Psychol 2020; 10: 2875
    CrossrefPubMedGoogle Scholar
  • 13 Khodabakhshi Koolaee A, Falsafinejad MR, Ghorbani Sakachaei L, Sanagoo A. Relation between metacognitive beliefs and psychological adjustment with improving quality of life in type II diabetic patients. Majallah-i Danishgah-i Ulum-i Pizishki-i Gurgan 2019; 21 (03) 79-87
    Google Scholar
  • 14 Naser AY, Hameed AN, Mustafa N. et al. Depression and anxiety in patients with cancer: a cross-sectional study. Front Psychol 2021; 12: 585534
    CrossrefPubMedGoogle Scholar
  • 15 Riedl D, Schuessler G. Prevalence of depression and cancer - a systematic review. Z Psychosom Med Psychother 2022; 68 (01) 74-86
    PubMedGoogle Scholar
  • 16 Wells A, Cartwright-Hatton S. A short form of the metacognitions questionnaire: properties of the MCQ-30. Behav Res Ther 2004; 42 (04) 385-396
    CrossrefPubMedGoogle Scholar
  • 17 Cartwright-Hatton S, Wells A. Beliefs about worry and intrusions: the Meta-Cognitions Questionnaire and its correlates. J Anxiety Disord 1997; 11 (03) 279-296
    CrossrefPubMedGoogle Scholar
  • 18 Tosun A, Irak M. Adaptation, validity, and reliability of the Metacognition Questionnaire-30 for the Turkish population, and its relationship to anxiety and obsessive-compulsive symptoms [in Turkish]. Turk Psikiyatr Derg 2008; 19 (01) 67-80
    Google Scholar
  • 19 Quattropani MC, Lenzo V, Mucciardi M, Toffle ME. The role of metacognitions in predicting anxiety and depression levels in cancer patients ongoing chemotherapy. Procedia Soc Behav Sci 2015; 205: 463-473
    CrossrefGoogle Scholar
  • 20 Dragan M., Dragan W. Ł. . (2011). Psychometric properties of the Polish version of the Metacognitions Questionnaire-30. Psychiatria polska 45 (04) 545-553
    Google Scholar
  • 21 Gerlach A, Adam S, Marschke S, Melfsen S. Development and validation of a child version of the Metacognitions Questionnaire. Paper presented at: 38th Annual Congress of the European Association for Behavioural and Cognitive Therapies; Helsinki; September 10–13, 2008
    PubMedGoogle Scholar
  • 22 Cook SA, Salmon P, Dunn G, Fisher P. Measuring metacognition in cancer: validation of the Metacognitions Questionnaire 30 (MCQ-30). PLoS One 2014; 9 (09) e107302
    CrossrefPubMedGoogle Scholar
  • 23 Inci H, Inci F, Ersoy S, Karatas F, Adahan D. Self-esteem, metacognition, and coping strategies in cancer patients: a case-control study. J Cancer Res Ther 2021; 17 (04) 956-962
    CrossrefPubMedGoogle Scholar
  • 24 Cherry MG, Salmon P, Byrne A, Ullmer H, Abbey G, Fisher PL. Qualitative evaluation of cancer survivors' experiences of metacognitive therapy: a new perspective on psychotherapy in cancer care. Front Psychol 2019; 10: 949
    CrossrefPubMedGoogle Scholar
  • 25 Anderson R, Capobianco L, Fisher P. et al. Testing relationships between metacognitive beliefs, anxiety and depression in cardiac and cancer patients: are they transdiagnostic?. J Psychosom Res 2019; 124: 109738
    CrossrefPubMedGoogle Scholar
  • 26 Cook SA, Salmon P, Dunn G, Holcombe C, Cornford P, Fisher P. The association of metacognitive beliefs with emotional distress after diagnosis of cancer. Health Psychol 2015; a 34 (03) 207-215
    CrossrefPubMedGoogle Scholar
  • 27 Mutlu HH, Bilican FI, Mutlu HH, Gumus M. A comparison of metacognitive factors among patients with cancer and the control group. Psychooncology 2018; 27 (04) 1277-1283
    CrossrefPubMedGoogle Scholar
  • 28 Quattropani MC, Lenzo V, Mucciardi M, Toffle ME. Metacognition as predictor of emotional distress in cancer patients. Life Span Disabil 2016; 19 (02) 221-239
    Google Scholar
  • 29 Quattropani MC, Lenzo V, Filastro A. Predictive factors of anxiety and depression symptoms in patients with breast cancer undergoing chemotherapy. An explorative study based on metacognitions. J Psychopathol 2017; 23: 67-73
    Google Scholar
  • 30 Cook SA, Salmon P, Dunn G, Holcombe C, Cornford P, Fisher P. A prospective study of the association of metacognitive beliefs and processes with persistent emotional distress after diagnosis of cancer. Cognit Ther Res 2015; b 39 (01) 51-60
    CrossrefPubMedGoogle Scholar
  • 31 Ranieri J, Guerra F, Perilli E, Cilli E, Di Giacomo D. Metacognitions and quality of life in survivorship after breast cancer diagnosis [in Italian]. Riv Psichiatr 2021; 56 (04) 217-222
    PubMedGoogle Scholar
  • 32 Ranieri J, Guerra F, Di Giacomo D. Role of metacognition thinking and psychological traits in breast cancer survivorship. Behav Sci (Basel) 2020; 10 (09) 135
    CrossrefPubMedGoogle Scholar
  • 33 Toffalini E, Veltri A, Cornoldi C. Metacognitive aspects influence subjective well-being in parents of children with cancer. Psychooncology 2015; 24 (02) 175-180
    CrossrefPubMedGoogle Scholar
  • 34 Xiao PP, Ding SQ, Duan YL. et al. Metacognitions associated with reproductive concerns: a cross-sectional study of young adult female cancer survivors in China. Front Psychol 2022; 13: 987221
    CrossrefPubMedGoogle Scholar
  • 35 Cheli S, Caligiani L, Martella F, De Bartolo P, Mancini F, Fioretto L. Mindfulness and metacognition in facing with fear of recurrence: a proof-of-concept study with breast-cancer women. Psychooncology 2019; 28 (03) 600-606
    PubMedGoogle Scholar
  • 36 Ng DWL, Foo CC, Ng SSM. et al. The role of metacognition and its indirect effect through cognitive attentional syndrome on fear of cancer recurrence trajectories: a longitudinal study. Psychooncology 2020; 29 (02) 271-279
    CrossrefPubMedGoogle Scholar
  • 37 Ağaç M, Üzar-Özçetin YS. Psychological resilience, metacognitions, and fear of recurrence among cancer survivors and family caregivers. Cancer Nurs 2022; 45 (02) E454-E462
    CrossrefPubMedGoogle Scholar
  • 38 Thewes B, Bell ML, Butow P. Fear of cancer recurrence in young early-stage breast cancer survivors: the role of metacognitive style and disease-related factors. Psychooncology 2013; 22 (09) 2059-2063
    CrossrefPubMedGoogle Scholar
  • 39 Ng DWL, Kwong A, Suen D. et al. Fear of cancer recurrence among Chinese cancer survivors: prevalence and associations with metacognition and neuroticism. Psychooncology 2019; 28 (06) 1243-1251
    CrossrefPubMedGoogle Scholar
  • 40 Butow P, Kelly S, Thewes B, Hruby G, Sharpe L, Beith J. Attentional bias and metacognitions in cancer survivors with high fear of cancer recurrence. Psychooncology 2015; 24 (04) 416-423
    CrossrefPubMedGoogle Scholar
  • 41 Fisher PL, Byrne A, Salmon P. Metacognitive therapy for emotional distress in adult cancer survivors: a case series. Cognit Ther Res 2017; 41 (06) 891-901
    CrossrefPubMedGoogle Scholar
  • 42 Fisher PL, Byrne A, Fairburn L, Ullmer H, Abbey G, Salmon P. Brief metacognitive therapy for emotional distress in adult cancer survivors. Front Psychol 2019; 10: 162
    CrossrefPubMedGoogle Scholar
  • 43 Zahedian E, Bahreini M, Ghasemi N, Mirzaei K. Group meta-cognitive therapy and depression in women with breast cancer: a randomized controlled trial. BMC Womens Health 2021; 21 (01) 111
    CrossrefPubMedGoogle Scholar
  • 44 Fisher PL, McNicol K, Young B, Smith E, Salmon P. Alleviating emotional distress in adolescent and young adult cancer survivors: an open trial of metacognitive therapy. J Adolesc Young Adult Oncol 2015; 4 (02) 64-69
    CrossrefPubMedGoogle Scholar
  • 45 Javadi THS, Tajikzadeh F, Bayat H, Eshraghi N, Roshandel Z, Rahmani S. Comparison of effectiveness of the mindfulness-based cognitive therapy and the metacognition treatment on anxiety, depression and stress among breast cancer patients. Int Clin Neurosci J 2018; 5 (02) 62-66
    CrossrefGoogle Scholar
  • 46 Rahmani S, Talepasand S, Ghanbary-Motlagh A. Comparison of effectiveness of the metacognition treatment and the mindfulness-based stress reduction treatment on global and specific life quality of women with breast cancer. Iran J Cancer Prev 2014; 7 (04) 184-196
    PubMedGoogle Scholar
  • 47 Barjoee LK, Amini N, Keykhosrovani M, Shafiabadi A. Effectiveness of positive thinking training on perceived stress, metacognitive beliefs, and death anxiety in women with breast cancer: perceived stress in women with breast cancer. Arch Breast Cancer 2022; 9: 195-203
    CrossrefGoogle Scholar
  • 48 Wolf TJ, Doherty M, Kallogjeri D. et al. The feasibility of using metacognitive strategy training to improve cognitive performance and neural connectivity in women with chemotherapy-induced cognitive impairment. Oncology 2016; 91 (03) 143-152
    CrossrefPubMedGoogle Scholar
  • 49 Assis MRD, Maraglia PH, Brandão MAG, Peixoto MAP. Metacognition as an educational technology in self-care learning: the case of prevention of post-surgical lymphedema of breast cancer. Esc Anna Nery 2018;22
    Google Scholar
  • 50 Geng HM, Chuang DM, Yang F. et al. Prevalence and determinants of depression in caregivers of cancer patients: a systematic review and meta-analysis. Medicine (Baltimore) 2018; 97 (39) e11863
    CrossrefPubMedGoogle Scholar
  • 51 Northouse LL, Katapodi MC, Schafenacker AM, Weiss D. The impact of caregiving on the psychological well-being of family caregivers and cancer patients. Semin Oncol Nurs 2012; 28 (04) 236-245
    CrossrefPubMedGoogle Scholar
  • 52 Fashler SR, Weinrib AZ, Azam MA, Katz J. The use of acceptance and commitment therapy in oncology settings: a narrative review. Psychol Rep 2018; 121 (02) 229-252
    CrossrefPubMedGoogle Scholar
  • 53 Li Z, Li Y, Guo L, Li M, Yang K. Effectiveness of acceptance and commitment therapy for mental illness in cancer patients: a systematic review and meta-analysis of randomised controlled trials. Int J Clin Pract 2021; 75 (06) e13982
    PubMedGoogle Scholar
  • 54 Zhao C, Lai L, Zhang L. et al. The effects of acceptance and commitment therapy on the psychological and physical outcomes among cancer patients: a meta-analysis with trial sequential analysis. J Psychosom Res 2021; 140: 110304
    CrossrefPubMedGoogle Scholar
  • 55 Blumenstein KG, Brose A, Kemp C. et al. Effectiveness of cognitive behavioral therapy in improving functional health in cancer survivors: a systematic review and meta-analysis. Crit Rev Oncol Hematol 2022; 175: 103709
    CrossrefPubMedGoogle Scholar
  • 56 Kucherer S, Ferguson RJ. Cognitive behavioral therapy for cancer-related cognitive dysfunction. Curr Opin Support Palliat Care 2017; 11 (01) 46-51
    CrossrefPubMedGoogle Scholar
  • 57 Elimimian EB, Elson L, Stone E. et al. A pilot study of improved psychological distress with art therapy in patients with cancer undergoing chemotherapy. BMC Cancer 2020; 20 (01) 899
    CrossrefPubMedGoogle Scholar
  • 58 Forzoni S, Perez M, Martignetti A, Crispino S. Art therapy with cancer patients during chemotherapy sessions: an analysis of the patients' perception of helpfulness. Palliat Support Care 2010; 8 (01) 41-48
    CrossrefPubMedGoogle Scholar
  • 59 Bradt J, Shim M, Goodill SW. Dance/movement therapy for improving psychological and physical outcomes in cancer patients. Cochrane Database Syst Rev 2015; 1 (01) CD007103
    PubMedGoogle Scholar
  • 60 Datt KB. Cancer cases likely to go up by over 12% between '20 & '25, says ICMR. The New Indian Express. December 1, 2022. Accessed March 15, 2023 at: https://www.newindianexpress.com/nation/2022/dec/01/cancer-cases-likely-to-go-up-by-over-12-between-20-25-says-icmr-2523925.html
  • 61 Sharma P. India's cancer burden to rise to 29.8 million in 2025: ICMR report. Mint. May 13, 2022. Accessed March 15, 2023 at: https://www.livemint.com/science/health/indias-cancer-burden-to-rise-to-29-8-million-in-2025-icmr-report-11652382169284.html