Changing Metacognitive Appraisal Bias in High-Worriers Through Reappraisal Training

Background and Objectives Worry-related negative metacognitive beliefs about worrying maintain and predict pathological worry. For the current proof-of-principle study, we developed a computerized cognitive bias modification based-reappraisal training (RT), to modify the appraisal of negative metacognitive beliefs in a high-worrying sample. A functional and dysfunctional RT were pitted against each other to investigate whether appraisals of one's thinking and coping changed following training. Moreover, training effects on the number of negative thoughts and interpretations of the worry content were examined. Methods Participants (N = 81) were trained to adopt a functional (disconfirmation of negative metacognitive beliefs) or dysfunctional (confirmation of negative metacognitive beliefs) appraisal style using a series of vignettes that had to be completed in line with the intended training direction. Changes in negative thoughts from pre- to post-RT were assessed with a behavioral state worry task, and transfer to interpretations with an open-ended stem sentence task. Results Findings support the use of the RT to alter a metacognitive appraisal bias, as participants receiving the functional RT reported fewer negative appraisals of one's thinking and coping than participants in the dysfunctional RT group. Number of negative thoughts and interpretations were not directly affected by training. Limitations This study employed an analog sample and future research should replicate findings in a clinical sample for which negative metacognitions are more relevant. Conclusions These findings highlight the potential of metacognitive RT for future translational studies with (clinical) samples characterized by repetitive negative thinking and/or negative metacognitive beliefs.