A longitudinal comparison of metacognitive therapy and acceptance and commitment therapy models of anxiety disorders

Francisco J. Ruiz, Paula Odriozola-González


Metacognitive therapy (MCT) suggests that anxiety disorders are caused by the cognitive attentional syndrome (CAS), which is supported by dysfunctional metacognitive beliefs. Acceptance and commitment therapy (ACT) emphasizes the role of cognitive fusion and experiential avoidance in the development of these disorders. In this study, it was hypothesized that the ACT concepts of cognitive fusion and experiential avoidance would mediate the relationship between dysfunctional metacognitive beliefs and anxiety/stress symptoms. A longitudinal design was employed. One hundred and six nonclinical participants responded twice to an online survey with a lapse of nine months. Cognitive fusion at Time 2 mediated the effect of negative metacognitive beliefs at Time 1 on anxiety symptoms at T2, whereas both cognitive fusion and experiential avoidance mediated the effect on stress symptoms. Cognitive fusion mediated the effect of positive metacognitive beliefs only on stress symptoms. These results warrant further comparison of the MCT and ACT models.


Experiential avoidance; Cognitive fusion; Metacognitive beliefs; Anxiety; Stress

Full Text:



Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998). Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales (DASS) in clinical groups and a community sample. Psychological Assessment, 10, 176-181.

Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., … Zettle, R. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire – II: A revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy, 42, 676-688.

Borkovec, T. D. (1994). The nature, functions, and origins of worry. In G. Davey & F. Tallis (Eds.), Worrying: Perspective on theory, assessment, and treatment (pp. 5-33). Sussex, UK: John Wiley & Sons.

Daza, P., Novy, D. M., Stanley, M., & Averill, P. (2002). The Depression Anxiety Stress Scale-21: Spanish translation and validation with a Hispanic sample. Journal of Psychopathology and Behavioral Assessment, 24, 195-205.

Giorgio, J. M., Sanflippo, J., Kleiman, E., Reilly, D., Bender, R. E.,

Wagner, C. A., … Alloy, L. (2010). An experiential avoidance conceptualization of depressive rumination: Three tests of the model. Behaviour Research and Therapy, 48,

Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis. A regression-based approach. New York, NY: Guilford Press.

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy. An experiential approach to behavior change. New York, NY: Guilford Press.

Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. D. (1996). Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64, 1152-1168.

Herzberg, K. N., Sheppard, S. C., Forsyth, J. P., Credé, M., Earleywine, M., & Eifert, G. H. (2012). The Believability of Anxious Feelings and Thoughts Questionnaire (BAFT): A psychometric evaluation of cognitive fusion in a nonclinical and highly anxious community sample. Psychological Assessment, 24, 877-891.

Kenny, D. A. (2014, April 9). Mediation. Retrieved from http://davidakenny.net/cm/mediate.htm

Odriozola-González, P. (2011). El papel del pensamiento mágico en las alucinaciones y el trastorno obsesivo compulsivo. Comparación entre grupos clínicos y no clínicos. [The role of magical thinking in hallucinations and obsessive-compulsive disorder. Comparison between clinical and nonclinical groups] (Unpublished doctoral dissertation). Universidad de Oviedo, Oviedo.

Preacher, K. J., & Kelley, K. (2011). Effect size measures for mediation models: Quantitative strategies for communicating indirect effects. Psychological Methods, 16, 93–115.

Roemer, L., & Orsillo, S. M. (2002). Expanding our conceptualization of and treatment for generalized anxiety disorder: Integrating mindfulness/acceptance-based approaches with existing cognitive-behavioral models. Clinical Psychology: Science and Practice, 9, 54-68.

Ruiz, F. J., Langer, A. I., Luciano, C., Cangas, A. J., & Beltrán, I. (2013). Measuring experiential avoidance and psychological inflexibility: The Spanish translation of the Acceptance and Action Questionnaire. Psicothema, 25, 123-129.

Ruiz, F. J., Odriozola-González, P., & Suárez-Falcón, J. C. (2014). The Spanish version of the Believability of Anxious Feelings and Thoughts. Psicothema, 26, 308-313.

Ruiz, F. J., Suárez-Falcón, J. C., Cárdenas-Sierra, S., Durán, Y., Guerre-ro, K., & Riaño-Hernández, D. (2016). Psychometric properties of the Acceptance and Action Questionnaire – II in Colombia. The Psychological Record, 66, 429-437.

Wells, A. (2000). Emotional disorders and metacognition: Innovative cognitive therapy. Chichester, UK: Wiley.

Wells, A. (2009). Metacognitive therapy for anxiety and depression. New York, NY: Guilford Press.

Wells, A., & Cartwright-Hatton, S. (2004). A short form of the Metacognitions Questionnaire: Properties of the MCQ-30. Behavior Research and Therapy, 42, 385-396.

Wells, A., & Matthews, G. (1994). Attention and emotion: A clinical perspective. Hove, UK: Erlbaum.

DOI: http://dx.doi.org/10.6018/analesps.32.3.227041


  • There are currently no refbacks.

Copyright (c) 2017 Servicio de Publicaciones, Universidad de Murcia (Spain)

Open AccessSello de Calidad FECyT 2013ClarivAnaliticsWJ.jpgScielo-Españadoajscimago