Metabeliefs about worry, cognitive fusion, and acceptance: Associations and Mediations Analysis

Francisco Sanchez-Escamilla^1,2*Marta Redondo-Delgado^1,2Antonia María Jímenez-Ros^3,4Miguel Ángel Pérez-Nieto^1,2

• ¹HM Faculty of Health Sciences, Camilo José Cela University, Madrid, Spain
• ²HM Hospitals Health Research Institute, Madrid, Spain
• ³University Center of Research in Psychology (CUIP), Faro, Portugal
• ⁴Universidade do Algarve, Faro, Portugal

Background: Although Metacognitive Therapy (MCT) and Acceptance and Commitment Therapy (ACT) are are grounded in different theoretical frameworks, both target repetitive negative thinking (RNT) processes, such as worry and rumination, and share a focus on fostering psychological flexibility and reducing experiential avoidance. However, no integrated theoretical model currently exists to combine their potential strengths. Recent research highlights the importance of metacognitive beliefs and acceptance-related processes in maintaining maladaptive RNT. Objective: This study aimed to explore metacognitive and acceptance-based variables in relation to RNT. based on different theoretical and technical principles, they have several points in common, such as their focus on ruminative processes and an increase in self-consciousness and emotional regulation. Nevertheless, there has yet to be a common theoretical model that integrates these approaches to exploit their combined strengths. The objective of this research is to explore the integration of the significant variables of MCT and ACT, identifying common and overlapping areas and facilitating the integration of both approaches. Method: The sample consisted of 149 people (116 females), aged between 18 and 71 (M = 34.7; SD = 14.9) who answered the following questionnaires: PSWQ, The AAQ-II, The CFQ, The VQ, MCQ-30 and TCQ. Results: The mediation analysis reveals that cognitive fusion significantly mediated the relationship between metacognitive beliefs and worry, whereas acceptance had a weaker mediating effectacts as a mediating variable between beliefs about the uncontrollability of worry and levels of acceptance (measured by the AAQ-II), as well as worrying. Conclusion: Beliefs about the uncontrollability of worry appear to play a pivotal role in sustaining worry, primarily through their influence on cognitive fusion. These findings provide preliminary support for conceptual overlaps between MCT and ACT in addressing RNT. However, as this is an exploratory and cross-sectional study, conclusions about treatment mechanisms should be drawn cautiously, and future longitudinal and experimental studies are needed to strengthen these insights. are a key factor as shown by their major influence on cognitive fusion.