Negative Thoughts and Metacognitions in Anxious Children Following CBT

The purpose of this study was to evaluate reductions in negative automatic thoughts and metacognitive beliefs as predictors of treatment gains in CBT for childhood anxiety disorders. A sample of 44 clinically anxious children between 7 and 12 years of age, who underwent CBT, completed questionnaires assessing negative thinking, metacognitive beliefs and processes, and anxiety symptoms before, after, and 6 months following treatment. Results indicated that negative thoughts and metacognitions decreased equally during the treatment period. Furthermore, metacognitions continued to decrease during the posttreatment period. Negative thinking and metacognitions were both significant predictors of reductions in child-reported anxiety from pre- to posttreatment. For long-term anxiety changes, only decreases in negative thoughts were related to anxiety reduction. Mediation analysis showed that metacognitions partially mediated the relation between negative thinking and anxiety. The study supports negative automatic thoughts and metacognitive beliefs and processes as putative mediators of CBT.