Both elevated intolerance of uncertainty (IU) and maladaptive metacognitive beliefs (MBs) were associated with depression. However, the relationship between MBs and IU in clinical depression is unclear. The current study aimed to investigate the putative impairment of MBs and IU in major depressive disorder (MDD) and explore the relationship between these two factors with depressive symptoms. Metacognition Questionnaire—30 Items (MCQ-30), Intolerance of Uncertainty Scale—Short Form (IUS-12) and clinical rating scales were administered to 53 patients with MDD and 56 healthy controls (HCs). Stepwise regressions were performed to explore independent contributions of MBs and IU on depression. Mediation analysis was used to examine associations among variables. Patients with MDD reported higher IUS-12 and MCQ-30 scores than HCs. Stepwise regressions revealed a unique contribution of negative MBs concerning the consequences of not controlling thoughts (MCQ-NC) on depression symptoms while controlling the effects of age, gender, anxiety symptoms and IU. MCQ-NC and negative MBs concerning the uncontrollability and danger of negative thinking (MCQ-NEG) completely mediated the effects of IU on depression and anxiety symptoms. Our results provided clear evidence that maladaptive negative MBs are directly associated with depression symptoms, and mediated the effect of IU on depression and anxiety symptoms, suggesting that IU and MBs influence clinical symptoms in a hierarchical manner.

中文翻译：

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适应不良的元认知信念介导了不确定性不耐受对抑郁症的影响

不确定性不耐受（IU）和适应不良的元认知信念（MBs）升高都与抑郁症有关。然而，临床抑郁症中MBs和IU之间的关系尚不清楚。目前的研究旨在调查MBs和IU在重度抑郁症（MDD）中的假定损害，并探讨这两个因素与抑郁症状之间的关系。对 53 名 MDD 患者和 56 名健康对照者 (HCs) 进行了元认知问卷——30 项 (MCQ-30)、不确定性不耐受量表——简表 (IUS-12) 和临床评定量表。进行逐步回归以探索 MB 和 IU 对抑郁症的独立贡献。中介分析用于检查变量之间的关联。MDD 患者报告的 IUS-12 和 MCQ-30 评分高于 HC。逐步回归揭示了消极 MB 对不控制思想 (MCQ-NC) 对抑郁症状的影响的独特贡献，同时控制了年龄、性别、焦虑症状和 IU 的影响。MCQ-NC 和关于消极思维的不可控性和危险性的消极 MB（MCQ-NEG）完全介导了 IU 对抑郁和焦虑症状的影响。我们的研究结果提供了明确的证据表明，适应不良的阴性 MBs 与抑郁症状直接相关，并介导 IU 对抑郁和焦虑症状的影响，表明 IU 和 MBs 以分级方式影响临床症状。焦虑症状和IU。MCQ-NC 和关于消极思维的不可控性和危险性的消极 MB（MCQ-NEG）完全介导了 IU 对抑郁和焦虑症状的影响。我们的研究结果提供了明确的证据表明，适应不良的阴性 MBs 与抑郁症状直接相关，并介导 IU 对抑郁和焦虑症状的影响，表明 IU 和 MBs 以分级方式影响临床症状。焦虑症状和IU。MCQ-NC 和关于消极思维的不可控性和危险性的消极 MB（MCQ-NEG）完全介导了 IU 对抑郁和焦虑症状的影响。我们的研究结果提供了明确的证据表明，适应不良的阴性 MBs 与抑郁症状直接相关，并介导 IU 对抑郁和焦虑症状的影响，表明 IU 和 MBs 以分级方式影响临床症状。