Universität zu Köln

Ivan, Lavinia ORCID: 0009-0004-3247-3803, Foerster, Petra, Bermpohl, Frederic Maas genannt ORCID: 0000-0002-2370-4946, Gerlach, Alexander L. ORCID: 0000-0001-6794-5349, Pohl, Anna ORCID: 0000-0002-3761-5768 and Kubis, Hans-Peter (2025). Do metacognitions contribute to pathological health anxiety? A systematic review and meta-analysis. PLOS One, 20 (7). pp. 1-16. PLoS Public Library of Science. ISSN 1932-6203

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Abstract

[Aritkel-Nr.: e0325563] Objective: The purpose of this meta-analysis is to give an overview of the relationships between positive and negative metacognitions (PMC, NMC) with health anxiety and pathological safety seeking and avoidant behavior (SSB, AB). Method: The preregistered systematic literature screening included following data bases: MEDLINE, PsycINFO, PSYNDEX, PubMed, The Cochrane Library, Web of Science, ProQuest Dissertations & Theses, and The German National Library. The studies were evaluated based on predefined eligibility criteria (i.e., data for PMC/NMC and health anxiety and/ or SSB/AB from adult samples, assessed with validated inventories and presented in English or German language) and risk of bias categories. Correlation coefficients were aggregated with random effect models. Publication biases were estimated with contour enhanced funnel plots and outlier analyses. Results: 23 studies (N = 9229) were included in the meta-analysis. Most studies assessed health anxiety in analogue samples. A significant medium effect was found for PMC and health anxiety (r = .36, p < 0.0001, 95% CI:.29 ≤ r ≤ .43), whereas for NMC the effect was large (r = .52, p < 0.0001, 95% CI:.46 ≤ r ≤ .58). For the relationship with SSB the results revealed a moderate effect for PMC (r = 0.31, p = .004; 95%-CI: 0.19 ≤ r ≤ 0.42) and a small effect for NMC (r = .25, p = .02, 95% CI:.05 ≤ r ≤ .43). No study assessed AB. Discussion: Metacognitions are a significant pathological factor in health anxiety, with particularly strong association with NMC. PMC might be of special interest for health anxiety and SSB compared to other psychopathologies. Heterogeneity, missing clinical samples and studies on AB limit generalizability. Future research should further explore the role of metacognitions in health anxiety and focus on the relation with pathological SSB and AB.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Ivan, Lavinia UNSPECIFIED https://orcid.org/0009-0004-3247-3803 UNSPECIFIED Foerster, Petra UNSPECIFIED UNSPECIFIED UNSPECIFIED Bermpohl, Frederic Maas genannt UNSPECIFIED https://orcid.org/0000-0002-2370-4946 UNSPECIFIED Gerlach, Alexander L. UNSPECIFIED https://orcid.org/0000-0001-6794-5349 UNSPECIFIED Pohl, Anna UNSPECIFIED https://orcid.org/0000-0002-3761-5768 UNSPECIFIED Kubis, Hans-Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-811489
Identification Number:	10.1371/journal.pone.0325563
Journal or Publication Title:	PLOS One
Volume:	20
Number:	7
Page Range:	pp. 1-16
Number of Pages:	16
Date:	16 July 2025
Publisher:	PLoS Public Library of Science
ISSN:	1932-6203
Language:	English
Faculty:	Faculty of Human Sciences
Divisions:	Faculty of Human Sciences > Department Psychologie
Subjects:	Psychology
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/81148