|Lam, Chiu Kim
|The cognitive attentional syndrome (CAS) in Hong Kong people with depression
|Depression, Mental -- China -- Hong Kong
Hong Kong Polytechnic University -- Dissertations
|Faculty of Health and Social Sciences
|viii, 101 pages : color illustrations
|Aim: The aim of this study is to examine the occurrence of Cognitive Attentional Syndrome (CAS) in the Hong Kong Chinese population suffering from depression and to assess the psychometric properties of the translated Traditional Chinese version of the CAS-1.
Method: The original English version of the CAS-1 was first translated into Traditional Chinese for this study. A total of 128 subjects with and without depression completed the translated version of the CAS-1. The psychometric properties were then assessed for this translated questionnaire. The aspects of the CAS-1's formulation in depression group subjects were measured with assessment tools that were already validated in the Chinese population. The translated CAS-1 was tested to determine if this has a significant correlation with these validated measurements of similar constructs (convergent validity) in addition to evaluating its internal reliability. Finally, the CAS-1 scores of both the depression and healthy groups were analysed to determine whether the questionnaire could differentiate the presence of the syndrome between depression and healthy groups.
Results: A total of 64 clinical samples from outpatients with Major Depressive Disorders (MDD) and 64 non-clinical samples of healthy subjects participated in the study. All subjects in the depression group completed the translated Chinese version of the CAS-1, the Chinese version of the DASS-21, a Penn State Worry Questionnaire (PSWQ), a Ruminative Response Scale (RRS), and a Metacognitions Questionnaire 30 (MCQ-30). The internal consistency of the total CAS-1 scores (α=0.704), metacognitive strategies (α=0.789) and metacognitive belief subscales (α=0.716) of the translated Chinese CAS-1 were found to be statistically acceptable. Further analysis found a statistically significant correlation between different aspects of the CAS-1 with a number of similar constructs, including ruminative response to depressive mood, pathological worry, and also a wide range of metacognitive beliefs. ANCOVA indicated a statistically significant difference between subjects with depression and healthy subjects (F=4.574, p<0.034) in CAS-1 total scores and CAS-1 Metacognitive strategies subscale (F=46.615, p<0.000), treating education level and gender as a covariate. The overall result showed that the translated Chinese version of the CAS-1 questionnaire was able to capture all the elements of CAS and could differentiate the differences in adopting the maladaptive metacognitive strategy level between depression and healthy subjects.
Conclusion: The results support the use of this translated version of the CAS-1 assessment tool in both clinical and research settings. In addition, the findings provide the first empirical evidence of the existence of CAS in the Chinese population suffering from depression. It shows a requisite for adopting a new wave of psychotherapy – Metacognitive Therapy (MCT) – in treating people with mood disorders such as depression in the local Chinese population.
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