Developing a Structural Model of the Relationship Between Metacognitive Beliefs and Psychological Distress with the Mediating Role of Psychological Wellbeing Among Male Prisoner Clients

Today, psychological distress is one of the most common disorders in the general population, associated with a decreased quality of life at the individual level. In addition, it harms people's performance and negative attitudes toward the environment, others, and even themselves. It may appear with a range of psycho–physiological and behavioral symptoms such as depression, stress, anxiety, disturbance, neurosis, sleep disorders, sexual dysfunction, physical pain, and inability to regulate emotion. The present study was conducted to develop a structural model of the relationship between metacognitive beliefs and psychological distress with the mediating role of psychological well–being among man prisoner clients.

The present study was correlational and used structural equation modeling. The statistical population of this study consisted of all male prisoners in the vocational training and occupational therapy camp of Chenaran City located in Khorasan Razavi province, Iran, in 2020. According to Klein (1998), the acceptable number of samples for correlational studies in large populations is between 15 to 20 people for each variable. Considering at least 15 people for each variable is an optimal rule in structural equations that follow multivariate regression. Accordingly, since we have 14 observed variables (5 subscales of metacognitive beliefs, 3 subscales of psychological distress, and 6 subscales of psychological wellbeing), considering 20 people for each observed variable, the minimum sample size was 280. However, due to the characteristics of the study sample, the high probability of the sample dropout, and the existence of incomplete questionnaires, this number increased to 350 people. Sampling was done by convenience method and considering the inclusion and exclusion criteria. The inclusion criteria were as follows: prisoners having symptoms of psychological distress based on a psychiatrist's diagnosis; having knowledge and insight about their underlying problems and feeling the need for low medical intervention (based on prisoner's feedback and psychiatrist's diagnosis); willingness to participate in research. The exclusion criteria were as follows: lack of chronic medical problems, use of psychiatric and psychotropic drugs, history of hospitalization in psychiatric hospitals, and use of psychological interventions. After receiving the clinical history of the prisoners by the researcher, the questionnaires were administered to the prisoners. In this study, participants answered the short form of the Wales Metacognition Questionnaire (1997), Lovibond and Lovibond Depression, Anxiety and Stress Scale (1995), and Ryff Psychological Wellbeing Questionnaire (short form) (1989). In addition, questions related to age, marital status and education were used to obtain demographic information. Data were analyzed using structural equation modeling with SPSS–25 and AMOS–24 statistical software programs, and the significance level of the tests in this study was considered 0.05.

The results showed that the direct path coefficient between metacognitive beliefs and psychological wellbeing was negative and significant (p=0.002; β=–0.273), and the direct path coefficient between metacognitive beliefs and psychological distress was positive and significant (p=0.001; β=0.300). The direct coefficient of psychological wellbeing on psychological distress is also negative and significant (p=0.002; β=–0.504). The coefficient of the indirect effect of metacognitive beliefs on psychological distress is also positive and significant (p=0.001; β=0.138). The goodness of model fit index showed that psychological wellbeing mediated the relationship between metacognitive beliefs and psychological distress (CFI=0.95; RMSEA=0.06).

Based on the study results, psychological wellbeing mediates the structural relationship between metacognitive beliefs and psychological distress. Therefore, these findings can be used by prison managers and officials, as well as they can also be effective in promoting mental health and reducing the psychological distress of prisoners.