Metacognitive beliefs, affective-defensive processes, spiritual coping, and psychological distress: A structured narrative review

This structured narrative review integrates metacognitive, affective-defensive, and spiritual-coping perspectives on psychological distress and proposes a clinically bounded Recursive Belief-Affect-Meaning model.Searches of PubMed/MEDLINE, APA PsycINFO, Scopus, and Web of Science Core Collection were iteratively updated through May 26, 2026, with supplementary Google Scholar checks.Sources were purposively selected for construct definition, measurement, clinical relevance, competing explanations, and cultural boundary conditions; the review was non-exhaustive and did not pool effects or grade evidence certainty.Across the component literatures, negative metacognitive beliefs and repetitive negative thinking show the strongest psychometric and intervention support.Affective-defensive processes provide formulation-relevant but method-dependent evidence, whereas spiritual coping and struggle are heterogeneous and culturally contingent.Evidence for the proposed cross-domain interactions remains indirect.The model therefore distinguishes established component findings from adjacent evidence and untested recursive pathways, maps affective loading, metacognitive appraisal, sacred attribution, and regulatory response, and identifies falsifiable longitudinal and cross-cultural tests.It is intended as a culturally sensitive formulation heuristic for psychiatric assessment and psychotherapy, not as a diagnostic algorithm, causal theory, or treatment protocol.