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Despite a wide base of research suggesting a major role for dysfunctional metacognitions in contributing to anxiety, their role in explaining psychological distress in the context of the COVID-19 pandemic remains unclear. In this study we investigated whether metacognitions would predict anxiety, while controlling for fear and perceived danger of COVID-19. A total of 862 individuals were included in this study. Participants completed sociodemographic questions, emotional state questions relating to COVID-19, the Metacognitions Questionnaire‐30, and the Generalized Anxiety Disorder-7. Results showed that both negative beliefs about thoughts concerning uncontrollability and danger, and cognitive self-consciousness were significant predictors of anxiety beyond the fear and perceived danger of COVID-19. Future studies involving clinical populations are needed to investigate the longer-term impact of metacognitions in the maintenance and exacerbation of anxiety associated with the fear and perceived danger of COVID-19.

Objectives Cyberchondria involves the excessive and compulsive use of the Internet to search for health information. The present study investigated the relative contribution of health cognitions and metacognitions about health anxiety to prospective cyberchondria scores, controlling for health anxiety and hours spent online per day. Methods A convenience sample of 221 participants was recruited for the purpose of this study with a final sample totaling 125 participants (58.4% females, Mage = 34.51 years) who completed the full survey at baseline (T0) and a measure of cyberchondria after 30 days (T1). Results The results of the study showed that metacognition about health anxiety relating to beliefs about the uncontrollability of thoughts was the only significant predictor of prospective cyberchondria scores when controlling for health anxiety. Conclusions These results offer further support to the role of beliefs about the uncontrollability of thoughts in cyberchondria. The implications of the findings are discussed.

The evaluation of cognitive functions in Attention Deficit and Hyperactivity Disorder (ADHD) is fundamental to improve the efficacy of therapeutic interventions. However, the role of specific higher-order cognitive functions in adult ADHD, including cognitive flexibility, emotion recognition, and metacognitions, remains unclear. Therefore, in the current study, we aimed to examine these three distinct higher-order cognitive functions among adult ADHD individuals. Forty patients with ADHD with predominantly inattentive presentation and 42 healthy controls participated in the study. The Adult Attention Deficit and Hyperactivity Disorder Scale (AADHDS), the Wisconsin Card Sorting Test (WCST), the Reading the Mind in the Eyes Test (RMET), and the Metacognitions Questionnaire-30 (MCQ-30) were administered. Results indicated that patients with ADHD had worse metacognitions scores, in specific subdimensions, relative to healthy controls. However, cognitive flexibility and emotion recognition did not differ between the groups. Moreover, the cognitive confidence subdimension of the MCQ-30 was found to be sole significant predictor in the attention deficit subdimension of the AADHDS. Our findings suggest that lack of cognitive confidence may contribute to ADHD symptomatology despite regularly functioning cognitive flexibility and emotion recognition. Therefore, metacognitions could be a suitable target to alleviate the severity of ADHD symptoms.

Research has shown that metacognition may play a role in problem eating. In this study we explored whether aspects of metacognition are relevant to the understanding of binge eating in patients with Binge Eating Disorder. We aimed to ascertain: (1) the presence of metacognitive beliefs about binge eating; (2) the goal of, and stop signal for, binge eating; and (3) the impact of binge eating on self-consciousness. Ten Binge Eating Disorder patients took part in the study and were assessed using the metacognitive profiling semi-structured interview. Results suggested that all patients endorsed both positive and negative metacognitive beliefs about binge eating. The goals of binge eating were stop thinking about personal concerns and improve emotional state. All patients reported that they did not know when these goals had been reached. The stop signals for binge eating included physical discomfort, beliefs about binge eating not being the best way to solve problems, and environmental stimuli. All patients also confirmed that a reduction in self-consciousness occurred during a binge eating episode. The results of this study confirm that metacognition may indeed be relevant to the understanding of Binge Eating Disorder.

Background: Using the Self-Regulatory Executive Function model as a basis, this study explored whether, in both general population and clinical samples, metacognitive beliefs and repetitive negative thinking (i.e., rumination and worry) are associated with higher levels of emotion dysregulation. Methods: 395 participants from the general population and 388 outpatients seeking psychological treatment were recruited. Emotion dysregulation, metacognitive beliefs, rumination, worry, anxiety, depression, personality disorders were assessed. ANOVA and Welch's tests, correlation and path analyses were run. Results: Repetitive negative thinking was found to play a mediating role in the relationship between metacognitive beliefs and emotion dysregulation in both general population and clinical samples. Moreover, metacognitive beliefs were found to be directly associated to emotion dysregulation. Limitations: The cross-sectional design. Conclusions: Emotion dysregulation appears to be associated with the tendency to engage in repetitive negative thinking and metacognitive beliefs. Repetitive negative thinking and metacognitive beliefs could be a suitable therapeutic target to reduce difficulties in emotion regulation.

With the largest online gamer population worldwide and a heightened rate of Internet Gaming Disorder (IGD), China has a long-lasting need to identify salient correlates of IGD and provide corresponding assessment tools to support cost-effective IGD screening and interventions. To respond to such a need, the present study aimed to validate the Metacognitions about Online Gaming Scale (MOGS) among Chinese gamers to provide an additional tool for promoting studies investigating metacognition, a promising and newly emerged correlate of IGD, in China. To evaluate the psychometric properties of MOGS, we collected data from 1340 Chinese university students with gaming experiences (59.3% female, M

Self-critical rumination is a process whereby individuals focus attention on past failures and inadequacies without consideration for improvement or problem-solving. Past research has demonstrated that self-critical rumination is a separate process from the experience of having intrusive self-critical thoughts and that engaging in self-critical rumination is strongly correlated with beliefs that it is uncontrollable or represents a weakness of character. What is less clear at this time, however, is the impact that self-critical rumination has on levels of distress when faced with failure. Thirty volunteers who were not experiencing significant levels of depression were randomly assigned across three groups: one rumination and two controls. Acute distress was measured prior to and immediately following a task, as well as upon debrief. Individuals expected to complete an impossible task, who experienced simulated self-critical rumination experienced greater levels of acute distress than controls immediately following the task. There was also a significant correlation between reported levels of trait self-critical rumination, negative metacognitive beliefs and self-esteem with levels of distress following debrief when controlling for initial levels of distress and group membership. The use of subjective self-reports and small sample size limits the findings of this exploratory study. Engaging in self-critical rumination, and associated negative metacognitive beliefs, may have a significant impact on levels of acute distress following a recent failure.

In the current study, we aimed to test a metacognitive model of self-esteem grounded in the Self-Regulatory Executive Function model of psychopathology.A convenience sample of 346 community participants were recruited and completed a battery of online questionnaires that measured self-esteem, self-criticism, self-critical rumination, metacognitions about self-critical rumination, generic metacognitions and negative affect. Initially, we tested a series of hypotheses to establish the relationships between the study variables. We then conducted a path analysis to test a metacognitive model of self-esteem, where the process of self-critical rumination and its associated metacognitive beliefs was hypothesized to mediate the relationship between affect and self-esteem.Self-critical rumination and its associated negative metacognitions, levels of depression and self-criticism independently predicted self-esteem. However, the multicollinearity between rumination and metacognitions suggests that one might not exist without the other. Additionally, a path analysis revealed that the study data was a very good fit to the proposed metacognitive model of self-esteem.The metacognitive model of self-esteem presented in this paper may be used to generate novel interventions to improve self-esteem and decrease self-critical rumination.

Past research has shown that perfectionism, can negatively impact self-esteem. However, the mediating factors that explain this relationship remain unclear. The current study aimed to investigate whether specific cognitive processes, namely, self-critical rumination and associated metacognitions, mediate this relationship. An opportunity sample of 347 participants completed a battery of online questionnaires measuring clinical perfectionism, self-critical rumination, metacognitions about self-critical rumination, self-esteem, and levels of psychological distress. Several hypotheses were tested to examine the associations between the study variables. Following this, a path analysis was used to determine whether the influence of perfectionistic concerns and perfectionistic striving on self-esteem is mediated by positive metacognitions about self-critical rumination, self-critical rumination, and negative metacognitions about self-critical rumination, serially. Positive metacognitions about self-critical rumination, self-critical rumination, and negative metacognitions about self-critical rumination partially mediated the relationship between perfectionistic concerns and self-esteem and fully mediated the relationship between perfectionistic striving and self-esteem. These results point towards possible interventions for those who struggle with low self-esteem due to their perfectionistic tendencies. Further investigations should explore additional factors that help to explain why perfectionism impacts self-esteem levels, whilst also addressing the limitations of this current research.

Background and aims In the current study we have sought to clarify the contribution of metacognitions concerning smartphone use relative to smartphone use expectancies in the relationship between well-established predisposing psychological factors and problematic smartphone use (PSU). We tested a model where psychological distress, impulsivity, and proneness to boredom predict metacognitions about smartphone use and smartphone use expectancies, which in turn predict PSU. Methods A sample of 535 participants (F = 71.2%; mean age = 27.38 ± 9.05 years) was recruited. Results The model accounted for 64% of the PSU variance and showed good fit indices (χ 2 = 16.01, df = 13, P = 0.24; RMSEA [90%CI] = 0.02 [0–0.05], CFI = 0.99; SRMR = 0.03). We found that: (i) when it comes to psychological distress and boredom proneness, negative metacognitions, and both positive and negative expectancies play a mediating role in the association with PSU, with negative metacognitions showing a dominant role; (ii) there is no overlap between positive expectancies and positive metacognitions, especially when it comes to smartphone use as a means for socializing; (iii) impulsivity did not show a significant effect on PSU Direct effects of the predictors on PSU were not found. Discussion and conclusions The current study found additional support for applying metacognitive theory to the understanding of PSU and highlight the dominant role of negative metacognitions about smartphone in predicting PSU.

The current study aimed to investigate the mediating role of metacognitions, intolerance of uncertainty and emotion regulation in the relationship between fear of COVID-19 (FC-19) and health anxiety, among families with COVID-19 infected. Participants were 541 individuals from family members of patients with COVID-19 (F = 52.3%, mean age = 41.3 ± 13.2 years). Data were collected with a packet including sociodemographic and risk factors, the Fear of COVID-19 Scale, the Short Health Anxiety Inventory, the Metacognitions Questionnaire 30, the Intolerance of Uncertainty Scale-12 and the Emotion Regulation Questionnaire. Structural equation modelling analyses revealed a full mediation of metacognitions (i.e., positive beliefs about worry, negative beliefs about thoughts concerning uncontrollability and danger, cognitive confidence and beliefs about the need to control thoughts), intolerance of uncertainty and expressive suppression in the relation between FC-19 and health anxiety. Moreover, the strongest indirect links were found between FC-19 and health anxiety through negative beliefs about thoughts concerning uncontrollability and danger and intolerance of uncertainty. These associations were independent of gender and risk status. The final model accounted for 71% of the variance of health anxiety. These findings suggest that particularly metacognitions, intolerance of uncertainty and expressive suppression play a full mediational role in the relation between FC-19 and health anxiety. [Abstract copyright: © 2021 John Wiley & Sons, Ltd.]

The most common behavioral addictions in adolescents are Internet Gaming Disorder (IGD), Compulsive Sexual Behavior Disorder (CSBD), and Problematic Social Networks Use (PSNU). In the present study, we investigated whether thought suppression and impulsiveness mediate the relationship between metacognitions and these three behavioral addictions (IGD, CSBD and PSNU). In Study 1 (n = 471), we examined whether online gaming thought suppression and impulsiveness mediate the relationship between metacognitions and IGD. In Study 2 (n = 453), we examined whether sex thought suppression and impulsiveness mediate the relationship between metacognitions and CSBD. In Study 3 (n = 1004), we examined whether social media thought suppression and impulsiveness mediate the relationship between metacognitions and PSNU. Results of path analysis indicated, across the three studies, the importance of both thought suppression and impulsiveness as mediators between metacognitions and the three behavioral addictions (IGD, CSBD and PSNU) being investigated. These findings provide an opportunity for therapists as well as educators to gain a better insight into the link between metacognitions, thought suppression, impulsiveness, and behavioral addictions as part of developmental behavior among adolescents.

Background: The use of new technologies is growing, and some authors have suggested that frequent use might hide a non-chemical addiction (i.e., technological addiction). Over the last five years several studies investigating the role of metacognitions in technological addictions have been published. We aim to provide the first systematic review focused on this topic, by updating the initial evidence highlighted by a previous systematic review on metacognitions across addictive behaviors (Hamonniere & Varescon, 2018) Methods: Electronic literature databases (Pubmed, PsychINFO, SCOPUS, and Web of Science) were searched to identify studies that examined the relationship between metacognitions and four different technological addictions (Internet Gaming Disorder, IGD; problematic Internet use, PIU; problematic smartphone use, PSU; and problematic social networking sites use.) Results: We found 13 empirical studies published between 2018 and 2021. Positive low-to-moderate cross-sectional associations between the four technological addictions and both generic and specific metacognitions were found, in accordance with the metacognitive model of addictive behaviors. Positive beliefs about worry, negative beliefs about thoughts concerning uncontrollability and danger, beliefs about the need to control thoughts, and a lack of cognitive confidence were associated with IGD, PIU, PSU, and PSNSU. Conclusions: The absence of longitudinal studies prevent us from providing definitive answers about the role of metacognitions in technological addictions. Despite this limitation, interventions that target metacognitions could be beneficial for people presenting with technological addictions.

Research on metacognitions and repetitive negative thinking in patients with Personality Disorder (PD) is scarce. We aimed to determine if metacognitions and repetitive negative thinking differed between patients with PD and those without PD, and if metacognitions would predict repetitive negative thinking in patients with PD controlling for several variables. A sample of 558 clinical participants were assessed for the presence of a PD diagnosis and completed the following questionnaires: Penn-State Worry Questionnaire, Ruminative Response Scale, Metacognitions Questionnaire 30, Beck Anxiety Inventory and Beck Depression Inventory. Compared to patients without a diagnosis of PD, patients with a PD diagnosis reported higher scores on both rumination and worry (as well as depression and anxiety) and three out of five of the MCQ-30 subscales (positive beliefs about worry, negative beliefs about thoughts concerning uncontrollability and danger, and beliefs about the need to control thoughts). Furthermore, the results of two hierarchical regression analyses in patients with a diagnosis of PD indicated that positive beliefs about worry and negative beliefs about thoughts concerning uncontrollability and danger were independent predictors of worry, and that negative beliefs about thoughts concerning uncontrollability and danger and cognitive self-consciousness were independent predictors of rumination. Metacognitions and repetitive negative thinking may play a role in the severity of psychological distress experienced in PD presentations. The implications of these findings are discussed. [Abstract copyright: Copyright © 2021 Elsevier B.V. All rights reserved.]

Research undertaken over the last fifteen years has applied the Self-Regulatory Executive Function (S-REF) model of psychopathology to the conceptualisation and treatment of alcohol use disorder (AUD). From this perspective, metacognitive beliefs may contribute to the initiation, perseveration and maintenance of alcohol use, promoting the engagement on Cognitive Attentional Syndrome (CAS), which in turn might increase the likelihood of using alcohol as a means of cognitive-affective regulation. Reducing the propensity to engage in the CAS and modifying related metacognitive beliefs have been proposed as therapeutic targets for the treatment of AUD. Preliminary evidence has shown that Metacognitive Therapy may be a feasible treatment for AUD as a primary diagnosis, promoting controlled alcohol use. In this chapter, we review research on metacognitive beliefs in AUD and outline the Metacognitive Therapy approach to the treatment of AUD.

Background and aimsIn recent years, Internet Gaming Disorder (IGD) has been recognized as a mental health problem. Although research has found that social anxiety, motives, the preference for online social interactions (POSI), and metacognitions about online gaming are independent predictors of IGD, less is known about their relative contribution to IGD. The aim of the current study was to model the relationship between social anxiety, motives, POSI, metacognitions about online gaming, and IGD.MethodsFive hundred and forty three Italian gamers who play more than 7 h a week (mean age = 23.9 years; SD = 6.15 years; 82.5% males) were included in the study. The pattern of relationships specified by the theoretical model was examined through path analysis.ResultsResults showed that social anxiety was directly associated with four motives (escape, coping, fantasy, and recreation), POSI, and positive and negative metacognitions about online gaming, and IGD. The Sobel test showed that negative metacognitions about online gaming played the strongest mediating role in the relationship between social anxiety and IGD followed by escape, POSI, and positive metacognitions. The model accounted for 54% of the variance for IGD.Discussion and conclusionsOverall, our findings show that, along with motives and POSI, metacognitions about online gaming may play an important role in the association between social anxiety and IGD. The clinical and preventive implications of these findings are discussed.

Cyberchondria refers to the tendency to excessively and compulsively search for online medical information despite the distress experienced, with consequent impairment of daily-life activities. The current two studies sought to explore (i) the factor structure of the Italian version of the Cyberchondria Severity Scale (CSS) and (ii) a metacognitive model of cyberchondria. Participants were Italian community adults who reported using the Internet to search for health-related information (Study 1: N = 374, Study 2: N = 717). Results from Study 1 supported the Italian version of the CSS exhibiting a five-factor structure, with the resulting scales demonstrating good internal consistency, 5-week test-retest reliability, and generally strong correlations with indices of health anxiety. In Study 2, results of a path analysis showed that the negative metacognitive belief domain ("thoughts are uncontrollable") shared the strongest direct association with each of the five dimensions of cyberchondria, followed by beliefs about rituals. Consistently, the strongest indirect associations were found between "thoughts are uncontrollable" and all the five cyberchondria dimensions via beliefs about rituals. These results provide support for an Italian version of the CSS and the metacognitive conceptualization of cyberchondria.

Background and aims Problematic social networking sites (SNS) use is associated with important psychological problems among adolescents. Nevertheless, research on the aetiology of problematic SNS use is limited. Our aim was to investigate the role of metacognitions and emotion recognition in predicting problematic SNS use during the late adolescence period. Methods Eight hundred and sixty-one high school students were recruited for the study. Participants completed the Bergen Social Media Addiction Scale (BSMAS), the Metacognitions Questionnaire for Children (MCQ-C), and the Children's Version of Reading the Mind in the Eyes Test (RMET). Results A stepwise multiple linear regression analysis showed that all subdimensions of metacognitions (positive meta-worry, negative meta-worry, superstition, punishment, and responsibility beliefs, and cognitive monitoring), but not emotion recognition, independently predicted the BSMAS total score controlling for daily SNS use. Conclusions Our findings indicate that maladaptive metacognitions are associated, independently frequency of daily SNS use, to problematic SNS use among late adolescents. Interventions targeting dysfunctional metacognitions may aid adolescents who suffer from the detrimental effects of problematic SNS use.

The metacognitive approach conceptualizes the relationship between anger and rumination as driven by metacognitive beliefs, which are information individuals hold about their own cognition and about coping strategies that impact on it. The present study aimed to test the prospective predictive impact of metacognitive beliefs and rumination on anger in a community sample. Seventy-six participants were recruited and engaged in a 2-week anger, rumination, and metacognitive beliefs monitoring protocol. A multi-wave panel design was employed to test whether metacognitive beliefs and rumination have a prospective impact on anger. Metacognitive beliefs and rumination were found to have a significant prospective impact on anger that was independent from the number of triggering events. Metacognitive beliefs about the need to control thoughts were shown to have a direct impact on subsequent anger, independently from rumination. These findings provide support for the potential value for applying metacognitive theory and therapy to anger-related problems. Aggr. Behav. 9999:1-9, 2017. © 2017 Wiley Periodicals, Inc.

© 2016 International Association for Cognitive Psychotherapy.Behavioral and cognitive therapies for addictive behaviors have shown clinical utility, however, many patients continue to experience residual symptoms, particularly craving, a major precipitating factor in relapse. We review a desire-related cognitive elaboration, termed desire thinking, which has been found to play an important role in the perpetuation and escalation of both craving and addictive behaviors. We argue that novel treatment approaches, rooted in metacognitive therapy, may help to interrupt the perseveration of desire thinking and improve the well-being of populations suffering from addictive behaviors.

Psychological mechanisms that may explain the link between peer victimization and its adverse outcomes are still understudied. The current study aimed to apply the Self-Regulatory Executive Function (S-REF) model of psychopathology (Wells & Matthews, 1994, 1996) to help explain this link in a sample of adolescents. A total of 1,169 Italian adolescents (47.7% females; Mage = 15.79, SD = 1.07) completed self-report measures of peer victimization, metacognitions, thinking styles (worry and rumination), and adjustment indices (somatic symptoms, anxiety, depression). The hypothesized model based on the S-REF model was tested through path analysis. Results confirmed that peer victimization was positively associated with both positive and negative metacognitions that, in turn, were linked to worry and rumination, which were associated with higher psychological and somatic problems. The strongest indirect links were found between peer victimization and anxiety via negative metacognitions and worry, and between victimization and depression via negative metacognitions and rumination. Overall, the results support to the application of the S-REF model to peer victimization experiences during adolescence. The clinical implications of these findings are discussed.

OBJECTIVES: Off periods in Parkinson's disease are associated with a worsening of nonmotor symptoms and acute psychological distress. The relationship between motor fluctuations and episodic distress in naturalistic settings remains unclear, particularly the role of individual psychological factors. This study aimed to identify those factors through real-life, real-time assessment using ecological momentary assessment (EMA). METHOD: Twenty participants (seven female) completed multiple brief prompted surveys over a 7-day period assessing current motor and medication state, social situation, episodic distress, and cognitive processes (rumination, symptom focus, and worry). Baseline depression and anxiety were measured using validated questionnaires, as were positive and negative beliefs and attitudes (metacognitions) regarding cognitive processes. The feasibility of EMA via smartphones was assessed at the end of the study. RESULTS: Across participants, 496 complete data sets were collected. Generalized linear mixed-model regression analyses showed that episodic distress was predicted by a combination of cognitive processes, F(1, 483) = 41.14, p CONCLUSIONS: Time of day, cognitive processes, and negative metacognitions predict episodic distress independent of motor state. This indicates potential targets for nonpharmacological interventions aimed at alleviating episodic distress in patients with motor fluctuations. EMA is a feasible methodology for Parkinson's disease research and potential tool for delivering such interventions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Background and aims Recent research used attachment theory and the metacognitive tenet as frameworks to explain problematic Facebook use (PFU). This study aims to test, in a single model, the role of different attachment styles and metacognitions in PFU among adolescents. Methods Two separate studies were conducted in order to establish the link between security (Study 1) and insecurity (Study 2), metacognitions, and PFU. A total of 369 and 442 Italian adolescents (age: 14–20 years old) participated in Study 1 and Study 2, respectively. Results Path analyses revealed the relative importance of different attachment dimensions with mother and father in predicting PFU and the mediating role of metacognitions between attachment styles and PFU. Discussion and conclusion In conclusion, since attachment styles and PFU may significantly affect adolescents’ development and well-being, the results of this study may provide some practical indications for researchers and practitioners.

Anxiety and depression add to the burden of Chronic Fatigue Syndrome (CFS), Fibromyalgia (FM), and Type 1 Diabetes Mellitus (T1DM). Metacognitions play a role in this distress. The Metacognitions about Symptoms Control Scale (MaSCS) measures metacognitive beliefs regarding symptoms but has weaknesses. The current study created a revised MaSCS (MaSCS-R) in English, German, and Arabic versions using CFS, FM, and T1DM samples, and examined the transcultural, transdiagnostic, and concurrent validity of metacognitions about symptom control. This study used data from a total of 563 participants clinically diagnosed with CFS (n = 124; English), FM (n = 348; German), or T1DM (n = 91; Lebanese). CFS and FM data had been used in earlier published studies but were subjected to new analyses. CFS data was used to create the English version of the MaSCS-R, and FM and T1DM data for German and Arabic versions. Metacognitions about worry, anxiety, depression, and symptom severity were measured. The three MaSCS-R versions, consisting of two factors (each with four items), had adequate psychometric properties, possessing configural and metric invariance. Metacognitive factors were associated with distress and symptom severity in all three samples. Metacognitions about symptom control have transcultural, transdiagnostic, and concurrent validity. This is the peer reviewed version of the following article: Fernie, B.A., Aoun, A., Kollman, J., Spada, M.M., and Nikcevic, A.V. (2019). Transcultural, transdiagnostic, and concurrent validity of a revised Metacognitions about Symptoms Control Scale. Clinical Psychology and Psychotherapy, which has been published in final form at 10.1002/cpp.2367 . This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions

Over the last twenty years metacognitive theory has been applied to the conceptualization and treatment of psychological distress (Wells, 2009). In this paper we consider the evidence linking Post-Traumatic Stress Disorder and problem gambling. This is followed by an overview of the role of metacognition in psychopathology and its specific application to the conceptualisation and treatment of Post-Traumatic Stress Disorder. We then proceed to discuss the possible role of metacognition in the relationship between Post-Traumatic Stress Disorder and problem gambling, and conclude by considering the clinical implications of metacognitive therapy for the transdiagnostic treatment of these co-occuring conditions.

OBJECTIVES: Fibromyalgia is a chronic condition of unknown aetiology, characterised by widespread pain, sleep disturbances, and fatigue. In this paper we examined the relationship metacognitions and the impact of Fibromyalgia in a German sample, detailing the translation and validation of a self-report metacognitive instrument. METHODS: The Metacognitions about Symptoms Control Scale (MaSCS) was translated into German using the back-forward translation process. A total of 348 patients (316 female and 26 male) with Fibromyalgia contributed data to the study to test the structure and psychometric properties of the MaSCS. RESULTS: Confirmatory factor analyses, informed by modification indices, resulted in a 16-item scale consisting of two factors pertaining to positive and negative metacognitions about symptoms control. Further analyses revealed that both factors had good internal consistency. Correlation analyses established convergent validity, indicating that both factors were significantly associated with: (1) established positive and negative metacognitions scales; and (2) with symptoms severity in Fibromyalgia. Regression analyses revealed that positive metacognitions about symptoms control significantly predicted impairment in physical functioning while negative metacognitions about symptoms control significantly predicted the overall Fibromyalgia impact value, when controlling for stress, anxiety, and depression and a general metacognitions. CONCLUSION: The findings support the potential relevance of metacognitions, and utility of the German version of MaSCS, in examining the role of metacognitions in Fibromyalgia and other chronic health conditions.

ObjectiveMotor fluctuations (characterised by a sudden increase in symptom intensity, referred to as an 'off-period') are common side effects after treatment of Parkinson's disease (PD) with dopaminergic medication. A proportion of these people find motor fluctuations highly distressing. This study aimed to identify metacognitions associated with cognitive and attentional responses to these experiences. MethodsTen individuals with PD who experience motor fluctuations were interviewed for this study using an adapted metacognitive profiling schedule. Participants were asked about their metacognitions, and the cognitive processes and attentional strategies activated in response to a distressing off-period. ResultsMetacognitions identified were more often related to conceptual thinking about symptoms rather than symptom focus and data suggested trends for increased depressive symptoms among individuals with stronger metacognitive beliefs. Conclusion Metacognitions may play a role in determining or maintaining off-period distress in PD.

Background: procrastination is highly prevalent amongst students and impairs academic performance. The metacognitive model of procrastination explains a significant proportion of unintentional procrastination variance. However, the model has yet to be tested using academic performance as the dependent variable. We tested whether the metacognitive model of procrastination explained self-reported academic performance (AP). Methods: a convenience sample of 204 current undergraduate and postgraduate students completed a battery of online questionnaires that measured intentional and unintentional procrastination, metacognitions about procrastination, AP, and depression. We conducted a series of correlation analyses and a path analysis (based on the metacognitive model of procrastination) that specified AP as the dependent variable. Results: the correlation analyses indicated that there are significant, negative associations between AP and depression, AP and negative metacognitions about procrastination, and AP and unintentional procrastination. The tested model was a good fit of the data and explained 13% of the variance in AP. Limitations: this study is cross-sectional. Conclusions: our findings provide further support for the metacognitive model of procrastination, indicating that novel interventions that target metacognitions may help to tackle procrastination and optimize AP.

Cyberchondria refers to the repeated use of the Internet to search for health information that leads to negative consequences. The present set of studies examined the tenability of a proposed metacognitive conceptualization of cyberchondria that includes metacognitive beliefs about health-related thoughts, beliefs about rituals, and stop signals. The contribution of those variables to cyberchondria was examined among 330 undergraduate students from a U.S. university in Study 1 and 331 U.S. community respondents in Study 2. All participants reported using the Internet to search for health information. Across both studies, metacognitive beliefs, beliefs about rituals, and stop signals shared positive bivariate associations with cyberchondria and accounted for unique variance in cyberchondria scores in multivariate analyses. Beliefs about rituals and stop signals emerged as relatively specific to cyberchondria versus health anxiety in multivariate analyses. Results provide preliminary support for a metacognitive conceptualization of cyberchondria, with extensions of the present findings discussed.

In this study, our principal aim was to investigate whether metacognitions about desire thinking predict the severity of binge eating in women and, if so, whether this relationship is independent of age, self-reported body mass index (BMI), negative affect, irrational food beliefs and craving. One hundred and four women, consisting of 32 consecutive patients with binge eating disorder undergoing initial assessment for cognitive therapy for eating disorders, 39 moderate binge eaters, and 33 non-binge eaters (both from the general population), completed the following measures: Self-reported BMI, Hospital Anxiety and Depression Scale, Irrational Food Beliefs Scale, General Craving Scale, Metacognitions about Desire Thinking Questionnaire, and Binge Eating Scale. A series of Spearman's rho correlation analyses revealed that self-reported BMI, anxiety, depression, irrational food beliefs, craving, and all three factors of the metacognitions about desire thinking questionnaire were significantly associated with the severity of binge eating. A stepwise regression analysis identified self-reported BMI, craving, and negative metacognitions about desire thinking as significant predictors of the severity of binge eating. These results, taken together, highlight the possible role of metacognitions about desire thinking in predicting the severity of binge eating. The clinical implications of these findings are discussed.

article i nfo Available online xxxx Objectives:Recentresearchhassuggestedthatmetacognitionsmay play aroleinsmoking.The goalofthecurrent set of studies was to develop the first self-report instrument of metacognitions about smoking. Method: We conducted three studies with samples of smokers (n = 222, n = 143, n = 25) to test the structure and psychometric properties of the Metacognitions about Smoking Questionnaire and examined its capacity to predict smoking behaviour. Results: Exploratory and confirmatory factor analyses supported a four-factor solution: positive metacognitions about cognitive regulation, positive metacognitions about emotional regulation, negative metacognitions about uncontrollability, and negative metacognitions about cognitive interference. Internal consistency, predictive and divergent validity, and temporal stability were acceptable. The metacognition factors correlated positively with daily cigarette use and levels of nicotine dependence, and contributed to the prediction of these outcomes over and above smoking outcome expectancies. Conclusions: The Metacognitions about Smoking Questionnaire was shown to possess good psychometric prop- erties, as well as predictive and divergent validity within the populations that were tested. The metacognition factors explained incremental variance in smoking behaviour above smoking outcome expectancies.

Introduction The aim of this study was to provide an overview of the construct of desire thinking and test a metacognitive model of desire thinking and craving, based on the work of Spada, Caselli and Wells (2012; 2013), which aims to explain the perseveration of desire thinking. Method We conducted two studies involving four clinical samples (total N = 493) and a community sample (N = 494) presenting with different addictive behaviors. The relationships among variables were examined by testing the fit of path models within each sample. Results In the model presented it was proposed that positive metacognitions about desire thinking are associated with, in turn, imaginal prefiguration and verbal perseveration, marking the activation of desire thinking. Verbal perseveration is then associated to negative metacognitions about desire thinking and craving denoting the pathological escalation of desire thinking. Finally, a direct association between positive metacognitions about desire thinking and negative metacognitions about desire thinking would mark those occasions where target-achieving behaviour runs as an automatized schemata without the experience of craving. Results indicated a good model fit in the clinical sample and a variation in the model structure in the community sample. Conclusion These findings provide further support for the application of metacognitive theory to desire thinking and craving in addictive behaviors.

Background: Studies have reported that Cognitive Behavioural Therapy (CBT) and Graded Exercise Therapy (GET) are effective treatments for Chronic Fatigue Syndrome (CFS). Method: One hundred and seventy-one patients undertook a course of either CBT (n = 116) or GET (n = 55) and were assessed on a variety of self-report measures at pre- and posttreatment and follow-up. Aims: In this paper we present analyses on treatment outcomes for CBT and GET in routine clinical practice and evaluate whether changes on subscales of the Metacognitions Questionnaire-30 (MCQ-30) predict fatigue severity independently of changes in other covariates, and across the two treatment modalities. Results: Both CBT and GET were equally effective at decreasing fatigue, anxiety, and depression, and at increasing physical functioning. Changes on the subscales of the MCQ-30 were also found to have a significant effect on fatigue severity independently of changes in other covariates and across treatment modalities. Conclusion: The findings from the current study suggest that CFS treatment protocols for CBT and GET, based on those from the PACE trial, achieve similar to poorer outcomes in routine clinical practice as in a RCT.

Metacognitions about the positive and negative effects of smoking have been associated with cigarette use and nicotine dependence. The aim of the present study was to validate the Turkish version of the Metacognitions about Smoking Questionnaire (MSQ; Nikcevic et al., 2015). The sample consisted of 859 self-declared smokers (452 female) aged between 18 and 68 years (mean = 28.3; SD = 7.9). Once the English to Turkish translation of the MDQ was completed, confirmatory factor analyses were conducted based on the four-factor structure of the original measure. Initially results suggested that this model was an inadequate fit of the data obtained. However, by allowing three pairs of items (within factor) to co-vary, a re-specified model was tested that was found to be a satisfactory fit of the data. Internal reliability and predictive validity of the translated scale were observed to be good. The Turkish version of the MSQ exhibited suitable psychometric properties. This study also showed that metacognitions about smoking predict nicotine dependence independently of demographic variables, length of cigarette use, negative affect, and smoking outcome expectancies.

Recent research has suggested that metacognitions may play a role across the spectrum of addictive behaviours. The goal of our studies was to develop the first self-report scale of metacognitions about gambling. We conducted three studies with one community (n = 165) and two clinical (n = 110; n = 87) samples to test the structure and psychometric properties of the Metacognitions about Gambling Questionnaire and examined its capacity to prospectively predict severity of gambling. Findings supported a two factor solution consisting of positive and negative metacognitions about gambling. Internal consistency, predictive and divergent validity were acceptable. All the factors of the Metacognitions about Gambling Questionnaire correlated positively with gambling severity. Regression analyses showed that negative metacognitions about gambling were significantly associated to gambling severity over and above negative affect and gambling-specific cognitive distortions. Finally only gambling severity and negative metacognitions about gambling were significant prospective predictors of gambling severity as measured three months later. The Metacognitions about Gambling Questionnaire was shown to possess good psychometric properties, as well as predictive and divergent validity within the populations that were tested.

BACKGROUND: Both positive smoking outcome expectancies and metacognitions about smoking have been found to be positively associated with cigarette use and nicotine dependence. The goal of this study was to test a model including nicotine dependence and number of daily cigarettes as dependent variables, anxiety and depression as independent variables, and smoking outcome expectancies and metacognitions about smoking as mediators between the independents and dependents. METHODS: The sample consisted of 524 self-declared smokers who scored 3 or above on the Fagerstrom Test for Nicotine Dependence (FTND: Uysal et al., 2004). RESULTS: Anxiety was not associated with either cigarette use or nicotine dependence but was positively associated with all mediators with the exception of stimulation state enhancement and social facilitation. Depression, on the other hand, was found to be positively associated with nicotine dependence (and very weakly to cigarette use) but was not associated with either smoking outcome expectancies or metacognitions about smoking. Only one smoking outcome expectancy (negative affect reduction) was found to be positively associated with nicotine dependence but not cigarette use. Furthermore one smoking outcome expectancy (negative social impression) was found to be positively associated with cigarette use (but not to nicotine dependence). All metacognitions about smoking were found to be positively associated with nicotine dependence. Moreover, negative metacognitions about uncontrollability were found to be positively associated with cigarette use. CONCLUSIONS: Metacognitions about smoking appear to be a stronger mediator than smoking outcome expectancies in the relationship between negative affect and cigarette use/nicotine dependence. The implications of these findings are discussed.

BACKGROUND:\ud procrastination refers to the delay or postponement of task or decision-making initiation or completion and is often conceptualised as a failure of self-regulation. Recent research has suggested that metacognitions play a role in procrastination and that unintentional procrastination (UP), as opposed to intentional procrastination (IP), may be the most problematic form of this behaviour. We aimed to test a metacognitive model of procrastination that was grounded in the Self-Regulatory Executive Function model.\ud \ud METHODS:\ud a convenience sample of 400 participants were recruited and completed (at least partially) a battery of online questionnaires that measured IP and UP, metacognitions about procrastination, depression, and Cognitive Attentional Syndrome (CAS) configurations. Initially, we tested series of hypotheses to establish the relationships between the experimental variables and to test whether CAS configurations would independently predict UP when controlling for age, depression, IP, metacognitions about procrastination, and whether an individual reported that they had been diagnosed with a psychiatric disorder.\ud \ud RESULTS:\ud CAS configurations, depression, and metacognitions independently predicted UP. Additionally, path analysis revealed that the study data was an excellent fit to the proposed metacognitive model of procrastination.\ud \ud LIMITATIONS:\ud the study is cross-sectional.\ud \ud CONCLUSIONS:\ud the metacognitive model of procrastination presented in this paper can be used to generate novel interventions to treat this problematic behaviour.

The objective of this study was to verify the structure of a model of how surface approach to studying is influenced by the trait variables of motivation and metacognition and the state variables of avoidance coping and evaluation anxiety. We extended the model to include: (1) the investigation of the relative contribution of the five metacognition sub-traits; and (2) the prediction of academic examination performance while controlling for past academic examination performance. A sample of 101 university students completed prior to undertaking academic examinations of the following self-report instruments: Work Preference Inventory, Metacognitions Questionnaire 30, Revised COPE Inventory, Evaluation Anxiety Scale and Approaches and Study Skills Inventory for Students. Results supported the original structure of the metacognitive-motivational model of surface approach to studying in addition to showing that it predicts academic examination performance controlling for past academic examination performance. ...

Objectives Recent research has suggested that specific metacognitions may play a role in the activation and escalation of desire thinking and craving. The goal of this research project was to develop the first self-report instrument of metacognitions about desire thinking. Method We conducted three studies with nonclinical samples (N = 213, N = 279, N = 60) to construct the Metacognitions about Desire Thinking Questionnaire (MDTQ) and test its structure and psychometric properties. A fourth study was added to test the predictive validity of MDTQ in a sample of alcohol abusers (N = 75). Results Explorative and confirmatory factor analysis supported a 3-factor solution: positive metacognitions about desire thinking, negative metacognitions about desire thinking, and need to control desire related thoughts. Internal consistency, divergent validity, temporal stability were also examined in a community sample and predictive validity was confirmed even in a sample of alcohol abusers. Conclusions The MDTQ was shown to possess good psychometric properties, as well as divergent and predictive validity within the populations that were tested.

BACKGROUND: Self-criticism refers to a series of persistent and negative self-judgements, often involuntary, that an individual makes about themselves. Recent research has explored the possibility that self-criticism can lead to a more perseverative style of thinking called self-critical rumination. There is evidence that self-critical rumination may be a separate construct from other forms of rumination, such as depressive rumination and post-event processing. Research has indicated that metacognitions, beliefs that individuals have about their internal experiences and how to control them, may play a role in self-critical rumination. The aim of our work was to develop a measure to assess metacognitions related to self-critical rumination. METHOD: In Study 1, a community sample of 178 participants completed the newly developed Metacognitions about Self-Critical Rumination Questionnaire (MSCRQ) and results were subjected to a Principal Components Analysis. In Study 2, a community sample of 247 participants completed a battery of questionnaires including the MSCRQ. A Confirmatory Factors Analysis was performed on the MSCRQ and validity was ascertained by correlating with other measures. RESULTS: In Study 1, a 15-item two-factor structure was identified. A 10-item two-factor structure was confirmed in Study 2. Results also indicated that the MSCRQ has acceptable levels of reliability, and good concurrent and incremental validity. CONCLUSIONS: The MSCRQ appears to be a reliable and valid measure of metacognitions about self-critical rumination whilst the MCQ-30 is a better predictor of general emotional distress.

Cyberchondria refers to the repeated use of the Internet to search for health-related information, which leads to negative consequences. This two-part study provides the first known examination of how cyberchondria relates to (a) problematic Internet use and (b) metacognitive beliefs. Participants were U.S. community adults who reported using the Internet to search for health-related information (Study 1: N = 337, Study 2: N = 260). In Study 1, cyberchondria shared a strong association with problematic Internet use, and that association was unaccounted for by age, gender, current reported medical status, negative affect, or health anxiety. In Study 2, cyberchondria was found to share moderate to strong associations with metacognitive beliefs. The association between cyberchondria and metacognitive beliefs about the uncontrollability of thoughts remained intact after accounting for the Study 1 covariates, as well as anxiety sensitivity and intolerance of uncertainty. Neither anxiety sensitivity nor intolerance of uncertainty shared unique associations with cyberchondria. These results provide a preliminary indication that a metacognitive conceptualization of problematic Internet use may be applicable to cyberchondria. Key practitioner message A metacognitive conceptualization of cyberchondria appears tenable. Metacognitive beliefs, particularly about the uncontrollability of thoughts, appear more relevant to cyberchondria than either anxiety sensitivity or intolerance of uncertainty. Metacognitive treatment strategies could be useful in the treatment of cyberchondria.

Metacognitive therapy is designed to impact directly on cognitive monitoring and control processes such that individuals can develop alternative ways of experiencing and regulating thoughts. One technique used for this purpose is 'detached mindfulness' which promotes a decentred perspective to thoughts and decouples repetitive thinking and coping from their occurrence. This study set out to test the effects of detached mindfulness against a control condition, a brief exposure to alcohol-related thoughts. Eight patients diagnosed with alcohol use disorder in an abstinence regime were exposed to detached mindfulness versus brief exposure in a counterbalanced repeated-measures design. Results showed that detached mindfulness led to significantly greater decreases in meta-appraisal and metacognitive beliefs about alcohol-related thoughts compared to a brief exposure. Significantly greater decreases in distress and urge to use alcohol were also observed in detached mindfulness. The clinical implications are discussed.

The metacognitive approach conceptualizes the relationship between anger and rumination as driven by metacognitive beliefs, which are information individuals hold about their own cognition and about coping strategies that impact on it. The present study aimed to test the prospective predictive impact of metacognitive beliefs and rumination on anger in a community sample. Seventy-six participants were recruited and engaged in a 2-week anger, rumination, and metacognitive beliefs monitoring protocol. A multi-wave panel design was employed to test whether metacognitive beliefs and rumination have a prospective impact on anger. Metacognitive beliefs and rumination were found to have a significant prospective impact on anger that was independent from the number of triggering events. Metacognitive beliefs about the need to control thoughts were shown to have a direct impact on subsequent anger, independently from rumination. These findings provide support for the potential value for applying metacognitive theory and therapy to anger-related problems. Aggr. Behav. 43:421-429, 2017. © 2017 Wiley Periodicals, Inc.

© 2015, Springer Science+Business Media New York. No research, to date, has directly investigated the role of metacognition in self-critical rumination and low self-esteem. The aims of this study are: to investigate the presence of metacognitive beliefs about self-critical rumination; the goal of self-critical rumination and its stop signal; and the degree of detachment from intrusive self-critical thoughts. Ten individuals reporting both a self-acknowledged tendency to judge themselves critically and having low self-esteem were assessed using metacognitive profiling, a semi-structured interview. All participants endorsed both positive and negative metacognitive beliefs about self-critical rumination. Positive metacognitive beliefs concerned the usefulness of self-critical rumination as a means of improving cognitive performance and enhancing motivation. Negative metacognitive beliefs concerned the uncontrollability of self-critical rumination and its negative impact on mood, motivation and perception of self-worth. The primary goal of engaging in self-critical rumination was to achieve a better or clearer understanding of a given trigger situation or to feel more motivated to resolve it. However, only four participants were able to identify when this goal had been achieved, which was if the trigger situation were not to occur again. Participants unanimously stated that they were either unable to detach from their self-critical thoughts or could do so some of the time with varying degrees of success. More often than not, though, self-critical thoughts were viewed as facts, would rarely be seen as distorted or biased, and could take hours or days to dissipate. These findings provide preliminary evidence that specific facets of metacognition play a role in the escalation and perseveration of self-critical rumination.

Desire thinking is a voluntary cognitive process involving verbal and imaginal elaboration of a desired target. Recent research has revealed that desire thinking may play a significant role in the escalation of craving. The goal of this study was to explore the effect of a desire thinking induction on craving in a sample of patients with alcohol use disorder.Ten patients with alcohol use disorder were exposed to a brief exposure to alcohol-related thoughts plus desire thinking induction versus brief exposure to alcohol-related thoughts plus distraction.The induction of desire thinking led to a significant increase in distress and urge to use alcohol when compared to a behavioural assessment test and a distraction task. The clinical implications for the treatment of alcohol use disorder are discussed. Copyright © 2016 John WileySons, Ltd.Psychotherapeutic strategies that target desire thinking, both at the assessment and at the intervention levels, may be relevant in the treatment of craving-related problems. Deriving and illustrating the role of desire thinking in a given episode of craving may support the development of metacognitive awareness about its functions and consequences.

In this paper, a triphasic metacognitive formulation of problem drinking and its implications for treatment are presented together with a summary of the evidence consistent with this approach. In the triphasic formulation during the pre-alcohol use phase, alcohol-related triggers, in the form of cravings, images, memories or thoughts, activate positive metacognitive beliefs about extended thinking, which lead to desire thinking, rumination and worry or their combination. The activation of the latter brings to an escalation of cravings and negative affect, strengthening negative metacognitive beliefs about the need to control thoughts and enhancing the likelihood of alcohol use. In the alcohol use phase, positive metacognitive beliefs about alcohol use and a reduction in metacognitive monitoring contribute to dysregulation in alcohol use. Over the course of time and as the drinking problem escalates in severity, negative metacognitive beliefs about the uncontrollability of alcohol use and alcohol-related thoughts emerge, contributing to the perseveration of dysregulated alcohol use. In the post-alcohol use phase following the activation of positive metacognitive beliefs about post-event rumination, the affective, cognitive and physiological consequences of dysregulated alcohol use become the subject of rumination. This, in turn, leads to a paradoxical increase in negative affect and alcohol-related thoughts, together with the strengthening of negative metacognitive beliefs about such thoughts. Intermittent attempts to suppress alcohol-related thoughts increase the likelihood of returning to use alcohol as a means of achieving self-regulation. Copyright © 2012 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE: A metacognitive formulation of problem drinking that may aid assessment, conceptualization and treatment across the problem drinking spectrum. Language: en

In this study, we put forward and tested a model of how surface approach to studying during examination preparation is influenced by the trait variables of motivation and metacognition and the state variables of avoidance coping and evaluation anxiety. A sample of 528 university students completed, one week before examinations, the following self-report instruments: Work Preference Inventory, Metacognitions Questionnaire 30, Revised COPE Inventory, Evaluation Anxiety Scale and Approaches and Study Skills Inventory for Students. Structural equation modelling indicated that metacognition directly promoted surface approach to studying. In addition, both avoidance coping and evaluation anxiety directly promoted surface approach to studying and partially mediated the relationships between traits and surface approach to studying. The implications of these findings are outlined.