Cognitive, Metacognitive, Motivational, and Emotional Predictors of the Intensity of Internet Gaming Disorder among Adolescents

Internet gaming disorder (IGD) is multifaceted and can have significant negative consequences. The present study examined the contribution of cognitive, metacognitive, motivational, and emotional factors as predictors for IGD severity. In a cross-sectional study, 703 Iranian adolescents (36.8% females, mean age = 16.98 years [SD = 1.23]) completed an online survey. Hierarchical regression analysis showed that the cognitive, metacognitive, motivational, and emotional factors predicted 7.8%, 17.4%, 1.4%, and 1.9% of the variance in IGD symptoms, respectively. The findings indicated that the cognitive factors including some maladaptive cognitions, such as cognitive salience, regret, and perfectionism, and metacognitive factors including some maladaptive metacognitions (negative metacognitions regarding the uncontrollability of online gaming and negative metacognitions regarding the dangers of online gaming) were significant predictors of IGD severity, highlighting their importance in understanding and predicting problematic gaming behaviors. Although contributing to the variance in IGD, motivational factors (escape, coping, and skill development) and emotional factors including emotion regulation (especially reappraisal) played relatively smaller roles compared to cognitive and metacognitive factors. Of the examined predictive factors, metacognitions were the most important predictor of IGD severity. Exploratory moderator analyses showed significant interactions between three predictors of IGD (reappraisal, negative metacognitions, and cognitive salience) with loneliness, stress, anxiety, and depressive symptoms. Reappraisal was the most frequent predictor and had a significant interaction with these variables. Other predictors independently impacted IGD irrespective of the level of loneliness, stress, anxiety, or depressive symptoms. Based on these findings, special attention to metacognitive, cognitive, emotional, and motivational factors is suggested in the treatment of IGD.

The relationship between metacognition, anger, and pain intensity among fibromyalgia patients: a serial mediation model

Fibromyalgia is a burdensome pain causing patients a very negative emotional state that can worsen their clinical profile, perceived disability, and treatment outcomes. In particular, anger can negatively affect pain and patient adjustment to the disease. Recent studies suggest that metacognitions and anger rumination can negatively affect anger, which in turn can amplify the intensity of pain. This study aims to investigate whether anger rumination and state anger serially mediate the relationship between metacognitions and the intensity of pain. The study included 446 subjects who: declared having received a fibromyalgia diagnosis by a rheumatologist/pain physician; completed measures of metacognitions, anger rumination, state-anger, and pain intensity. The serial mediation analysis was conducted using Hayes' PROCESS macro (Model 6). Negative beliefs about worry and beliefs about the need to control thoughts indirectly influenced the intensity of pain through two significant mediating pathways: state-anger and anger rumination to state-anger. Cognitive self-consciousness affected pain intensity directly (β = .11, p < .05) and indirectly through two significant mediating pathways: state-anger and anger rumination to state-anger. This study highlights the role of serial mediation of anger rumination and state-anger in the relationship between metacognitions and pain intensity in the field of fibromyalgia. Our work introduces new targets for anger management interventions for patients with fibromyalgia. Such interventions could be effectively addressed with a metacognitive approach considering its specific focus on dysfunctional metacognitive beliefs and repetitive negative thinking.

The Relationship Between Mental health, Metacognition, and Emotion Regulation in Older People

OBJECTIVES

It is unclear if using emotion regulation strategies can help manage the effects of anxiety and depression on metacognitive strategies in older people. This study aimed to verify the effect of emotion regulation in the interaction between mental disorders and metacognition.

METHODS

A mediation analysis was performed to assess the role of emotion regulation in the interaction between mental disorders and metacognition in older people.

RESULTS

Without mediator control, higher scores indicating mental disorder are associated with reduced metacognition scores. When mediators are added to the model, the mediation effect was significant. An indirect effect of anxiety and depression on metacognition was mediated by cognitive reappraisal to a greater extent than emotional suppression.

CONCLUSIONS

Cognitive reappraisal reduced the impact of anxiety and depression on metacognition in older adults.

CLINICAL IMPLICATIONS

Including cognitive reappraisal techniques in anxiety and depression intervention plans can be beneficial for improving older people's metacognition functioning.

Psychometric properties of an Arabic translation of the short form of the metacognition questionnaire (MCQ-30) in a non-clinical adult sample

BACKGROUND

Previous linguistic validations of the 30-item Metacognition Questionnaire (MCQ-30) have been performed in Western/Eastern populations, and no Arabic validated version exists to date for the wide Arabic-speaking populations in the Middle East-North African region and abroad. In this regard, we sought through the present study to test the psychometric properties of an Arabic translation of the MCQ-30 in a sample of Arabic-speaking community adults from Lebanon.

METHODS

The sample of this cross-sectional study consisted of 423 participants (mean age: 38.13 ± 11.03 years; 61.2% females). The Metacognition Questionnaire-short form, Teruel Orthorexia Scale and Emotion regulation questionnaire were used to assess metacognition, orthorexia nervosa and emotion regulation (cognitive reappraisal and expressive suppression) respectively.

RESULTS

Findings of Confirmatory Factor Analyses revealed that the five-factor model provided a good fit to the data. McDonald's ω coefficients ranged from 0.78 to 0.94 for the five MCQ-30 subscales, and was of 0.93 for the total score, hence supporting the adequacy of scale reliability. Results also supported configural, metric, and scalar equivalence of the five-factor model across gender groups. The MCQ-30 subscales showed patterns of correlations with the emotion regulation and disordered eating constructs in the expected directions, providing evidence of the criterion-related validity of the measure. In particular, positive emotion regulation strategies (i.e., cognitive reappraisal) were negatively correlated with cognitive self-consciousness and need to control thoughts; whereas maladaptive emotion regulation strategies (i.e., expressive suppression) showed positive correlations with lack of cognitive confidence, negative beliefs and need to control thoughts. Additionally, all metacognition dimensions (except for cognitive self-consciousness) were significantly and positively correlated with higher levels of orthorexia nervosa behaviors.

CONCLUSIONS

Our findings preliminarily suggest that the scale is valid, reliable, and can be recommended for use among the broad Arabic-speaking community worldwide.

Examining the Longitudinal Relationship Between Metacognitive Beliefs and Psychological Distress in an Adolescent Population: A Preliminary Analysis

Adolescence is a period marked by significant vulnerability to the onset of mental health concerns. Within adults, the metacognitive model of psychological disorders advocates for the involvement of metacognitive beliefs in the onset, and maintenance, of psychopathology. The current study aimed to assess the applicability of the metacognitive model in adolescence by exploring the relationship, as well as the trajectory, between metacognitive beliefs and psychological distress. The longitudinal prospective cohort study investigated data from a community-based sample of participants aged 12 to 13. Self-report assessment measures of metacognitive beliefs, psychological distress, and somatic distress are reported across four time-points. Baseline assessments are reported for 70 participants, which reduced to 53 participants at time-point four. Correlational analyses demonstrated a significant relationship between overall metacognition, as well as negative metacognitive beliefs, and psychological distress at each of the four time-points. Generalised Estimating Equations found a significant association between metacognitive predictors and psychological distress over the four time-points. These results indicate that negative metacognitive beliefs, positive metacognitive beliefs, metacognitive beliefs related to superstition, punishment, and responsibility, low perceived levels of cognitive confidence and cognitive self-consciousness predict psychological distress over 12 months in adolescents aged 12 to 13. The strongest longitudinal correlational structure was found for the model of negative metacognitive beliefs and psychological distress. These findings provide preliminary evidence for the positive linear relationship between metacognitive beliefs and psychological distress in adolescence. The study provides an important contribution to understanding the role of metacognitive beliefs in the aetiology and perpetuation of psychological distress in adolescence.

Perseverative thinking is associated with features of spoken language

Perseverative thinking (PT), such as rumination or worry, is a transdiagnostic process implicated in the onset and maintenance of emotional disorders. Existing measures of PT are limited by demand and expectancy effects, cognitive biases, and reflexivity, leading to calls for unobtrusive, behavioral measures. In response, we developed a behavioral measure of PT based on language. A mixed sample of 188 participants with major depressive disorder, generalized anxiety disorder, or no psychopathology completed self-report PT measures. Participants were also interviewed, providing a natural language sample. We examined language features associated with PT, then built a language-based PT model and examined its predictive power. PT was associated with multiple language features, most notably I-usage (e.g., "I", "me"; β = 0.25) and negative emotion language (e.g., "anxiety", "difficult"; β = 0.19). In machine learning analyses, language features accounted for 14% of the variance in self-reported PT. Language-based PT predicted the presence and severity of depression and anxiety, psychiatric comorbidity, and treatment seeking, with effects in the r = 0.15-0.41 range. PT has face-valid linguistic correlates and our language-based measure holds promise for assessing PT unobtrusively. With further development, this measure could be used to passively detect PT for deployment of "just-in-time" interventions.

The role of family functioning: How the Big Five affect metacognitions about smartphone use

The present study aimed to explore the relationship between the Big Five and metacognitions about smartphone use and the mediating role of family functioning. A cohort of 470 Chinese college students was selected as subjects based on the second edition of the Big Five Inventory-2, the Chinese version of the Metacognitions about Smartphone Use Questionnaire, and the general functioning subscale of Family Assessment Device. The results showed that only neuroticism was significantly and positively correlated with positive metacognition, while the correlation between other personality traits and positive metacognition was not statistically significant. Except for openness, the correlation between other personality traits and negative metacognition was statistically significant. In addition, conscientiousness, extraversion, and neuroticism were found to directly affect negative metacognitions about smartphone use and indirectly affect the negative metacognitions about smartphone use through family functioning. Findings provide insights into the design of interventions aimed at improving metacognitions about smartphone use and preventing smartphone addiction among college students.

Meaning-making processes across the lifespan: An investigation of the developmental course of metacognitive capacity

Deficits in metacognitive capacity (i.e., the ability to integrate knowledge of oneself and others into a cohesive whole) have been shown to lead to poor functional outcome in psychosis. However, there is a gap in the literature concerning the role of metacognition in typically developing populations, which makes it difficult to define what level of metacognition is normative and at what point deficits in metacognition suggest pathology. To explore this issue, we utilized cross-sectional design to assess metacognitive capacities among 69 neurotypical adults whose ages varied from 18 to 65 using the Metacognitive Assessment Scale - Abbreviated (MAS-A) and then compared those with MAS-A scores from a second previously gathered sample of 360 adults diagnosed with psychosis across four key developmental windows: emerging adulthood, early adulthood, middle adulthood, and late adulthood. Our findings suggest that in our overall sample, individuals with psychosis had significantly lower levels of metacognitive capacity across all domains assessed by the MAS-A in comparison to neurotypical individuals. Additionally, our data suggest a deleterious effect of psychosis such that individuals with psychosis showed significantly lower metacognition in each developmental stage. Additionally, these differences were largest in emerging and late adulthood and for both groups awareness of others stood out as the single metacognitive domain which was significantly less impaired among older groups. Our results suggest a developmental course for metacognitive capacity such that awareness of others is the sole domain that grows over the lifespan.

Effect of Alexithymia on Internet Addiction Among College Students: The Mediating Role of Metacognition Beliefs

Background: Previous studies have found that alexithymia plays an important role in the pathogenesis of Internet addiction. However, the effect of alexithymia on both metacognition and Internet addiction has yet to be examined. Methods: The Toronto Alexithymia Scale, Metacognition Questionnaire, and Internet Addiction Test were used to assess a sample of 356 college students. A parallel mediator effect analysis was applied to test the hypothesis that metacognition mediates the relationship between alexithymia and Internet addiction. Results: The parallel multiple mediator models showed that alexithymia predicted the five dimensions of metacognition and Internet addiction, and that three dimensions-cognitive confidence, positive beliefs about worry, and the need to control thoughts-partially mediated this relationship. Conclusion: Alexithymia could directly and indirectly predict Internet addiction via metacognition.

Evaluating U.S. gamers' metacognitions about digital entertainment: Validation of Metacognition about Online Gaming Scale in the U.S. context

Online gaming has become an important practice for several audiences in the last decade. Video games like Fortnite and League of Legends are played by millions of people daily, raising concerns about both addiction and disruptive attitudes. Several analytical instruments have been deployed for exploring this phenomenon, including the Metacognitions about Online Gaming Scale (MOGS). MOGS measures the role of metacognitions toward online gaming, echoing the increasing importance of such a construct in media consumption and perception. This article presents the highlights of a study involving 690 American gamers aimed at two purposes. First, the MOGS was validated for with U.S. gamers, who represent a leading niche in the current digital entertainment and were not involved with the original MOGS development. Second, the three subscales of MOGS were analyzed as mediators of the relationship between hours spent playing online gaming and Internet Gaming Disorder (IGD). The results from Confirmatory Factor Analysis suggested the MOGS has promising reliability and validity for use with U.S. gamers. The results also indicated that three subscales of the MOGS partially mediated the relationship between hours spent on playing online gaming and Internet Gaming Disorder.

The Combined Contribution of Fear and Perceived Danger of COVID-19 and Metacognitions to Anxiety Levels during the COVID-19 Pandemic

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.

Integrating Desire Thinking into the I-PACE Model: a Special Focus on Internet-Use Disorders

Purpose of Review

This manuscript aims to propose an integration of desire thinking into the Interaction of Person-Affect-Cognition-Execution (I-PACE) model based on theoretical considerations within the Elaborated Intrusion Theory of Desire and Self-Regulatory Execution Function model and empirical evidence from the field of internet-use disorders.

Recent Findings

Theory and research on desire thinking in the context of internet-use disorders suggest considerable relations to craving, metacognitive beliefs, and emphasizes its nature when initiated as a reaction towards unpleasant triggers. Accordingly, we postulate that desire thinking may be located at the position for affective and cognitive reactions towards triggers within the I-PACE model.

Summary

The suggested integration of desire thinking into the I-PACE model specifically implies the assumption of a relief-oriented and pleasure-oriented entry pathway into desire thinking and a feedback loop between desire thinking and the experience of gratification and compensation. The model pathways proposed here may serve as a theoretical basis for future research and need further empirical verification.

Validity and Reliability of the Turkish Version of Generalized Anxiety Disorder Scale-Revised

OBJECTIVE

This study aims to assess the psychometric values of the Generalized Anxiety Disorder Scale-Revised (GADS-R) which measures the intensity and duration of worry, various coping and avoidance strategies to cope with worrying, and positive and negative metacognitive beliefs about worrying.

METHODS

114 patients with generalized anxiety disorder and 198 healthy controls were included in the study. These patients were diagnosed according to DSM-IV TR, and the primary diagnosis of the patients was generalized anxiety disorder which was confirmed via SCID I and II, subsequently. Sociodemographic form, GADS-R total and subscale scores, and Meta-Cognitions Questionnaire-30 (MCQ-30), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Generalized Anxiety Disorder-7 Scale (GAD-7), and Penn State Worry Questionnaire (PSWQ) were used to assess validity, reliability and cut-off point.

RESULTS

GADS-R total and subscale scores and MCQ-30, BDI, BAI, GAD-7, and PSWQ were found to be statistically higher in the patients with GAD compared to a healthy control group. GADS-R has five factors and showed relatively acceptable sensitivity and specificity for detecting anxiety disorders at a cut-off point of 1188.

CONCLUSION

The GADS-R is a valid and reliable scale that can be used in the Turkish population as an assessment tool.

Metacognitions, rumination, and worry in personality disorder

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.

Metacognitive beliefs and emotional eating in adolescents

PURPOSE

Metacognition refers to how people think about their own thoughts. Existing studies have found that compared to healthy controls, individuals with eating disorders manifest elevated levels of dysfunctional metacognitive beliefs. No studies to date have investigated what role metacognitive beliefs play in the manifestation of emotional eating, a well-known risk factor for the development of eating disorders. The purpose of the current study was to assess the associations between metacognitive beliefs and emotional eating in a community sample of adolescents.

METHODS

Participants were 135 middle school students (Mean age = 13.62 years; SD = 0.57) who completed the Emotional Eating Scale Adapted for Children and Adolescents-Short-Form, Metacognition Questionnaire for Children, Positive and Negative Affect Schedule for Children, and a demographic questionnaire.

RESULTS

Participants classified as high emotional eaters reported statistically significant higher negative metacognitive beliefs (Mean = 15.56; SD = 4.22) compared to participants classified as low emotional eaters (Mean = 12.85; SD = 4.31; p ≤ 0.001; t =  - 3.69). There was a significant positive association between emotional eating and negative metacognitive beliefs in the hierarchical multiple linear regression analysis (standardized beta coefficient = 0.25; p < 0.05) after controlling for socio-demographic variables and negative affect.

CONCLUSIONS

The current findings provide preliminary evidence that negative metacognitive beliefs may play a role in the manifestation of emotional eating in adolescents. Future prospective studies are needed to elucidate the temporal associations between emotional eating and negative metacognitive beliefs in this population.

LEVEL OF EVIDENCE

Level III, case-control analytic study.

Fact-Checking of Health Information: The Effect of Media Literacy, Metacognition and Health Information Exposure

With the rampant circulation of health information, concerns for the information quality are growing. Thereby, scholars are calling for media literacy as an educative means to cultivate fact-checking behavior among information consumers. Focusing on the critical role of metacognition for education effectiveness, this study examined the underlying mechanism that is conducive to the success of media literacy in the context of health information consumption. Based on the survey data collected from 502 Reddit.com users, our findings showed that media literacy was positively associated with fact-checking behavior for health information. Mediation analysis indicated that metacognition mediated the positive relationship between media literacy and fact-checking behavior. In addition, moderated-mediation analysis demonstrated that the mediating effect was weaker for individuals who had higher exposure to health information. The study sheds light on the factors that are essential for the success of media literacy. Implications and future directions are discussed.

Metacognitions as a predictor of online gaming in adolescents: Psychometric properties of the metacognitions about online gaming scale among Iranian adolescents

The Metacognitions about Online Gaming Scale (MOGS) measures maladaptive metacognitions about online gaming. The purpose of the present study was to evaluate psychometric properties of the MOGS, including its factor structure, reliability, and predictive validity among Iranian adolescents. The scale was administered to 769 Iranian adolescents (577 male, mean age = 16.39 ± 1.68 years) with an age range of 15-19 years. The participants completed the Persian-translated version of the MOGS, the Big Five Inventory-10, the Depression, Anxiety and Stress Scale 21, the Video-Game Related Cognitions Scale, the Motives for Online Gaming Questionnaire, and the Problematic Online Gaming Questionnaire. The results of the Exploratory Factor Analysis (n = 350) and Confirmatory Factor Analysis (n = 419) confirmed three-factors similar to the parent version, including "negative metacognitions about uncontrollability of online gaming" (N-MOGU), "negative metacognitions about dangers of online gaming" (N-MOGD), and "positive metacognitions about online gaming" (P-MOG). The Persian MOGS's reliability showed a suitable internal consistency for the P-MOG, the N-MOGU, the N-MOGD, and the total score in both confirmatory and exploratory samples (range 0.79 to 0.93). A hierarchical regression analysis showed that the Persian MOGS predicted 33.9% of the variance in problematic online gaming independently of personality traits, anxiety, depression, stress, and both gaming-related cognitions and gaming motives. Furthermore, the results of analyses of variance with follow-up Bonferroni pairwise comparisons showed that interaction between the factors of MOGS and types of game and tools of gaming was significant. The findings provide evidence that the Persian MOGS among Iranian adolescents appears psychometrically appropriate to be used by researchers and practitioners dealing with the prevention and treatment of problematic online gaming.

Self-critical Rumination and Associated Metacognitions as Mediators of the Relationship Between Perfectionism and Self-esteem

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.

The Short Version of the Metacognitive Anger Processing Scale (MAP-SV) - initial psychometric testing

BACKGROUND

The 26-item version of the Metacognitive Anger Processing Scale (MAP) has shown good psychometric properties in previous studies. However, there is a need for a shorter version of the scale.

AIMS

The aim of the present study is to psychometrically evaluate the 9-item Metacognitive Anger Processing Scale - Short Version (MAP-SV) in comparison with the original, 26-item version.

METHOD

The 26-item MAP includes three subscales: rumination, positive beliefs and negative beliefs. Three items from each subscale were selected based on clinical validity to constitute the 9-item MAP-SV. A previous sample used for validation of the 26-item MAP was used for clinimetric testing. The sample included psychiatric patients (n = 88) and male forensic inpatients (n = 54). The MAP-SV was assessed according to scalability, convergent validity with general metacognition, and concurrent validity with anger measures.

RESULTS

The scalability of the 9-item MAP-SV was comparable to that of the original 26-item MAP in most psychometric tests. The Loevinger's coefficient of homogeneity for the total score of the MAP-SV items was 0.29 for the combined sample compared with 0.36 in the original MAP, indicating close to acceptable scalability. The alpha coefficient for the MAP-SV total score was 0.79. For the combined sample, Pearson inter-correlations between the subscales of the MAP-SV were highly correlated with the MAP-SV total score (ranging from .66 to .84).

CONCLUSIONS

The 9-item MAP-SV showed good psychometric properties and can be used as a reliable tool for assessing self-reported metacognitive anger processing.

Cognitive Control, Cognitive Biases and Emotion Regulation in Depression: A New Proposal for an Integrative Interplay Model

Research traditions on cognition and depression focus on relatively unconnected aspects of cognitive functioning. On one hand, the neuropsychological perspective has concentrated on cognitive control difficulties as a prominent feature of this condition. On the other hand, the clinical psychology perspective has focused on cognitive biases and repetitive negative patterns of thinking (i.e., rumination) for emotional information. A review of the literature from both fields reveals that difficulties are more evident for mood-congruent materials, suggesting that cognitive control difficulties interact with cognitive biases to hinder cognitive switching, working memory updating, and inhibition of irrelevant information. Connecting research from these two traditions, we propose a novel integrative cognitive model of depression in which the interplay between mood-congruent cognitive control difficulties, cognitive biases, and rumination may ultimately lead to ineffective emotion-regulation strategies to downregulate negative mood and upregulate positive mood.

Modelling the Contribution of Metacognitions, Impulsiveness, and Thought Suppression to Behavioural Addictions in Adolescents

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.

A systematic review of metacognitions in Internet Gaming Disorder and problematic Internet, smartphone and social networking sites use

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 5 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 behaviours (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, PSNSU).

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 behaviours. 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 prevents 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.

The Association Between Maladaptive Metacognitive Beliefs and Emotional Distress in People Living With Amyotrophic Lateral Sclerosis

OBJECTIVE

Approximately half of all people living with amyotrophic lateral sclerosis (ALS) experience persistent or recurrent emotional distress, yet little is known about the psychological processes that maintain emotional distress in this population. The self-regulatory executive functioning (S-REF) model specifies that maladaptive metacognitive beliefs and processes are central to the development and maintenance of emotional distress. This study explored whether maladaptive metacognitive beliefs are associated with emotional distress after controlling for demographic factors, time since diagnosis, and current level of physical functioning.

DESIGN

In a cross-sectional design, 75 adults with a diagnosis of ALS completed self-report questionnaires. Participants had a mean age of 60.40 years, mean duration of symptoms 63.92 months, and male:female gender ratio of 14:11.

MAIN OUTCOME MEASURES

Questionnaires assessed emotional distress (HADS, adapted for ALS), physical functioning (ALSFRS-R), repetitive negative thinking (RTQ-10), metacognitive beliefs (MCQ-30), and demographic factors.

RESULTS

Maladaptive metacognitive beliefs explained additional variance in emotional distress after controlling for age, gender, time since diagnosis, physical functioning, and repetitive negative thinking. Repetitive negative thinking partially mediated the relationships between positive and negative metacognitive beliefs and emotional distress.

CONCLUSIONS

These data support the utility of the metacognitive model in understanding emotional distress in people with ALS. Examination of the temporal relationship between maladaptive metacognitive beliefs and emotional distress in people living with ALS may help to guide the development of therapeutic approaches.

Metacognitive beliefs across eating disorders and eating behaviours: A systematic review

BACKGROUND

Literature has pointed out a probable association between metacognitive beliefs and eating disorders. To date, no study has synthetized all research exploring the differences or similarities in metacognitive beliefs across different eating disorders diagnoses and eating problems.

AIMS

To review the evidence on metacognitive beliefs across the spectrum of eating disorders and eating behaviours.

METHOD

A comprehensive search was conducted on PubMed and PsycInfo. The search terms used were: 'eating disorders/anorexia/bulimia/binge eating disorder/binge eating' AND 'metacognitions/metacognitive beliefs'. A manual search of reference lists was also run.

RESULTS

Eleven studies were identified. Anorexia Nervosa was broadly characterized by higher levels of metacognitive beliefs compared to the general population, particularly negative beliefs about worry and beliefs about the need to control thoughts. Positive beliefs about worry were higher in Anorexia Nervosa compared to Bulimia Nervosa and Eating Disorder Not Otherwise Specified, and in Bulimia Nervosa compared to Eating Disorder Not Otherwise Specified. Negative beliefs about worry were higher in Anorexia Nervosa compared to Bulimia Nervosa. Cognitive self-consciousness was higher in Anorexia Nervosa compared to Bulimia Nervosa and Eating Disorder Not Otherwise Specified.

CONCLUSIONS

Metacognitive beliefs appear to be implicated in eating disorders and eating behaviours.

Problematic Internet Use in early adolescence: The role of attachment and negative beliefs about worry

BACKGROUND AND AIMS

Problematic Internet Use (PIU) might be a potential mental health problem. Few studies have investigated the relative contribution of individual and family factors in the development of PIU in early adolescence. The aim of the current study was to model the relationship between attachment styles, negative beliefs about worry, and PIU in early adolescence.

METHODS

Five hundred and thirty-eight Italian early adolescents (51% females, M age = 12.7 years, SD = 0.87) were included in this study. The pattern of relationships specified by the theoretical model was examined through path analysis.

RESULTS

Results showed that avoidance (mother) and anxiety (father) were directly associated with PIU. Anxiety (mother) and avoidance (father) were indirectly associated with PIU via negative beliefs about worry.

DISCUSSION AND CONCLUSIONS

Overall, our findings show that attachment toward mother and father are differently linked to PIU and that negative beliefs about worry may play a mediating role in the association between attachment and PIU. Findings are discussed within clinical and preventive implications.

Anxiety in social interactions and nicotine dependence in nicotine-dependent men: The role of metacognitions about smoking

Anxiety in social interactions is an important factor in cigarette use and nicotine dependence. Metacognitions about smoking have been found to predict smoking behavior and may help understand the relationship between anxiety in social interactions and nicotine dependence. In the current study, we evaluated the direct effect of anxiety in social interactions on nicotine dependence and its indirect effect through metacognitions (controlling for anhedonia and depression) in nicotine-dependent men (n = 388). Participants completed measures of anxiety in social interactions [the Social Interaction Anxiety Scale (SIAS)], anhedonia [the Snaith HamiltonPleasure Scale (SHAPS)], metacognitions about smoking [e.g., theMetacognitions aboutSmoking Questionnaire (MSQ)] nicotine dependence [the Fagerström Test for Nicotine Dependence (FTND)], and clinical factors related to smoking including depressive symptoms [e.g., the Beck Depression Inventory-II (BDI-II)]. As expected, after controlling for depressive symptoms and anhedonia, anxiety in social interactions indirectly affected nicotine dependence through negative metacognitions about smoking, but not positive metacognitions. These findings are discussed in relation to the metacognitive model of addictive behaviors.

Metacognitions in heterosexual, bisexual, and homosexual men: with or without premature ejaculation and erectile dysfunction

BACKGROUND

Premature ejaculation (PE) and erectile dysfunction (ED) are prevalent sexual problems, with evidence to suggest variation across sexual orientation. Contributing factors have traditionally been divided into organic and psychological categories. While limited research has found support for the influence of metacognitive beliefs, these studies did not investigate potential differences in sexual orientation.

AIM

The current study aimed to investigate the differences in metacognitive beliefs in men with or without PE and/or ED and whether these varied according to sexual orientation.

METHOD

A sample of 531 men was recruited (65 met criteria for PE only, 147 for ED, 83 with PE and ED, and 236 healthy controls). Within this sample, 188 men identified as heterosexual, 144 as bisexual, and 199 as homosexual. Participants completed a cross-sectional online survey consisting of psychometric measures.

RESULTS

Participants with PE and ED were significantly higher in cognitive confidence, thoughts concerning uncontrollability and danger, and need to control thoughts than PE only, ED only, and healthy controls. Furthermore, the PE only group was significantly higher than healthy controls for cognitive confidence, with the ED significantly higher for thoughts concerning uncontrollability and danger. There were no significant differences between differing sexual orientations for men with/or without PE and/or ED.

CONCLUSIONS

Congruent with previous research, metacognitive beliefs play a role in PE and/or ED, although this is not exclusive to sexual orientation. The findings highlight that assessment and intervention regarding metacognitive beliefs may be beneficial for men of all sexual orientations with PE and/or ED.

Mediational mechanisms involved in the relation between attachment insecurity and depression: A meta-analysis

BACKGROUND

Several studies have investigated the intermediate variables or mediators through which attachment insecurity influence the development of depression. However, there has not been a systematic synthesis of this literature to date. The current meta-analytic review aimed at identifying such mediators and quantifying their effect size.

METHODS

We systematically searched Medline, Pubmed, Psycinfo, Embase, Proceedings Web of Science and ProQuest Dissertations & Theses Global up until May 2019. 108 studies met inclusion criteria (i.e., investigated intermediate variables that explain the effect of attachment insecurity [exposure] on depressive symptoms [outcome]). Standardized regression coefficients of the indirect and total paths of mediation models of 80 studies were pooled using the inverse of their variance as a weight. Studies were coded and ranked for quality.

RESULTS

Dysfunctional attitudes (β = 0.10, 95% CI = 0.01 to 0.20), self-criticism (β = 0.17, 95% CI = 0.04 to 0.28), low self-compassion (β = 0.16, 95% CI = 0.02 to 0.29), and cognitive hyperactivating regulation strategies (β = 0.13, 95% CI = 0.05 to 0.20), such as repetitive thinking (β = 0.17, 95% CI = 0.07 to 0.28), and particularly, brooding rumination β = 0.20, 95% CI = 0.07 to 0.32), mediated the association between insecure attachment and depressive symptoms. Indirect effects were only significant among adult populations.

LIMITATIONS

The methodological quality of studies was mostly moderate to low and analyses revealed considerable heterogeneity.

CONCLUSION

Our findings support the direct targeting of cognitive-emotional psychological mechanisms in prevention programs and treatment of depression. More longitudinal studies are needed to clarify the interplay of such mediators along with other interpersonal factors between insecure attachment and depression.

Assessment of the cognitive attentional syndrome in children: an adaptation of the CAS-1

BACKGROUND

Research suggests that the metacognitive model is applicable to clinical child populations. However, few measures related to the model are available for younger age groups. A key concept of the model is the cognitive attentional syndrome (CAS), which encompasses the individual's worry and rumination, maladaptive coping strategies, and metacognitive beliefs. While the CAS has been successfully measured in adults, this has not yet been attempted in children.

AIMS

The aim of this study was to adapt a measure of the CAS for use with children and investigate the measure's associations with anxiety, worry, depression and metacognitions.

METHODS

Our study included 127 children with anxiety disorders aged 7-13 years. The adult measure of CAS was adapted for use with children and administered at pre- and post-treatment. We examined the correlations between variables and the ability of the CAS measure to explain variance in anxious symptomatology, as well as the measure's sensitivity to treatment change.

RESULTS

The adapted measure, CAS-1C, displayed strong associations with overall anxiety, depression, worry and metacognitions. The CAS-1C explained an additional small amount of variance in anxiety and worry symptoms after accounting for metacognitions, which may be due to the measure also assessing thinking styles and coping strategies. Furthermore, the measure displayed sensitivity to treatment change.

CONCLUSIONS

The child measure of the CAS is a brief tool for collecting information on metacognitive beliefs and strategies that maintain psychopathology according to the metacognitive model, and it can be used to monitor treatment changes in these components.

Metacognitions about problematic Smartphone use: Development of a self-report measure

BACKGROUND AND AIMS

Recent research has suggested that metacognitions may play a role across the spectrum of addictive behaviours, including problematic use of technological devices. Metacognitions associated with problematic Smartphone use (PSU) have been scarcely investigated and measures to assess these beliefs are not yet available. The goal of the present study was: (i) to develop the first self-report scale of metacognitions about Smartphone use; and (ii) to investigate its predictive validity with respect to PSU.

METHODS

Twenty-four items concerning positive and negative metacognitions about PSU were framed and administered to a community sample of 701 Smartphone users (F = 66.2%; mean age: 28.08 ± 9.81; age range: 15-70). An exploratory factor analysis was first performed in a randomly allocated subsample of 350 participants. A confirmative factor analysis was then computed on a second subsample of 351 participants to test the fit of the factor structure identified.

RESULTS

Findings revealed a 3-factor solution consisting of positive metacognitions concerning emotional and cognitive regulation, positive metacognitions concerning social advantages, and negative metacognitions about uncontrollability and cognitive harm of Smartphone use. Regression analysis showed that all the Metacognitions about Smartphone Use Questionnaire (MSUQ) factors were significantly associated to PSU independently of anxiety and depressive symptoms.

CONCLUSIONS

The MSUQ might be a promising self-report measure and further support research into the role of metacognition in technological addictions.

The Underlying Mechanisms of Psychological Resilience on Emotional Experience: Attention-Bias or Emotion Disengagement

Psychological resilience is consisted of social resources and protective factors for individuals against negative effects, and can influence the process of meta-cognition of individuals in response to emotion feelings. However, individuals with high or low resilience may produce various emotional experiences when facing the same events. According to an emotional input-output model, the different impacts of resilience on emotional experience may be caused during the process of receiving or disengaging stages. In order to address this problem, three experiments were conducted in the present study. The Experiment 1 was designed to explore whether the positive and negative emotions were associated with higher or lower levels of resilience. The aims of Experiments 2 and 3 were to test at which stages the different emotional experiences were caused by high or low resilience of individuals. The results showed that individuals with low resilience were more likely to feel more negative and less positive emotions, and resilience was significantly negatively associated with anxiety or depression. However, there was no difference in the stage of receiving emotional information between high and low resilient individuals, but differ on their ability of disengagement from emotional information, the individuals with high resilience disengaged from both positive and negative emotional information much faster. These findings were discussed in the context of different theories about the relationship between resilience and emotional experience.

Metacognitions and emotion recognition in Internet Gaming Disorder among adolescents

•

Metacognitions and emotion recognition predict IGD in early adolescence.

•

Re-parenting, building assertiveness skills and metacognitions modification may protect adolescents from IGD.

Internet Gaming Disorder (IGD) is associated with considerable psychological distress in adolescents. However, studies which strive to shed light on the developmental background of IGD are still sparse. We aimed to examine the role of metacognitions and emotion recognition in predicting IGD during the early adolescence period. Four hundred and seventy-seven secondary school students were recruited for the study. Participants completed the Internet Gaming Disorder Test (IGDT), the Metacognitions Questionnaire for Children (MCQ-C), and the Children’s Version of Reading the Mind in the Eye Test (RMET). Correlation analyses indicated that three factors of the MCQ-C (positive meta-worry, negative meta-worry, and superstition, punishment, and responsibility) and its total score were positively correlated with the majority of factors of the IGDT. The negative factor of the RMET was positively correlated with the salience, tolerance, and relapse factors and total score of the IGDT. Daily internet use was positively correlated with all factors of the IGDT and its total score. Hierarchical regression analyses indicated that daily internet use and metacognitions (in different combinations) were significant independent predictors of IGDT factors and its total score, and that the negative factor of the RMET was a significant independent predictor of the salience and tolerance factors of IGDT and its total score. The implications of these findings are discussed.

Modelling Online Gaming Metacognitions: The Role of Time Spent Gaming in Predicting Problematic Internet Use

In recent years there have been growing concerns about problematic Internet use (PIU) as potential mental health problem. Among the many activities available on the Internet, the time spent gaming appears one of the most frequent risk factors in developing PIU. The aim of the current study was to model the relationship between negative affect, metacognitions about online gaming, frequency of online gaming and PIU. A total of 326 Italian gamers (mean age = 27 years, SD = 5.65 years; 93.3% males) participated in the study. The pattern of relationships specified by the theoretical model was examined through path analysis. Results showed that negative affect was directly associated with all other variables. Specifically, positive, strong and direct associations were found between negative affect and both positive and negative metacognitions about online gaming. Moreover, negative metacognitions about online gaming were strongly linked to PIU. Overall, the theoretical model was supported showing that metacognitions about online gaming may play a role in the association between time spent on online gaming to a broader pattern of PIU. Results are discussed within the context of the metacognitive model of psychopathology and clinical implications based on this model are outlined.

Profiling Metacognition in Binge Eating Disorder

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.

Aligning the "Manifesto for a European Research Network into Problematic Usage of the Internet" with the Diverse Needs of the Professional and Consumer Communities Affected by Problematic Usage of Pornography

The Manifesto for a European research network into Problematic Usage of the Internet was published in May 2018. It was written from the perspective of the COST Action Network, a programme of the European Cooperation in Science and Technology CA16207 and is expected to have significant influence on research funding priorities over the next decade. The Manifesto identified nine key research priorities to advance understanding in the field. Our analysis shows that while at the most general level it identified problematic usage of pornography (PUP) as a key research priority, it then barely mentioned it again within the body of the report. This paper uses the Manifesto's framework to suggest research areas into the problematic usage of pornography which are of particular relevance to clinicians and other professionals working in the field who want to develop approaches to assist individuals and target groups affected by PUP. It also looks at potential research opportunities inspired by the lived-experience of users withdrawing from PUP. A large number of opportunities are identified for new work on PUP across all nine key research areas of the Manifesto.

Parenting styles and metacognitions as predictors of cannabis use

•

First study to investigate metacognitions in cannabis use.

•

Negative affect, parenting styles and metacognitions were correlated with cannabis use.

•

Coercive authoritarian parenting style and cognitive confidence predicted cannabis use.

Metacognitions, the beliefs held about internal mental processes and the strategies aimed at controlling such processes, are known to play a significant role in the development and maintenance of addictive behaviours. Specifically, lack of cognitive confidence and beliefs about the need to control thoughts have been implicated across addictive behaviours. No research to date, though, has explored the role of metacognitions in cannabis use. Research has also shown that an authoritarian parenting style (where a parent uncompromisingly enforces their own ideas regardless of the will of the child) may be correlated with addictive behaviours. However very limited research has investigated the role of parenting styles in cannabis use. In the current study we aimed to investigate the relative contribution of parenting styles and metacognitions to cannabis use. A sample of 85 participants completed a series of online questionnaires, measuring negative affect, parenting styles, metacognitions and cannabis use. Spearman correlations indicated that cannabis use was positively correlated with each of the metacognitions and both permissive and authoritarian parenting styles. Regression analyses demonstrated that a combination of the physically coercive aspects of the authoritarian parental style and lack of cognitive confidence predicted cannabis use when controlling for negative affect. The implications of the current findings are discussed.

The Role of Metacognitions and Thinking Styles in the Negative Outcomes of Adolescents' Peer Victimization

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; M_age = 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.

Metacognition, Hardiness, and Grit as Resilience Factors in Unmanned Aerial Systems (UAS) Operations: A Simulation Study

Operators of Unmanned Aerial Systems (UAS) face a variety of stress factors resulting from both the cognitive demands of the work and its broader social context. Dysfunctional metacognitions including those concerning worry may increase stress vulnerability, whereas personality traits including hardiness and grit may confer resilience. The present study utilized a simulation of UAS operation requiring control of multiple vehicles. Two stressors were manipulated independently in a within-subjects design: cognitive demands and negative evaluative feedback. Stress response was assessed using both subjective measures and a suite of psychophysiological sensors, including the electroencephalogram (EEG), electrocardiogram (ECG), and hemodynamic sensors. Both stress manipulations elevated subjective distress and elicited greater high-frequency activity in the EEG. However, predictors of stress response varied across the two stressors. The Anxious Thoughts Inventory (AnTI: Wells, 1994) was generally associated with higher state worry in both control and stressor conditions. It also predicted stress reactivity indexed by EEG and worry responses in the negative feedback condition. Measures of hardiness and grit were associated with somewhat different patterns of stress response. In addition, within the negative feedback condition, the AnTI meta-worry scale moderated relationships between state worry and objective performance and psychophysiological outcome measures. Under high state worry, AnTI meta-worry was associated with lower frontal oxygen saturation, but higher spectral power in high-frequency EEG bands. High meta-worry may block adaptive compensatory effort otherwise associated with worry. Findings support both the metacognitive theory of anxiety and negative emotions (Wells and Matthews, 2015), and the Trait-Stressor-Outcome (TSO: Matthews et al., 2017a) framework for resilience.

Attachment and problematic Facebook use in adolescents: The mediating role of metacognitions

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.

Effectiveness of metacognitive interventions for mental disorders in adults-A systematic review and meta-analysis (METACOG)

We evaluated the effectiveness and acceptability of metacognitive interventions for mental disorders. We searched electronic databases and included randomized and nonrandomized controlled trials comparing metacognitive interventions with other treatments in adults with mental disorders. Primary effectiveness and acceptability outcomes were symptom severity and dropout, respectively. We performed random-effects meta-analyses. We identified Metacognitive Training (MCTrain), Metacognitive Therapy (MCTherap), and Metacognition Reflection and Insight Therapy (MERIT). We included 49 trials with 2,609 patients. In patients with schizophrenia, MCTrain was more effective than a psychological treatment (cognitive remediation, SMD = -0.39). It bordered significance when compared with standard or other psychological treatments. In a post hoc analysis, across all studies, the pooled effect was significant (SMD = -0.31). MCTrain was more effective than standard treatment in patients with obsessive-compulsive disorder (SMD = -0.40). MCTherap was more effective than a waitlist in patients with depression (SMD = -2.80), posttraumatic stress disorder (SMD = -2.36), and psychological treatments (cognitive-behavioural) in patients with anxiety (SMD = -0.46). In patients with depression, MCTherap was not superior to psychological treatment (cognitive-behavioural). For MERIT, the database was too small to allow solid conclusions. Acceptability of metacognitive interventions among patients was high on average. Methodological quality was mostly unclear or moderate. Metacognitive interventions are likely to be effective in alleviating symptom severity in mental disorders. Although their add-on value against existing psychological interventions awaits to be established, potential advantages are their low threshold and economy.

Metacognition, emotional functioning and binge eating in adolescence: the moderation role of need to control thoughts

PURPOSE

Binge eating is predicted by emotion dysregulation and poor emotional awareness. Dysfunctional metacognition is also implied in several eating disorders, but research has not yet investigated the interactions among emotional and metacognitive processes involved in binge eating. The present study investigated the relation between metacognition and binge eating in a sample of adolescents, testing the interaction effect between the need to control thoughts and the lack of emotional awareness on binge eating.

METHODS

Participants were 804 adolescents (age range 15-20; 49.7% female), who completed self-report instruments assessing binge eating, emotion regulation, and metacognition.

RESULTS

Binge eating was predicted by gender, BMI, emotion dysregulation, lack of emotional awareness, and dysfunctional metacognition dimensions (cognitive confidence and need to control thoughts). An important moderating effect was found, whereby the relationship between binge eating and lack of emotional awareness was only significant for individuals with a high need to control thoughts.

CONCLUSIONS

Results described emotional and metacognitive functioning in binge eating adolescents, suggesting that the need to control thoughts is a risk factor, whereas good metacognitive competencies are protective from binge eating, even in presence of poor emotional awareness.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Metacognitive beliefs in addictive behaviours: A systematic review

A wide research base has shown the link between metacognitive beliefs and psychopathology and there is currently evidence that elevated levels of maladaptive metacognitive beliefs are present in the majority of psychological disorders. An increasing body of evidence also suggests that metacognitive beliefs may play a role in alcohol use, nicotine use, gambling, online gaming and problematic internet use. This article provides a systematic review of empirical studies that have examined metacognitive beliefs and addictive behaviours. Thirty-eight studies were included, with results showing a significant positive association between metacognitive beliefs and addictive behaviours. These results are consistent with the metacognitive model of addictive behaviour that supports the central role of metacognitive beliefs in the development and maintenance of addictive behaviours. However, our review highlights the paucity of longitudinal and experimental studies, preventing the determination of the causal status of metacognitive beliefs in addictive behaviours. Despite this limitation, the current evidence has important treatment implications because it suggests that interventions that target metacognitive beliefs could be beneficial for people presenting with addictive behaviours.