Metacognition in Cardiac Patients With Anxiety and Depression: Psychometric Performance of the Metacognitions Questionnaire 30 (MCQ-30)
Open accessAbstract
The evaluation of effective psychological therapies for anxiety and depression in cardiac patients is a priority, and progress in this area depends on the suitability and validity of measures. Metacognitive Therapy is a treatment with established efficacy in mental health settings. It postulates that anxiety and depression are caused by dysfunctional metacognitions, such as those assessed with the Metacognitions Questionnaire 30 (MCQ-30), which impair effective regulation of repetitive negative thinking patterns. The aim of this study was to examine the psychometric properties of the MCQ-30 in a cardiac sample. A sample of 440 cardiac patients with co-morbid anxiety and/or depression symptoms completed the MCQ-30 and the Hospital Anxiety and Depression Scale. Confirmatory factor analysis (CFA) was used to test established factor structures of the MCQ-30: a correlated five-factor model and a bi-factor model. The five-factor model just failed to meet our minimum criteria for an acceptable fit on Comparative Fit Index (CFI) = 0.892 vs. criterion of ≥ 0.9; but was acceptable on the Root Mean Square Error of Approximation (RMSEA) = 0.061 vs. ≤ 0.08; whereas the bi-factor model just met those criteria (CFI = 0.913; RMSEA = 0.056). These findings suggest that the bi-factor solution may carry additional information beyond the five subscale scores alone. However, such a model needs to be evaluated further before widespread adoption could be recommended. Meantime we recommend cautious continued use of the five-factor model. Structural issues aside, all five subscales demonstrated good internal consistency (Cronbach alphas > 0.7) and similar relationships to HADS scores as in other patient populations. The MCQ-30 accounted for additional variance in anxiety and depression after controlling for age and gender.
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Several studies pointed out the impact that dysfunctional metacognitive beliefs can have on mental health.
“Several studies pointed out the impact that those dysfunctional metacognitive beliefs can have on mental health [26–30].”
From Association between time perspective and metacognition among Lebanese adults: the mediating role of mindfulness (2023) · cites this paper as [27]
All subscales of the MCQ-30 were highly consistent in cardiology patients, as well as the total score (Cronbach's alpha = 0.91).
“All subscales of the MCQ-30 were highly consistent in cardiology patients, as well as the total score (Cronbach’s alpha = 0.91) (44).”
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- Authors
- Faija, C. L., Reeves, D., Heal, C., & Wells, A.
- Affiliations
- Manchester Academic Health Science Centre (GB)
- Venue
- Frontiers in Psychology
- Publisher
- Frontiers Media SA
- Published
- 2020-05-26
- Volume
- 11
- Pages
- 1064-1064
- ISSN
- 1664-1078 (ISSN-L)
- PMC
- PMC7264260
- OpenAlex
- W3030285838
- Cited by
- 15
- References
- 42
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 4 · 2022: 2 · 2019: 1
- FWCI
- 1.45
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Psychology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Programme Grants for Applied Research
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Keywords
- Metacognitions Questionnaire-30, metacognition, cardiac patients, anxiety, depression, psychometric properties, factor structure, bifactor model, Big Five personality traits, metacognitive therapy, comorbidities, Hospital Anxiety and Depression Scale
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