Metacognition in eating disorders: Comparison of women with eating disorders, self-reported history of eating disorders or psychiatric problems, and healthy controls

Objective: The aim of the study was to compare a clinical sample with eating disorders to different control samples on self-report measures of metacognition and eating disorder symptoms, in order to investigate the role of metacognition in eating disorders. Method: The clinical group consisted of 53 female patients with eating disorders who completed the Metacognitions Questionnaire-30 and the Eating Disorder Examination Questionnaire 6.0. One-hundred and fifty women who served as a control group completed the questionnaires as an Internet survey. This control group was divided into three groups based on self-reported history of eating and psychiatric problems (N = 47), other psychiatric problems (N = 37), or no such problems (healthy controls: N = 66). Results: The clinical group scored significantly higher on dysfunctional metacognition than healthy controls, especially on "negative beliefs about uncontrollability and danger", "need to control thoughts", and total MCQ-30 score. Eating disorder symptomatology was positively correlated with metacognition. Metacognition explained 51% of the variance in eating disorder symptoms after controlling for age and BMI, with "need to control thoughts" as the most important factor. Conclusion: Metacognitive beliefs may be central in understanding eating disorders, and metacognitive treatment strategies could be a promising approach in developing new psychological treatments for eating disorders. (C) 2014 Elsevier Ltd. All rights reserved.