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.