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Differential Metacognitive Profiles in Relapsing-Remitting and Progressive Multiple Sclerosis: Associations with
Ozlem Totuk1, Merve Turkkol2, Hasan Can Gudek1
1Department of Neurology, University of Health Sciences, Hamidiye Faculty of Medicine, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, Istanbul, Turkey.
Summary
Metacognitive beliefs differ across multiple sclerosis (MS) types, impacting cognitive and functional outcomes. Tailored psychological interventions addressing these beliefs are crucial for managing MS.
Area of Science:
- Neuroscience
- Psychology
- Clinical Medicine
Background:
- Multiple sclerosis (MS) presents diverse phenotypes (RRMS, SPMS, PPMS) with varying impacts on cognition and function.
- Metacognitive beliefs, or beliefs about one's own thinking, are increasingly recognized as important in neurological conditions.
- Understanding metacognitive profiles in different MS subtypes is essential for targeted interventions.
Purpose of the Study:
- To examine metacognitive belief profiles in individuals with relapsing-remitting MS (RRMS), secondary progressive MS (SPMS), and primary progressive MS (PPMS).
- To investigate the associations between metacognitive beliefs and cognitive, emotional, and functional outcomes in MS.
- To determine if distinct metacognitive patterns characterize different MS disease phenotypes.
Main Methods:
- 504 participants with MS (75.6% RRMS, 9.9% SPMS, 14.5% PPMS) completed validated questionnaires assessing metacognition (MCQ-30), cognition (MoCA), depression (BDI), fatigue (MFIS), disability (EDSS), and quality of life (SF-12, OSA).
- Statistical analyses included ANOVA for group differences, Pearson correlations, and hierarchical/ordinal regression models.
- Group differences in metacognitive beliefs were compared across MS subtypes.
Main Results:
- Progressive MS phenotypes, especially PPMS, exhibited higher maladaptive metacognitive beliefs compared to RRMS.
- RRMS showed greater cognitive self-consciousness and need for control, while PPMS was linked to lower cognitive confidence and higher negative beliefs about uncontrollability.
- Maladaptive metacognition correlated with poorer cognitive performance, increased fatigue, depressive symptoms, reduced quality of life, and lower self-efficacy. Depression was the strongest negative predictor of self-efficacy, while cognitive self-consciousness was a positive predictor. Metacognitive beliefs and fatigue predicted higher neurological disability (EDSS).
Conclusions:
- Metacognitive belief patterns vary significantly across different MS phenotypes.
- These distinct metacognitive profiles are associated with crucial functional and neurological outcomes in MS.
- Findings advocate for integrating metacognitive assessment and tailored psychological interventions into routine MS care for improved cognitive-emotional regulation and patient management.
