Trends in Psychiatry and Psychotherapy
Trends in Psychiatry and Psychotherapy
Original Article

Validation and clinical application of the Metacognitions Questionnaire in a sample of Brazilian Generalized Anxiety Disorder patients: the effects of different treatment interventions

Julia Karl Schwinn, Sofia Giusti Alves, Marianna de Abreu Costa, Francine Gonçalves, Carolina Blaya Dreher, Gisele Gus Manfro

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Metacognitive beliefs about worry may trigger anxiety. However, the effect of Generalized Anxiety Disorder (GAD) treatment on Metacognition was not yet investigated.

To validate the Metacognitions Questionnaire (MCQ-30) in a Brazilian GAD sample and verify whether different interventions reduce metacognitive beliefs.

We included 180 GAD individuals randomized to Body in Mind Training (BMT), Fluoxetine (FLX) or an active control group (QoL) for 8 weeks. Internal consistency, confirmatory, exploratory factor analyses, and convergent validity with Penn State Worry Questionnaire from the MCQ-30 were applied. Generalized Estimating Equations (GEE) were conducted to evaluate differences after the interventions. 

MCQ-30 demonstrated good internal consistency and acceptability; the original five-factor model was supported. There was a positive moderate correlation between MCQ-30 and worry. GEE showed a significant Group x Time interaction (p < 0.001). BMT (Mean Difference = -6.04, Standard Error = -2.39, p = 0.034) and FLX (Mean Difference = -5.78, Standard Error = 1.91, p = 0.007) decreased MCQ-30. FLX was superior to QoL but not BMT at weeks 5 and 8; there was no difference between BMT and QoL. 

The Brazilian-Portuguese version of MCQ-30 showed good psychometric properties. Furthermore, the positive effect of FLX and BMT on metacognition suggests it may represent a potential therapeutic target.


Generalized Anxiety Disorder, Metacognition, MCQ-30, Mindfulness-Based Interventions, Body in Mind Training, Selective Serotonin Reuptake Inhibitor

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