Comparative Analysis of Metacognition and Mindfulness Across Social Anxiety Disorder, Panic Disorder and Healthy Controls.
Fikret Poyraz Çökmüş, Zeynep Tiftikçi, Osman İyilikçi, Orkun Aydın
Clinical Psychology & Psychotherapy September 1, 2026 DOI: 10.1002/cpp.70334 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional observational study Longitudinal Peer reviewed |
|---|---|
| Sample size | 147 |
| Population | Adults with social anxiety disorder, panic disorder, and healthy controls |
| Measures | Metacognitions Questionnaire 30 (MCQ-30), Five Facet Mindfulness Questionnaire Short Form (FFMQ-SF), disorder-specific severity measures |
| Topics | Anxiety Meditation |
| Keywords | Humans Middle aged Female Young adult Surveys and questionnaires Metacognition Phobia, social |
| Key findings | Metacognitive dysfunction was higher in social anxiety disorder and panic disorder than in controls, while mindfulness was lowest in social anxiety disorder, intermediate in panic disorder, and highest in controls. In social anxiety disorder, higher observing and nonjudging predicted lower severity; in panic disorder, need to control thoughts was the only metacognitive predictor positively associated with severity. |
Abstract
Metacognition and mindfulness are central to contemporary accounts of anxiety, yet their comparative profiles across social anxiety disorder (SAD) and panic disorder (PD) remain insufficiently defined. The objective of this study is to compare metacognition and mindfulness across SAD, PD and healthy controls (HC) and to examine how these processes predict disorder specific severity. Adults with SAD (n = 47), PD (n = 50) and HC (n = 50) participated, for a total of 147 individuals. Participants completed the Metacognitions Questionnaire 30 (MCQ-30), the Five Facet Mindfulness Questionnaire Short Form (FFMQ-SF) and disorder-specific severity measures. Group differences were tested, followed by multiple linear regressions predicting severity within each clinical group from MCQ-30 subscales and FFMQ-SF facets. Metacognitive dysfunction was higher in SAD and PD than in HC, with the clearest separations in cognitive self-consciousness and the need to control thoughts. Mindfulness was lowest in SAD, intermediate in PD and highest in HC. In regression analyses, only mindfulness variables predicted severity in SAD, with higher observing and higher nonjudging associated with lower symptom levels. In PD, the need to control thoughts was the sole metacognitive predictor positively associated with severity; other metacognitive and mindfulness facets were not significant. Metacognition and mindfulness index a shared liability across anxiety but show disorder-specific signatures. In SAD, mindfulness facets related to observing and nonjudging are most relevant for severity, whereas in PD, control-oriented metacognitive beliefs are most relevant. These patterns identify focused targets for future longitudinal and experimental studies and may inform disorder-sensitive intervention strategies.
Comparable studies
Other cross-sectional and survey studies on anxiety, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Psychological flexibility mediates the relations between acute psychedelic effects and subjective decreases in depression and anxiety. International sample of people who reported having used a psychedelic | 2020 | Cross-sectional survey | n = 985 |
| The Challenging Experience Questionnaire: Characterization of challenging experiences with psilocybin mushrooms Internet survey respondents reporting challenging experiences with psilocybin | 2016 | Questionnaire development and validation | |
| Psychedelics and Mental Health: A Population Study Adult population in the United States | 2013 | Cross-sectional survey | n = 130,152 |
| Ecstasy/MDMA attributed problems reported by novice, moderate and heavy recreational users Ecstasy users who participated in a WWW study of recreational drug use | 2002 | Cross-sectional survey | n = 282 |
| 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) used in a naturalistic group setting is associated with unintended improvements in depression and anxiety. Adults who used 5-MeO-DMT in a group setting with structured procedures | 2019 | Cross-sectional survey | n = 362 |
Citations in the library
Cites 4
- An Integrated Therapeutic Application Using Elements of Cognitive Behavioral Therapy and Mindfulness-based Cognitive Therapy in Treatment of Panic Disorder. Indian Journal of Psychological Medicine March 1, 2025
- Mindfulness-based interventions for social anxiety disorder: A systematic review and meta-analysis. Psychiatry Research April 20, 2021
- Impact of Mindfulness-Based Cognitive Therapy on Intolerance of Uncertainty in Patients with Panic Disorder. Psychiatry Investigation March 2016
- Effectiveness of mindfulness-based cognitive therapy as an adjuvant to pharmacotherapy in patients with panic disorder or generalized anxiety disorder. Depression and Anxiety 2009