Metacognition in patients with anorexia nervosa, dieting and non-dieting women: a preliminary study.

OBJECTIVE: To explore metacognition in women with anorexia nervosa (AN), dieting and non-dieting women. METHOD: A cross-sectional study between groups design compared women with AN (n = 15), normal dieters (n = 17) and non-dieters (n = 18). A semi-structured interview was used to explore presence and content of explicit metacognitions and use of metacognitive control strategies. RESULTS: Explicit metacognitions and metacognitive control strategies were present in all three groups of women. There were group differences in amount and function of metacognitive activity and trends in the qualitative data suggested participants with AN believed that their thoughts were abnormal and uncontrollable. They used six metacognitive strategies more than control groups and were less successful at using thought re-appraisal and attending to body and others. Half of participants with AN reported using these strategies to deliberately make themselves feel worse. DISCUSSION: It is suggested that metacognitive activity may play a role in the maintenance of AN, particularly in reinforcing negative self-evaluations.