{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:06:20Z","timestamp":1784696780830,"version":"3.55.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A growing body of literature has emphasized the role of worry and rumination in eating disorders (EDs). According to the metacognitive model, worry and rumination are maintained by dysfunctional metacognitive beliefs. Although metacognitive beliefs have been investigated in adults with EDs, their role in adolescents with EDs remains underexplored. The present exploratory study aimed to examine the specific association among worry, rumination, and metacognitive beliefs and eating disorder symptomatology in adolescents with AN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Thirty Italian female adolescents (mean age \u00b1 SD: 15.387 \u00b1 1.35 years, mean Body Mass Index (BMI): 16.34 \u00b1 2.5 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) completed a self-report survey composed of the Penn State Worry Questionnaire (PSWQ), the Ruminative Response Scale (RRS), the Metacognitions Questionnaire \u2013 30 (MCQ-30), and the Eating Disorder Inventory \u2013 3 (EDI-3).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thus, Model 1, including RRS and PSWQ, was significant (\n                      <jats:italic>F<\/jats:italic>\n                      \u00a0=\u00a017.5,\n                      <jats:italic>p&amp;lt;<\/jats:italic>\n                      0.001) and explained 57% of the variance (\n                      <jats:italic>R\u00b2<\/jats:italic>\n                      \u00a0=\u00a00.574). Within this model, RRS was the only significant predictor (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.019) of the Eating Disorder Risk Composite (EDRC) of EDI-3, indicating that higher rumination scores were associated with greater eating disorder symptomatology. Once MCQ was entered as a predictor of EDRC, there was no significant incremental variance compared with Model 2 (\u0394\n                      <jats:italic>R\u00b2<\/jats:italic>\n                      \u00a0=\u00a00.0034,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.658), even though the model remained significant overall (\n                      <jats:italic>F<\/jats:italic>\n                      \u00a0=\u00a011.4,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001). The final model explained 58% of variance (\n                      <jats:italic>R\u00b2<\/jats:italic>\n                      \u00a0=\u00a00.578; Cohen\u2019s\n                      <jats:italic>\n                        f\n                        <jats:sup>2<\/jats:sup>\n                      <\/jats:italic>\n                      \u00a0=\u00a01.37).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Rumination was significantly associated with eating disorder symptomatology. Although worry showed strong positive associations with eating disorder symptomatology at the correlational level, it did not maintain an independent role once rumination was included in the regression model. The final model showed a very large effect size (Cohen\u2019s f\u00b2 = 1.37), suggesting strong associations between predictors and eating disorder symptoms in the present sample. However, this estimate should be interpreted cautiously, given the limited sample size and the exploratory nature of the analysis. Contrary to our expectations, metacognitive beliefs did not significantly explain the variance of eating disorder symptomatology. This finding may reflect the more proximal role of RNT in explaining the variance in eating disorder symptomatology, or alternatively, the possibility that only specific metacognitive domains\u2014rather than overall metacognitive functioning\u2014are relevant in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1812206","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:42:38Z","timestamp":1784695358000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The association between worry, rumination, and metacognitive beliefs in female adolescents with Anorexia Nervosa"],"prefix":"10.3389","volume":"17","author":[{"given":"Anna","family":"Guerrini Usubini","sequence":"first","affiliation":[{"name":"Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS)","place":["Piancavallo-Verbania, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adele","family":"Bondesan","sequence":"additional","affiliation":[{"name":"Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS)","place":["Piancavallo-Verbania, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Caroli","sequence":"additional","affiliation":[{"name":"Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS)","place":["Piancavallo-Verbania, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Frigerio","sequence":"additional","affiliation":[{"name":"Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS)","place":["Piancavallo-Verbania, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Abbruzzese","sequence":"additional","affiliation":[{"name":"Division of Auxology, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS)","place":["Piancavallo-Verbania, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Deodato","sequence":"additional","affiliation":[{"name":"Division of Auxology, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS)","place":["Piancavallo-Verbania, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Castelnuovo","sequence":"additional","affiliation":[{"name":"Psychology Research Laboratory, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS)","place":["Piancavallo-Verbania, Italy"]},{"name":"Department of Psychology, Catholic University","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Sartorio","sequence":"additional","affiliation":[{"name":"Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS)","place":["Piancavallo-Verbania, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mpmed.2008.05.003","article-title":"Eating in eating disorders","volume":"20","author":"Treasure","year":"2012","journal-title":"Eur Eating Disord Rev"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-012-0282-y","article-title":"Epidemiology of eating disorders: incidence, prevalence and mortality rates","volume":"14","author":"Smink","year":"2012","journal-title":"Curr Psychiatry Rep"},{"key":"B3","doi-asserted-by":"crossref","DOI":"10.1097\/YCO.0000000000000818","article-title":"Worldwide prevalence of DSM-5 eating disorders among young people","volume":"35","author":"Sil\u00e9n","year":"2022","journal-title":"Curr Opin Psychiatry"},{"key":"B4","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.cpr.2018.03.004","article-title":"Rumination and eating disorder psychopathology: A meta-analysis","volume":"61","author":"Smith","year":"2018","journal-title":"Clin Psychol Rev"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10112448","article-title":"Repetitive negative thinking and eating disorders: A meta-analysis of the role of worry and rumination","volume":"10","author":"Palmieri","year":"2021","journal-title":"J Clin Med"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2013.06.014","article-title":"The relationship between worry, rumination, and comorbidity: Evidence for repetitive negative thinking as a transdiagnostic construct","volume":"151","author":"McEvoy","year":"2013","journal-title":"J Affect Disord"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1037\/0021-843x.116.1.198","article-title":"Reciprocal relations between rumination and bulimic, substance abuse, and depressive symptoms in female adolescents","volume":"116","author":"Nolen-Hoeksema","year":"2007","journal-title":"J Abnormal Psychol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.eatbeh.2005.05.001","article-title":"Worry and eating disorders: A psychopathological association","volume":"6","author":"Sassaroli","year":"2005","journal-title":"Eating Behaviours"},{"key":"B9","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/0005-7967(83)90121-3","article-title":"Preliminary exploration of worry: Some characteristics and processes","volume":"21","author":"Borkovec","year":"1983","journal-title":"Behav Res Ther"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.61.1.115","article-title":"A prospective study of depression and posttraumatic stress symptoms after a natural disaster: the 1989 Loma Prieta Earthquake","volume":"61","author":"Nolen-Hoeksema","year":"1991","journal-title":"J Pers Soc Psychol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1111\/cpsp.12037","article-title":"Specificity of rumination in anxiety and depression: A multimodal meta\u2010analysis","volume":"20","author":"Olatunji","year":"2013","journal-title":"Clin Psychology: Sci Pract"},{"key":"B12","doi-asserted-by":"crossref","first-page":"53","DOI":"10.4324\/9780429295713-6","article-title":"Repetitive negative thinking in eating disorders","volume-title":"Schema Therapy for Eating Disorders: Theory and Practice for Individual and Group Settings","author":"Brockman","year":"2019"},{"key":"B13","volume-title":"Attention and Emotion: A Clinical Perspective (Classic Edition)","author":"Wells","year":"2015"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/s0005-7967(96)00050-2","article-title":"Modelling cognition in emotional disorder: The S-REF model","volume":"34","author":"Wells","year":"1996","journal-title":"Behav Res Ther"},{"key":"B15","doi-asserted-by":"crossref","DOI":"10.1002\/9780470713662","volume-title":"Emotional Disorders and Metacognition: Innovative Cognitive Therapy","author":"Wells","year":"2002"},{"key":"B16","article-title":"The body of cognitive and metacognitive variables in eating disorders: need of control, negative beliefs about worry uncontrollability and danger, perfectionism, self-esteem and worry","volume":"55","author":"Sapuppo","year":"2018","journal-title":"Israel J Psychiatry Related Sci"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1186\/2050-2974-1-22","article-title":"Thinking about internal states, a qualitative investigation into metacognitions in women with eating disorders","volume":"1","author":"Vann","year":"2013","journal-title":"J Eating Disord"},{"key":"B18","first-page":"96","article-title":"The role of metacognitive beliefs in eating disorders","volume":"1","author":"Safdari","year":"2013","journal-title":"J Soc Issues Humanities"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.24193\/jebp.2017.1.1","article-title":"Reduced sympathetic activity and dysfunctional metacognition in patients with anorexia nervosa: A preliminary study","volume":"17","author":"Palomba","year":"2017","journal-title":"J Evidence-Based Psychotherapies"},{"key":"B20","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.eatbeh.2014.10.019","article-title":"Metacognition in eating disorders: Comparison of women with eating disorders, self-reported history of eating disorders or psychiatric problems, and healthy controls","volume":"16","author":"Olstad","year":"2015","journal-title":"Eating Behav"},{"key":"B21","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/s40337-015-0060-4","article-title":"Dysfunctional metacognition and drive for thinness in typical and atypical anorexia nervosa","volume":"3","author":"Davenport","year":"2015","journal-title":"J Eating Disord"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1007\/s40519-018-0603-1","article-title":"Metacognition, emotional functioning and binge eating in adolescence: the moderation role of need to control thoughts","volume":"23","author":"Laghi","year":"2018","journal-title":"Eating Weight Disorders-Studies Anorexia Bulimia Obes"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1007\/s10942-020-00364-1","article-title":"Profiling metacognition in binge eating disorder","volume":"39","author":"Palmieri","year":"2021","journal-title":"J Rational-Emotive Cognitive-Behavior Ther"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1007\/s40519-020-01078-0","article-title":"Metacognitive beliefs and emotional eating in adolescents","volume":"26","author":"Limbers","year":"2021","journal-title":"Eating Weight Disorders-Studies Anorexia Bulimia Obes"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3390\/jcm15020573","article-title":"Worry, rumination, and metacognitive beliefs in adolescents with obesity associated with binge eating disorder (BED) vs. Age-matched adolescents with essential obesity: A cross-sectional study","volume":"15","author":"Guerrini Usubini","year":"2026","journal-title":"J Clin Med"},{"key":"B26","volume-title":"Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR","year":"2022"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(90)90135-6","article-title":"Development and validation of the penn state worry questionnaire","volume":"28","author":"Meyer","year":"1990","journal-title":"Behav Res Ther"},{"key":"B28","first-page":"13","article-title":"Penn State Worry Questionnaire e Worry Domains Questionnaire. Presentazione delle versioni italiane ed analisi della fedelt\u00e0","volume":"5","author":"Morani","year":"1999","journal-title":"Psicoterapia Cognitiva e Comportamentale"},{"key":"B29","first-page":"15","article-title":"Una misura disposizionale della ruminazione depressiva: la RRS di Nolen-Hoeksema e Morrow","volume":"10","author":"Palmieri","year":"2007","journal-title":"Psychofenia"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/s0887-6185(97)00011-x","article-title":"Beliefs about worry and intrusions: The Meta-Cognitions Questionnaire and its correlates","volume":"11","author":"Cartwright-Hatton","year":"1997","journal-title":"J Anxiety Disord"},{"key":"B31","article-title":"Psychometric properties of the Italian version of the Short Form of the Metacognitions Questionnaire (MCQ-30)","volume":"62","author":"Quattropani","year":"2014","journal-title":"BPA-Applied Psychol Bull (Bollettino Di Psicologia Applicata)"},{"key":"B32","volume-title":"Eating Disorder Inventory-3 (Edi-3). Professional Manual","author":"Garner","year":"2004"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1017\/s1352465812000847","article-title":"Worry and rumination in anorexia nervosa","volume":"41","author":"Startup","year":"2013","journal-title":"Behav Cogn Psychother"},{"key":"B34","doi-asserted-by":"crossref","DOI":"10.1093\/med:psych\/9780198528883.001.0001","volume-title":"Cognitive Behavioural Processes Across Psychological Disorders: A Transdiagnostic Approach to Research and Treatment","author":"Harvey","year":"2004"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-025-01197-y","article-title":"Emotion regulation difficulties and disordered eating in adolescents and young adults: a meta-analysis","volume":"13","author":"Zhou","year":"2025","journal-title":"J Eating Disord"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2008.01.005","article-title":"Eating disorder psychopathology does not predict the overweight severity in subjects seeking weight loss treatment","volume":"49","author":"Castellini","year":"2008","journal-title":"Compr Psychiatry"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1891\/0886-6708.vv-d-18-00016","article-title":"The role of metacognitions and thinking styles in the negative outcomes of adolescents' Peer victimization","volume":"34","author":"Gini","year":"2019","journal-title":"Violence Victims"},{"key":"B38","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1186\/s13052-024-01717-7","article-title":"Eating disorder risks and psychopathological distress in Italian high school adolescents","volume":"50","author":"Calcaterra","year":"2024","journal-title":"Ital J Pediatr"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1812206\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:42:50Z","timestamp":1784695370000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1812206\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,22]]},"references-count":38,"alternative-id":["10.3389\/fpsyt.2026.1812206"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2026.1812206","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,22]]},"article-number":"1812206"}}