The Metacognitions About Symptoms Control Scale: Development and Concurrent Validity

Objective: This paper presents the development and preliminary validation of a self-report instrument designed to measure metacognitions pertaining to symptoms control in the form of the following: (1) symptoms focusing and (2) symptoms conceptual thinking.

Methods: A total of 124 patients (95 female and 29 male) presenting with chronic fatigue syndrome (CFS) contributed data to the study to test the structure and psychometric properties of the Metacognitions about Symptoms Control Scale (MaSCS).

Results: A principal components factor analysis indicated that a two-factor solution best fitted the data. The factors were labelled positive and negative metacognitions about symptoms control. Further analyses revealed that both factors had good internal consistency. Correlation analyses established preliminary concurrent validity, indicating that both positive and negative metacognitions about symptoms control were significantly associated with levels of fatigue in CFS. Regression analysis revealed that positive and negative metacognitions about symptoms control significantly predicted fatigue severity when controlling for anxiety and depression.

Conclusions: The newly developed instrument may help future research that examines the role of metacognitions in CFS, as well as aiding clinical assessment and case formulation.

Key Practitioner Message: The MaSCS is a useful first instrument to assess metacognitions in CFS. The MaSCS may help to deepen our understanding of symptoms control (symptoms focusing and conceptual thinking about symptoms) in the experience of CFS symptoms. Assessing and conceptualizing symptoms control through the MaSCS may aid treatment of CFS.