Metacognition, psychopathology and daily functioning in adult ADHD

Figures & data

Table 1. Characteristics of patients with ADHD and controls (mean ± standard deviation)

	Patients with ADHD (N = 46)	Controls (N = 46)
Age (years)	36.07 ± 11.02	34.41 ± 13.94
Vocabulary^a	104.46 ± 10.99	106.80 ± 11.48
Educational level^b	1.85 ± 1.37	1.43 ± 1.05
Gender (female/male)	19/27	25/21
ASRS^c	28.63 ± 8.11*	9.80 ± 5.65
WURS-K^d	36.42 ± 12.92*	12.54 ± 8.47
BDI^e	20.65 ± 10.39 *	7.35 ± 6.71

*Pairwise comparison significant at p < .001, ^aMultiple Choice Vocabulary Test (MWT-B), ^bLower scores indicate higher educational level (see anamnesis), ^cASRS: ADHD Self-Report Scale, ^dWURS-K: Wender-Utah Rating Scale, short form, ^eBeck’s Depression Inventory.

Table 2. Descriptives (means and standard deviations) of all variables used in the analyses

Measures	Patients with ADHD (N = 46)	Controls (N = 46)	MW-U	p	r
Metacognition
MAI Procedural K^a,b	1.59 ± 1.02	2.59 ± 1.36	602.00	<.001	.38
MAI Declarative K^a,b	4.00 ± 1.75	6.93 ± 1.02	169.50	<.001	.73
MAI Conditional K^a,b	2.76 ± .92	3.96 ± 1.01	392.00	<.001	.57
MAI Knowledge^a	8.35 ± 2.89	13.48 ± 2.63	203.50	<.001	.70
MAI Information Management^a	5.71 ± 2.19	7.09 ± 1.84	631.00	.001	.35
MAI Debugging^a	3.63 ± 1.00	4.17 ± 1.06	711.00	.004	.30
MAI Planning^a	3.03 ± 1.63	5.09 ± 1.67	412.00	<.001	.53
MAI Comprehension Monitoring^a	3.65 ± 1.62	4.65 ± 1.64	702.50	.005	.29
MAI Evaluation^a	2.23 ± 1.29	3.35 ± 1.61	652.50	.001	.34
MAI Regulation^a	18.25 ± 5.92	24.35 ± 5.98	478.00	<.001	.47
Vigilance RT DS^c,d	2.67 ± 29.25	−8.39 ± 29.21	768.50	.034	.22
Vigilance Omissions DS^c	11.87 ± 37.79	3.38 ± 29.02	884.50	.232	.13
Selective Attention RT DS^c,d	21.82 ± 26.60	10.91 ± 28.11	802.00	.064	.19
Attention Domain DS^c	11.23 ± 24.59	2.00 ± 23.02	810.50	.053	.20
Psychopathology
BDI^e	20.65 ± 10.39	7.35 ± 6.71	284.50	<.001	.63
STAI State^f	50.32 ± 11.26	34.63 ± 7.53	216.50	<.001	.64
STAI Trait^f	53.60 ± 11.59	37.26 ± 8.52	206.00	<.001	.65
CAARS DSM Inattention^g	16.68 ± 4.77	4.85 ± 3.76	69.50	<.001	.81
CAARS DSM HypImp^h	10.24 ± 5.09	4.48 ± 2.68	314.00	<.001	.61
Daily functioning
WFIRS Family^i	1.22 ± .66	.53 ± .47	396.00	<.001	.53
WFIRS Work^i	1.11 ± .64	.36 ± .29	241.50	<.001	.64
WFIRS School^i	1.31 ± .75	.54 ± .39	269.00	<.001	.55
WFIRS life skills^i	1.22 ± .55	.57 ± .36	344.50	<.001	.58
WFIRS Self concept^i	1.52 ± .76	.58 ± .54	340.00	<.001	.58
WFIRS Social^i	1.11 ± .58	.47 ± .30	339.00	<.001	.59
WFIRS Risk^i	.66 ± .39	.37 ± .26	535.00	<.001	.42
WFIRS Total^i	8.15 ± 3.23	3.54 ± 1.78	126.00	<.001	.69
I-WFIRS Total^j	8.74 ± 3.32	2.83 ± 1.59	39.00	<.001	.73

* = statistically significant with a p-value <.006. Variables printed in italics are combined scales used for the regression analysis. There were slight variations in the sample as not for all measures data was available for all participants. ^aMAI = Metacognitive Awareness Inventory, ^bK = knowledge, ^cDS = Discrepancy score, ^dRT = Reaction Time, ^eBDI = Beck’s Depression Inventory, ^fSTAI = State Trait Anxiety Inventory, ^gCAARS DSM Inattention = DSM Inattention subscale of the Conners’ adult ADHD rating scales, ^hCAARS DSM HypImp = DSM Hyperacitivity/ Impulsivity subscale of the Conners’ adult ADHD rating scales, ⁱWFIRS = Weiss Functional Impairment Rating Scale, ^jI-WFIRS = Informant rated – Weiss Functional Impairment Rating Scale.

Table 3. Regression coefficients for the models predicting MAI Knowledge and MAI Regulation in the whole sample

Outcomes	MAI Knowledge^f					MAI Regulation^f
Predictors	B	SE (B)	β	t	p	B	SE (B)	β	t	p
BDI^a	−.03	.05	−.09	−.66	.510	.09	.09	.16	.98	.332
CAARS Inattention^b	−.34	.07	−.66	−5.17	<.001*	−.71	.13	−.80	−5.31	<.001*
CAARS HypImp^c	.07	.09	.09	.77	.445	−.13	.18	−.10	−.72	.472
STAI State^d	−.00	.04	.01	.08	.940	.10	.08	.19	1.24	.218
STAI Trait^d	−.02	.05	−.05	−.32	.749	.09	.09	.18	.95	.345

* = significant at p < .001. ^aBDI = Beck’s Depression Inventory, ^bCAARS DSM Inattention = DSM Inattention subscale of the Conners’ adult ADHD rating scales, ^cCAARS DSM HypImp = DSM Hyperacitivity/ Impulsivity subscale of the Conners’ adult ADHD rating scale, ^dSTAI = State Trait Anxiety Inventory, ^fMAI = Metacognitive Awareness Inventory.

Table 4. Regressions metacognition and daily functioning

Outcomes	Self-rated WFIRS^b					Informant-rated WFIRS^b
Predictors	B	SE (B)	β	t	p	B	SE (B)	β	t	p
MAI knowledge^a	−.61	.11	−.67	−5.52	<.001*	−.44	.15	−.45	−2.88	.006*
MAI regulation^a	.05	.06	.09	.73	.466	−.05	.09	−.10	−.62	.541

* = significant at p < .01. ^aMAI = Metacognitive Awareness Inventory, ^bWFIRS = Weiss Functional Impairment Rating Scale.

Figure 1. Knowledge of cognition and self-rated daily functioning in patients with ADHD and controls

Note: Self-rated daily functioning was assessed with the total score of the WFIRS and metacognition (knowledge of cognition) with the MAI. The black line represents the linear regression line.

Figure 2. Knowledge of cognition and informant-rated daily functioning in patients with ADHD and controls

Note: Informant-rated daily functioning was assessed with the total score of the WFIRS-Informant version and metacognition (knowledge of cognition) with the MAI. The black line represents the linear regression line.