Differential Metacognitive Profiles in Relapsing–Remitting and Progressive Multiple Sclerosis: Associations with Fatigue, Cognition, and Perceived Disability
Bibliographic record
Abstract
OBJECTIVE: This study examined metacognitive belief profiles in individuals with multiple sclerosis (MS) and their associations with cognitive, emotional, and functional outcomes. Specifically, we compared relapsing-remitting MS (RRMS), secondary progressive MS (SPMS), and primary progressive MS (PPMS) to determine whether distinct metacognitive patterns characterize different disease phenotypes. METHOD: A total of 504 participants (75.6% RRMS, 9.9% SPMS, 14.5% PPMS) were recruited from a neurology clinic. Participants completed the Metacognitions Questionnaire-30 (MCQ-30), Montreal Cognitive Assessment (MoCA), Beck Depression Inventory (BDI), Modified Fatigue Impact Scale (MFIS), Expanded Disability Status Scale (EDSS), Short Form-12 (SF-12), and Occupational Self-Assessment (OSA). Group differences were examined using ANOVA, correlations via Pearson coefficients, and hierarchical and ordinal regression models. RESULTS: Progressive phenotypes, particularly PPMS, showed significantly higher maladaptive metacognitive beliefs than RRMS. RRMS individuals exhibited greater cognitive self-consciousness and need for control, whereas PPMS was associated with lower cognitive confidence and stronger negative beliefs about uncontrollability. No subtype differences emerged in positive beliefs. Maladaptive metacognition correlated with lower cognitive performance, greater fatigue, depressive symptoms, reduced quality of life, and lower self-efficacy. In regression models, depression was the strongest negative predictor of self-efficacy, while cognitive self-consciousness was a positive predictor. Clinical and psychological variables together explained 60% of the variance in self-efficacy. Metacognitive beliefs and fatigue also predicted higher neurological disability (EDSS). CONCLUSIONS: Metacognitive belief patterns differ across MS phenotypes and significantly impact both functional and neurological outcomes. These findings support incorporating metacognitive assessment into routine MS care and underscore the need for tailored psychological interventions addressing cognitive-emotional regulation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".