Clinical Neuropsychiatry (2015) 12, 6, 157-165 Metacognition assessMent interview: instruMent description and factor structure

Objective: Metacognition is a multi-component psychological construct, characterised by the ability to identify and describe one’s own mental states and those of others. Evidence has been found for an association between deficits in metacognitive abilities and poor social functioning, low quality of life, psychopathology, and symptoms in personality disorders (pds). However, to date, there are few psychometrically validated instruments available for assessing the different components of metacognition. a semi-structured interview, the Metacognition assessment interview (Mai), has been developed to evaluate different domains of metacognition. in the present study, we investigated the psychometric properties of the Mai in an outpatient clinical sample. Method: the Mai was administered to a clinical population of 306 outpatients attending a private clinical centre. Exploratory factor analysis, confirmatory factor analysis and correlation with instruments assessing alexithymia and interpersonal problems were carried out to examine the dimensionality and validity of the Mai. Result: Explorative and confirmatory factor analyses revealed a good fit for both a two-factor model and a four-factor model of metacognition. The two-factor model yielded two main dimensions, which we named: Self domain, defined as self-reflection, and Other domain, defined as critical distancing from one’s own mental state and that of others. The fourfactor solution is composed of four sub-domains: monitoring, integration, differentiation and decentration. Moreover, the MAI showed good convergent validity, with significant correlations with both alexithymia and interpersonal problems. Conclusions: These results confirm that the MAI is a reliable instrument for measuring metacognition and its different sub-domains. In particular, the MAI represents a useful and flexible instrument for the assessment of metacognition impairments in different psychopathologies and it can provide useful indications for the focus of psychotherapy treatment.