Qom University of Medical Sciences Journal

Introduction
Anxiety refers to an unpleasant and vague sense of fear with unknown source, which increases uncertainty, helplessness and physiological arousal [1].
With a prevalence of about 10%, anxiety disorders are the most common mental disorders in childhood and adolescence[2]. Considering the consequences of anxiety, identifying the risk factors and development of treatment methods are necessary [5].
Metacognitive therapy (MCT), as a transdiagnostic therapy for emotional disorders, focuses on the self-regulatory executive function. According to this model, a perseverative thinking style called “cognitive-attentional syndrome” (CAS) contributes to occurrence, persistence, and relapse in most psychological disorders [6]. CAS includes processes such as worry, rumination, threat monitoring and use of coping strategies such as thought control and reassurance [7]. CAS is associated with negative and positive metacognitive beliefs about these strategies [6].
These metacognitive beliefs has two types of positive beliefs (the usefulness of worry) and negative beliefs (the uncontrollability and the dangerous nature of worry) [8].
Metacognitive beliefs play an important role in maladaptive thoughts and strategies and the development of mental disorders [13] and negative and positive beliefs about worry are important predictors of anxiety [14]. Many studies have shown that metacognition is a significant predictor in the treatment of psychological disorders. For example, changes in metacognitions play an important role in improving the symptoms of patients with social phobia and other anxiety disorders [2، 15].
One of the tools that is used to measure metacognitive beliefs in children is the Metacognitions Questionnaire for Children (MCQ-C).
It is a 24-item scale with 4 subscales of positive meta-worry, negative meta-worry, cognitive monitoring, and superstition, punishment and responsibility (SPR). The higher score indicates having more metacognitions [15].
Considering the role of metacognitive beliefs in children’s psychopathology, especially anxiety disorders, and the lack of appropriate tool to measure these beliefs in Iranian children, this study aims to evaluate the psychometric properties of the Persian version of MCQ-C in Iranian children.
Method
In this study, participants were 338 children aged 9-13 years from primary schools in Qom city. First, the MCQ-C was translated to Persian and then translated back into English. After confirming translation and obtaining the necessary permits, the final questionnaire was administered to children.
The correlation of MCQ-C score with the scores of Spence Children’s Anxiety Scale (SCAS), The Penn State Worry Questionnaire for Children (PSWQ-C) and Children’s Depression Inventory (CDI) was assessed to examine the convergent validity of the Persian MCQ-C. Confirmatory Factor Analysis (CFA) was employed to determine the factor structure of the scale. Cronbach’s alpha coefficient and the test-retest method were used to evaluate the reliability of the Persian MCQ-C. Data were analyzed in SPSS v. 21 and Amos v. 24 applications.
Results
Participants were 47% boy and 54.7 % girl. Their mean MCQ-C score was 56.67±10.26. The correlation matrix of the questionnaire subscales is presented in Table 1. The results showed that the correlation between the subscales was positive and significant.
The correlation between the scores of MCQ-C, SCAS, PSWQ-C and CDI was examined. The results showed that all components of the MCQ-C had a significant correlation with the mentioned questionnaires, where correlation coefficient ranged from 0.19 to 0.41. The CFA results in Table 2, showed that the model had a relative fit to the data.
Cronbach’s alpha coefficient for the whole scale was 0.77 and the three-week test-retest coefficient for the whole scale was 0.70, indicating the good reliability of the questionnaire (Table 3).
Discussion
The purpose of present study was to evaluate the psychometric properties of the Persian MCQ-C. The results of CFA showed that the model had a relative fit. Cronbach’s alpha coefficient (0.77) showed the high internal consistency of the questionnaire. These findings are consistent with the results of previous studies in this field [15, 22].
The test-retest coefficient of the questionnaire (0.70) showed the high reliability of this questionnaire over time. in Irak’s study, the test-retest coefficient of 0.76-0.82 for the total score and subscales of Turkish MCQ-C were reported [22]. In line with previous studies[15, 22], our findings showed the significant relationship of the score of Persian MCQ-C with those of SCAS, PSWQ-C and CDI, which indicates the convergent validity of this questionnaire.
Overall, our study results showed the appropriate psychometric properties of the Persian MCQ-C. The results confirm the applicability of this questionnaire in Iranian children, for checking the applicability of this tool for other populations, more studies are needed.
Measuring the metacognitive beliefs of children referred to psychological clinics can be useful for reducing their psychological symptoms.
Ethical Considerations
Compliance with ethical guidelines
This study was approved by the Ethics Committee of the Qom University of Medical Sciences (Code: IR.MUQ.REC.1400.058). All ethical principles are considered in this article. The participants were informed of the purpose of the research and its implementation stages. They were also assured about the confidentiality of their information and were free to leave the study whenever they wished, and if desired, the research results would be available to them.
Funding
The paper was extracted from the PhD. dissertation of the first author at the Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, Shiraz University, Shiraz.
Authors contributions
All authors equally contributed to preparing this article.
Conflicts of interest
The authors declared no conflict of interest.