From Dispositional Traits to Psychopathological Symptoms: Social-Cognitive Vulnerabilities as Intervening Mechanisms

Beyond neuroticism: mediators of personality traits and internalizing psychopathology

BACKGROUND

Neuroticism is considered the general antecedent of many specific psychopathological conditions. Even though previous studies addressed the issue of a mediated relationship by which it exerts its influence, they failed to encapsulate the changes that occur over time. Approaching the pathway between neuroticism and psychopathology from a longitudinal perspective might clarify its underlying mechanisms.

METHODS

The present study aimed to address this by examining the associations between neuroticism, social-cognitive vulnerabilities (anxiety sensitivity, intolerance of uncertainty, experiential avoidance, looming cognitive style), and internalizing psychopathology (depression, anxiety, panic) in an N = 373 student sample. Cross-lagged Panel Model (CLPM) and Random-Intercept Cross-Lagged Panel Model (RI-CLPM) were used to test the mediation analyses in a longitudinal three-wave design.

RESULTS

At the between-person level, the effect of neuroticism and social-cognitive vulnerabilities, such as experiential avoidance and intolerance of uncertainty, on depression and anxiety was found to be significant. An indirect effect of neuroticism was observed specifically for anxiety sensitivity and panic. No significant effects emerged at the within-person level.

CONCLUSIONS

Neuroticism and social-cognitive factors together contribute to depression and anxiety symptoms, while neuroticism's indirect influence better explains the onset of panic at a stable, between-person level. Theoretical considerations of the results and prospective research implications are discussed.

Beyond the Moderating Role of Neuroticism on Evaluative Conditioning: Threat Appraisal

OBJECTIVE

Reality perception is often altered by general dispositional factors that are associated with emotional vulnerability, both inherited and acquired, that emerge in a specific learning context. The current study will examine whether neuroticism and looming cognitive style, factors that account for emotional vulnerability, interact in a manner that influences the evaluative conditioning effect (the magnitude of valence change in a conditioned stimulus due to pairing with an unconditioned stimulus).

METHOD

To achieve this, we will implement an evaluative conditioning procedure that pairs positive stimuli, nonthreatening negative stimuli, and threatening negative stimuli with neutral stimuli. Participants will also provide measures of valence and threat characteristics for the unconditioned stimuli, along with assessments of neuroticism and looming cognitive style.

RESULTS

We expect that the evaluative conditioning effect will be mediated by threat and valence evaluations of unconditioned stimuli. We also expect that neuroticism will moderate the valence and threat values of unconditioned stimuli, whereas cognitive looming will moderate the magnitude of valence transfer from unconditioned stimuli to conditioned stimuli.

CONCLUSIONS

We presume that neuroticism will explain the reactivity to valenced and threatening stimuli, while looming cognitive style will account for the negative bias in the conditioned stimuli evaluation.

Biocultural Aspects of Mental Distress: Expanding the Biomedical Model Towards an Integrative Biopsychosocial Understanding of Disorder

To produce a theoretical approach about the relations between neuroscience and psychopathology that expands beyond the biomedical model to include a non-reductionist, enactive, and biocultural perspective. An integrative review, drawing from the biocultural approach from Anthropology, is used to produce examples from epigenetics, neuroplasticity, and functional neuroanatomy. A biocultural approach points to a brain that is highly plastic, reinforcing a much more complex model in which biological vulnerabilities and the historical-cultural environment co-construct each other. The examples given seem to point to the pressing need for a critical expansion of reductionist models of psychopathology. Importantly, the cultural-historical environment to which we refer is not a set of neutral social relations to which individuals are homogeneously exposed, such that aspects that are usually studied under the social determinants of health and disease (poverty, discrimination, violence, and other factors that represent sources of control, production, and distribution of material resources, ideology, and power) need to be incorporated in adequate biopsychosocial models of mental distress.

Intolerance of uncertainty and anxiety: The role of beliefs about emotions

BACKGROUND

Intolerance of uncertainty (IU) is a dimensional trait fundamental to most psychopathologies, and anxiety disorders in particular, making it an important transdiagnostic construct for researchers and clinicians. Current psychological therapies focus on changing underlying cognitive assumptions related to uncertainty. However, we posit that IU conveys beliefs about emotions too. In line with established findings on beliefs about emotions in general, we tested the hypothesis that the relationship between IU and anxiety is mediated by beliefs about the controllability and/or usefulness of emotions.

METHODS

Participants (N = 2260) were administered the Emotions Beliefs Questionnaire (EBQ); the General Anxiety Disorder 7-item (GAD-7), and the Intolerance of Uncertainty Scale (IUS - 12). A confirmatory factor analysis (CFA) on the EBQ was conducted followed by Pearson correlation coefficients among the central measures, and a parallel mediation analysis to address the central research question.

RESULTS

Our CFA supported the intended factor structure of the EBQ. The results of our mediation analysis supported the prediction that the association between IU and anxiety is partially mediated by general beliefs about emotions.

LIMITATIONS

Although our sample size was large, the age range was limited so future research could expand the age range to maximise generalizability. This is a cross-sectional study so causal inferences are restricted.

CONCLUSION

Given the present findings, current interventions for IU and their focus on beliefs about uncertainty, might benefit from incorporating strategies to improve beliefs about emotions, and thus improve therapeutic effectiveness.

Intolerance of Uncertainty, Looming Cognitive Style, and Avoidant Coping as Predictors of Anxiety and Depression During COVID-19: a Longitudinal Study

The COVID-19 pandemic has resulted in increased distress and uncertainty. Understanding the progression of mental health and factors underlying the perpetuation of distress during the pandemic is pivotal in informing interventions and public health messaging. This current study examined longitudinal effects of two cognitive vulnerabilities, looming cognitive style, and intolerance of uncertainty, as well as coping styles on anxiety and depression through online questionnaires at two time points in the pandemic, May 2020 (N = 1520) and August 2020 (N = 545). Depression, but not anxiety, significantly increased across time, which was moderated by coping style. Serial mediation modeling using path analysis demonstrated a significant pathway illustrating increased looming cognitive style in the beginning of the pandemic leads to increased intolerance of uncertainty, avoidant coping, and anxiety later in the pandemic. Results suggest a novel model in conceptualizing anxiety during the pandemic, namely highlighting looming cognitive style as an underlying cognitive vulnerability factor and antecedent of intolerance of uncertainty and illuminating the temporal directionality between looming cognitive style and intolerance of uncertainty. These findings provide important implications regarding intervention and public health messaging with modifiable behavioral and cognitive factors to improve mental health during a pandemic.

Early childhood temperament predicts intolerance of uncertainty in adolescence

Intolerance of uncertainty (IU) is the trait propensity to react negatively to uncertainty. To date, very few studies have explored early childhood predictors of IU. The current study identifies relations between child temperament assessed at age 3 (N = 559) and IU assessed at ages 12 (N = 432) and 15 (N = 415). Temperament was assessed through both laboratory observation (Laboratory Temperament Assessment Battery) and maternal report (Children's Behavior Questionnaire). IU was assessed through both maternal rating and child self-report using the 12-item Intolerance of Uncertainty Scale for Children. Higher levels of temperamental negative emotionality/neuroticism and lower levels of temperamental positive emotionality/extraversion assessed at age 3 predicted higher levels of IU in early-mid adolescence. Unique relationships were found at the trait facet level, and differences were observed between informants. These findings suggest that certain early child temperament traits can serve as markers of risk for difficulty dealing with uncertainty later in life. Future research should explore whether this relationship translates to increased risk for psychopathology.

Responding to uncertain threat: A potential mediator for the effect of mindfulness on anxiety

Mindfulness-based interventions have gained extensive support for their application in the treatment of anxiety. However, their mechanisms remain largely unexplored. Excessive reactivity to uncertainty plays a central role in anxiety, and may represent a mechanism for the effect of mindfulness on anxiety, as mindfulness training fosters an open and accepting stance towards all aspects of experience. The present study sought to investigate both (i) self-reported intolerance of uncertainty (IU) as well as (ii) physiological and subjective responding to uncertain threat in a threat-of-shock paradigm, the NPU-threat test, as mediators for the relationship between mindfulness and anxiety in a cross-sectional study of healthy participants (N = 53). The results indicated that IU mediated the effect of mindfulness on some anxiety symptoms. In contrast, scores of physiological as well as subjective responses to uncertain threat from the NPU-threat test were largely unrelated to mindfulness, anxiety, or the IU self-report measure. The results provide initial evidence that reactions to uncertainty may play a role in the mindfulness-anxiety relationship and suggest that studies are needed to address how methodological variations of the NPU-threat test affect perceived levels of uncertainty and uncertainty-related anxiety.

Specificity of trait anxiety in anxiety and depression: Meta-analysis of the State-Trait Anxiety Inventory

The State-Trait Anxiety Inventory - Trait version (STAI-T) was developed to measure an individual's tendency to experience anxiety, but it may lack discriminant evidence of validity based on strong observed relationships with measures of depression. The present series of meta-analyses compares STAI-T scores among individuals with depressive disorders, anxiety disorders, and nonclinical comparison groups, as well as correlations with measures of anxiety and depressive symptom severity, in order to further examine discriminant and convergent validity. A total of 388 published studies (N = 31,021) were included in the analyses. Individuals with an anxiety disorder and those with a depressive disorder displayed significantly elevated scores on the STAI-T compared to nonclinical comparison groups. Furthermore, anxiety and depressive symptom severity were similarly strongly correlated with the STAI-T (mean r = .59 - .61). However, individuals with a depressive disorder had significantly higher STAI-T scores than individuals with an anxiety disorder (Hedges's g = 0.27). Given these findings, along with previous factor analyses that have observed a depression factor on the STAI-T, describing the scale as a measure of 'trait anxiety' may be a misnomer. It is proposed that the STAI-T be considered a non-specific measure of negative affectivity rather than trait anxiety per se.

Sociotropy, Autonomy and Emotional Symptoms in Patients with Major Depression or Generalized Anxiety: The Mediating Role of Rumination and Immature Defenses

The relationships between dimensions of personality (sociotropy and autonomy), coping strategies (rumination: brooding and reflection subtypes, and immature defenses) and symptoms of depression and anxiety were explored in patients with Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD). A total of 279 patients completed questionnaires including measures of personality dimensions, rumination, immature defenses, depression and anxiety. Our findings suggested that sociotropy and autonomy may be associated with both depressive and anxious symptoms in patients with MDD and with GAD. Multiple mediation analyses indicated that brooding always acted as a mediating link between personality vulnerabilities (sociotropy and autonomy) and depressive and anxiety symptoms, independently of the patient group. In addition, in patients with MDD and those with GAD, brooding and immature defenses functioned together by linking sociotropy and autonomy, respectively, with depressive symptoms. Our results also showed that, in patients with GAD, both types of rumination explained the relationship between sociotropy and autonomy and anxiety symptoms. Overall, our findings provided evidence of the transdiagnostic role of the brooding, linking the vulnerability of personality dimensions and emotional symptoms. They also indicated that reflection and immature defenses can operate in conjunction with brooding, depending on the type of vulnerability and emotional context.

Intolerance of uncertainty fuels depressive symptoms through rumination: Cross-sectional and longitudinal studies

The current study replicated and extended previous studies by examining the mediating and moderating role of rumination in the relationship between intolerance of uncertainty (IU) and depression in a community sample using both cross-sectional (n = 494; 56.9% female) and a two-months longitudinal (n = 321; 48.4% female) designs. Participants in each study were recruited through online crowdsourcing websites and completed study questionnaires. Results from Study 1 suggested that, while rumination did not appear to moderate the relationship between IU and depression, rumination appeared to partially mediates such relationship. Results from Study 2 supported rumination as fully mediating the relationship between IU and depression over two months. The brooding and reflection rumination subtypes exerted a significant indirect, but not moderating, effect on the relationship between IU and depression. Brooding exhibited a stronger mediation effect than did reflection. Overall, current results suggest that high levels of IU fuel the development of depression symptoms over time through engagement in heightened rumination. The IU-depression association appeared fully explained through rumination as it is a passive and contextually-dependent coping response that may enhance individuals’ emotion and facilitate the development of depressive symptoms.

The impact of methodological and measurement factors on transdiagnostic associations with intolerance of uncertainty: A meta-analysis

Intolerance of uncertainty is a dispositional trait associated with a range of psychological disorders, but the influence of methodological factors on theses associations remains unknown. The first aim of this meta-analysis was to quantify the strengths of the association between IU and symptoms of generalised anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, obsessive compulsive disorder, depression, and eating disorders. The second aim was to assess the influence of methodological factors on these relationships, including clinical (vs. non-clinical) status, age group, sex, IU measure, and symptom measure. We extracted 181 studies (N participants = 52,402) reporting 335 independent effect sizes (Pearson's r). Overall, there was a moderate association between IU and symptoms (r = 0.51, 95% CI = 0.50-0.52), although heterogeneity was high (I² = 83.50, p < .001). Some small but significant moderator effects emerged between and within disorders. Effect sizes were not impacted by sample size. The results indicate that IU has robust, moderate associations with a range of disorder symptoms, providing definitive evidence for the transdiagnostic nature of IU.

Relations of Shared and Unique Components of Personality and Psychosocial Functioning to Depressive Symptoms

Consistent with theories of depression, several personality (e.g., high neuroticism, low extraversion) and psychosocial (e.g., interpersonal problems, cognitive content) variables predict depressive symptoms substantively. In this extended replication, we clarified whether 13 theoretically relevant personality and psychosocial variables were unique versus overlapping predictors of symptoms among 351 adult outpatients with recurrent major depressive disorder who received acute-phase cognitive therapy (CT). Using factor analysis and regression methods, we partitioned the measures' variance into general components common across the two types of measures (psychosocial and personality), within-type components shared only with other measures of the same type, and scale-specific components. From early to late in CT, and from late in CT through 8 months after response, the general components were the strongest (median r = .23)-and scale-specific components the weakest (median r = .01)-forward predictors of symptoms. We discuss implications for measurement and treatment of depression.

The predictive specificity of psychological vulnerability markers for the course of affective disorders

High scores on markers of psychological vulnerability have been associated with a worse course of affective disorders. However, little is known about the specificity of those associations in predicting the course of different depressive and anxiety disorders. We examined the impact of psychological vulnerability on the short- and long-term course of depressive and anxiety disorders. Participants from the Netherlands Study of Depression and Anxiety with a current diagnosis of depression or anxiety (n = 1256) were reassessed after 2 and 6 years. Diagnostic status and chronic duration (>85% of the time) of symptoms were the outcomes. Predictors were neuroticism, extraversion, locus of control, cognitive reactivity (rumination and hopelessness reactivity), worry and anxiety sensitivity. High neuroticism, low extraversion and external locus of control predicted chronicity of various affective disorders. Rumination, however, predicted chronicity of depressive but not anxiety disorders. Worry specifically predicted chronicity of GAD and anxiety sensitivity predicted chronicity of panic disorder and social anxiety disorder. These patterns were present both at short-term and at long-term, without losing predictive accuracy. Psychological vulnerabilities that are theoretically specific to certain disorders indeed selectively predict the course of these disorders. General markers of vulnerability predicted the course of multiple affective disorders. This pattern of results supports the notion of specific as well as transdiagnostic predictors of the course of affective disorders and is consistent with hierarchical models of psychopathology.

Self-reported volitional control in adolescents and young adults from a community cohort: Associations with current, past and future mental disorders

Alterations in volitional control have been found for various mental disorders. However, it remains unclear to which degree such alterations vary by type of psychopathology and constitute preceding vulnerabilities or correlates of mental disorders. DSM-IV mental disorders were assessed among adolescents and young adults from the community at baseline (age 14-24) and in up to 3 follow-up assessments over 10 years (n = 2515) using a standardized diagnostic interview (DIA-X/M-CIDI). Self-reported volitional control was assessed at second follow-up (T2) when subjects were aged 17-28 using the German version of the Short Form of the Volitional Components Inventory. Linear regressions adjusted for sex, age and lifetime disorders revealed that anxiety and affective disorders were associated with widespread alterations in self-reported volitional control (lower self regulation, higher self inhibition and volitional inhibition), while substance use disorders were specifically associated with higher volitional inhibition. Logistic regressions adjusted for sex, age and prior lifetime psychopathology revealed that lower self-reported volitional control at T2 predicted incident panic, social phobia and substance use at T3 (follow-up interval M = 4.8 years). Findings point toward at least partly disorder-specific alterations in volitional control in mental disorders, which might be antecedent vulnerability factors and thus useful to guide early recognition and prevention.

The Looming Maladaptive Style Questionnaire: Measurement invariance and relations to anxiety and depression across 10 countries

The Looming Maladaptive Style Questionnaire (LMSQ) is a self-report measure designed to assess the looming cognitive style, a tendency to interpret threats as rapidly approaching and increasing in magnitude. To date, no systematic evaluation on the psychometric properties of the LMSQ across diverse cultural contexts has been done. In the present research, the measurement invariance of the LMSQ test scores was examined in 10 countries (N=4000). Confirmatory factor analysis suggested that a two-factor model (i.e., physical looming and social looming) fitted the data well across countries. Partial measurement invariance was established for the LMSQ scores across the countries whereas full measurement invariance was achieved across gender. Meta-analytic structural equation modeling was applied to examine the unique contributions of the two looming factors to anxiety and depression symptoms. Results indicated that the test scores underlying two looming factors were crucial and valid predictors of symptoms. The LMSQ shows promise as a measure with cross-cultural generalizability and opens new avenues for its use in diverse cultural settings.

Pathways from uncertainty to anxiety: An evaluation of a hierarchical model of trait and disorder-specific intolerance of uncertainty on anxiety disorder symptoms

Uncertainty is central to anxiety-related pathology and intolerance of uncertainty (IU) appears to be a transdiagnostic risk and maintaining factor. The aim of the present study was to evaluate a hierarchical model to identify the unique contributions of trait and disorder-specific IU (i.e., uncertainty specific to generalised anxiety disorder, social anxiety, obsessive compulsive disorder, and panic disorder) to disorder-specific symptoms, beyond other disorder-specific cognitive vulnerabilities (i.e., negative metacognitive beliefs, fear of negative evaluation, inflated responsibility, and agoraphobic cognitions, respectively). Participants (N=506) completed a battery of online questionnaires. Structural equation modelling was used to evaluate model fit, as well as direct and indirect pathways. Trait and disorder-specific IU were significantly associated with multiple cognitive vulnerability factors and disorder symptoms. Indirect effects between trait IU and symptoms were observed through disorder-specific IU and cognitive vulnerabilities. The relative contribution of trait IU and disorder-specific IU to symptoms varied and theoretical and clinical implications are highlighted. Limitations include the cross-sectional design and reliance on self-report. Avenues for further research include a need for replication and extension of the model in different samples and using experimental and multi-method research methods.

What Lies Beyond Neuroticism? An Examination of the Unique Contributions of Social-Cognitive Vulnerabilities to Internalizing Disorders

Extensive research has identified various social-cognitive vulnerabilities for internalizing disorders. However, few studies have assessed multiple disorders simultaneously, so it is unclear whether these vulnerabilities are transdiagnostic or specific risk factors. Their unique associations with disorders are also uncertain, given that they correlate strongly with neuroticism and one other. Psychiatric outpatients completed self-report and interview measures of six disorders (depression, generalized anxiety disorder, posttraumatic stress disorder, social anxiety, panic, obsessive-compulsive disorder), and personality (the Big Five, neuroticism facets, and four vulnerabilities: anxiety sensitivity, intolerance of uncertainty, perfectionism, experiential avoidance). All constructs were modeled as latent variables using structural equation modeling. All four vulnerabilities were closely associated with neuroticism, loading on its anxiety facet in factor analyses. Furthermore, after accounting for the contribution of neuroticism facets, intolerance of uncertainty and experiential avoidance were not uniquely associated with any disorders, and perfectionism was only related to obsessive-compulsive disorder. However, anxiety sensitivity accounted for substantial unique variance in several disorders (i.e., depression, social anxiety, posttraumatic stress disorder, and panic). We discuss theoretical and clinical implications of these results.

Intolerance of uncertainty in emotional disorders: What uncertainties remain?

The current paper presents a future research agenda for intolerance of uncertainty (IU), which is a transdiagnostic risk and maintaining factor for emotional disorders. In light of the accumulating interest and promising research on IU, it is timely to emphasize the theoretical and therapeutic significance of IU, as well as to highlight what remains unknown about IU across areas such as development, assessment, behavior, threat and risk, and relationships to cognitive vulnerability factors and emotional disorders. The present paper was designed to provide a synthesis of what is known and unknown about IU, and, in doing so, proposes broad and novel directions for future research to address the remaining uncertainties in the literature.

Are Worry and Rumination Specific Pathways Linking Neuroticism and Symptoms of Anxiety and Depression in Patients with Generalized Anxiety Disorder, Major Depressive Disorder and Mixed Anxiety-Depressive Disorder?

This study examines the relationships between neuroticism (higher-order vulnerability factor), the cognitive styles of worry, brooding and reflection (second-order vulnerability factors) and symptoms of anxiety and depression in three groups of patients: patients with Generalized Anxiety Disorder (GAD), with Major Depressive Disorder (MDD) and with Mixed Anxiety-Depressive Disorder (MADD). One hundred and thirty four patients completed a battery of questionnaires including measures of neuroticism, worry, rumination (brooding and reflection), anxiety and depression. Multiple mediation analyses indicate that worry may act as a mediating mechanism linking neuroticism and anxiety symptoms in the three diagnostic groups, whereas brooding-rumination may play a mediating role between neuroticism and depressive symptoms in patients with MDD and MADD and, with less certainty, in patients with GAD. Overall, our findings suggest that neuroticism may increase the risk of anxious and depressive symptoms via specific links involving either worry or brooding, respectively, and that both worry and brooding may operate in the three groups examined, irrespectively of whether anxiety or depression are the main emotions or whether they coexist without any clear predominance; consequently, we hypothesize the existence of "specific transdiagnostic" mechanisms.

The Hopelessness Theory of Depression: A Quarter Century in Review

Since the formulation of the hopelessness theory of depression (Abramson, Metalsky, & Alloy, 1989) a quarter century ago, it has garnered considerable interest. The current paper presents a systematic review of this theory including its subsequent elaborations (Rose and Abramson's [1992] developmental elaboration, Abela and Sarin's [2002] weakest-link approach, Panzarella, Alloy, and Whitehouse's [2006] expansion of the hopelessness theory, and the hopelessness theory of suicide [Abramson et al., 2000]), followed by recommendations for future study. Although empirical support was consistently found for several major components of the hopelessness theory, further work is required assessing this theory in relation to clinically significant phenomena. Among the most significant hindrances to advancement in this area is the frequent conceptual confusion between the hopelessness theory and the reformulated learned helplessness theory.

The interaction of extraversion and anxiety sensitivity on social anxiety: evidence of specificity relative to depression

Neuroticism and extraversion have been linked to the etiologies and course of anxiety and mood disorders, such that neuroticism is broadly associated with numerous disorders and extraversion is most strongly associated with social anxiety and depression. While previous research has established the broad associations between temperament and emotional disorders, less is known about the specific, proximal factors that are associated with them, and very few studies have situated these risk factors into a larger etiological model that specifies how they may relate to one another. The current study examined the interaction of extraversion and anxiety sensitivity (AS) in predicting social anxiety symptoms in a large, diagnostically diverse clinical sample (N=826). Symptoms were assessed with self-report and dimensional interview measures, and regression analyses were performed examining the main effects and interaction of extraversion and AS (examining both total and lower-order components) on social anxiety. Results showed that at higher levels of AS, the inverse relationship between extraversion and social anxiety was stronger, and the social concerns component of AS is responsible for this effect. This interaction was also observed with regard to depression symptoms, but the interaction was not present after accounting for shared variance (i.e., comorbidity) between depression and social anxiety symptoms. Clinical and theoretical implications of the results are discussed.

Temperament and Anxiety: The Mediating Role of Metacognition

The present study examines a simple model for the relationship between temperament, anxiety and maladaptive metacognition. A clinical sample of patients diagnosed with anxiety disorders (n = 216) completed a set of self-reported questionnaires measuring temperament dimensions, state anxiety and metacognitions. Three temperament traits were included in the hypothesized model: emotional reactivity, perseveration and briskness. A structural equation modeling analysis supported a model in which the relationship between the three temperament traits and anxiety were fully mediated by metacognition. Dissimilar models were identified for the male and female subgroups, and also with reference to individual categories of maladaptive metacognition. The findings support the significance of metacognition as a factor influencing the temperament-anxiety relationship. Moreover, they confirm the roles both of emotional reactivity and of perseveration, being major traits related to anxiety which also turned out to be strongly associated with metacognition. In case of the models for the categories of metacognition, emotional reactivity was associated with negative beliefs, perseveration with negative and positive beliefs, while briskness predicted anxiety independently of metacognition. These results suggest the existence of more specific associations between temperament traits, anxiety, and various types of metacognition.