Comparative Analysis of Metacognition and Mindfulness Across Social Anxiety Disorder, Panic Disorder and Healthy Controls

Metacognition and mindfulness are central to contemporary accounts of anxiety, yet their comparative profiles across social anxiety disorder (SAD) and panic disorder (PD) remain insufficiently defined. The objective of this study is to compare metacognition and mindfulness across SAD, PD and healthy controls (HC) and to examine how these processes predict disorder specific severity. Adults with SAD (n = 47), PD (n = 50) and HC (n = 50) participated, for a total of 147 individuals. Participants completed the Metacognitions Questionnaire 30 (MCQ-30), the Five Facet Mindfulness Questionnaire Short Form (FFMQ-SF) and disorder-specific severity measures. Group differences were tested, followed by multiple linear regressions predicting severity within each clinical group from MCQ-30 subscales and FFMQ-SF facets. Metacognitive dysfunction was higher in SAD and PD than in HC, with the clearest separations in cognitive self-consciousness and the need to control thoughts. Mindfulness was lowest in SAD, intermediate in PD and highest in HC. In regression analyses, only mindfulness variables predicted severity in SAD, with higher observing and higher nonjudging associated with lower symptom levels. In PD, the need to control thoughts was the sole metacognitive predictor positively associated with severity; other metacognitive and mindfulness facets were not significant. Metacognition and mindfulness index a shared liability across anxiety but show disorder-specific signatures. In SAD, mindfulness facets related to observing and nonjudging are most relevant for severity, whereas in PD, control-oriented metacognitive beliefs are most relevant. These patterns identify focused targets for future longitudinal and experimental studies and may inform disorder-sensitive intervention strategies.