Adverse experiences in childhood: association with metacognition, personality disorders and distress

Ilaria Riccardi 1 2, Elena Bilotta 1 2, Luigi Leone 3, Giuseppe Nicolò 1 2, Michele Procacci 1 2, Antonio Semerari 1 2, Antonino Carcione 1 2

1 Third Centre of Cognitive Psychotherapy, Rome, Italy; 2 Italian School of Cognitive Psychotherapy (SICC), Rome, Italy; 3 Department of Social and Developmental Psychology, Sapienza University of Rome, Italy

DOI 10.36148/2284-0249-366


Several studies provided evidences that Personality Disorders (PDs) are characterized by an impairment in the abilities to reflect on one’s and others’ mental state. These abilities have been often named as metacognition or mentalization. There are also evidences that adverse experiences in childhood (ACE) (abuse, neglect, maltreatment) affected metacognition and are associated to PDs and symptom distress. The present study aims to explore metacognition, distress and severity of personality pathology in relation to the presence or absence of adverse experiences in childhood (ACE) in a sample of 373 outpatients diagnosed having a PDs. The hypothesis was that metacognition is most impaired in patients that experienced adversities in childhood, as there is higher symptoms distress and major personality impairment. The metacognitive Differentiation and Integration sub-functions are hypothesized to be more compromised in ACE group than in the no-ACE one.


All the patients have been scored using SCID-II, Metacognition Assessment Interview, SCL-90-R. ACE has been detected through a clinical interview. In order to test the associations among metacognition, symptoms distress (GSI-SCL-90-R) and personality severity (number of SCID-II criteria) with ACE, we run a series of ANOVAs using the dichotomous ACE variable (0 = no ACE; 1 = at least 1 ACE) as the grouping variable.


Results confirmed that metacognition is more impaired, symptoms distress is higher and personality is more compromised in ACE group. The metacognitive Differentiation and Integration sub-functions are the most compromised.


The study is a contribute to explore the association between trauma, metacognition and personality disorders and provide suggestions to further studies to focus on pathways leading to the comprehension of impact of ACE on psychopathology.

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