Metacognition and theory of mind in children with migraine and children with internalizing disorders

Mentalization, theory of mind (ToM) and metacognition are abilities that explain or predict behavior based on beliefs, intentions, or feelings attributed to the self or others, mental states and thoughts. Some studies have showed an impairment of these abilities in children and adolescents with several disorders, such as anxiety, depression, Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD). Moreover, some studies have hypothesized a relationship between a deficit on metacognition, TOM abilities and alexithymia. There are very few data on the relationship between ToM and metacognition in children and adolescents with migraine and there is no study comparing these children with those with internalizing disorders. Since the literature suggests that children with migraine have a high comorbidity with internalizing disorders, our hypothesis is that these problems may have in common persistent and maladaptive patterns of thinking which are related to maladaptive metacognitive beliefs. For these reasons we used the Domain of Social Perception included in the NEPSY-II to assess levels of ToM, Metacognitions Questionnaire for Children (MCQ-C) for metacognitive abilities and Alexithymia Questionnaire for Children (AQC) for alexithymia, both in children with migraine and children with internalizing disorders. These two group will be compared with a control group without any psychiatric or psychological disorders. We expect to find higher level of Alexithymia and a greater impairment on TOM and Metacognition in both clinical samples compared to the healthy group. Moreover, we expect a significative correlation between migraine characteristics (e.g. intensity, frequency, duration of the attacks etc.) and deficit on metacognition and ToM abilities and in alexithymia.