Quiet Ego and Metacognitive Beliefs in Euthymic Bipolar Disorder: A Preliminary Report

Bipolar Disorder (BD) is associated with functional disability even during euthymia, when residual dysfunctional thinking patterns, distinct from mood symptoms and neurocognitive deficits, may persist largely untreated by standard pharmacotherapy, psychoeducation, or cognitive remediation. This preliminary study examined the association between Quiet Ego, as measured by the Quiet Ego Scale (QES), and metacognitive beliefs, as measured by the Metacognitions Questionnaire-30 (MCQ-30), in fifty euthymic patients with BD. The QES total score was entered as a continuous predictor of each MCQ-30 subscale in simple linear regression models. Higher Quiet Ego scores were associated with higher Cognitive Confidence (i.e., lower scores on the MCQ-30 Cognitive Confidence subscale; β = -.393, R² = .154, p = .005), the only association that survived Bonferroni correction (α = .01). The association with negative beliefs about uncontrollability and danger was significant only at the uncorrected level (p = .034), and all remaining associations were not significant (p > .05). These preliminary findings suggest that Quiet Ego may be related to how patients appraise the reliability of their own cognition. Given the small sample, the cross-sectional design, and the self-reported nature of cognitive confidence, the results should be interpreted cautiously and require replication. Longitudinal and intervention studies are needed to test whether quiet-ego-enhancing approaches could serve as an adjunct in the long-term self-management of BD.