Abstract
The cognitive model of obsessive-compulsive disorder emphasizes the importance of “obsessive beliefs” (e.g., about threat/responsibility, certainty/perfection, and the importance of/need to control thoughts) in the maintenance of obsessive-compulsive (OC) symptoms. Metacognitive theory, in contrast, posits that OC symptoms develop as a result of maladaptive beliefs about thoughts themselves (i.e., thoughts are meaningful and powerful). Although both have empirical support, no study has yet investigated the relative contributions of these models in the prediction of OC symptom dimensions using a common sample. The present study tested the hypothesis that both obsessive and metacognitive beliefs uniquely predict OC symptom dimensions even after controlling for general distress. A nonclinical sample (N = 110) completed self-report questionnaires measuring general distress, obsessive beliefs, metacognitive beliefs, and OC symptoms. Linear regression analyses separately predicting OC symptom dimensions showed that (a) neither obsessive nor metacognitive beliefs uniquely predicted contamination symptoms, (b) both obsessive and metacognitive beliefs uniquely predicted responsibility for harm, (c) only metacognitive beliefs uniquely predicted unacceptable obsessional thoughts, and (d) only metacognitive beliefs uniquely predicted symmetry concerns. Potential implications for understanding, assessing, and treating OC symptoms are discussed.
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Abramowitz, J. S., Khandker, M., Nelson, C. A., Deacon, B. J., & Rygwall, R. (2006). The role of cognitive factors in the pathogenesis of obsessive-compulsive symptoms: a prospective study. Behaviour Research and Therapy, 44(9), 1361–1374. https://doi.org/10.1016/j.brat.2005.09.011.
Abramowitz, J. S., Deacon, B. J., Olatunji, B. O., Wheaton, M. G., Berman, N. C., Losardo, D., et al. (2010). Assessment of obsessive-compulsive symptom dimensions: development and evaluation of the Dimensional Obsessive-Compulsive Scale. Psychological Assessment, 22(1), 180–198.
Abramowitz, J. S., Fabricant, L. E., Taylor, S., Deacon, B. J., McKay, D., & Storch, E. A. (2014). The relevance of analogue studies for understanding obsessions and compulsions. Clinical Psychology Review, 34(3), 206–217. https://doi.org/10.1016/j.cpr.2014.01.004.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington: American Psychiatric Publishing.
Beck, A. T. (1976). Cognitive therapy and the emotional disorders. International Universities Press.
Berman, N. C., Abramowitz, J. S., Pardue, C. M., & Wheaton, M. G. (2010). The relationship between religion and thought–action fusion: use of an in vivo paradigm. Behaviour Research and Therapy, 48(7), 670–674. https://doi.org/10.1016/j.brat.2010.03.021.
Cartwright-Hatton, S., & Wells, A. (1997). Beliefs about worry and intrusions: the meta-cognitions questionnaire and its correlates. Journal of Anxiety Disorders, 11(3), 279–296. https://doi.org/10.1016/S0887-6185(97)00011-X.
Cohen, J., Cohen P, West S., & Aiken, L. (2013). Applied Multiple regression/corectional analysis for the behavioral sciences.
Coles, M. E., Cook, L. M., & Blake, T. R. (2007). Assessing obsessive compulsive symptoms and cognitions on the internet: evidence for the comparability of paper and Internet administration. Behaviour Research and Therapy, 45(9), 2232–2240.
Deacon, B., & Olatunji, B. O. (2007). Specificity of disgust sensitivity in the prediction of behavioral avoidance in contamination fear. Behaviour Research and Therapy, 45(9), 2110–2120. https://doi.org/10.1016/j.brat.2007.03.008.
Fisher, P. L. (2009). Obsessive compulsive disorder: a comparison of CBT and the metacognitive approach. International Journal of Cognitive Therapy, 2(2), 107–122. https://doi.org/10.1521/ijct.2009.2.2.107.
Freeston, M. H., Rhéaume, J., Letarte, H., & Dugas, M. J. (1994). Why do people worry? Personality and Individual Differences, 17(6), 791–802.
Gwilliam, P., Wells, A., & Cartwright-Hatton, S. (2004). Dose meta-cognition or responsibility predict obsessive–compulsive symptoms: a test of the metacognitive model. Clinical Psychology & Psychotherapy, 11(2), 137–144. https://doi.org/10.1002/cpp.402.
Hansmeier, J., Exner, C., Rief, W., & Glombiewski, J. A. (2016). A test of the metacognitive model of obsessive-compulsive disorder. Journal of Obsessive-Compulsive and Related Disorders, 10, 42–48. https://doi.org/10.1016/j.jocrd.2016.05.002.
Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the depression anxiety stress scales (2nd ed.). Sydney: Psychology Foundation.
Muris, P., Merckelbach, H., & Clavan, M. (1997). Abnormal and normal compulsions. Behaviour Research and Therapy, 35(3), 249–252. https://doi.org/10.1016/S0005-7967(96)00114-3.
Myers, S. G., & Wells, A. (2005). Obsessive-compulsive symptoms: the contribution of metacognitions and responsibility. Journal of Anxiety Disorders, 19(7), 806–817. https://doi.org/10.1016/j.janxdis.2004.09.004.
Myers, S. G., & Wells, A. (2013). An experimental manipulation of metacognition: a test of the metacognitive model of obsessive-compulsive symptoms. Behaviour Research and Therapy, 51(4–5), 177–184. https://doi.org/10.1016/j.brat.2013.01.007.
Myers, S. G., Fisher, P. L., & Wells, A. (2009a). An empirical test of the metacognitive model of obsessive-compulsive symptoms: fusion beliefs, beliefs about rituals, and stop signals. Journal of Anxiety Disorders, 23(4), 436–442. https://doi.org/10.1016/j.janxdis.2008.08.007.
Myers, S. G., Fisher, P. L., & Wells, A. (2009b). Metacognition and cognition as predictors of obsessive-compulsive symptoms: a prospective study. International Journal of Cognitive Therapy, 2(2), 132–142. https://doi.org/10.1521/ijct.2009.2.2.132.
Obsessive Compulsive Cognitions Working Group. (1997). Cognitive assessment of obsessive-compulsive disorder. Behaviour Research and Therapy, 35(7), 667–681.
Obsessive Compulsive Cognitions Working Group. (2001). Development and initial validation of the obsessive beliefs questionnaire and the interpretation of intrusions inventory. Behaviour Research and Therapy, 39(8), 987–1006. https://doi.org/10.1016/S0005-7967(00)00085-1.
Obsessive Compulsive Cognitions Working Group. (2003). Psychometric validation of the obsessive beliefs questionnaire and the interpretation of intrusions inventory: Part I. Behaviour Research and Therapy, 41(8), 863–878.
Obsessive Compulsive Cognitions Working Group. (2005). Psychometric validation of the obsessive belief questionnaire and interpretation of intrusions inventory—part 2: factor analyses and testing of a brief version. Behaviour Research and Therapy, 43(11), 1527–1542.
Olatunji, B. O., Sawchuk, C. N., Lohr, J. M., & de Jong, P. J. (2004). Disgust domains in the prediction of contamination fear. Behaviour Research and Therapy, 42(1), 93–104. https://doi.org/10.1016/S0005-7967(03)00102-5.
Rachman, S. (1997). Acognitive theory obsessions: Behaviour Research and Theraphy, 35(9):793-802.
Rachman, S. J. (1998). A cognitive theory of obsessions: elaborations. Behaviour Research and Therapy, 36(4), 385–401. https://doi.org/10.1016/S0005-7967(97)10041-9.
Rachman, S. J., & de Silva, P. (1978). Abnormal and normal obsessions. Behaviour Research and Therapy, 16(4), 233–248.
Radomsky, A. S., & Rachman, S. (2004). Symmetry, ordering and arranging compulsive behaviour. Behaviour Research and Therapy, 42(8), 893–913. https://doi.org/10.1016/j.brat.2003.07.001.
Radomsky, A. S., Rachman, S., & Hammond, D. (2001). Memory bias, confidence and responsibility in compulsive checking. Behaviour Research and Therapy, 39(7), 813–822.
Radomsky, A. S., Gilchrist, P. T., & Dussault, D. (2006). Repeated checking really does cause memory distrust. Behaviour Research and Therapy, 44(2), 305–316. https://doi.org/10.1016/j.brat.2005.02.005.
Salkovskis, P. M. (1996). Cognitive-behavioral approaches to the understanding of obsessional problems. In R. M. Rapee (Ed.), Current controversies in the anxiety disorders (pp. 103–133). New York: Guilford Press.
Salkovskis, P. M., Wroe, A. L., Gledhill, A., Morrison, N., Forrester, E., Richards, C., et al. (2000). Responsibility attitudes and interpretations are characteristic of obsessive compulsive disorder. Behav Res Ther, 38(4), 347–372. https://doi.org/10.1016/S0005-7967(99)00071-6.
Shafran, R., Thordarson, D. S., & Rachman, S. (1996). Thought-action fusion in obsessive compulsive disorder. Journal of Anxiety Disorders, 10(5), 379–391. https://doi.org/10.1016/0887-6185(96)00018-7.
Solem, S., Myers, S. G., Fisher, P. L., Vogel, P. A., & Wells, A. (2010). An empirical test of the metacognitive model of obsessive-compulsive symptoms: replication and extension. Journal of Anxiety Disorders, 24(1), 79–86. https://doi.org/10.1016/j.janxdis.2009.08.009.
Taylor, S., Abramowitz, J. S., & McKay, D. (2007). Cognitive-behavioral models of obsessive-compulsive disorder. In C. Purdon, M. M. Antony, & L. J. Summerfeldt (Eds.), Psychological treatment of obsessive-compulsive disorder: Fundamentals and beyond (pp. 9–29). Washington, DC: American Psychological Association Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2006-20713-001&site=ehost-live&scope=site.
Wells, A. (2000). Emotional disorders and metacognition: Innovative cognitive therapy. New York: Wiley.
Wells, A., & Cartwright-Hatton, S. (2004). A short form of the metacognitions questionnaire: properties of the MCQ-30. Behaviour Research and Therapy, 42(4), 385–396. https://doi.org/10.1016/S0005-7967(03)00147-5.
Wheaton, M. G., Abramowitz, J. S., Berman, N. C., Riemann, B. C., & Hale, L. R. (2010). The relationship between obsessive beliefs and symptom dimensions in obsessive-compulsive disorder. Behaviour Research and Therapy, 48(10), 949–954.
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Nance, M., Abramowitz, J.S., Blakey, S.M. et al. Thoughts and Thoughts about Thoughts: the Relative Contribution of Obsessive Beliefs and Metacognitive Beliefs in Predicting Obsessive-Compulsive Symptom Dimensions. J Cogn Ther 11, 234–248 (2018). https://doi.org/10.1007/s41811-018-0013-1
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DOI: https://doi.org/10.1007/s41811-018-0013-1