A test of the metacognitive model of obsessive-compulsive disorder

• We examine the relevance of OC-specific metacognitions to OC symptoms.
• An OCD group reported more positive beliefs about rituals and stop signals.
• No differences were found for thought fusion beliefs.
• In the OCD group, each metacognition explained incremental variance in OC symptoms.
• Metacognitive therapy methods might address these beliefs and reduce OC symptoms.

The question of the relative importance of dysfunctional cognitive beliefs and metacognitions in the development and maintenance of obsessive-compulsive (OC) symptoms is still a matter of debate. This study aims to investigate the relevance of OC-specific metacognitions, such as thought fusion beliefs, beliefs about rituals and stop signals for OC symptoms. Patients with obsessive-compulsive disorder (OCD) (n = 71), anxiety disorders (n = 51), and depressive disorders (n = 81), and a nonclinical sample (n = 300), were assessed for (meta)cognitive beliefs and OC symptoms. Analyses of variances indicated that the OCD group reported significantly more positive beliefs about rituals and stop signals than did the other three groups, also when controlling for comorbidity of depression disorder. No differences were found with regard to thought fusion beliefs. In regression analyses in the OCD sample, OC-specific metacognitions such as thought fusion beliefs explained incremental variance in OC symptoms, when controlling for cognitive beliefs and general, non OC-specific metacognitions. Overall, these findings provide further evidence for the relevance of specific metacognitions to OCD. Metacognitive therapy might address these metacognitive beliefs and thereby lead to a reduction of OC symptoms in OCD patients.