The role of metacognitive beliefs about thoughts and rituals: A test of the metacognitive model of obsessive-compulsive disorder in a clinical sample

•The role of three metacognitive belief domains were examined in a sample of 210 OCD patients.•Thought fusion, beliefs about rituals, and stop signals significantly correlated with obsessive-compulsive symptoms.•In regressions, each domain entered, incrementally predicted symptoms, with worry and non-metacognitive beliefs controlled.•Results provide further support for the metacognitive model of OCD.

The metacognitive model of obsessive-compulsive disorder (OCD; Wells, 1997) emphasises the role of metacognitive beliefs about both thoughts and rituals. The current study tested hypotheses that emerge from the model concerning three domains of these metacognitive beliefs: though fusion beliefs, beliefs about rituals, and stop signals, in an OCD sample (N =210). Results showed that each type of metacognitive belief significantly and positively correlated with two different measures of obsessive-compulsive symptoms. Additionally, in hierarchical regressions, with worry, and non-metacognitive beliefs linked to OCD in other theories controlled, each of the metacognitive domains, when entered in their hypothesised order of activation, incrementally predicted each obsessive-compulsive symptom measure. Results provide further support for the role of these three metacognitive belief domains as hypothesised in the metacognitive model.