Abstract
Introduction: Metacognitions are considered to be crucial factors for the development and maintenance of pathologic anxiety. The present case–control study aimed to examine how metacognitive beliefs are associated with the diagnostic status and subtypes of obsessive–compulsive disorder (OCD). In addition, we examined the pattern of changes in metacognitive beliefs after a 3-month pharmacological treatment in patients with OCD.Methods: A total of 562 cases with OCD and 236 healthy controls were assessed with the Metacognitions Questionnaire (MCQ) and various measures of OC symptom severity. Multivariate analyses of variance (MANOVAs) with covariates were conducted to explore the relationship between subdimensions of metacognitive beliefs and OCD disease status. In addition, for the OCD patients, Pearson's correlation was performed between baseline MCQ subdimensions and Obsessive–Compulsive Inventory-Revised-Korean subscales (OCI-R-K). Finally, in a subset of drug-free OCD patients (n = 144), the MCQ was reassessed after 3 months of treatment and patterns of changes in subdimensions of the MCQ were examined.Results: Patients with OCD scored significantly higher on the four dimensions of the MCQ. There were significant associations between all MCQ subdimensions and OCI-R-K subscales. In the repeated-measure MANOVA, a significant group (non-responders vs. responders)-by-time interaction effect was found only for the negative beliefs about the uncontrollability and danger of worry (NB) subdimension (F = 10.75; η2 = 0.072; p = 0.001).Conclusion: The presence of dysfunctional metacognitive beliefs in OCD subjects and their association with OCD characteristics suggest that dysfunctional metacognitions may play a crucial role in the pathophysiology of OCD. Improvement of metacognitive beliefs in the NB dimension may be a clinically meaningful correlate of good treatment response in the pharmacological treatment of OCD.
Highlights
Metacognitions are considered to be crucial factors for the development and maintenance of pathologic anxiety
There was no difference in age, sex, or duration of education between obsessive–compulsive disorder (OCD) patients and controls, but OCD patients scored significantly higher on the Yale–Brown Obsessive Compulsive Scale (Y-BOCS) [25.52 (7.01) vs. 0.47 (1.86), p < 0.001] and Montgomery–Asberg Depression Rating Scale (MADRS) [20.45 (9.64) vs. 3.39 (4.09), p < 0.001] compared to controls
The results showed that compared to healthy controls, OCD patients scored significantly higher on subdimensions of negative beliefs about the uncontrollability and danger of worry (NB), beliefs about the need for control of thoughts (NFC), cognitive self-consciousness (CSC), and beliefs concerning cognitive competence (CC)
Summary
Metacognitions are considered to be crucial factors for the development and maintenance of pathologic anxiety. Metacognition, the knowledge or beliefs about thinking and strategies used to control thinking processes, has been suggested to play an important role in the maintenance of such symptoms [2]. The first metacognitive model of OCD proposed by Wells assumes that beliefs about the importance of thinking cause a person to assign high significance to his/her thoughts, and when that person experiences an obsession, metacognitive processing is activated, which accesses knowledge about the intrusion [3]. In another study of 304 community volunteers, thought-fusion beliefs and beliefs about rituals predicted obsessive-compulsive symptoms, further providing empirical support for the metacognitive model [5]. In a study of 25 OCD patients, after 15 weekly sessions of MCT, 74% of patients met the criteria for recovery [7]. In another study that compared MCT to OCD CBT, 95 OCD patients who participated in 12 weekly sessions of MCT improved significantly more than the CBT cohort; 86.3% of patients in the MCT group responded compared with 64% in the CBT group [8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
