Thoughts and Thoughts about Thoughts: the Relative Contribution of Obsessive Beliefs and Metacognitive Beliefs in Predicting Obsessive-Compulsive Symptom Dimensions

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.