Predictive Values of Obsessive Beliefs and Metacognitions in OCD Symptom Dimensions

Özet

Objective:The cognitive model explains the obsessive-compulsive symptoms with dysfunctional beliefs (i.e., beliefs about responsibility, perfectionism). In contrast, the metacognitive model gives the central role to metacognitive beliefs (i.e., beliefs about the thought process such as control or dangerousness of thoughts). Both cognitive and metacognitive models of obsessive-compulsive disorder (OCD) separately have been empirically supported. The purpose of this study was to explore the relationship between cognitive beliefs and metacognition and OCD symptom dimensions in an OCD outpatient sample.Methods: One hundred and fifty-three patients diagnosed with OCD were included in the study. Dimensional Obsessive-Compulsive Scale (DOCS), Obsessive Beliefs Questionnaire (OBQ), Metacognitive Questionnaire-30 (MCQ), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were applied to the participants. Hierarchical regression analysis for each symptom dimension conducted to evaluate predictive values of obsessive beliefs and metacognitions after controlling for level of depression and anxiety.Results: For DOCS-contamination dimension OBQ – perfectionism and intolerance of uncertainty (OBQ-PC) (the final model accounted for 10 % variance in DOCS – contamination scores, F (10, 142) = 2.846, p = 0.003) ; for DOCS-responsibility dimension BAI, OBQ – overestimation of threat and inflated responsibility (OBQ-TR), OBQ – importance of and need to control thoughts (OBQ-ICT), and MCQ – positive beliefs about worry (MCQ-POS) ( the final model accounted for 31 % of the variance in DOCS – responsibility scores, F(10, 142) = 7.960, p < 0,001); for DOCS-unacceptable thoughts dimensions BAI, OBQ – ICT, MCQ – beliefs concerning cognitive competence (MCQ-CC) and MCQ – beliefs about the need for control of thoughts (MCQ-NC) (the final model accounted for 31 % of the variance in DOCS – unacceptable thoughts scores, F(10, 142) = 8.120, p < 0.001) ; and for DOCS-symmetry dimension BAI, OBQ – PC, OBQ – ICT, MCQ – POS and MCQ – cognitive self-consciousness (MCQ-CSC) ( the final model accounted for 25 % variance in DOCS – symmetry scores, F (10, 142) = 6.322, p = < 0.001) subscale scores were predictor factors.Conclusion:In this study, ‘perfectionism and intolerance of uncertainty’ was the only variable associated with the contamination dimension. ‘Importance of and need to control thoughts,’ which is the metacognitive subscale of OBQ, was associated with all OCD symptom dimensions except contamination. These findings could imply that obsessive patients have different cognitive profiles according to their symptom dimensions. In addition to obsessive beliefs and generic metacognitions, further studies, including OCD specific metacognitions, will clarify our knowledge about OCD symptom dimensions.