Cognitive and Metacognitive Changes in Exposure and Response Prevention Treatment for Obsessive –Compulsive Disorder: Empirical Support for a Metacognitive Model

The aim of the current study was to further investigate the role of metacognitive beliefs implicated inWells’ (1997) model of obsessive-compulsive disorder (OCD). The metacognitive domains of thought-fusion beliefs and beliefs about rituals were positively correlated with obsessive-compulsive symptomsin a community control sample (N = 269) and in an OCD sample (N = 57). The OCD sample hadsignificantly more obsessive-compulsive symptoms as well as higher scores on the metacognitiveconstructs than the control sample. In order to perform amore stringent test of themetacognitivemodelof OCD and to explore the role of a thirdmetacognitive construct, that of stop signals, a second studywasconducted using a community control sample (N = 304). All three metacognitive constructs werepositively correlated with obsessive-compulsive symptoms. Thought-fusion beliefs and beliefs aboutrituals predicted obsessive-compulsive symptoms, even when controlling for worry, threat, and non-metacognitive beliefs such as perfectionism/certainty and responsibility. Results of this study providefurther evidence for the importance of metacognitions in OCD.2009 Elsevier Ltd. All rights reserved. * Corresponding author. Tel.: +47 73591801; fax: +47 73597694.E-mail address: [email protected] (S. Solem).