Cognitive predictors of obsessive-complusive symptoms : the contributions of metacognitive beliefs and beliefs about rituals

• Main Author: McNicol, Kirsten
• Published: University of Manchester 2004
• Subjects: 616.85
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.635556

In the metacognitive model of obsessive-compulsive disorder (Wells, 1997, 2000), two domains of beliefs are considered central to the pathogenesis of the disorder: (1) metacognitive beliefs about the meaning and danger of thoughts and feelings and (2) beliefs about the advantages and disadvantages of performing rituals. Previous research has demonstrated that metacognitive beliefs about thoughts/feelings make a unique contribution to obsessive-compulsive symptoms. However, the role of beliefs about rituals has not been systematically investigated. This study had three primary aims: (1) to undertake a preliminary exploration of the psychometric properties of a new self-report measure, the Beliefs about Rituals Inventory (BARI); (2) to replicate previous studies, which have demonstrated that metacognitive beliefs about thoughts/feelings contribute to the prediction of obsessive-compulsive symptoms; and (3) to determine whether beliefs about rituals contribute to symptoms beyond the contribution made by metacognitive beliefs about thoughts/feelings. A sample of university students (n = 177) completed five self-report measures: the BARI; the Thought Fusion Instrument, which assesses three subtypes of thought-fusion beliefs (thought-action fusion, thought event fusion and thought-object fusion); three measures of obsessive compulsive symptoms (Padua Inventory-Washington State University Revision, Frequency and Distress scales of the Obsessive-Compulsive Inventory); and a measure of worry proneness (Penn State Worry Questionnaire). Factor analysis of the BARI demonstrated that it is composed of three domains of beliefs about rituals: (1) beliefs that rituals prevent unwanted behaviour and character change; (2) beliefs that rituals prevent guilt and loss of function; and (3) beliefs that rituals prevent anxiety. The BARI had adequate internal consistency, modest stability and preliminary evidence supported its discriminant validity. The results of the analyses supported Wells' (1997, 2000) assertion that metacognitive beliefs about thoughts/feelings and beliefs about rituals each make a unique contribution to obsessive-compulsive symptoms. In addition, the results of exploratory regression analyses, conducted to determine the best individual metacognitive predictors of obsessive compulsive symptoms, indicated that subtypes of thought-fusion beliefs and beliefs about rituals predicted symptoms. Two subscales, BARI 'Anxiety' and TFI 'Thought-Action Fusion', were reliable predictors in all the equations. Implications of the results for theory, practice and future research are discussed, as well as the limitations of the study.