Metacognitive Model and Treatment of OCD
Abstract
According to the metacognitive model three factors are important: the significance that the individual assigns to such inner events; the experiential perspective the person occupies in relation to them; and the choice of strategies for self-regulation. This chapter explains how these factors are central to the model and treatment and can explain the transition from normal obsessions to clinical disorder. There is growing evidence that metacognitive beliefs and dysfunctional thought control strategies play a vital role in the development and maintenance of anxiety disorders, including obsessive-compulsive disorder (OCD). Most of the metacognitive therapy (MCT) techniques used with adults are appropriate for use with younger patients. The chapter presents brief overview of data that emerges from three of the research areas: the relationship between general dysfunctional metacognitions; the role of thought-fusion beliefs; and the centrality of metacognitive beliefs when compared with the beliefs (schemas) proposed by other theories of OCD.
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According to the cognitive model of OCD, emotional processing theory, and Wells' metacognitive model, dysfunctional beliefs play an important role in the development and maintenance of OCD.
“According to the cognitive model of OCD [6–8], emotional processing theory [9], and Wells’ metacognitive model [10–12], dysfunctional beliefs play an important role in the development as well as maintenance of OCD.”
From Metacognitive Training for Obsessive-Compulsive Disorder: A study protocol for a randomized controlled trial (2020) · cites this paper as [12]
The importance of targeting dysfunctional (meta-)cognitive beliefs, biases and dysfunctional coping strategies in the treatment of OCD has already been demonstrated.
“The importance of targeting dysfunctional (meta-)cognitive beliefs, biases as well as dysfunctional coping strategies in the treatment of OCD has already been demonstrated [6–8, 10–12].”
From Metacognitive Training for Obsessive-Compulsive Disorder: A study protocol for a randomized controlled trial (2020) · cites this paper as [12]
Cites
Obsessional-compulsive problems: A cognitive-behavioural analysis
Salkovskis, P. M. (1985) · Behaviour Research and Therapy · doi:10.1016/0005-7967(85)90105-6 · Cited by 1,842 · see citing works
A short form of the metacognitions questionnaire: properties of the MCQ-30
Wells, A., & Cartwright-Hatton, S. (2004) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(03)00147-5 · Cited by 1,396 · see citing works
Metacognitive therapy for anxiety and depression
Veeraraghavan, V. (2009) · Anxiety, Stress & Coping · doi:10.1080/10615800902833770 · Cited by 1,165 · see citing works
Beliefs about Worry and Intrusions: The Meta-Cognitions Questionnaire and its Correlates
Cartwright-Hatton, S., & Wells, A. (1997) · Journal of Anxiety Disorders · doi:10.1016/s0887-6185(97)00011-x · Cited by 977 · see citing works
Obsessive Compulsive Cognitions Working Group (2005) · Behaviour Research and Therapy · doi:10.1016/j.brat.2004.07.010 · Cited by 880 · see citing works
(1997) · Research Explorer (The University of Manchester) · Cited by 714 · see citing works
Thought-action fusion in obsessive compulsive disorder
Shafran, R., Thordarson, D. S., & Rachman, S. (1996) · Journal of Anxiety Disorders · doi:10.1016/0887-6185(96)00018-7 · Cited by 663 · see citing works
Obsessions, responsibility and guilt
Rachman, S. (1993) · Behaviour Research and Therapy · doi:10.1016/0005-7967(93)90066-4 · Cited by 598 · see citing works
Thought Action Fusion in Obsessive Compulsive Disorder
ÇÝFTÇÝ, &., & Kuru, T. (2013) · DOAJ (DOAJ: Directory of Open Access Journals) · Cited by 501 · see citing works
Family Accommodation in Pediatric Obsessive–Compulsive Disorder
Storch, E. A., Geffken, G. R., Merlo, L. J., Jacob, M. L., Murphy, T. K., Goodman, W. K., Larson, M. J., Fernandez, M. A., & Grabill, K. M. (2007) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374410701277929 · Cited by 397 · see citing works
Fisher, P. L., & Wells, A. (2005) · Behaviour Research and Therapy · doi:10.1016/j.brat.2004.11.007 · Cited by 377 · see citing works
Self-citationRelationships between worry, obsessive–compulsive symptoms and meta-cognitive beliefs
Wells, A., & Papageorgiou, C. (1998) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(98)00070-9 · Cited by 340 · see citing works
Perfectionism in Obsessive-Compulsive Disorder patients
Frost, R. O., & Steketee, G. (1997) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(96)00108-8 · Cited by 335 · see citing works
Repeated checking causes memory distrust.
van den Hout, M., & Kindt, M. (2003) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(02)00012-8 · Cited by 313 · see citing works
Attention and emotion: a clinical perspective
Eysenck, M. W. (1995) · Personality and Individual Differences · doi:10.1016/0191-8869(95)90043-8 · Cited by 301 · see citing works
Compulsive neurosis: A review of the literature.
Carr, A. T. (1974) · Psychological Bulletin · doi:10.1037/h0036473 · Cited by 288 · see citing works
THE EFFICACY OF METACOGNITIVE THERAPY FOR ANXIETY AND DEPRESSION: A META-ANALYTIC REVIEW
Normann, N., van Emmerik, A., & Nexhmedin Morina, B. (2014) · Depression and Anxiety · doi:10.1002/da.22273 · Cited by 266 · see citing works
van der Heiden, C., Muris, P., & van der Molen, H. T. (2012) · Behaviour Research and Therapy · doi:10.1016/j.brat.2011.12.005 · Cited by 265 · see citing works
Metacognitive therapy for obsessive–compulsive disorder: A case series
Fisher, P. L., & Wells, A. (2008) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2006.12.001 · Cited by 240 · see citing works
Self-citationMyers, S. G., Fisher, P. L., & Wells, A. (2008) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2007.03.012 · Cited by 210 · see citing works
Self-citationThought-action fusion: a review
Shafran, R., & Rachman, S. (2004) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2004.04.002 · Cited by 207 · see citing works
Gwilliam, P., Wells, A., & Cartwright‐Hatton, S. (2004) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.402 · Cited by 201 · see citing works
Perceived responsibility: Structure and significance
Rachman, S., Thordarson, D. S., Shafran, R., & Woody, S. R. (1995) · Behaviour Research and Therapy · doi:10.1016/0005-7967(95)00016-q · Cited by 200 · see citing works
Cognitive confidence in obsessive-compulsive disorder: Distrusting perception, attention and memory
Hermans, D., Engelen, U., Grouwels, L., Joos, E., Lemmens, J., & Pieters, G. (2008) · Behaviour Research and Therapy · doi:10.1016/j.brat.2007.11.001 · Cited by 196 · see citing works
Hermans, D., Martens, K., De Cort, K., Pieters, G., & Eelen, P. (2003) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(02)00015-3 · Cited by 181 · see citing works
Qualitative dimensions of normal worry and normal obsessions: A comparative study
Wells, A., & Morrison, A. P. (1994) · Behaviour Research and Therapy · doi:10.1016/0005-7967(94)90167-8 · Cited by 180 · see citing works
Too much thinking about thinking?: metacognitive differences in obsessive–compulsive disorder
Janeck, A. S., Calamari, J. E., Riemann, B. C., & Heffelfinger, S. K. (2003) · Journal of Anxiety Disorders · doi:10.1016/s0887-6185(02)00198-6 · Cited by 174 · see citing works
Obsessive-compulsive symptoms: the contribution of metacognitions and responsibility
Myers, S. G., & Adrian Wells, A. (2004) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2004.09.004 · Cited by 165 · see citing works
Self-citationThought–action fusion as a causal factor in the development of intrusions
Rassin, E., Merckelbach, H. L. G. J., Muris, P., & Spaan, V. (1999) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(98)00140-5 · Cited by 165 · see citing works
How to remain neutral: An experimental analysis of neutralization
Rachman, S., Shafran, R., Mitchell, D., Trant, J., & Teachman, B. A. (1996) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(96)00051-4 · Cited by 162 · see citing works
Solem, S., Håland, Å. T., Vogel, P. A., Hansen, B., & Wells, A. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.01.003 · Cited by 152 · see citing works
Development and preliminary validation of the Meta-cognitions Questionnaire—Adolescent Version
Cartwright‐Hatton, S., Mather, A. E., Illingworth, V., Brocki, J., Harrington, R., & Adrian Wells, A. (2002) · Journal of Anxiety Disorders · doi:10.1016/s0887-6185(02)00294-3 · Cited by 149 · see citing works
Fisher, P. L., & Wells, A. (2005) · Behaviour Research and Therapy · doi:10.1016/j.brat.2004.09.002 · Cited by 140 · see citing works
Self-citationAn open trial of group metacognitive therapy for obsessive-compulsive disorder
Rees, C. S., & van Koesveld, K. E. (2008) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2007.11.004 · Cited by 123 · see citing works
Lewin, A. B., Park, J. M., Jones, A. M., Crawford, E. A., Nadai, A. S. D., Menzel, J. E., Arnold, E. B., Murphy, T. K., & Storch, E. A. (2014) · Behaviour Research and Therapy · doi:10.1016/j.brat.2014.02.001 · Cited by 115 · see citing works
Yılmaz, A. E., Gençöz, T., & Adrian Wells, A. (2008) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.589 · Cited by 111 · see citing works
Simons, M., Schneider, S., & Herpertz-Dahlmann, B. (2006) · Psychotherapy and Psychosomatics · doi:10.1159/000092897 · Cited by 109 · see citing works
Self-citationMyers, S. G., Fisher, P. L., & Wells, A. (2009) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2008.08.007 · Cited by 95 · see citing works
Self-citationSica, C., Steketee, G., Ghisi, M., Chiri, L. R., & Franceschini, S. (2007) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.520 · Cited by 86 · see citing works
Believe in yourself: Manipulating beliefs about memory causes checking
Alcolado, G. M., & Radomsky, A. S. (2010) · Behaviour Research and Therapy · doi:10.1016/j.brat.2010.10.001 · Cited by 84 · see citing works
Exploring the role of metacognition in obsessive–compulsive and anxiety symptoms
Irak, M., & Tosun, A. (2008) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2008.01.012 · Cited by 73 · see citing works
Solem, S., Myers, S. G., Fisher, P., Vogel, P. A., & Adrian Wells, A. (2009) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2009.08.009 · Cited by 71 · see citing works
Self-citationMetacognition and Cognition as Predictors of Obsessive-Compulsive Symptoms: A Prospective Study
Myers, S. G., Fisher, P., & Adrian Wells, A. (2009) · International Journal of Cognitive Therapy · doi:10.1521/ijct.2009.2.2.132 · Cited by 60 · see citing works
Self-citationMetacognitive Beliefs and Processes in Clinical Anxiety in Children
Smith, K. E., & Hudson, J. L. (2013) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2012.755925 · Cited by 58 · see citing works
Does magical thinking produce neutralising behaviour? An experimental investigation
Bocci, L., & Gordon, P. K. (2007) · Behaviour Research and Therapy · doi:10.1016/j.brat.2007.02.003 · Cited by 57 · see citing works
Metacognitive therapy for obsessive–compulsive disorder: A pilot study
van der Heiden, C., Melchior, K., Dekker, A., Damstra, M., & Deen, M. L. (2016) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2016.02.002 · Cited by 52 · see citing works
Myers, S. G., & Adrian Wells, A. (2013) · Behaviour Research and Therapy · doi:10.1016/j.brat.2013.01.007 · Cited by 50 · see citing works
Self-citationMetacognition, Responsibility, and Perfectionism in Obsessive–Compulsive Disorder
Grøtte, T., Solem, S., Vogel, P. A., Güzey, I. C., Hansen, B. K. A., & Myers, S. G. (2014) · Cognitive Therapy and Research · doi:10.1007/s10608-014-9635-7 · Cited by 44 · see citing works
Self-citationObsessive Compulsive Disorder: A Comparison of CBT and the Metacognitive Approach
Fisher, P. (2009) · International Journal of Cognitive Therapy · doi:10.1521/ijct.2009.2.2.107 · Cited by 43 · see citing works
Self-citationvan den Hout, M., Kindt, M., Weiland, T., & Peters, M. L. (2002) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/s0005-7916(02)00048-4 · Cited by 43 · see citing works
Test of the Metacognitive Model of Generalized Anxiety Disorder in Anxiety-Disordered Adolescents
Ellis, D. M., & Hudson, J. L. (2011) · Journal of Experimental Psychopathology · doi:10.5127/jep.011910 · Cited by 38 · see citing works
Diminished confidence in prospective memory causes doubts and urges to check
Cuttler, C., Sirois-Delisle, V., Alcolado, G. M., Radomsky, A. S., & Taylor, S. J. (2013) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2013.01.001 · Cited by 28 · see citing works
Cho, Y., Jahng, S., & Chai, S. (2012) · Journal of Clinical Psychology · doi:10.1002/jclp.20867 · Cited by 26 · see citing works
Crye, J., Laskey, B., & Cartwright‐Hatton, S. (2009) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1348/147608309x468176 · Cited by 22 · see citing works
Thought Control Strategies in Adolescents: Links with OCD Symptoms and Meta-Cognitive Beliefs
Wilson, C. E., & Hall, M. R. (2012) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s135246581200001x · Cited by 17 · see citing works
McNicol, K., & Adrian Wells, A. (2012) · International Journal of Cognitive Therapy · doi:10.1521/ijct.2012.5.3.330 · Cited by 17 · see citing works
Effects of cognitive self-consciousness on visual memory in obsessive–compulsive disorder
Kikul, J., Vetter, J., Lincoln, T. M., & Exner, C. (2011) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2010.12.002 · Cited by 16 · see citing works
Cognitive restructuring and detached mindfulness: Comparative impact on a compulsive checking task
Ludvik, D., & Boschen, M. J. (2015) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2015.01.004 · Cited by 14 · see citing works
Timpano, K. R., Rasmussen, J. L., Exner, C., Rief, W., & Wilhelm, S. (2013) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2013.10.001 · Cited by 10 · see citing works
A metacognitive model and therapy for generalized anxiety disorder
Wells, A. (1999) · Clinical Psychology & Psychotherapy · doi:10.1002/(sici)1099-0879(199905)6:2
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Metacognitive Training for Obsessive-Compulsive Disorder: A randomized controlled trial
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- Authors
- Wells, A., Myers, S., Simons, M., & Fisher, P.
- Venue
- The Wiley Handbook of Obsessive Compulsive Disorders
- Publisher
- Wiley
- Published
- 2017-06-19
- Pages
- 644-662
- OpenAlex
- W2665952501
- Cited by
- 17
- References
- 60
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 3 · 2023: 1 · 2021: 3 · 2020: 4 · 2019: 1
- Type
- other
- Language
- en
- Open access
- closed
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- metacognitive model, obsessive-compulsive disorder, metacognitive therapy, metacognitive beliefs, self-regulation, anxiety disorders, obsession, cognitive schemas, children and adolescents
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