The DOI matches its Crossref record; 47 of the 47 references it cites were found in a registry or an index.
Change in metacognitions predicts outcome in obsessive–compulsive disorder patients undergoing treatment with exposure and response prevention
Abstract
Wells' (Wells, A. (1997). Cognitive therapy of anxiety disorders: a practice manual and conceptual guide. Chichester, UK: Wiley) metacognitive model of obsessive-compulsive disorder (OCD) predicts that metacognitions must change in order for psychological treatment to be effective. The aim of this study was to explore: (1) if metacognitions change in patients undergoing exposure treatment for OCD; (2) to determine the extent to which cognitive and metacognitive change predicts symptom improvement and recovery. The sample consisted of 83 outpatients with a diagnosis of OCD who completed exposure and response prevention treatment. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Metacognitions Questionnaire (MCQ-30) and the Obsessive Beliefs Questionnaire (OBQ-44) were administered before treatment, after treatment, and at 12-month follow-up. Treatment resulted in significant changes in symptoms, metacognition score, responsibility and perfectionism. Regression analysis using post-treatment Y-BOCS as the dependent variable indicated that when the overlap between predictors was controlled for, only changes in metacognition were significant. Changes in metacognitions explained 22% of the variance in symptoms at post-treatment when controlling for pre-treatment symptoms and changes in mood. A further regression revealed that two MCQ-30 subscales made individual contributions. The patients had significantly higher scores compared to community controls on the MCQ-30. Patients who achieved clinical significant change had lower scores on the MCQ-30 compared to patients who did not change. The results did not change significantly from post-treatment to follow-up assessment. These findings provide further support for the importance of metacognitions in treating OCD.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Another study showed that the need to control thoughts during exposure therapy predicted a subsequent improvement in OC symptoms [18].”
From Metacognitive Training for Obsessive-Compulsive Disorder: A study protocol for a randomized controlled trial (2020) · cites this paper as [18]
Citations
Cites
Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation
Beck, A. T., Steer, R. A., & Carbin, M. G. (1988) · Clinical Psychology Review · doi:10.1016/0272-7358(88)90050-5 · Cited by 11,696
Cognitive Therapy for Depression
(2012) · PsycEXTRA Dataset · doi:10.1037/e675542012-001 · Cited by 9,678
The Yale-Brown Obsessive Compulsive Scale: I. Development, Use, and Reliability
Goodman, W. K. (1989) · Archives of General Psychiatry · doi:10.1001/archpsyc.1989.01810110048007 · Cited by 7,712
Cognitive Therapy in Depression
Kovács, M. (1980) · Journal of the American Academy of Psychoanalysis · doi:10.1521/jaap.1.1980.8.1.127 · Cited by 3,422
The Yale-Brown Obsessive Compulsive Scale: II. Validity
Goodman, W. K. (1989) · Archives of General Psychiatry · doi:10.1001/archpsyc.1989.01810110054008 · Cited by 2,799
The Yale-Brown Obsessive-Compulsive Scale: measures of internal consistency.
Kim, S.-W., Dysken, M., Pheley, A., & Hoover, K. M. (1994) · Psychiatry Research · doi:10.1016/0165-1781(94)90039-6 · Cited by 2,333
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
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
A cognitive theory of obsessions
Rachman, S. (1997) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(97)00040-5 · Cited by 1,179
Metacognitive therapy for anxiety and depression
Veeraraghavan, V. (2009) · Anxiety, Stress & Coping · doi:10.1080/10615800902833770 · Cited by 1,165
Flagged first, then by citations
Cited by
Sorted by citations
Items 101–152 of 152
Metacognitive Model of Obsessive Compulsive Disorder
Şenormancı, Ö., Konkan, R., Güçlü, O., & Sungur, M. Z. (2012) · Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry · doi:10.5455/cap.20120420 · Cited by 5
Exposure Therapy in OCD: Is There a Need for Adding Cognitive Elements?
Daflos, S., & Whittal, M. L. (2012) · Springer eBooks · doi:10.1007/978-1-4614-3342-2_19 · Cited by 6
Towards improving treatment for childhood OCD: Analyzing mediating mechanisms & non-response
Wolters, L. H. (2013) · UvA-DARE (University of Amsterdam) · Cited by 6
Adrian Wells, A. (2013) · Wiley eBooks · doi:10.1002/9781118528563.wbcbt06 · Cited by 6
Isaksen, C. S., Hybel, K. A., Wolters, L. H., Højgaard, D. R. M. A., Farrell, L. J., & Thomsen, P. H. (2024) · Behavior Therapy · doi:10.1016/j.beth.2024.04.011 · Cited by 4
Literature Review of the Metacognitive Model of Obsessive Compulsive Disorder
Yörük, P., & Tosun, A. (2014) · Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry · doi:10.5455/cap.20140807024558 · Cited by 5
Typaldou, G. M., Konstantakopoulos, G., Roxanis, I., Nidos, A., Vaidakis, N., Papadimitriou, G. N., & Adrian Wells, A. (2014) · PubMed · Cited by 5
Ong, C. W., Sheehan, K. G., Xu, J., Falkenstein, M. J., & Kuckertz, J. M. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.03.089 · Cited by 6
Effect of CBT on Metacognitive Beliefs in Depressive Disorders
AARZOO, Kumari, S., & Chavan, B. S. (2023) · Turkish Journal of Psychiatry · doi:10.5080/u26398 · Cited by 4
Generalized anxiety disorder: Assessment and treatment
Gerlach, A. L., & Stevens, S. (2014) · The Wiley Handbook of Anxiety Disorders · doi:10.1002/9781118775349.ch48 · Cited by 3
Covert neutralization in the treatment of OCD with overt compulsions
O’Connor, K. P., Freeston, M. H., St-Pierre-Delorme, M.-È., Aardema, F., Polman, A., Careau, Y., & Grenier, S. (2012) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2012.06.003 · Cited by 3
The Effectiveness of Virtual Reality Exposure Therapy Module for Reducing Acrophobia Symptoms
Akpewila, F., Utami, M. S., & Ramdhani, N. (2022) · Gadjah Mada Journal of Professional Psychology (GamaJPP) · doi:10.22146/gamajpp.76407 · Cited by 3
Li, X., Gu, H., Zhao, X., Chen, F., & Liu, L. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.1023346 · Cited by 3
Targeting the function of inner experiences in obsessive compulsive and related disorders
Twohig, M. P., & Smith, B. M. (2015) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2014.12.033 · Cited by 3
Veloso, P., & Pereira, F. (2025) · Cureus · doi:10.7759/cureus.94299 · Cited by 2
A study of clinical correlates and predictors of insight in obsessive compulsive disorder
Sinha, N., Ram, D., Singh, K. K., & Pattojoshi, A. (2024) · Indian Journal of Psychiatry · doi:10.4103/indianjpsychiatry.indianjpsychiatry_432_23 · Cited by 2
Teckchandani, T. A., Shields, R. E., Andrews, K. L., Nisbet, J., Afifi, T. O., Asmundson, G. J. G., Maguire, K. Q., Jamshidi, L., Neary, J. P., Krätzig, G. P., et al. (2025) · International Journal of Cognitive Behavioral Therapy · doi:10.1007/s41811-025-00231-w · Cited by 4
Assessment of Cognitive Distortions and Cognitive Biases
Vogel, P. A., & Solem, S. (2017) · Wiley eBooks · doi:10.1002/9781118890233.ch8 · Cited by 2
Self-citationNikfarjam, M., Rabiei, M., Donyavi, V., & Rahnejat, A. M. (2015) · Journal of Behavioral and Brain Science · doi:10.4236/jbbs.2015.57024 · Cited by 1
Gedanken und Überzeugungen werden überschätzt
Lincoln, T. M., Heumann, K., Teichert, M., Schienle, A., Ille, R., Sommer, E. N. B. N. G. M., Arendasy, M. E., Rief, W., Schimek, M., Walter, T., et al. (2014) · Verhaltenstherapie · doi:10.1159/000360872 · Cited by 1
Metacognitive therapy for rumination
Borders, A. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-812545-8.00012-7 · Cited by 1
Ouellet‐Courtois, C., Aardema, F., & O’Connor, K. P. (2020) · International Journal of Cognitive Therapy · doi:10.1007/s41811-020-00087-2 · Cited by 2
Thought Content and Thinking Processes in Psychotherapy: Cognitive Versus Metacognitive Approaches
Batmaz, S., & Altınöz, A. E. (2023) · Integrated science · doi:10.1007/978-3-031-15959-6_18 · Cited by 1
Gray, E., & Boag, S. (2024) · Studia Psychologica · doi:10.21697/sp.2024.24.2.01
A Review of Metacognition in the diagnosis and treatment of Obsessive Compulsive Disorder
Ninawe, K., & Shroff, H. (2017) · Indian Journal of Mental Health(IJMH) · doi:10.30877/ijmh.4.3.2017.210-220 · Cited by 1
Eum, K., & Rice, K. G. (2020) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2020.100612 · Cited by 1
Revisiting verbal recognition memory in obsessive-compulsive disorder: A computational approach
Solway, A., Lin, Z., & Kaplan, C. M. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.04.015 · Cited by 1
Kapfhammer, H. (2011) · Springer eBooks · doi:10.1007/978-3-642-03637-8_58 · Cited by 1
Response to Aubin et al. Letter
Kim, N., Yurgelun-Todd, D. A., & Renshaw, P. F. (2011) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2010.1010150r · Cited by 1
Autogenous and Reactive Obsessions in Obsessive-Compulsive Disorder: A Keyness and Collocation StudyPreprint
Kim, S. Y., & Dykeman, C. (2021) · PsyArXiv (OSF Preprints) · doi:10.31234/osf.io/fq5vy · Cited by 1
The Treatment of Obsessive-Compulsive Disorder
Collins, L. M., Bragdon, L. B., & Coles, M. E. (2018) · Evidence‐Based Psychotherapy · doi:10.1002/9781119462996.ch6 · Cited by 1
Phenomenology, etiology, and the religious counterpart of Obsessive-Compulsive Disorder (OCD)
Overduin, M. (2013) · UCL Discovery (University College London)
Morrissey, K. (2011) · Research on Social Work Practice · doi:10.1177/1049731509347880
Obsesif Kompulsif Bozuklukta Üst-Bilişsel
Tosun, A. (2015)
Hamid, A. A. R. M. (2017) · Horizons in Humanities and Social Sciences An International Refereed Journal · doi:10.19089/hhss.v2i2.63
Simons, M., & Vloet, T. D. (2017) · Verhaltenstherapie · doi:10.1159/000460825
Metacognition, stress & recovery
Capobianco, L. (2017) · Research Explorer (The University of Manchester)
Nosratabadi, M., Afzaligrouh, A., & tali, M. Z. P. (2018)
Güneysu, İ., Batmaz, S., Aslan, E. A., & Güneysu, S. (2020) · doi:10.31234/osf.io/pqu9k
Kim, S. Y., & Dykeman, C. (2021) · OSF Preprints (OSF Preprints) · doi:10.31219/osf.io/kw7p3
Carter, J. D., Helliwell, E. L., Jordan, J., Woolcock, C., Bell, C., & Gilbert, C. (2022) · Behaviour Change · doi:10.1017/bec.2022.8
Şenay, O., & Tükel, R. (2022) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001608
Metakognitive profiler ved hørselshallusinasjoner og OCD
Rørvik, T. M. (2013) · NORA - Norwegian Open Research Archives
Wheaton, M. G., Rosenfield, B., Rosenfield, D., Marsh, R., Foa, E. B., & Simpson, H. B. (2023) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2023.100850
Felberg, H. S. (2012) · BIBSYS Brage (BIBSYS (Norway))
Irak, M., & Duman, T. N. (2026) · Counselling and Psychotherapy Research · doi:10.1002/capr.70110
Die Metakognitive Therapie (MCT) nach Adrian Wells
Gindele, C. (2024) · Elsevier eBooks · doi:10.1016/b978-3-437-21372-4.00020-2
Halaj, A., Sorka, H., Huppert, J. D., & David, A. S. (2026) · Cognitive Therapy and Research · doi:10.1007/s10608-026-10782-7
A Metacognitive Perspective on Somatic Symptom Reporting
Milner, P. (2012) · Research Explorer (The University of Manchester)
Metadata
- Authors
- Solem, S., Håland, Å. T., Vogel, P. A., Hansen, B., & Wells, A.
- Affiliations
- Norwegian University of Science and Technology (NO)
- Sørlandet Sykehus (NO)
- Corresponding author
- Solem, Stian
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2009-04
- Volume
- 47
- Issue
- 4
- Pages
- 301-307
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W1983463944
- Cited by
- 152
- References
- 47
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 6 · 2023: 7 · 2022: 6 · 2021: 16 · 2020: 11 · 2019: 8 · 2018: 7 · 2017: 16 · 2016: 8 · 2015: 11 · 2014: 11 · 2013: 11 · 2012: 13
- FWCI
- 9.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- 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 › Psychoanalysis and Psychopathology Research
- Keywords
- obsessive-compulsive disorder, metacognition, exposure and response prevention, metacognitive model, treatment outcome prediction, cognitive therapy, responsibility, perfectionism, obsessive beliefs, Yale-Brown Obsessive Compulsive Scale
- MeSH terms
- Adult, Cognition, Female, Humans, Male, Middle Aged, Obsessive-Compulsive Disorder, Patient Compliance, Prognosis, Psychiatric Status Rating Scales, Cognitive Behavioral Therapy, Treatment Outcome, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review