Predicting Obsessive-Compulsive Symptoms Based on Cognitive Bias and the Mediating Role of Metacognitive Beliefs
Keywords:
Obsessive-Compulsive Disorder, Cognitive Bias, Metacognitive BeliefsAbstract
Objective: This study aimed to investigate the predictive role of cognitive bias in obsessive-compulsive symptoms with the mediating effect of metacognitive beliefs among adolescents in Tehran.
Methodology: This descriptive-correlational study was conducted on 395 high school students in Tehran, selected via multistage cluster sampling based on Morgan’s table. Data were collected using the Obsessive-Compulsive Inventory-Revised (OCI-R), Cognitive Bias Questionnaire (CBQ), and Metacognitions Questionnaire (MCQ-30). Pearson correlation (SPSS-27) and Structural Equation Modeling (SEM) via AMOS-21 were used for data analysis.
Findings: Cognitive bias significantly predicted obsessive-compulsive symptoms (β = 0.31, p < 0.001) and metacognitive beliefs (β = 0.45, p < 0.001). Metacognitive beliefs also significantly predicted OCD symptoms (β = 0.48, p < 0.001). The indirect effect of cognitive bias on OCD symptoms through metacognitive beliefs was significant (β = 0.22). The model showed good fit (χ²/df = 2.16, RMSEA = 0.054, CFI = 0.96).
Conclusion: The findings support the joint role of cognitive bias and metacognitive beliefs in the severity of obsessive-compulsive symptoms, suggesting that effective clinical interventions should target metacognitive structures alongside cognitive distortions.
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Ardestani, S. Y., Keykhosrovani, M., & Amini, N. (2022a). The Effectiveness of Acceptance and Commitment Therapy on Experiential Avoidance, Uncertainty Intolerance and Positive Metacognitive Beliefs in Women With Obsessive-Compulsive Disorder. Jayps, 3(1), 209-221. https://doi.org/10.61838/kman.jayps.3.1.17
Ardestani, S. Y., Keykhosrovani, M., & Amini, N. (2022b). The Effectiveness of Metacognitive Therapy on Experiential Avoidance, Uncertainty Intolerance and Positive Metacognitive Beliefs in Women With Obsessive-Compulsive Disorder. Aftj, 3(3), 211-236. https://doi.org/10.61838/kman.aftj.3.3.13
Atmaca, M. (2022). Metacognitive Therapy in Patients With ObsessiveCompulsive Disorder: A Review. Alpha Psychiatry, 23(5), 212-216. https://doi.org/10.5152/alphapsychiatry.2022.22840
Baptista, A., Maheu, M., Mallet, L., & N’Diaye, K. (2021). Joint Contributions of Metacognition and Self-Beliefs to Uncertainty-Guided Checking Behavior. Scientific reports, 11(1). https://doi.org/10.1038/s41598-021-97958-1
Carter, J. D., Helliwell, E. L., Jordan, J., Woolcock, C., Bell, C., & Gilbert, C. (2022). Group Metacognitive Therapy for Obsessive-Compulsive Disorder in a Routine Clinical Setting: An Open Trial. Behaviour Change, 40(2), 117-132. https://doi.org/10.1017/bec.2022.8
Çim, E. F. A., Aydın, A., Atlı, A., & Kurhan, F. (2020). Effect of Obsessive Compulsive Disorder on Word Stem Completion Test (WSCT) and Cognitive Processes. Kafkas Journal of Medical Sciences, 10(3), 240-245. https://doi.org/10.5505/kjms.2020.56767
Gurrieri, R. (2025). Memory Functions in Obsessive–Compulsive Disorder. Brain Sciences, 15(5), 492. https://doi.org/10.3390/brainsci15050492
Gutierrez, R. G., Hirani, T., Curtis, L., & Ludlow, A. K. (2020). Metacognitive Beliefs Mediate the Relationship Between Anxiety Sensitivity and Traits of Obsessive-Compulsive Symptoms. BMC psychology, 8(1). https://doi.org/10.1186/s40359-020-00412-6
Hoven, M., Rouault, M., Holst, R. J. v., & Luigjes, J. (2022). Differences in Metacognitive Functioning Between Obsessive-Compulsive Disorder Patients and Highly Compulsive Individuals From the General Population. https://doi.org/10.31234/osf.io/fb32r
Hoven, M., Rouault, M., Holst, R. J. v., & Luigjes, J. (2023). Differences in Metacognitive Functioning Between Obsessive–compulsive Disorder Patients and Highly Compulsive Individuals From the General Population. Psychological medicine, 53(16), 7933-7942. https://doi.org/10.1017/s003329172300209x
Kashani Vahid, S., Mohammadi Aria, A., & Abolmaali Alhosseini, K. (2024). Structural Relationship of Metacognitive Beliefs, Stress, Attachment Styles with Anorexia Nervosa Mediated by Self-Image. Applied Family Therapy Journal (AFTJ), 5(3), 66-75. https://doi.org/10.61838/kman.aftj.5.3.7
Kim, S. T., Park, C. I., Kim, H. W., Jeon, S., Kang, J. I., & Kim, S. J. (2021). Dysfunctional Metacognitive Beliefs in Patients With Obsessive–Compulsive Disorder and Pattern of Their Changes Following a 3-Month Treatment. Frontiers in Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.628985
Krüger, R. T. (2024). Obsessive–Compulsive Disorders. 295-307. https://doi.org/10.1007/978-981-99-7508-2_7
Kul, A. T., Uğurlu, G. K., & Gündoğmuş, İ. m. (2024). The Effects of Metacognition on Social Functioning in Patients With Obsessive-Compulsive Disorder. Psychiatric Annals, 54(4). https://doi.org/10.3928/00485713-20240131-01
Melchior, K., Franken, I. H. A., Vuijk, R., Peerbooms, V., & Heiden, C. v. d. (2021). The Assessment of Thought Fusion Beliefs and Beliefs About Rituals. Psychological Test Adaptation and Development, 2(1), 50-61. https://doi.org/10.1027/2698-1866/a000011
Meraj, M. B., Singh, S., Kar, S. K., Sharma, E., & Sarraf, S. R. (2020). Metacognitions in Symptomatic and Remitted Patients With Obsessive Compulsive Disorder: Preliminary Evidence for Metacognitive State and Trait Markers. Indian Journal of Psychological Medicine, 44(1), 22-29. https://doi.org/10.1177/0253717620975295
Miegel, F., Cludius, B., Hottenrott, B., Demiralay, C., & Jelinek, L. (2020). Session-Specific Effects of the Metacognitive Group Training for Obsessive–Compulsive Disorder: Significant Results for Thought Control. Scientific reports, 10(1). https://doi.org/10.1038/s41598-020-73122-z
Nematollahi, S., Afshari Nia, K., Alsadat Hosseini, S., Kakabraei, K., & Parandin, S. (2023). The Effectiveness of Metacognitive Therapy and Compassion-Based Therapy on Reducing Rumination, Anxiety and Worry in Obsessive-Compulsive Patients. Journal of Psychological Dynamics in Mood Disorders (PDMD), 2(3), 50-61. https://doi.org/10.22034/pdmd.2023.188277
Okati, G. N., Shahabizadeh, F., & Bahreinian, S. A. M. (2023). The Effectiveness of Metacognitive Therapy on Relationship Obsessive-Compulsive Disorder (ROCD) and Experiential Avoidance. Journal of Psychological Dynamics in Mood Disorders (PDMD), 1(4), 18-29. https://ijpdmd.com/article_183693_565efe26e7dc835d28a16da0da470f5c.pdf
Rezvanpour, M., Ganjeh, F., Rafiei, F., & Khosravi, S. (2024). Relationships Between Students' Stress, Anxiety and Depression And; Parents' Obsessive‒compulsive Disorder. https://doi.org/10.21203/rs.3.rs-4816176/v1
Saadatzadeh Hisar, B., Abdi, R., Mohammad Zadeh Salteh, H., & Narimani, M. (2021). Investigating the relationship between cognitive biases in investor behavior and stock price volatility. Financial Economics, 15(56), 303-320. https://journals.iau.ir/article_687880.html
Sabzipour, A., Jafarizadeh, Z., & Heydarivafa, R. (2024). Investigating the relationship between metacognitive beliefs and cognitive emotion regulation and assertiveness in first-grade middle school female students in Kouhnani. Scientific Quarterly: A New Approach to Children's Education, 6(1), 132-156. https://journal.iocv.ir/article_197979.html?lang=en
Sarlak, M., Kashni, F. L., & Mirhashmi, M. (2022). Use of Structural Modeling to Explain High School Students Obsessive Beliefs Based on Symptoms of Stress, Anxiety, and Depression, Metacognitive Beliefs, and Self-Esteem: The Mediating Role of Inferential Confusion. Shenakht Journal of Psychology and Psychiatry, 9(2), 1-15. https://doi.org/10.32598/shenakht.9.2.1
Şenay, O., & Tükel, R. (2022). Comparison of Obsessive-Compulsive Disorder and Schizophrenia With Comorbid Obsessive-Compulsive Disorder in Terms of Insight, Metacognitive Beliefs, and Clinical Features. The Journal of Nervous and Mental Disease. https://doi.org/10.1097/nmd.0000000000001608
Seow, T. X., Fleming, S. M., & Hauser, T. U. (2024). Metacognitive Biases in Anxious-Depression and Compulsivity Extend Across Perception and Memory. https://doi.org/10.31234/osf.io/avyph
Sinha, N., Ram, D., Singh, K. K., & Pattojoshi, A. (2024). A Study of Clinical Correlates and Predictors of Insight in Obsessive Compulsive Disorder. Indian Journal of Psychiatry, 66(7), 656-659. https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_432_23
Tabassum, S., Hussain, S. D., & Shafiq, S. (2023). Metacognitions and Obsessive-Compulsive Symptoms in Ocd Patients: Moderating Role of Guilt Sensitivity. Pakistan Journal of Social Research, 05(02), 1037-1049. https://doi.org/10.52567/pjsr.v5i02.1216
Yalım, E., Ünsal, C., & Gündoğmuş, İ. m. (2024). The Relationship Between Occupational Functionality and Metacognition in Patients With Obsessive-Compulsive Disorder. Cureus. https://doi.org/10.7759/cureus.51738
Yılmaz, O. (2020). The Relationship of Insight With Obsessive Beliefs and Metacognition in Obsessive Compulsive Disorder. Journal of psychiatric nursing. https://doi.org/10.14744/phd.2020.83584
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