| Abstract: |
Self-awareness and self-regulation are key mechanisms in depression and obsessive-compulsive disorder (OCD) that are believed to be metacognitive processes. Comparative studies of metacognitive abilities in these different psychiatric disorders are still very limited, although they are clinically important. The present study compared the metacognitive processes of people diagnosed with both OCD and major depressive disorder (MDD) with a non-clinical control group. The participants included 180 people (60 MDD, 60 OCD, and 60 healthy controls). Assessment included validated questionnaires of metacognitive beliefs, thought control strategies and executive functioning. The data analysis used were multivariate analysis of variance (MANOVA), hierarchical regression and structural equation modeling (SEM). The results showed that metacognitive monitoring, negative metacognitive beliefs and thought control behaviors significantly differed between groups. There were increased intrusive thought monitoring and positive beliefs about worry in individuals with OCD and increased rumination-focused metacognitive patterns in individuals with MDD. There were maladaptive thought control strategies in both clinical groups, relative to controls. Importantly, metacognitive variables were significant predictors of symptom severity in both conditions in different ways. Results indicate that metacognitive dysfunction is evident in both disorders, but the nature of the dysfunctions and the functional connections vary significantly. The implications of these differential metacognitive profiles include a need for tailored metacognitive treatment protocols of the metacognitive patterns of different disorders for transdiagnostic cognitive-behavioral interventions. The findings will help to understand the variability of psychiatric disorders, and advance the field of precision mental health. |
