Metacognitive Mechanisms in Obsessive Compulsive Disorder: Thought Fusion, Ritual Beliefs, and Stop Signals
Year: 2026
Type: article
Abstract: Cognitive models of obsessive compulsive disorder largely relate the maintenance of symptoms to dysfunctional beliefs attributed to the content of thoughts. The metacognitive approach, in contrast, conceptualizes obsessive compulsive disorder not primarily through the content of thoughts, but through the individual’s relationship with thoughts, the meanings assigned to them, and the way behaviors are regulated. In this review, three central metacognitive mechanisms in obsessive compulsive disorder—thought fusion, ritual beliefs, and stop signals—are evaluated integratively in light of theoretical accounts and empirical findings. In addition, the associations of these mechanisms with the interpretation of obsessions as threats, the initiation of compulsions, and the difficulty in terminating behaviors are considered together. Findings suggest that thought fusion may contribute to the threatening interpretation of obsessions, ritual beliefs may legitimize compulsive behaviors as necessary, protective, and responsibility-related actions, and impairments in stop signals may make the completion and termination of behaviors more difficult. The reciprocal interaction of these three mechanisms points to an integrative metacognitive model for the cyclical maintenance of obsessive compulsive symptoms. In conclusion, evaluating metacognitive processes together may contribute to a better understanding of the maintenance mechanisms of obsessive compulsive disorder, to more targeted clinical interventions, and to the development of more comprehensive models for future research.
DOI: 10.18863/pgy.1886303
Author: Pınar Yörük
Institution: Okan University
Language: Turkish
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: diamond
OpenAlex ID: W7225004650