Responsibility, metacognition and unrealistic pessimism in obsessive-compulsive disorder

Cognitive models stress the importance of cognitive belief domains (CBD) for the pathogenesis of obsessive-compulsive disorder (OCD). However, the relative contribution of responsibility and metacognition - core aspects of CBD - to OC symptoms is not fully understood yet. Furthermore, two subcomponents of overestimation of threat (OET), overestimation of the personal probability (unrealistic pessimism) and overestimation of the general risk of negative events, require clarification. First, we investigated the relative contribution of responsibility and metacognition to OC symptoms. Second, we hypothesized that OCD patients overestimate the personal risk and display unrealistic pessimism. Thirty-four OCD patients and 34 healthy controls completed the Obsessive Beliefs Questionnaire (OBQ) and the Unrealistic Optimism Questionnaire (UO). Responsibility significantly predicted obsessive symptoms after controlling for metacognition. In contrast to previous findings, responsibility is not fully explained by metacognition. Finally, our results confirm unrealistic pessimism in OCD, even after controlling for depression.