Exploring The Metacognitive Beliefs in OCD: A Randomized Controlled Trial of Metacognitive Therapy

Summary

Exploring The Metacognitive Beliefs in OCD: A Randomized Controlled Trial of Metacognitive Therapy Introduction Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions). These symptoms cause significant distress and impair daily functioning. OCD can be difficult to treat, and relapse rates are high even after conventional treatments. This study evaluates whether Metacognitive Therapy (MCT) is more effective than Treatment as Usual (TAU) in reducing OCD symptoms and improving overall well-being. The study explores how MCT, which targets metacognitive beliefs (thoughts about thoughts), can help manage symptoms more effectively than standard treatments.

Study Goal and Research Question

The primary goal of this study is to assess the effectiveness of Metacognitive Therapy (MCT) compared to Treatment as Usual (TAU) for treating Obsessive-Compulsive Disorder (OCD). The key research question is:

Does Metacognitive Therapy (MCT) reduce OCD symptoms more effectively than Treatment as Usual (TAU)? Study Design

This study is a Randomized Controlled Trial (RCT), which means participants are randomly assigned to one of two treatment groups:

Metacognitive Therapy (MCT): Participants in this group receive a 12-session therapy program that focuses on addressing harmful metacognitive beliefs, such as the need to control thoughts and the belief that thoughts can cause harm.

Treatment as Usual (TAU): Participants in this group receive the standard treatment for OCD, which may include Exposure and Response Prevention (ERP) and/or medication.

Who Can Participate? Adults aged 18 and older who have been diagnosed with OCD are eligible to participate in the study. To be eligible, participants must have moderate to severe OCD symptoms, measured by the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Individuals with severe mental health conditions other than OCD, such as psychosis or substance use disorders, are excluded from participation. Participants must also be able to attend therapy sessions and complete the necessary assessments throughout the study.

How the Study Was Conducted Randomization: Participants were randomly assigned to either the MCT group or the TAU group.

MCT Group: Participants in the MCT group attended 12 therapy sessions, which focused on changing metacognitive beliefs that contribute to OCD symptoms.

TAU Group: Participants in the TAU group received standard treatment for OCD, which may have included a combination of therapy and medications.

Assessments: Participants were assessed at three time points: before treatment (pre-treatment), immediately after treatment (post-treatment), and six months after treatment (follow-up). These assessments measured changes in OCD symptoms, metacognitive beliefs, and overall quality of life.

Study Procedures and Timeline Pre-Treatment Assessment: Participants completed initial assessments to measure their OCD symptoms, metacognitive beliefs, and quality of life.

Therapy Sessions: Participants in both groups attended their respective therapy sessions (12 sessions for MCT, standard sessions for TAU).

Post-Treatment and Follow-Up Assessments: After the therapy ended, participants completed post-treatment assessments. Six months later, they participated in a follow-up assessment to measure the long-term effectiveness of the treatment.

Important Information for Participants Metacognitive Therapy (MCT) is designed to help people change the way they think about their thoughts, addressing beliefs such as the need to control thoughts or the belief that having certain thoughts can cause harm.

Treatment as Usual (TAU) is the standard treatment for OCD, which may include Exposure and Response Prevention (ERP) therapy or medication management.

Participants in this study can withdraw at any time, and their decision will not affect their treatment or relationship with their healthcare provider.

Expected Benefits If MCT is found to be more effective than TAU, it may offer a new, personalized approach to treating OCD, especially for individuals whose symptoms are driven by dysfunctional metacognitive beliefs. Additionally, since MCT targets the underlying thought processes that maintain OCD symptoms, it may provide longer-lasting symptom relief and reduce the likelihood of relapse compared to standard treatments.

Study Impact This study will provide important insights into whether MCT can provide better outcomes for individuals with OCD compared to standard treatments. If MCT is shown to be effective, it could become a valuable treatment option for those who do not respond well to traditional therapies like ERP. Moreover, MCT's focus on addressing metacognitive beliefs may lead to more durable improvements in OCD symptoms.

Conditions

• Obsessive-Compulsive Disorder (OCD)

Interventions

BEHAVIORAL

MCT

Metacognitive Therapy (MCT) is a 12-week manualized treatment for OCD targeting maladaptive thought patterns. Clinicians deliver structured sessions including: (1) Attention Training to modify focus, (2) Detached Mindfulness to change responses to intrusive thoughts, and (3) behavioral experiments to reduce compulsions. Treatment progresses through psychoeducation, challenging perfectionism, addressing thought control, and relapse prevention. Primary outcome: Y-BOCS; secondary: MCQ-30 and TFI. Based on the evidence-based myMCT protocol.

Sponsors & Collaborators

• Northeast Normal University

  lead OTHER

Principal Investigators

• Dr Jiang Yingjie, PhD · Northeast Normal University, China

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2024-01-01

Primary Completion

2024-05-30

Completion

2024-09-30

Countries

• Pakistan

Study Locations