Obsessional beliefs, cognitive distortions and metacognitive thinking in clinical and non-clinical populations

Obsessive thoughts are intrusive, repetitive cognitive experiences that occur across a continuum from benign, transient phenomena in the general population to persistent and distressing symptoms in clinical conditions such as obsessive–compulsive and anxiety disorders. Contemporary cognitive and metacognitive models suggest that the pathological significance of these thoughts is determined less by their occurrence and more by the beliefs individuals hold about them. The present study aimed to comparatively examine obsessional beliefs, cognitive distortions, and metacognitive thinking in clinical and non-clinical populations, and to explore the differential patterns of association among these variables. Using a comparative quantitative design, the study assessed 300 adults from Rajasthan, comprising 150 non-clinical participants and 150 clinically diagnosed individuals with anxiety disorders, obsessive–compulsive disorder, or generalized anxiety disorder. Standardized psychometric instruments were employed to measure dysfunctional attitudes, obsessional beliefs, metacognitive processes, and obsessive–compulsive symptomatology, alongside a semi-structured interview to capture qualitative aspects of intrusive thought experiences. Statistical analyses included independent samples t-tests and Pearson correlation analyses. Results indicated that clinical participants reported significantly higher frequency of obsessional thoughts than non-clinical participants, despite intrusive thoughts being present in both groups. Cognitive distortions were consistently and moderately associated with obsessional beliefs across both populations, suggesting a stable underlying cognitive mechanism. However, metacognitive thinking demonstrated a stronger relationship with obsessional beliefs in the clinical group, highlighting its enhanced role in symptom maintenance among clinically distressed individuals. These findings support continuum-based models of obsessional phenomena and underscore the importance of metacognitive processes in differentiating clinical from non-clinical functioning. The study emphasizes the need for integrative intervention approaches that address both cognitive distortions and maladaptive metacognitive beliefs to improve clinical outcomes and inform preventive strategies.