Metacognitive Model of Obsessive Compulsive Disorder

Abstract

Several authors have suggested that not only appraisal of significance of external events and signals from the body, but also appraisal of the personal significance of thoughts are important, and emphasized the conceptual limitations of the schema approach in cognitive model and developed the integrative information processing model of emotional disorders. According to this approach, the assessment of the meaning of thought, rather than thought itself is more important in the development and maintenance of the psychopathology. In the metacognitive model of obsessive compulsive disorder, three types of metacognitive beliefs are emphasized. These are; thought-action fusion (thought-action, thought-event, thought-object), metacognitive beliefs on performing the rituals and metacognitive beliefs on the warning to stop to terminate the rituals. According to the model, targeting directly to change in metacognitive beliefs will increase success in therapy. In this article, the concept of metacognition in emotional disorders, the metacognitive model of obsessive compulsive disorder and the advances that the model introduced in conceptualization and treatment of obsessive compulsive disorder have been discussed.

Keywords

• Metacognition, obsessive-compulsive disorder, cognitive behavioral therapy

Obsesif Kompulsif Bozukluğun Metakognitif Modeli

Öz

Çeşitli araştırmacılar tarafından bilişsel modeldeki şema yaklaşımının kavramsal sınırlılıklarını vurgulanarak dış olayların ve bedensel duyumların anlamlarının değerlendirilmesinin ötesinde düşüncelerin kişisel anlamlarının değerlendirilmesinin önemini gündeme getirilmiş ve duygusal bozuklukların işlemleme modeli geliştirilmiştir. Bu yaklaşıma göre, psikopatolojinin oluşumu ile sürmesinde kişinin sahip olduğu düşüncelerden çok böyle düşünüyor olmanın anlamlarına yönelik değerlendirmeler daha önemlidir. Obsesif kompulsif bozukluğun metakognitif modelinde üç tip metakognitif inanca vurgu yapılır. Bunlar; düşünce-eylem kaynaşmaları (düşünce-eylem, düşünce-olay, düşünce-nesne), ritüelleri gerçekleştirme ihtiyacına dair ve ritüelleri sonlandırılması için durma uyarısına dair metakognitif inançlardır. Modele göre, obsesif kompulsif bozukluk tedavisinde başarılı olmak için doğrudan metakognitif inançlardaki değişikliğin hedeflenmesi tedavi başarısını arttıracaktır. Bu makalede duygusal bozukluklarda metakognisyon kavramı, obsesif kompulsif bozukluğun metakognitif modeli, bu modelin bozukluğun kavramsallaştırılmasına ve tedavisine getirdiği yenilikler tartışılmıştır.

Anahtar Kelimeler

• Metakognisyon, obsesif kompulsif bozukluk,kognitif davranışçı terapi

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38. Ömer Şenormancı, Uzm.Dr., Bakırköy Prof. Dr. Mazhar Osman Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve
39. Araştırma Hastanesi, İstanbul; Ramazan Konkan, Uzm.Dr., Bakırköy Prof. Dr. Mazhar Osman Ruh Sağlığı ve
40. Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul; Oya Gönüllü Güçlü, Uzm.Dr., Bakırköy Prof. Dr.
41. Mazhar Osman Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul; Mehmet Zihni
42. Sungur, Prof. Dr., Marmara Üniversitesi Tıp Fakültesi Psikiyatri Anabilim Dalı, İstanbul