Cognitive and Metacognitive Structures and Processes in Obsessive Compulsive Disorder

Öz

The present study aimed to review and discuss the cognitive and metacognitive structures and processes in the etiology Obsessive Compulsive Disorder (OCD). Studies concerned cognitive structures research dysfunctional thoughts and primary negative appraisals in OCD and use self-report inventories. At the other hand studies concerned cognitive process research cognitive deficient, information processing problems or biases and use performance measurements. However studies at the cognitive level have not explained OCD in an effective way, because of not using proper measurements, properties of participants and inconsistent results. Thus studies at the metacognitive level which focuses on appraisals, monitoring and control of cognitive structures and process. Metacognitive structure studies explain OCD secondary negative appraisal and metacognition; which appraise, monitor and control cognitive structure and process by using self-report inventories. Metacognitive process studies explain OCD executive function; which monitor control, cognitive process; and use performance measurements. In literature it is stated that metacognitive level studies explain OCD in more effective way than cognitive level studies. However metacognitive structure studies and process studies have some problems because of having same results with using different measurements, and operational definitions. By the way there is confusion in literature. Thus in this study implicated further studies taking consideration both metacognitive structure and metacognitive process.

Anahtar Kelimeler

• OCD,Cognitive,Metacognitive Level,Structure,process

Kaynakça

1. Abramovitch, A., & Cooperman, A. (2015). The cognitiveneuropsychology of obsessive-compulsive disorder: Acritical review. Journal of Obsessive-Compulsive andRelated Disorders, 5,24–36.
2. Abramowitz, J. S, & Houts, A. C. (2005). Concepts and controversies in obsessive compulsive disorder. Rochester: Springer.
3. Abramowitz, J. S., Whiteside, S., Kalsy, S. A., & Tolin, D. F. (2003). Thought control strategies in obsessivecompulsive disorder: a replication and extension. Behaviour Research and Therapy, 41, 529–540.
4. Ahmari, S. E., Eich, T., Cebenoyan, D., Smith, E. E., & Blair Simpson, H. (2014). Assessing neurocognitive function in psychiatric disorders: A roadmap for enhancing consensus. Neurobiology of Learning and Memory, 115, 10–20.
5. Algom, D., Chajut, E. & Lev, S. (2004). A rational look at the emotional Stroop phenomenon: a generic slowdown, not a Stroop effect. Journal of Experimental Psychology: General, 133, 323–338.
6. American Psikiyatri Birliği. Ruhsal Bozuklukların Tanısal ve Sayımsal Elkitabı, Beşinci Baskı (DSM-5), (2013). Tanı Ölçütleri Başvuru el kitabı (çeviri ed. E Köroğlu) Ankara, Hekimler Yayın Birliği.
7. Amir, N., Freshman, M., Ramsey, B., Neary, E., & Brigidi, B. (2001). Thought-action fusion in individuals with OCD symptoms. Behaviour Research and Therapy, 39, 765–776.
8. Arntz, A. Voncke, M., & Goosen, A. C. (2007). Responsibility and obsessive–compulsive disorder: An experimental test. Behaviour Research and Therapy 45, 425–435.

9. Ashbaugh, A. R. & Radomsky, A. S. (2007). Attentional focus during repeated checking influences memory but not metamemory. Cognitive Therapy Research, 31, 291-306.
10. Bienvenu, O.J, , Samuels, J.F., & Wuyek, L. A, et al. (2012). Is obsessive compulsive disorder an anxiety disorder, and what, if any, are spectrum conditions? A family study perspective. Psychological Medicine, 42, 1–13.
11. Bannon, S., Gonsalvez, C.G., Croft, R. C. & Boyce, P. M. (2006). Executive functions in obsessive–compulsive disorder: state or trait deficits? Australian and New Zealand Journal of Psychiatry 40, 1031–1038.
12. Boelen, P. A., & Carleton, R. N. (2012). Intolerance of uncertainty, hypochondriacal concerns, obsessive-compulsive symptoms, and worry. Journal of Nervous and Mental Disease, 200(3), 208–229.
13. Bohne, A., Savage, C.R., Deckersbach, T., Keuthen, N.J., Jenike, M.A., Tuschen-Caffier, B. & Wilhelm, S. (2005). Visuospatial abilities, memory, and executive functioning in trichotillomania and obsessive–compulsive disorder. Journal of Clinical and Experimental Neuropsychology 27(4), 385–399.
14. Boschen, M. J. & Vuksanovic, D. (2007).Deteriorating memory confidence, responsibility perceptions and repeated checking: Comparisons in OCD and control samples. Behaviour Research and Therapy, 45, 2098-2109.
15. Boysan, M., Beşiroğlu, L. & Çetinkaya, N (2010). Obsesif İnanışlar Ölçeği-44'ün (OİÖ-44) Türkçe formunun geçerlik ve güvenirliği. Nöropsikiyatri Arşivi, 47, 216-222.
16. Buhlmann, U., Etcoff, N. L., & Wilhelm, S. (2008). Facial attractiveness ratings and perfectionism in body dysmorphic disorder and obsessive–compulsive disorder. Journal of Anxiety Disorders, 22, 540–547.
17. Cartwright-Hatton, S. & Wells, A. (1997). Beliefs about worry and intrusions: the meta-cognitions questionnaire and its correlates. Journal of Anxiety Disorders, 11, 279–296.
18. Clark, D. A. (2004). Cognitive-behavioral therapy for OCD. New York: The Guilford.
19. Clark, D. A, & Claybourn, M. (1997). Process characteristics of worry and obsessive intrusive thoughts. Behaviour Research and Therapy 35, 12, 1139-1141.
20. Clark, D.A, Purdon, C. & Byers, E. S. (2000). Appraisal and control of sexual and non-sexual intrusive thoughts in university students. Behaviour Research and Therapy 38, 439-455.
21. Chamberlain, S. R., Blackwell, A. D., Fineberg, N. A., Robbins, T. W. & Sahakian, B. J. (2005). The neuropsychology of obsessive compulsive disorder: The importance of failures in cognitive and behavioural inhibition as candidate endophenotypic markers. Neuroscience and Biobehavioral Reviews, 29, 399−419.
22. Cisler, J. M., Brady, R. E., Olatunji, B. O. & Lohr, J. M. (2010). Disgust and obsessive beliefs in contamination-related OCD. Cognitive Therapy Research, 34(5): 439–448.
23. Cohen, R.J. & Calamari, J. E. (2004). Thought-focused attention and obsessive–compulsive symptoms: An evaluation of cognitive self-consciousness in a nonclinical sample. Cognitive Therapy and Research, 28, 4, 457-471.
24. Coles, M. E., Heimberg, R. G., Frost, R. O. & Steketee, G. (2005). Not just right experiences and obsessive–compulsive features: experimental and self-monitoring perspectives. Behaviour Research and Therapy, 43, 153–167. Constans, J. I. (2001).Worry propensity and the perception of risk. Behaviour Research and Therapy, 39, 721-729.
25. Constans, J.I., Foa, E.B., Franklin, M.E. & Mathews, A. (1995). Memory for actual and imagined events in OC checkers. Behavioral Research Therapy, 33 (6), 665–671.
26. Cougle, J.R., Lee, H., & Salkovskis, P.M. (2007). Are responsibility beliefs inflated in non-checking OCD patients? Journal of Anxiety Disorders 21, 153–159.
27. Dar, R. (2004). Elucidating the mechanisms of uncertainty and doubt in obsessive–compulsive checkers. Journal of Behavior Therapy and Experimental Psychiatry, 35, 153–163.
28. Deckersbach, T., Otto, M.W., Savage, C.R., Baer, L. & Jenike, M.A (2000). The relationship between semantic organization and memory in obsessive–compulsive disorder. Psychotherapy and Psychosomatics, 69 (2), 101–107.
29. Deckersbach, T., Savage, C.R., Dougherty, D.D., Bohne, A., Loh, R., Nierenberg, A., Sachs, G. & Rauch, S.L. (2005). Spontaneous and directed application of verbal learning strategies in bipolar disorder and obsessive–compulsive disorder. Bipolar Disorders 7 (2), 166–175.
30. Dienes, Z., & Perner, J. (1999). A theory of implicit and explicit knowledge. Cambridge: Cambridge University Press.
31. Ecker, W. & Engelkamp, J. (1995). Memory for actions in obsessive–compulsive disorder. Behavioural and Cognitive Psychotherapy, 23, 349–371.
32. Exner, C., Kohl, A., Zaudig, M., Langs, G., Lincoln, T. M., & Rief, W. (2009). Metacognition and episodic memory in obsessive-compulsive disorder. Journal of Anxiety Disorders, 23(5), 624–663.
33. Foa, E.B, Amir, N., Gershuny, B., Molnar, C., & Kozak, M.J. (1997). Implicit and explicit memory in obsessive–compulsive disorder. Journal of Anxiety Disorders, 11 (2) 119–129.
34. Foa, E. B., Ilai, D. & McCarthy, P. R. (1993). Information processing in Obsessive–Compulsive Disorder. Cognitive Therapy and Research, 17, 173–189.
35. Foa, E. B., Sacks, M. B., Tolin, D. E., Prezworski, A. & Amir, N. (2002). Inflated perception of responsibility for harm in OCD patients with and without checking compulsions: A replication and extension. Journal of Anxiety Disorders, 16, 443–453.
36. Freeston, M.H. & Ladouceur, R. (1993). Appraisal of cognitive intrusions and response style: Replication and extension. Behaviour Research and Therapy 31(2), 185-191.
37. Freeston, M. H., Ladouceur, R., Gagnon, F., Thibodeau, N., Rhe´aume, J., Letarte, H., & Bujold, A. (1997). Cognitive– behavioral treatment of obsessive thoughts: a controlled study. Journal of Consulting and Clinical Psychology, 65, 405–413.
38. Frost, R.O, & Steketee G. (1997). Perfectionism in obsessive-compulsive disorder patients. Behaviour Research and Therapy, 35(4), 291-296.
39. Gentes, E. L., & Ruscio, A. M. (2011). A meta-analysis of the relation of intolerance of uncertainty to symptoms of generalized anxiety disorder, major depressive disorder, and obsessive-compulsive disorder. Clinical Psychology Review, 31(6), 923–933 . Gwilliam, P., Wells, A. & Cartwright-Hatton S. (2004). Does meta-cognition or responsibility predict obsessive–compulsive symptoms: a test of the metacognitive model. Clinical. Psychology and Psychotherapy, 11, 137–144.
40. Greisberg, S., & McKay, D. (2003). Neuropsychology of obsessive compulsive disorder: a review and treatment implications. Clinical Psychology Review 23, 95–117.
41. Harkness, E. L., Harris, L. M., Jones, M. K., & Vaccaro, L. (2009). No evidence of attentional bias in obsessive compulsive checking on the dot probe paradigm. Behaviour Research and Therapy, 47, 437– 443.
42. Hermans, D., Engelen, U., Grouwels, L., Joosa, E., Lemmensb, J., & Pietersa, G. (2008). Cognitive confidence in obsessive-compulsive disorder: distrusting perception, attention and memory. Behaviour Research and Therapy, 46, 98-113.
43. Hermans, D., Martens, K., De Cort, K., Pieters, G., & Eelen, G. (2003). Reality monitoring and meta-cognitive beliefs related to cognitive confidence in obsessive–compulsive disorder. Behaviour Research and Therapy, 41, 383–401.
44. Holaway, R. M., Heimberg, R. G., & Coles, M. E. (2006). A comparison of intolerance of uncertainty in analogue obsessive-compulsive disorder and generalized anxiety disorder. Journal of Anxiety Disorders, 20(2), 158–174.
45. Höping, W., & Jong-Meyer, R. (2003). Differentiating unwanted intrusive thoughts from thought suppression: what does the White Bear Suppression Inventory measure? Personality and Individual Differences, 34, 1049–1055.
46. Irak, M. & Flament, M. F. (2007). Çocukluk dönemi başlangıçlı obsesif-kompulsif bozukluğun nöropsikolojik profili. Türk Psikiyatri Dergisi, 18(4), 293-301.
47. Irak, M. & Tosun, A. (2008). Exploring the role of metacognition in obsessive–compulsive and anxiety symptoms. Journal of Anxiety Disorders 22, 1316–1325.
48. Janeck, A. S., Calamari, J.E., Riemann, B.C. (2003). Too much thinking about thinking: Metacognitive differences in obsessive compulsive disorder. Journal of Anxiety Disorders, 17, 181-195.
49. Kampman, M., Keijsers, G.P., Verbraak, M.J., Naring, G. & Hoogduin, C.A. (2002). The emotional Stroop: a comparison of panic disorder patients, obsessive–compulsive patients, and normal controls, in two experiments. Journal of Anxiety Disorder, 16 (4), 425–441.
50. Kuelz, A.K., Hohagen, F., & Voderholzer, U. (2004). Neuropsychological performance in obsessive-compulsive disorders. Biological Psychology, 65, 185–236.
51. Kyrios, M. & Iob, M. A. (1998). Automatic and strategic processing in obsessive-compulsive disorder: attentional bias, cognitive avoidance or more complex phenomena? Journal of Anxiety Disorders, 12, 271–292.
52. Ladouceur, R., Freeston, M. H., Gagnoa, F., Thibodeau, N., & Dumont, J. (1995). Cognitive-behavioral treatment of obsessions. Behavior Modification, 19, 247-257.
53. Lee, H.J. & Kwon, S.M. (2003). Two types obsession: autogenous obsessions and reactive obsessions. Behaviour Research and Therapy, 41,11-29.
54. Mancini, F. & Gangemi, A. (2004). Fear of guilt from behaving irresponsibly in obsessive–compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry, 35, 109–120.
55. Mathews, A.& MacLeod, C. (1994). Cognitive approaches to emotion and emotional disorders. Annual Review of Psychology, 45, 25–50.
56. McHugh O’Leary, E.M. (2005). Cognitive processing characteristics in obsessive-compulsive disorder subtypes. Published Doctorate Thesis. University of Canterbury. New Zealand.
57. McNally, R.J. & Kohlbeck, P. A. (1993). Reality monitoring in obsessive–compulsive disorder. Behaviour Research and Therapy, 31, 249–253.
58. Menzies, R.G., Harris, L. M., Cumming, S. R. & Einstein, D. A. (2000). The relationship between inflated personal responsibility and exaggerated danger expectancies in obsessive-compulsive concerns. Behaviour Research and Therapy, 38, 1029–1037.
59. Moritz, S., Birkner, C., Kloss, M., Jacobsen, D., Fricke, S. Bothern, A. & Hand, I. (2001). Impact of comorbid depressive symptoms on neuropsychological performance in obsessive-compulsive disorder. Journal of Abnormal Psychology, 110, 653–657.
60. Moritz, S. & Pohl, R. (2009). Biased processing of threat-related information rather than knowledge deficits contributes to overestimation of threat in obsessive-compulsive disorder. Behavior Modification, 33(6) 763–777.
61. Moritz, S. & Von Muhlenen, A. (2005). Inhibition of return in patients with obsessive-compulsive disorder. Anxiety Disorders, 19, 117–126.
62. Moritz, S., Von Muhlenen, A., Randjbar, S., Fricke, S. & Jelinek, L. (2009). Evidence for an attentional bias for washing- and checking-relevant stimuli in obsessive– compulsive disorder. Journal of the International Neuropsychological Society, 15, 365–371.
63. Muller, J. & Roberts, J. E (2005). Memory and attention in Obsessive-Compulsive Disorder: a review. Journal of Anxiety Disorders, 19, 1–28.
64. Myers, S. G., Fisher, P. L. & Wells, A. (2008). Belief domains of the Obsessive Beliefs Questionnaire-44 (OBQ-44) and their specific relationship with obsessivecompulsive symptoms. Journal of Anxiety Disorders, 22, 475-484.
65. Myers, S.G & Wells, A. (2005). Obsessive–compulsive symptoms: the contribution of metacognitions and responsibility. Journal of Anxiety Disorders, 19, 806–817.
66. Norman, R. M. G., Davies, F., Nicholson, I. R., Cortese, L. & Malla, A. K. (1998). The relationship of two aspects of perfectionism with symptoms in a psychiatric outpatient population. Journal of Social and Clinical Psychology, 17, 50−68.
67. Obsessive Compulsive Cognitions Working Group, OCCWG. (2003). Psychometric validation of the Obsessive Beliefs Questionnaires and the interpretation of Intrusions Inventory. Behaviour Research and Therapy, 41, 863-878.
68. Purcell, R., Maruff, P., Kyrios, M. & Pantelis, C. (1998). Neuropsychological deficits in obsessive–compulsive disorder: a comparison with unipolar depression, panic disorder, and normal controls. Archive. General Psychiatry 55 (5), 415–423.
69. Purdon, C. (2001). Special series on understanding the persistence of depressive and anxious thinking appraisal of obsessional thought recurrences: Impact on anxiety and mood state. Behaviour Research and Therapy, 32(1), 47-64.
70. Purdon, C. & Clark, D.A. (1994). Perceived control and appraisal of obsessional intrusive thoughts: A replication and extension. Behavioural and Cognitive Psychotherapy, 22, 269–285.
71. Purdon, C. & Clark, D.A. (1999). Metacognition and obsessions. Clinical Psychology and Psychotherapy, 6, 102-110.
72. Purdon, C. & Clark, D. A. (2001). Suppression of obsession-like thoughts in nonclinical individuals: impact on thought frequency, appraisal and mood state. Behaviour Research and Therapy, 39, 1163–1181.
73. Purdon, C., Rowa, K. & Antohny, M. (2005). Thought suppression and its effects on thought frequency, appraisal and mood state in individuals with obsessive compulsive disorder. Behaviour Research and Therapy, 43, 93–108.
74. Rachman, S. (2004). Fear of contamination. Behaviour Research and Therapy, 42, 1227-1255.
75. Rachman, S. (2002). A cognitive theory of compulsive checking. Behaviour Research and Therapy, 40, 625–639.
76. Rachman S., & Shafran R. (1999). Cognitive distortions: Thought- action fusion. Clinical Psychology and Psychotherapy, 6, 80-85.
77. Rachman, S., Shafran, R., Mitchell, D., Trant, J. & Teachman, B. (1996). How to remain neutral: an experimental analysis of neutralization. Behaviour Research and Therapy, 34(11-12), 888-898. Rankins, D., Bradshaw, J., Moss, S., & Georgiou-Karistianis, N. (2004). Inhibition of return in obsessive-compulsive disorder. Journal of the International Neuropsychological Society, 10, 54 – 59.
78. Radomsky, A. S., Dugas, M. J., Alcolado, G. M., & Lavoie, S. L. (2014). When more is less: doubt, repetition, memory, metamemory, and compulsive checking in OCD. Behaviour Research & Therapy, 59, 30-39.
79. Radomsky, A. S, Gilschirt, P. T. & Dussault D. (2006). Repeated checking really does cause memory distrust .Behaviour Research and Therapy 44, 305–316.
80. Radomsky, A.S. & Rachman, S. (1999). Memory bias, in obsessive compulsive disorder (OCD). Behaviour Research and Therapy, 37, 605-618.
81. Radomsky, A.S, Rachman, S. & Hammond, D. (2001). Memory bias, confidence and responsibility in compulsive checking. Behaviour Research and Therapy, 39, 813–822.
82. Rassin, E., Merckelbach, H., Muris, P. & Schmidt, H. (2001). The thought-action fusion scale: Further evidence for its reliability and validity. Behaviour Research and Therapy, 39, 537–544.
83. Rassin, E., Merckelbach, H., Muris, P. & Spaan, V. (1999). Thought–action fusion as a causal factor in the development of intrusions. Behaviour Research and Therapy, 37(3), 231–237.
84. Rauch, S.L., Wedig, M.M., Wright, C.I., Martis, B., McMullin, K.G., Shin, L.M., Cannistraro, P.A. & Wilhelm, S. (2007). Functional magnetic resonance imaging study of regional brain activation during implicit sequence learning in obsessive–compulsive disorder. Biological Psychiatry, 61, 330–336.
85. Rheaume, J., Freeston, M. H., Dugas, M. J., Letarte, H. & Ladouceur, R. (1995). Perfectionism, responsibility, and obsessive–compulsive symptoms. Behaviour Research and Therapy, 33, 785–794.
86. Rice, K. G., & Pence, S. L. (2006). Perfectionism and Obsessive–Compulsive symptoms. Journal of Psychopathology and Behavioral Assessment, 28, 103–111.
87. Rubenstein, C. S., Peynirdoglu, Z. F., Chambless, D. L. & Pigott, T. A. (1993). Memory in subclinical obsessive–compulsive checkers. Behaviour Research and Therapy, 31, 759–765.
88. Salkovskis, P. M. (1989). Cognitive-behavioral factors and the persistence of intrusive thoughts in obsessional problems. Behavior Research and Therapy, 27, 677–682. Salkovskis, P.M., Wroe, A.L., Gledhill, A., Morrison, N, Forrester, E., Richards, C., Reynolds, M. & Thorpe, S. (2000). Responsibility attitudes and interpretations characteristic of obsessive-compulsive disorder. Behaviour Research and Therapy, 38, 347–372.
89. Savage, C.R., Deckersbach, T., Wilhelm, S., Rauch, S.L., Baer, L., Reid, T. & Jenike, M.A., (2000). Strategic processing and episodic memory impairment in obsessive-compulsive disorder. Neuropsychology 14, 141–151.
90. Sma´ri, J. & Ho´lmsteinsson, H. E. (2001). Intrusive thoughts, responsibility attitudes, thought action fusion andchronic thought suppression in relation to obsessive-compulsive symptoms. Behavioural and Cognitive Psychotherapy, 29, 13–20.
91. Sher, K. J., Frost, R. O., Kushner, M., Crews, T. & Alexander, J. (1989). Memory deficits in sub-clinical checkers: Replication and extension in a clinical sample. Behaviour Research and Therapy, 27, 65 – 69.
92. Siev, J., Chambless, D. L. & Huppert, J. D. (2010). Moral thought action fusion and OCD symptoms: The moderating role of religious affiliation. Journal of Anxiety Disorders, 24, 309–312.
93. Sookman, D. & Pinard, G. (2002). Overestimation of threat and intolerance of uncertainty in obsessive compulsive disorder. R.O. Frost, G Steketee (Eds.), Cognitive approaches to obsessions and compulsions: Theory, assessment, and treatment. 63-89: Pergamon/Elsevier Science Inc, Amsterdam, Netherlands.
94. Steketee, G.S. & Frost, R.O. (1994). Measurement of risk –taking in obsessive compulsive disorder. Behavioral and Cognitive therapy, 21, 13-25.
95. Taylor, S., Abramowitz, J.S. & McKay, D. (2005). Are there interactions among dysfunctional beliefs in obsessive compulsive disorder? Cognitive Behaviour Therapy, 34(2), 89-98.
96. Tekcan, A.I., Topçuoğlu, V. & Kaya, B. (2007). Memory and metamemory for semantic information in obsessive–compulsive disorder. Behaviour Research and Therapy, 43, 15–27.
97. Tolin, D.F., Abramowitz, J.S., Brigidi, B.D., Amir, N., Street, G.P. & Foa, E.B. (2001). Memory and memory confidence in obsessive-compulsive disorder. Behavioral Research and Therapy 39, 913–927.
98. Tolin, D. F., Abramowitz, J. S., Przeworski, A., & Foa, E. B. (2002). Thought suppression in obsessive–compulsive disorder. Behaviour Research and Therapy, 40, 1255–1274.
99. Tolin, D. F, Woods, C. M. & Abramowitz, J. S. (2003). Relationship between obsessive beliefs and obsessive-compulsive symptoms. Cognitive Therapy and Research, 27(6), 657-669.
100. Tolin, D. F., Worhunskya, P. & Maltby, N. (2006). Are ‘‘obsessive’’ beliefs specific to OCD?: A comparison across anxiety disorders. Behaviour Research and Therapy, 44, 469–480.
101. Tuna, Ş., Tekcan, A.I., & Topçuoğlu, V. (2005). Memory and metamemory in obsessive–compulsive disorder. Behaviour Research and Therapy, 45, 2164-2172.
102. Van den Hout, M. & Kindt, M. (2004). Obsessive–compulsive disorder and the paradoxical effects of perseverative behavior on experienced uncertainty. Journal of Behavior Therapy and Experimental Psychiatry 35, 165–181.
103. Wells, A. (2000). Emotional disorders and metacognition: innovative cognitive therapy. Chichester, UK: Wiley. pp. 179–199.
104. Wells, A. (2009). Metacognitive therapy for anxiety and depression. NewYork: Guilford Press.
105. Wells, A., & Cartwright-Hatton, S. (2004). A short form of the meta-cognitions questionnaire: Properties of the MCQ- 30. Behavior Therapy, 42, 385–396.
106. Wells, A. & Mathews, G. (1994). Attention and emotion: a clinical perspective. Hove, UK: Erlbaum.
107. Wheaton , M.G., Abramowitz, J.S., Berman , N.C., Riemann, B.C. & Hale, L. R. (2010). The relationship between obsessive beliefs and symptom dimensions in obsessive-compulsive disorder. Behaviour Research and Therapy 48, 949-954.
108. Williams, J. M., Watts, F. N., MacLeod, C., & Mathews, A. (1997). Cognitive psychology and emotional disorders. (2nd ed.) Chichester, U.K.: John Wiley & Sons.
109. Woods, C.M., Frost, R.O. & Steketee, G. (2002). Obsessive Compulsive (OC) symptoms and subjective severity, probability, and coping ability estimations of future negative events. Clinical Psychology & Psychotherapy, 9, 104-111.
110. Wu, K. D. & Cortesi, G. T. (2009). Relations between perfectionism and obsessivecompulsive symptoms: examination of specificity among the dimensions. Journal of Anxiety Disorders, 23, 393–400.
111. Yorulmaz, O. & Gençöz, T. (2008). OKB semptomlarında yorumlama ve kontrol süreçlerini değerlendiren İstem Dışı Düşünceleri Yorumlama Envanteri, Obsessif İnanışlar Anketi ve Düşünceleri Kontrol Anketi’nin psikometrik özellikleri. Türk Psikoloji Yazıları, 11, 1-13.
112. Yorulmaz, O., Karancı, A. N, Baştuğ, B., Kısa, C. & Göka, E. (2008). Responsibility, thought-action fusion and thought suppression in Turkish patients with Obsessive-Compulsive Disorder. Journal of Clinical Psychology, 64, 308-317.
113. Yorulmaz, O., Yılmaz A. E. & Gençöz T. (2004) Psychometric properties of the Thought-Action Fusion Scale in a Turkish sample. Behavioral Research Therapy, 42, 1203-1214.
114. Zitterl, W., Urban, C., Linzmayer, L., Aigner, M., Demal, U., Semler, B. & Zitterl-Eglseer, K., (2001). Memory deficits in patients with DSM-IV obsessive-compulsive disorder. Psychopathology 34, 113–117.