# Obsessive Beliefs, Metacognitive Beliefs, and Rumination in Parents of Adolescents with and Without Obsessive–Compulsive Disorder: A Linear Mixed-Effects Model

## TL;DR

This study found that parents of adolescents with OCD have higher levels of certain cognitive traits, which may be linked to their children's symptom severity.

## Contribution

The study introduces a novel approach using linear mixed-effects models to examine parental cognitive traits in relation to OCD symptom profiles in adolescents.

## Key findings

- Parents of adolescents with OCD showed higher scores in cognitive self-consciousness and thought control beliefs.
- Maternal rumination predicted later OCD onset in adolescents, while lower cognitive confidence predicted earlier onset.
- Specific parental cognitive traits correlated with distinct OCD symptom dimensions in children.

## Abstract

Background: Parental cognitive characteristics may represent environmental risk factors in obsessive–compulsive disorder (OCD). This study compared obsessive beliefs, metacognitions, and ruminative thinking in parents of adolescents with OCD and healthy controls (HCs), and examined links with clinical features in patients. Methods: Participants were 45 adolescents with OCD, 45 HCs, and both their mothers and fathers. The Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS) assessed symptom severity in adolescents. Parents completed the Obsessive Beliefs Questionnaire (OBQ), Ruminative Thought Style Questionnaire (RTSQ), 30-item Metacognitions Questionnaire (MCQ-30), and Patient Health Questionnaire-9 (PHQ-9). Data were analyzed using linear mixed-effects models, followed by correlation and regression analyses. Results: Parents of patients had higher scores on the importance/control of thoughts, the need to control thoughts, and cognitive self-consciousness (MCQ-CSC). Mothers of adolescents with OCD had the highest scores on inflated responsibility/threat estimation (OBQ-RTE), perfectionism/intolerance of uncertainty (OBQ-PIU), rumination, and cognitive confidence (MCQ-CC). Regression analyses showed that lower maternal MCQ-CC predicted earlier OCD onset, while higher rumination predicted later onset. Obsession severity in adolescents was linked to higher maternal MCQ-CSC, obsessive slowness to maternal OBQ-PIU, and pathological doubt to greater maternal rumination. Children’s indecisiveness correlated with paternal OBQ-RTE and OBQ-PIU. Conclusions: Our findings revealed elevated cognitive vulnerabilities for OCD in mothers of affected adolescents and identified specific associations between parental cognitive characteristics and their children’s symptom profiles. Future longitudinal studies using dyadic parental design with larger samples may further elucidate the role of parental cognitive patterns in the development and course of OCD.