Negative Rearing Behavior and Its Association with Maladaptive Metacognition in Children and Adolescents with Obsessive–Compulsive Disorder

According to metacognitive theory, maladaptive metacognition is associated with the development and maintenance of obsessive–compulsive disorder (OCD). Negative rearing behavior has been proposed as a possible pathway to increased maladaptive metacognition. An initial test would be to determine if negative rearing behavior is associated with maladaptive metacognition. We wanted to take the first step in examining such possible pathway among children and adolescents with OCD. A cross-sectional study design was used with a sample of 52 pediatric OCD patients (age 7–18 years) and their mothers, using questionnaire-based assessments of maternal rearing behaviors and metacognition. First, a hierarchical multiple linear regression model was used to test rearing behaviors as predictors of total offspring metacognition. Second, bivariate linear regression analyses were conducted to explore the associations with offspring metacognitive subdomains. Age group was explored as a moderator. Maternal rearing behaviors explained 20% of the variance in offspring metacognition. Lower emotional warmth predicted more maladaptive metacognition and was associated with increased offspring beliefs about the need to control thoughts and lack of cognitive confidence. Furthermore, increased offspring positive beliefs about worry were associated with more controlling rearing behaviors in the total sample as well as more anxious rearing behavior among adolescents. Contrary to our hypothesis, low rejection was associated with increased cognitive self-consciousness in the offspring. This study provides initial evidence that maternal rearing behaviors are associated with maladaptive metacognition in children and adolescents with OCD. Lower emotional warmth and certain controlling or anxious behaviors showed notable associations with specific metacognitive beliefs. These findings highlight family factors that warrant further investigation in longitudinal and experimental or intervention research to clarify their role in the development and maintenance of maladaptive metacognition.