Metacognitive biases in anxiety-depression and compulsivity extend across perception and memory.

Metacognitive biases are characteristic of common mental health disorders like depression and obsessive-compulsive disorder (OCD). However, recent transdiagnostic approaches consistently contradict traditional clinical studies, with overconfidence in perception among highly compulsive individuals versus underconfident memory in OCD patients. To reconcile these differences, we investigated whether these metacognitive divergences may arise due to cognitive domain-specific effects, comorbid overshadowing effects, and/or different manifestations at disparate levels of a local to global metacognitive hierarchy. Using a transdiagnostic individual differences approach with a general population sample (N = 327), we quantified metacognitive patterns across memory and perception. Across cognitive domains, we found that underconfidence was linked to anxiety-depression and overconfidence was linked to compulsivity. While both anxiety-depression and compulsivity were predominantly explained by global low self-esteem, other associations varied across a confidence hierarchy, with compulsivity exhibiting more specific alterations at more local metacognitive levels. Our results support a domain-general alteration of metacognition across mental health dimensions, with differential contributions from distinct levels of a metacognitive hierarchy.