Magical contagion beliefs in psychopathology: A review of cognitive mechanisms and maintaining factors.

Magical contagion beliefs-the idea that harm, essence, or impurity can be transmitted symbolically through resemblance, association, contact, or thought-are observed across several mental health conditions, including obsessive-compulsive disorder (OCD), trauma-related disorders, eating disorders, and hoarding disorder. This narrative review synthesizes empirical evidence to clarify the emotional and cognitive mechanisms that activate and sustain these beliefs. We propose a theoretical model describing how characteristics of the perceived contaminant (contact, proximity, association, emotional valence, perceived dynamic force) interact with individual vulnerability factors (contamination sensitivity, disgust proneness), cognitive misappraisals (sympathetic magic, contamination thought-action fusion, emotional reasoning), and maintaining processes (intolerance of uncertainty, rumination, cognitive biases), to collectively amplify subjective contamination experiences and reinforce avoidance and cleansing behaviors. The review integrates findings across disorders to highlight shared and distinct pathways through which symbolic contamination beliefs persist and generalize, providing a framework to guide future research and inform targeted clinical interventions.