The relationship between cognitions and symptoms in obsessive-compulsive disorder.

•OCD cognitions were associated with comorbid symptom severity rather than with OCD severity.•Impulses and rumination/doubting subtypes were uniquely associated with OCD cognitions.•Baseline OCD cognitions did not predict OCD severity at follow up.•Prospectively, several symptom subtypes demonstrated both unidirectional and bidirectional associations with OCD cognitions.•Cognitions may participate in the maintenance of some OCD subtypes. However, mechanisms alternative to cognitive biases in OCD should be further examined.