From intrusive thoughts to obsessions: The role of perceptions of responsibility, salience, and thought suppression
ABSTRACT Salkovskis [1985. Obsessional-compulsive problems: A cognitive-behavioural analysis. Behaviour Research and Therapy, 23, 571–583.] hypothesized that intrusive thoughts are more likely to occur if the thought is salient for the individual, triggers feelings of responsibility and if the individual attempts to suppress the thought. The relationship between these three factors (responsibility, salience, thought suppression) and frequency of intrusive thoughts as well as anxiety were examined in the present study. One hundred female college students were led to believe that a snake had escaped from the cage in which it was housed. Half of the participants were led to believe that they were responsible for the snake's escape and half were not (Responsibility/No Responsibility). Half of the participants in each Responsibility condition were instructed to suppress thoughts of snakes during a stream of consciousness exercise and half were not (Thought Suppression vs. No Thought Suppression). All participants then completed a second stream of consciousness without suppression instructions. Salience groups were determined by a median split on a measure of snake fearfulness. Participants for whom the snake was a salient stimulus and who believed that they were responsible for the snake's escape had the highest frequency of snake thoughts during the second stream of consciousness task and also experienced the highest levels of state anxiety. Findings are discussed with respect to Salkovskis' model.
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ABSTRACT: The current study examined clinical correlates and treatment response as they relate to auxiliary clinical characteristics (i.e., insight; avoidance; indecisiveness; sense of responsibility; pervasive slowness; pathological doubt; duration of obsession-free and compulsion-free intervals) in 172 adults with OCD. A trained evaluator administered the Yale-Brown Obsessive Compulsive Scale and the Anxiety Disorders Interview Schedule for DSM-IV. As well, patients completed the Obsessive Compulsive Inventory-Revised; Beck Depression Inventory-Second Edition; State-Trait Anxiety Inventory; RAND 36-Item Health Survey; and Sheehan Disability Scale. Results indicated numerous associations between auxiliary OCD features and both depressive and anxious symptoms as well as impaired health and functioning. All auxiliary features, excluding insight, were reduced following cognitive-behavioral therapy. In particular, changes in symptom-free intervals; avoidance; and indecisiveness were most reliably associated with reductions in core OCD features. The lack of a relationship with insight did not come as a surprise, as insight is considered a relatively stable construct in those with OCD. Implications of these findings in the assessment and treatment of patients with OCD are highlighted. KeywordsObsessive compulsive disorder–Yale-brown obsessive compulsive scale–Clinical correlates–Treatment response–Auxiliary featuresCognitive Therapy and Research 01/2011; 35(5):404-413. · 1.70 Impact Factor
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ABSTRACT: Recent theories of psychopathology have suggested that thought suppression intensifies the persistence of intrusive thoughts, and proposed that difficulty with thought suppression may differ between groups with and without psychopathology. The current meta-analytic review evaluates empirical evidence for difficulty with thought suppression as a function of the presence and specific type of psychopathology. Based on theoretical proposals from the psychopathology literature, diagnosed and analogue samples were expected to show greater recurrence of intrusive thoughts during thought suppression attempts than non-clinical samples. However, results showed no overall differences in the recurrence of thoughts due to thought suppression between groups with and without psychopathology. There was, nevertheless, variation in the recurrence of thoughts across different forms of psychopathology, including relatively less recurrence during thought suppression for samples with symptoms of Obsessive-Compulsive Disorder, compared to non-clinical samples. However, these differences were typically small and provided only mixed support for existing theories. Implications for cognitive theories of intrusive thoughts are discussed, including proposed mechanisms underlying thought suppression.Clinical psychology review 01/2012; 32(3):189-201. · 7.18 Impact Factor