From intrusive thoughts to obsessions: The role of perceptions of responsibility, salience, and thought suppression
University of Maine, Orono, Maine, USAJournal of Behavior Therapy and Experimental Psychiatry (Impact Factor: 2.23). 12/2008; 39(4):610-624. DOI: 10.1016/j.jbtep.2008.02.002
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 10/2011; 35(5):404-413. DOI:10.1007/s10608-009-9275-5 · 1.70 Impact Factor
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