Inferential confusion, obsessive beliefs, and obsessive-compulsive symptoms: A replication and extension

Northern Illinois University, 311 Psychology-Computer Science Bldg, Department of Psychology, DeKalb, IL 60115, United States.
Journal of anxiety disorders (Impact Factor: 2.68). 04/2009; 23(6):746-52. DOI: 10.1016/j.janxdis.2009.02.017
Source: PubMed


This study replicated and extended previous research regarding utility of an inference-based approach (IBA) to the study of Obsessive-Compulsive Disorder (OCD). The IBA is a model for the development of OCD symptoms through false reasoning. One of its key features is inferential confusion-a form of processing information in which an individual accepts a remote possibility based only on subjective evidence. In a nonclinical sample, this study examined the specificity of relations between the expanded Inferential Confusion Questionnaire (ICQ-EV) and OC symptoms. Results were that the ICQ-EV significantly predicted OC symptoms after controlling for general distress, anxiety, and depression. This finding supports the unique association between inferential confusion and OCD. Further, the ICQ-EV was a stronger predictor of certain OC symptoms than scales from the Obsessive Beliefs Questionnaire, which itself has shown strong relations with OC symptoms. Thus, both inference-based and cognitive appraisal models appear useful for understanding OCD.

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Available from: Frederick Aardema, Feb 27, 2015
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    • "Yet, inferential confusion as measured by the ICQ has been found to be distinct from overestimation of threat, and is independently related to most obsessive-compulsive symptoms when controlling for overestimation of threat (Aardema et al. 2006b). In fact, multidimensional studies controlling for negative mood states and other cognitive domains have revealed inferential confusion as the strongest predictor of obsessive-compulsive symptoms (Aardema et al. 2008; Emmelkamp and Aardema 1999; Wu et al. 2009). The construct is also distinct from Thought Action Fusion, which albeit phonetically similar, refers to the belief having a thought can increase the likelihood of an event occurring, or that a thought is the moral equivalent of carrying out the event (Rachman and Shafran 1999). "
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    ABSTRACT: The current study represents the further development and validation of an expanded version of the Inferential Confusion Questionnaire (ICQ-EV) in non-clinical and clinical samples. Inferential confusion seems to be particularly relevant to Obsessive-Compulsive Disorder (OCD) and is defined as a failure to recognize the unrealistic nature of obsessions due to a subjective form of reasoning. Factor analysis of the item-set of the ICQ-EV indicated a one-dimensional solution in non-clinical and clinical samples. It was hypothesized that inferential confusion as measured by the ICQ-EV would be particularly relevant to participants with OCD. Results confirmed convergent validity with strong relationships between the ICQ-EV and obsessive-compulsive symptoms in all samples independent of other cognitive domains and general distress. In addition, those with OCD scored higher on the ICQ-EV than non-clinical controls and a mixed anxiety disorder group so confirming group-criterion validity. Finally, the ICQ-EV also showed clinical validity with change in ICQ-EV scores during treatment significantly related to successful treatment outcome. KeywordsObsessive-compulsive disorder-Inferential confusion-Cognition-Treatment outcome-Questionnaires
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    ABSTRACT: Distorted metacognitive beliefs are increasingly considered in theoretical models of obsessive-compulsive disorder (OCD). However, so far no consensus has emerged regarding the specific metacognitive profile of OCD. Participants with OCD (n=55), schizophrenia (n=39), and nonclinical controls (n=49) were assessed with the Metacognitions Questionnaire (MCQ-30). Except for positive beliefs about worry, both patient samples exceeded nonclinical controls on all MCQ subscales. The MCQ "need to control thoughts" and "negative beliefs about uncontrollability and danger" subscales showed strong correlations with obsessions, and scores in the former scale were elevated in hallucinators. In contrast to several prior studies, "cognitive confidence" was related neither to core OCD nor to schizophrenia symptomatology. Notwithstanding large pathogenetic differences between OCD and schizophrenia, findings suggest that obsessions and hallucinations may share a common metacognitive pathway. Need to control thoughts and dysfunctional beliefs about the malleability of worries may represent critical prerequisites for the two phenomena to emerge.
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