Richard Moulding

• BSc(Hons),MPsych,MBioStatsPh.D.
• Professor (Associate) at Cairnmillar Institute

The study aimed to examine the factor structure of the Obsessive Beliefs Questionnaire (OBQ), the most widely used measure of dysfunctional beliefs in obsessive—compulsive disorder (OCD). Multiple exploratory methods (exploratory factor analysis, cluster analysis by variable, multidimensional scaling) were used to examine the questionnaire. Confirm...

Obsessive-compulsive disorder (OCD) is a highly disabling psychiatric disorder, characterized by the occurrence of intrusive, unwanted thoughts (obsessions), which lead to the performance of repetitive compulsions and/or rituals in order to reduce distress and prevent feared outcomes from occurring. In particular, one grouping of obsessive themes t...

A large body of research has implicated difficulties in emotion regulation as central to the development and maintenance of psychopathology. Emotion regulation has therefore been proposed as a transdiagnostic construct or an underlying mechanism in psychopathology. The transdiagnostic role of emotion regulation has yet to be systematically examined...

Objective Politically‐slanted fake news (FN)—manufactured disinformation, hoaxes, and satire appearing to present true information about events—is currently receiving extensive attention in the mainstream media. However, it is currently unclear what factors may influence an individual's likelihood to believe in FN, outside of political identity. As...

Excessive or maladaptive object attachment is the defining feature of Hoarding Disorder (HD) and the acquisition process within Compulsive Buying-Shopping Disorder (CBSD). In recent years, the relationship of object attachment within HD and CBSD to individual’s self-concept has become the focus of direct research. On the basis of this literature, i...

Background: Recent studies have shown that individuals with obsessive-compulsive disorder (OCD) tend to endorse a feared self that they perceive to be immoral, insane and/or dangerous. The current study investigated the relationship between morality-related feared self, self-relevance and OC-related cognitions and behaviours such as moral delibera...

Young carers represent a poorly understood subset of Australian youth. Data were collected through semi-structured interviews with 13 young Australian adults who undertook an informal caring role prior to the age of 20. Findings indicate that providing care to a loved one as a child or adolescent is a difficult task that appears highly transformati...

Objectives The feared possible self refers to an imagined version of self that one is afraid of being or becoming. Previous evidence has shown that dysfunctional reasoning (i.e., inferential confusion) is associated with obsessive-compulsive disorder (OCD) symptoms, which is partially mediated by a feared self. However, the evidence is reliant on n...

Objectives There is a significant relationship between a general feared self and contact contamination concerns in obsessive-compulsive disorder (OCD), especially when the influence of mental contamination is considered a part of this relationship. However, these associations have not been explored in a clinical OCD sample when using each dimension...

Obsessive-compulsive and related disorders include obsessive-compulsive disorder, hoarding disorder, body dysmorphic disorder, trichotillomania (hair-pulling disorder), and excoriation (skin-picking) disorder. This volume reviews the phenomenology and epidemiology of each of the disorders. Next, it reviews how the disorders are maintained, from bio...

Experiencing a thought about harming or injuring another person is commonly reported by the general population. Aggressive intrusive thoughts (AITs) and aggressive scripts are two constructs commonly used to define the experience of thinking about harming another person. However, they are generally investigated separately and with two significantly...

Concerns and processes regarding one’s identity and “self” are arguably a central component of existential concerns within humankind. This chapter briefly introduces self-related constructs before looking at how they have been applied to specific domains of psychopathology in recent empirical and theoretical works. First, it has been argued that se...

Objective: Dysregulated behaviors including substance use, disordered eating, and nonsuicidal self-injury (NSSI) have significant negative implications for individuals and health systems. It is therefore paramount to understand factors influencing behavioral dysregulation, to inform prevention and treatment approaches. The literature suggests that...

Background/Objective Unwanted mental intrusions (UMIs) with contents related to Obsessive-Compulsive Disorder (OCD), Body Dysmorphic Disorder (BDD), Illness Anxiety Disorder (IAD), and Eating Disorders (EDs) are highly prevalent, independently of the cultural and/or social context. Cognitive-behavioral explanations for these disorders postulates th...

Background: The aim of the study was to examine the impact of diagnostic status (i.e., having a clinical diagnosis of irritable bowel syndrome (IBS) or being symptomatic but undiagnosed on quality of life (QoL)). We also examined whether the relationships between QoL and variables such as symptom frequency, pain catastrophizing, visceral sensitivi...

Background and aims Using the Common Sense Model (CSM), this study aimed to examine the extent to which illness beliefs, coping styles, self-efficacy, and mindfulness mediate this relationship. Methods Two hundred and sixty-one adults (198 females; 169 with Crohn's Disease) with IBD participated in this cross-sectional study. Measures used in this...

Treatment non-response, drop-out, and relapse have led researchers to examine if issues related to the “self” contribute to obsessive-compulsive disorder. The present systematic review investigated whether self-beliefs relate to obsessive-compulsive symptoms and related phenomena, and if these beliefs contribute to the concealment of personal and s...

This paper presents the development and validation of the Possessions as Others and Self Inventory (POSI). The POSI is a 23-item self-report measure that assesses the extent to which possessions are perceived to be extensions of self and significant others in hoarding disorder. In Study 1 (N = 246 community participants, M age = 33.70), exploratory...

Objective: There is a demonstrated link between the mental health and substance use comorbidities experienced by young adults, however the vast majority of psychological interventions are disorder specific. Novel psychological approaches that adequately acknowledge the psychosocial complexity and transdiagnostic needs of vulnerable young people are...

In recent years, cognitive‐behavioural models of OCD have increasingly recognized the potential role of feared possible selves in the development and maintenance of OCD, while simultaneously re‐examining factors that have historically been linked to self‐perceptions in OCD. The current article describes the development and validation of a multidime...

While negative self-views have been implied in many theories regarding obsessive compulsive disorder (OCD), empirical research on feared self-concerns that one may be bad, immoral, or insane-has only recently emerged. The current study aimed to investigate the role of feared self as a potential mechanism in obsessive-compulsive symptoms. Non-clinic...

Feared self beliefs have been found to relate with OCD, whereby fears of who one is or might become have had implications for the experience of obsessive-compulsive symptoms. The present study aimed to further the investigation of the fear of self to different OCD-symptom dimensions, including the understudied dimensions of relationship OCD and sex...

In this article, we focus on the various recent healthcare reforms in Australia and their implication for cognitive behavioural therapy (CBT). Specifically, we focus on three areas relevant to CBT in Australia. After discussing the background of mental healthcare in Australia, we highlight the impact that recent health reforms have had on the foreg...

Objectives Young people accessing mental health treatment in Australia frequently engage in dysregulated behaviours, such as substance misuse, deliberate self‐harm (DSH), and binge eating and purging. Rumination has been identified as a correlate of behavioural dysregulation; however, a qualitative examination of the functional relationship between...

While current cognitive conceptualisations of obsessive‐compulsive disorder (OCD) emphasise that rituals are performed in order to avoid overtly threatening outcomes, it has also been noted that there are individuals for whom the attempt to correct “not just right experiences” (NJREs) rather than dangerous outcomes per se appear important. This art...

Irritable bowel syndrome (IBS) affects up to 20% of the global population and is associated with impaired health-related quality of life (HRQoL). This systematic review and meta-analysis aimed to investigate differences in HRQoL of those with IBS compared with healthy controls and to examine whether HRQoL improves following psychological interventi...

Buying-shopping disorder (BSD) is a disabling condition that is characterized by excessive buying and associated phenomena. While the recently released International Classification of Diseases (ICD-11) have not included excessive buying as a formal mental health disorder, the ICD-11 has listed BSD as an example of “other specified impulse-control d...

Dietary restraint is associated with a number of health risks, especially in young women. Research has shown that dispositional self-control negatively predicts dieting behaviour. However, it is possible that empirical findings regarding this relationship have been confounded by a number of related variables, such as prior dieting success and body...

Economic analyses of treatments for OCD have been limited. This study analysed the comparative economic benefits and costs of an internet-based CBT (iCBT) relative to internet-based progressive relaxation therapy (iPRT) control. These were benchmarked against current estimates for face-to-face CBT (ffCBT) sourced from literature. The benefits to so...

It is argued that problem video game use (PVGU) has similarities with behavioral addictions such as problem gambling. Unlike other addictions, the predictors of online PVGU have not been studied extensively. We applied a stress-coping model, previously developed for electronic gambling addiction, to PVGU. In this model, stressors lead to excessive...

Deficits regulating emotions are a core process underlying both substance use and mental health disorders. Research has focused on identifying one-to-one associations between individual emotion regulation (ER) strategies and mental health symptoms. Consequently, little is known about how patterns of ER relate to a broad range of psychopathology, in...

Objectives The role of cognitions and beliefs in trichotillomania (TTM; hair pulling disorder) has been the subject of only limited investigation. This study aimed to develop and validate the Beliefs in TTM Scale (BiTS). Methods A pool of 50 items based upon themes identified in previous research was administered online to 841 participants with an...

Socially prescribed perfectionism (SPP) is often considered as a key risk factor for disordered eating (DE). However, current conceptualizations of SPP largely assume that this perfectionism pressure is non‐specific (i.e., a global pressure), despite research indicating that for females experiencing DE, female‐dominated groups impose this pressure...

Background/Objective Unwanted mental intrusions (UMIs), typically discussed in relation to Obsessive-Compulsive Disorder (OCD), are highly prevalent, regardless of the specific nationality, religion, and/or cultural context. Studies have also shown that UMIs related to Body Dysmorphic Disorder (BDD), Illness anxiety/Hypochondriasis (IA-H), and Eati...

Deficits regulating emotions are a core process underlying both substance use and mental health disorders. Research has focused on identifying one-to-one associations between individual emotion regulation (ER) strategies and mental health symptoms. Consequently, little is known about how patterns of ER relate to a broad range of psychopathology, in...

Socially prescribed perfectionism appears to drive disordered eating behaviour in young women, usually via messages from fellow women. Social psychological research suggests that framing effects can be manipulated to reduce the effect of unhealthy messages. This research used contrasting messages about perfectionism to reduce perfectionism among fe...

Objective Socially prescribed perfectionism is considered an important contributor to eating disorder (ED) development and maintenance. Despite this fact, it is unclear how social groups apply this pressure to be perfect, and how this pressure originates and manifests. Our research sought to clarify how group membership relates to perfectionism in...

The phenomenon of buying-shopping disorder (BSD) was described over 100 years ago. Definitions of BSD refer to extreme preoccupation with shopping and buying, to impulses to purchase that are experienced as irresistible, and to recurrent maladaptive buying excesses that lead to distress and impairments. Efforts to stop BSD episodes are unsuccessful...

Objectives The aim of this study was to explore the importance of possessions as extensions of self‐concept and connections to significant others for people that hoard. Design A total of 10 participants were recruited through hoarding group treatment programmes. Participants photographed significant possessions in their home and discussed these in...

Objective The role of emotion regulation (ER) has been receiving increased attention in relation to various forms of psychopathology including hoarding disorder (HD). However, questionnaire designs are limited to finding associations of ER with symptoms or symptom groups, without finding out how such constructs might be involved in the disorder. M...

Aims: Hoarding disorder is a disabling condition, characterized by the acquisition and retention of possessions to the point where it negatively impacts the individual's life. While treatments are promising, the chronic and ego syntonic nature of the disorder means that further development of the underlying theoretical model of hoarding is importan...

Background: Obsessive Compulsive Disorder (OCD) is a highly disabling psychological disorder with a chronic course if left untreated. Cognitive-behavioral therapy (CBT) has been shown to be an effective treatment, but access to face-to-face CBT is not always possible. Internet-based CBT (iCBT) has become an increasingly viable option. However, no...

The aim of the current study was to use Structural Equation Modelling (SEM) to examine whether psychological flexibility (i.e. mindfulness, acceptance, valued-living) mediates the relationship between distress, irritable bowel syndrome (IBS) symptom frequency, and quality of life (QoL). Ninety-two individuals participated in the study (12 male, 80...

Hoarding disorder is a disabling condition associated with significant health risks, and social, occupational, and economic impairment. While the cognitive-behavioral model of compulsive hoarding has been successful in explaining the phenomenology of hoarding, recent research has suggested emotion regulation (ER) might play an important role in dri...

This study aimed to investigate the specificity of inferential confusion and obsessive beliefs to symptoms of obsessive-compulsive disorder (OCD). The construct of inferential confusion is grounded in an Inference-Based Approach (IBA) to the study of OCD, which maintains that dysfunctional reasoning plays a central role in its development, whereas...

Sexual Orientation-Obsessive Compulsive Disorder (SO-OCD) is yet understudied in the literature. The current study was prompted to test the role of specific and general beliefs potentially involved in the genesis and maintenance of SO-OCD. As such, 263 patients with SO-OCD, 42 patients with OCD (NSO-OCD) and 116 non-clinical participants (NCP) were...

Individuals accessing treatment within the youth alcohol and other drug (AoD) sector represent a highly vulnerable population who present with complex patterns of substance use and mental health comorbidity. Current treatments often fail to address this complexity. Emotion regulation (ER) has been identified as a promising transdiagnostic treatment...

Mixed findings regarding the long-term efficacy of cognitive behavior therapy (CBT) for the treatment of hoarding has led to the investigation of novel treatment approaches. “Blended” therapy, a combination of face-to-face (f2f) and online therapy, is a form of therapy that enables longer exposure to therapy in a cost-effective and accessible forma...

The cognitive–behavioural model of hoarding disorder incorporates information processing difficulties, maladaptive attachment to possessions, erroneous beliefs about the nature of possessions, and mood problems as etiologically significant factors, although developmental experiences such as a compromised early family environment have also been prop...

Objective: Emotion regulation difficulties are implicated in psychological disorders but their role in obsessive-compulsive disorder (OCD) is unclear. Two studies examining these difficulties in OCD are presented. Method: A community sample (Study 1; n = 306) and a clinical OCD sample (Study 2; n = 59) completed the Difficulties in Emotion Regul...

Purpose of Review Although not recognized as a discrete psychiatric disorder, compulsive buying (CB) is a widespread psychological problem characterized by a preoccupation with shopping and impulses to purchase that are experienced as irresistible and chronic, leading to distress and significant impairment. Recent Findings Social psychological fra...

Increasingly, cognitive-behavioural models have been considering the role of beliefs about the self in the development and maintenance of obsessive-compulsive disorder (OCD), including sensitive domains of self-concept and feared self-perceptions. This has led to the development of the Fear of Self Questionnaire (FSQ; Aardema et al., ), which has s...

Hoarding disorder is a disabling psychiatric disorder, characterized by the acquisition and retention of possessions to the point where it negatively impacts the individual's life, regardless of the value of the items. While treatments for hoarding disorder are promising, the chronic and egosyntonic nature of the disorder means that further develop...

Individuals with ADHD and comorbid hoarding disorder are vulnerable to severe consequences from hoarding symptoms. Despite this, and the early onset of hoarding disorder, the nature of hoarding symptoms in children with comorbid ADHD is unknown. We therefore explored the phenomenology of hoarding symptoms among ten 8–12 year olds with ADHD and clin...

Emotion regulation difficulties in trichotillomania (TTM) have been documented in past studies. However, the potential conflation of relationships due to comorbid affective symptoms means that the relationship between TTM symptoms and emotion regulation constructs requires further investigation. In addition, the relationship between different hair...

Purpose: Existing research suggests that the decision to grant or deny workplace accommodations for people with disabilities is influenced by a range of legal and non-legal factors. However, less is known about how these factors operate at the within-person level. Thus, we proposed and tested a multilevel model of the accommodation decision-making...

Purpose: Existing research suggests that the decision to grant or deny workplace accommodations for people with disabilities is influenced by a range of legal and nonlegal factors. However, less is known about how these factors operate at the within-person level. Thus, we proposed and tested a multilevel model of the accommodation decision-making...

Conspiracy Theory (CT) endorsers believe in an omnipresent, malevolent, and highly coordinated group that wields secret influence for personal gain, and credit this group with the responsibility for many noteworthy events. Two explanations for the emergence of CTs are that they result from social marginalisation and a lack of agency, or that they a...

This presentation presents the results of a recent study investigating contextual determinants of clinical obsessions. Independent clinicians rated naturally occurring intrusive cognitions of 248 non-clinical participants on ego-dystonicity and evidence for their potential reality. Results suggested that abnormal intrusions occur without evidence i...

Background Obsessive preoccupation, doubts, and compulsive behaviors focusing on one’s romantic relationship and partner are receiving increasing clinical, theoretical, and empirical attention. Commonly referred to as relationship obsessive–compulsive disorder (ROCD), such symptoms have been linked with decreased relational and sexual functioning a...

Sexual Orientation - Obsessive-Compulsive Disorder (SO-OCD) is characterized by intrusive thoughts, images and urges related to one’s sexual orientation, and by consequent avoidance, reassurance seeking, and overt and covert compulsions. Currently there is no short self-report measure that assesses SO-OCD symptoms. The current article describes two...

This must-have reference is a unique exploration of how the individual notion of 'self' and related constructs, such as early schemas and attachment styles, impact on psychopathology, psychotherapy processes and treatment outcomes for psychological disorders across DSM-5, such as depression, bipolar and schizophrenia spectrum disorders, anxiety and...

Key practitioner message: A 12-week group programme delivered in a community setting was effective for helping with hoarding symptoms with a large effect size. Hoarding beliefs (emotional attachment and responsibility) and depression were reduced, with moderate effect sizes. A third of all participants who completed post-treatment questionnaires e...

The literature concerning obsessive-compulsive disorder (OCD) indicates that obsessions frequently imply negative evaluative beliefs regarding the self. The construct of the feared self has been used to describe the set of harmful attributes an individual worries they may possess. This study aimed to partially replicate previous research that demon...

Background/aims: Using a cognitive framework, this paper examined self-perceptions as a vulnerability to phenomena in obsessive-compulsive disorder. Specifically, Guidano and Liotti's model of self-ambivalence (from 1983) and the notion of self-worth contingent upon moral standards were investigated as possible mechanisms to explain how individual...

Cognitive-behavioral and inference-based models have linked unacceptable or repugnant thoughts in obsessive-compulsive disorder (OCD) with vulnerable self-themes and fear-of-self concerns. To investigate this notion, Aardema et al. (2013) recently developed and validated the Fear of Self-Questionnaire (FSQ) in non-clinical samples, finding it had g...

Trichotillomania (TTM) is characterised by the removal of one's hair, causing hair loss. Phenomenological research on TTM has investigated its associated behavioural and affective factors. Few studies have investigated the possible role of cognitions and beliefs, despite emerging support for cognitive therapies in treating this disorder. This study...

Background Trichotillomania (hair-pulling disorder) is a debilitating and distressing disorder associated with great secrecy and shame. A lack of understanding regarding interventions for Trichotillomania contributes to poor routine outcomes for the disorder.Method This systematic review and meta-analysis assessed the efficacy of behaviourally base...

This study aimed to test which particular facets of emotion regulation (ER) are most linked to symptoms of hoarding disorder, and whether beliefs about emotional attachment to possessions (EA) mediate this relationship. A non-clinical sample of 150 participants (108 females) completed questionnaires of emotional tolerance (distress tolerance, anxie...

This paper aims to provide an overview of evidence-based psychological treatments for trichotillomania. Advances in the understanding of the phenomenology of trichotillomania has led to the augmentation of behavioural treatments with dialectical behaviour therapy and acceptance and commitment therapy. Further studies of treatment component efficacy...

With its re-classification as an obsessive-compulsive related disorder in DSM-5, trichotillomania (TTM) is now conceptualised alongside several disorders (e.g., obsessive-compulsive disorder, body dysmorphic disorder) that are characterised by cognitions and beliefs such as perfectionism and negative self-beliefs. Anecdotally, similar beliefs have...

Objective: The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is the most widely accepted measure of obsessive-compulsive disorder (OCD) symptom severity. Recently, the scale has been revised into a second edition (Y-BOCS-II) in order to improve its measurement properties. The present study aimed to evaluate the psychometric properties of the Itali...

Key practitioner message: Unacceptable thoughts in OCD have been linked with vulnerable self-themes and a fear of self. Aardema and coworkers recently developed and validated the Fear of Self-Questionnaire (FSQ). Study 1 investigated the Psychometric properties of an Italian translation of the FSQ in a non-clinical sample. Study 2 investigated the...

Following observations in the literature that obsessions often contain or imply negative evaluative information about the self, Aardema et al. (2013) recently developed a measure of feared-self relevant to OCD. The current study aimed to provide further examination of the relevance of such feared self-beliefs to obsessive compulsive processes - in...

Objective Sensory-processing sensitivity refers to a trait-like difference in the extent to which individuals strongly and deeply process a variety of stimuli in the environment. While being highly sensitive has been linked to increased experiences of distress, the reasons for this are not well known. One potential mediator of this effect is emotio...

Hoarding disorder has a frequent co-occurrence with attention-deficit/hyperactivity disorder (ADHD). An accurate understanding of the comorbidity between hoarding disorder and ADHD remains unclear but is essential to inform appropriate assessment, prevention and treatment approaches. This paper will provide a review of potential comorbidity models...

Background and objectives Compulsive buying is a disabling condition, where individuals are unable to resist or control their buying behavior, leading to substantial social and financial problems. Cognitive models implicate the role of beliefs as one factor in buying behavior, for example, “this item is unique and will help me improve my life”. Me...

Background: Obsessive-Compulsive Disorder (OCD) is a common chronic psychiatric disorder that constitutes a leading cause of disability. Although Cognitive-Behaviour Therapy (CBT) has been shown to be an effective treatment for OCD, this specialised treatment is unavailable to many due to access issues and the social stigma associated with seeing...

Cognitive models of Obsessive Compulsive Disorder (OCD) purport that obsessions are normal intrusive thoughts that are misappraised as significant, leading to negative emotional responses and maladaptive attempts to control the thoughts and related emotions. This paper utilised a large multi-national dataset of interview data regarding intrusive th...