Avoidance of negative emotional contrasts as a diagnostic feature of OCD: A receiver-operator characteristic curve analysis of the contrast avoidance questionnaires

Abstract

BackgroundModels focusing on transdiagnostic mechanisms, such as repetitive negative thinking, may be of additive value to existing conceptualizations of obsessive-compulsive disorder (OCD). One such model is the Contrast Avoidance Model (CAM), which posits that individuals with generalized anxiety disorder (GAD) are sensitive to sharp increases in emotions, and use worry to maintain heightened states of negative arousal to avoid these emotional shifts. The current study used receiver operator characteristic (ROC) curve analyses to examine the predictive utility of two contrast avoidance questionnaires in detecting probable OCD. MethodsUndergraduate students with probable OCD (N = 431) and a non-OCD group (N = 433) completed measures of contrast avoidance (CAQ-GE and CAQW) and obsessive-compulsive symptoms. ResultsResults showed significant differences in total CAQ-GE and CAQ-W scores between the probable OCD group and the non-OCD group. Area under the curve values demonstrated excellent accuracy in predicting probable OCD on the CAQ-GE and CAQW, (0.87 and 0.88, respectively). Correlation analyses revealed that certain OC symptom dimensions (e.g., Unacceptable Thoughts; Responsibility for Harm) were more closely associated with the CAQ-GE and the CAQ-W relative to other symptom dimensions. LimitationsThe study had a cross-sectional design and relied on an undergraduate sample. ConclusionIdentifying shared mechanisms across OCD and its comorbidities is an important and novel approach to understanding the etiology and maintenance of symptoms.