Freeze! The Impact of a Guided Imagery Intervention on Looming Vulnerability and Subclinical Contamination-OCD Symptoms

Abstract

Looming vulnerability (LV) refers to the tendency to appraise and perceive potential threats as dynamic and increasing in risk. Research suggests that contamination-fearful individuals may have an increased tendency to interpret contamination as growing or spreading (i.e., “looming”), which may hinder habituation to contamination and play a role in the maintenance of contamination-OCD symptoms. Studies have shown that engaging in imagery in which one mentally freezes contamination in place decreases state levels of fear, though little is known about its longer-term effects (e.g., after one week). The present study aimed to experimentally manipulate LV using freeze imagery in a subclinical contamination-OCD sample and test the effects of this intervention on contamination fear-related symptoms over time. In sessions one (baseline) and two (24-hours later), participants (N = 127) completed self-report measures of 1) LV, including the tendency to interpret both contamination and threat in general as looming; and 2) contamination fear, disgust sensitivity and propensity, and OCD symptoms. Additionally, participants completed a “chain of contagion” task in which they provided contamination ratings of objects over a series of removals from an initial contaminant. At the end of session one, participants were randomized to one of three conditions in which they completed a guided imagery intervention: freeze imagery (i.e., imagining germs as frozen in place), loom imagery (i.e., imagining germs as moving and spreading), or a no-task control condition (i.e., no imagery intervention). Participants completed their same assigned intervention at the end of session two. One-week later (session three), participants completed the same self-report measures and chain of contagion task. As expected, participants in the freeze imagery condition (but not other conditions) demonstrated significant reductions over time (i.e., from sessions one to three) in contamination fear, OCD symptoms, and in their tendency to interpret contamination and threat in general as looming. Further, participants in the freeze condition demonstrated decreased average chain of contagion contamination ratings from sessions two to three, whereas those in the loom and control conditions demonstrated increased contamination ratings over time (i.e., from sessions one to three). Condition did not affect disgust sensitivity or propensity. Finally, results revealed that changes in looming of contamination cognitions mediated the relationship between condition and changes in contamination fear and OCD symptoms. Findings suggest that engaging in freeze imagery may effectively modify LV in a subclinical contamination-OCD sample and be an adaptive strategy to reduce related symptoms over time. Overall, this study provides