Obsessional Intrusions Research Articles

Effects of a brief education on psychologists’ attitudes and diagnostic impressions of paedophilic obsessive-compulsive intrusive thoughts

This study investigated whether an educational intervention could reduce psychologists’ stigma towards clients with paedophilic obsessional intrusions and aid diagnosis. Psychologists (N = 109) read a vignette describing someone experiencing paedophilic intrusions, were asked to suggest a diagnosis, and completed measures on negative views and fear, before and after watching a brief educational video on differential diagnosis. Generalised Linear Mixed Models found a reduction in pre- to post-test scores in perception of psychological problem (F[1, 193] = 9.56, p = .002, small to medium effect size η2= 0.04), general concern (F[1, 193] = 34.95, p < .001, large effect size η2= 0.15), and fear (F[1, 194] = 47.39, p < .001, large effect size η2= 0.20). There was a significant difference in the number of psychologists stating obsessive-compulsive disorder (OCD) was the likely diagnosis pre-test (67.3%) versus post-test (97.8%), t(93) = 31.59, p < .001. These findings suggest that although psychologists were generally able to identify paedophilic intrusions as OCD, the education reduced scores of negative views and fear, despite psychologists already displaying relatively low scores, and improved recognition of OCD. This research highlights the importance of continued education of clinicians to improve outcomes for clients.

Validation and Measurement Invariance of the Leuven Obsessional Intrusions Inventory in Two Different Cultures.

Obsessions – recurrent unwanted intrusive thoughts – are one of the two pillars of the Obsessive Compulsive Disorder (OCD). Although OCD has been reported across many different cultures, research on these cultural variations is hampered by the lack of cross-culturally sound instruments to assess intrusive thoughts. The aim of the current study is to investigate the psychometric properties of the recently developed Leuven Obsessional Intrusions Instrument (LOII) in two different cultural contexts. Turkish (N = 663) and Belgian (N = 496) participants were sampled from non-clinical student populations. Results from confirmatory factor analyses yielded a shortened version of the LOII (i.e., LOII-R) with a four-factor solution – aggressive, sexual, and contamination intrusions, and ‘just-right’ doubts – as the best fitting model across both cultures. The model met most criteria for strong measurement invariance, and proved to be both valid and reliable. The results of this study suggest that the LOII-R is a good candidate for cross-cultural studies on obsessional intrusions.

What's Sex Got to Do With It? Associations Between Sexual Intrusive Thoughts, Gender, and Metacognition

Although sexual intrusive thoughts (SITs) are often studied in combination with other intrusions, little is known about the metacognitive processes that are specific to SITs. The present study evaluated sexual versus non-SIT frequency in relation to two main factors: gender and general negative beliefs (GNB), a component of metacognition involving beliefs about the consequences of failing to control thoughts. A nonclinical sample of 286 undergraduate students completed the Revised Obsessional Intrusions Inventory-Sex Version and the Meta-Cognitions Questionnaire. Results indicated main effects for GNB and a significant interaction between gender and GNB for SITs. More specifically, frequency of SITs was significantly higher for males, as well as for participants with higher GNB. In contrast, analyses for non-SITs revealed a main effect for GNB, but no main effects for gender or a significant interaction. These findings suggest a link between high GNB and increased SIT and non-SIT frequency. Moreover, gender may function as a moderator between GNB and SIT frequency. Further characterizing the effects of gender and GNB may help in form treatments for disorders involving clinically significant SITs.

The Appearance Intrusions Questionnaire

Abstract. This study aims to examine whether Body Dysmorphic Disorder (BDD) related preoccupations might consist of unwanted intrusive cognitions, and if so, their degree of universality, its dimensionality from normality to BDD psychopathology, and their associations with symptom measures. The Appearance Intrusions Questionnaire (AIQ) was designed to assess intrusive thoughts related to appearance defects (AITs). A sample of 410 undergraduate university students completed a former 54-item version of the AIQ. Principal Components Analyses (PCA) and Parallel Analysis yielded a five-factor structure and a reduction to 27 items. The 27-items AIQ was examined in a new sample of 583 non-clinical community participants. Confirmatory Factor Analyses (CFAs) grouped the AITs in five factors: Defect-related, Others-related, Concealment, Bodily functions, and Urge to do something. Up to 90% of the participants experienced AITs. The AIQ scores were more associated with BDD, Obsessive-Compulsive Disorder (OCD), and body image measures than with worry, suggesting that AITs are closer to obsessional intrusions than to worries. The new AIQ might be a valid and reliable measure of AITs and would help to reliably detect individuals at risk for BDD in nonclinical populations using a brief self-report.

Modifying thought-action fusion via a single-session computerized interpretation training

Thought-action fusion (TAF) is an important cognitive bias in various emotional disorders, especially, obsessive-compulsive disorder (OCD). TAF leads individuals to interpret the presence of unwanted mental intrusions as morally equivalent to acting on them, and/or increasing the likelihood of the feared consequence. We sought to test the feasibility of a brief computerized cognitive bias modification for interpretations (CBM-I) as a potential intervention to reduce TAF among undergraduates who reported obsessional intrusions. We also examined if the TAF-focused CBM-I can decrease participants’ emotional reactions towards a variety of obsessional thoughts, including personally-relevant intrusions. Participants were randomized to (a) the TAF-incongruent condition (TAF-INC), designed to decrease TAF linked to obsessional thoughts, or (b) the TAF-congruent condition (TAF-CON), designed to render TAF-like interpretation of obsessional thoughts unchallenged. Results indicate the TAF-INC group displayed a significantly greater reduction in the severity of total TAF and TAF moral than the TAF-CON group. Reductions on TAF likelihood did not differ by group. Emotional reaction to personally-relevant obsessional intrusions was also shown to be lower after training in the TAF-INC group. Overall, this study presents preliminary data supporting the feasibility of CBM-I to be used as an effective intervention for TAF.

Psychometric Properties of a Short Korean Version of the Revised Obsessive Intrusion Inventory.

ObjectiveThe Revised Obsessive Intrusion Inventory (ROII) is a 52-item scale that evaluates obsessional intrusive thoughts. The aim of the present study was to validate a short, 20-item Korean version of the ROII (ROII-20).MethodsOf the 1125 participants who completed the ROII-20, 895 participants completed the scale to examine the factor structure of the scale. A subgroup of these participants (n=53) completed the scale twice to determine test-retest reliability. To establish external validity, 230 participants completed the scale and other questionnaires.ResultsExploratory factor analyses suggested a hierarchical model comprising two higher order factors of autogenous obsessions (resulting from aggressive thoughts and sexual thoughts) and reactive obsessions (resulting from thoughts about contamination, thoughts about accidents, and thoughts about dirt). Confirmatory factor analyses supported this model. The results indicated good internal consistency and test-retest reliability. External validity was supported by relationships with obsessive-compulsive symptoms and general distress.ConclusionThe ROII-20 presents good psychometric properties and may be considered as a promising instrument for measuring obsessional intrusions.

The Appraisal of Intrusive Thoughts in Relation to Obsessional–Compulsive Symptoms

Research has shown that although intrusive thoughts occur universally, the majority of individuals do not view intrusive thoughts as being problematic (Freeston, Ladouceur, Thibodeau, & Gagnon, 1991; Rachman & de Silva, 1978; Salkovskis & Harrison, 1984). Thus, it is not the presence of intrusive thoughts that leads to obsessional problems but rather some other factor that plays a role in the development of abnormal obsessions. According to the cognitive model of obsessive–compulsive disorder (OCD) put forth by Salkovskis (1985), the crucial factor that differentiates between individuals with OCD and those without is the individual's appraisal of the naturally occurring intrusive thoughts. This study aimed to test Salkovskis's model by examining the role of cognitive biases (responsibility, thought–action fusion, and thought control) as well as distress in the relationship between intrusive thoughts and obsessive–compulsive symptoms in an undergraduate sample of 326 students. An existing measure of intrusive thoughts (the Revised Obsessional Intrusions Inventory) was modified for this study to include a scale of distress associated with each intrusive thought in addition to the current frequency scale. When the Yale-Brown Obsessive-Compulsive Scale was used as the measure of OCD symptoms, a significant interaction effect of frequency and distress of intrusive thoughts resulted. Additionally, a significant three-way interaction of Frequency × Distress × Responsibility was found when the Obsessive Compulsive Inventory–Revised was used as the measure of OCD symptoms. These results indicate that the appraisal of intrusive thoughts is important in predicting OCD symptoms, thus providing support for Salkovskis's model of OCD.

Autogenous/reactive obsessions and their relationship with OCD symptoms and schizotypal personality features

This study was conducted to examine the autogenous-reactive model of obsessions [Behav. Res. Ther. 41 (2003) 11–29]. A large number of college students ( n = 932) were administered a questionnaire battery assessing obsessional intrusions, schizotypal personality features, depressive symptoms, general anxiety and OCD symptoms. Hierarchical regression analyses revealed that autogenous obsessions were more strongly associated with schizotypal personality features than with OCD symptoms, general anxiety, or depression, whereas the relationship between reactive obsessions and schizotypal personality features was negligible. Moreover, autogenous obsessions were more strongly associated with covert OCD symptoms, whereas reactive obsessions were more strongly associated with overt OCD symptoms. These findings suggest that autogenous obsessions are more strongly associated with cognitive features (e.g., anomalous perception, obsessing), whereas reactive obsessions are more strongly associated with overt behavioral features (e.g., checking, washing, ordering). Theoretical and clinical implications are discussed.

Intrusive thoughts in non‐clinical subjects: the role of frequency and unpleasantness on appraisal ratings and control strategies

AbstractThis study explores the frequency of the appearance of intrusive thoughts in normal people, as well their association with cognitive appraisals and control strategies. A total of 336 subjects completed the Spanish adaptation of the Obsessional Intrusions Inventory‐Revised (ROII), designed by Purdon and Clark (1993, 1994a, 1994b). Most of the subjects (99.4%) reported experiencing intrusive thoughts occasionally, but only 13% reported having them with some frequency. The intrusions were included in two factors: aggression, sexually and socially inappropriate behaviours, and doubts, checking, and cleanliness. The frequency of appearance of the most upsetting intrusive thought was associated with: the likelihood/probability bias, the need to control the thoughts, and neutralizing strategies. Nevertheless, the unpleasantness was associated with the morality bias and a broad range of control strategies. These results are discussed in relation to the different roles that the appraisal and the thought control responses play, both regarding the persistence as well as the unpleasantness associated with the most upsetting intrusions. Copyright © 2004 John Wiley &amp; Sons, Ltd.

Characteristics of illness intrusions in a non-clinical sample

This study examines whether illness intrusions can be distinguished from obsessional intrusions and worries. It also assesses the relationship between strategies, thought characteristics, and appraisal of illness intrusions. Two hundred and forty-three non-clinical participants identified an obsessive intrusive thought, a worry, and an illness intrusion. They evaluated each thought using items from the Cognitive Intrusions Questionnaire. The comparisons of intrusions showed that illness intrusions share characteristics of worries and obsessional intrusions, but also have their own characteristics. Illness intrusions seem to be particularly egosyntonic. The relationships between the strategies used to counter illness intrusions and their appraisal were also tested. Results support the idea that there are specific links between the evaluation of cognitive intrusions and the way they are processed. It demonstrated that escape/avoidance strategies are associated with the egodystonic nature of the thought and that problem-focused strategies are associated with the thought’s basis in reality. Illness intrusions may be conceptualised as either obsessions or worries. This study demonstrated that the category of an intrusive thought might not be as important as the way it is processed. It seems more important to consider appraisal of the disturbing thought and the way in which the person subsequently reacts and behaves.

Pensamientos intrusos en obsesivos subclínicos : contenidos, valoraciones, estrategias de control

Recent cognitive theories of obsessions consider that they differ from unwanted intrusive thoughts (IT) in terms of frequency of ocurrence, valorative appraisals, and thought control strategies. This paper examines that assumption comparing the responses provided by normal (N= 239) and subclinical (N=28) subjects to the following instruments: Revised Obsessional Intrusions Inventory (ROII), Maudsley Obsessive Compulsive Inventory (MOCI), BDI, and STAIS. Significant relationships were obtained among all the instruments, and the association between ROII and MOCI was maintained when depression scores were partialled out. Subclinically obsessive scored higher than normals on depressive, anxious and obsessional symptoms, reported more unwanted ITs, and rated their most upsetting IT as significantly more frequent. Moreover, showed higher negative valorative appraisal ratings and displayed most thought control strategies than normal subjects.

Intrusions and inferences in obsessive compulsive disorder

AbstractThis article compares two models about the nature of obsessional intrusions: one, that they are just ‘normal thoughts’ whose obsessional significance derives from their appraisal; the other, that they are specific inferences about thoughts and things, which form conditional premises and are part of the obsessional reasoning. Support for the first model comes from questionnaire studies showing that the content of obsessional intrusions is similar or even identical to intrusions in non‐obsessional people. Also there is growing clinical evidence that addressing the appraisals made about the intrusions rather than the content of the intrusions alleviates OCD symptoms. However, regarding the second model, intrusions tend to be thematic; they do explicitly take the form of an ‘inference’ (X may occur) whose development can be traced to inductive logic; ‘intrusions’ can be modified by changing inference processes, and such modification alone can reduce OCD‐related anxiety. It is proposed that both primary inference and secondary appraisal may form two separate parts of the same evaluative sequence, and both should be targeted in treatment. Copyright © 2002 John Wiley &amp; Sons, Ltd.

Differences and similarities between obsessive intrusive thoughts and worry in a non-clinical population: study 2

Differences between obsessions and worry have been clearly demonstrated on several variables [Langlois, F., Freeston, M. H., & Ladouceur, R. (2000). Differences and similarities between obsessive intrusive thoughts and worry in a non-clinical population: study 1. Behaviour Research and Therapy, 38, 157–173.]. Previous factor analysis of obsessions or worries have typically been used in developing measures for OCD and GAD symptoms. These studies generally support the distinctiveness of obsessions and worries but there have been no direct comparisons of the factor structure of obsession and worry on the same measure. This study aimed to compare the general structure of worry and obsessional intrusions. It also attempted to identify the relations between the respective factors identified in the appraisals of intrusions and the factor structures of coping strategies used in reaction to the thoughts. 254 students participated in the study. They first identified an obsession-like intrusion and a worry and then evaluated them with the Cognitive Intrusion Questionnaire. Different factor structures were obtained for worry and obsessive intrusive thoughts. However, the factor structure for the strategies used to counter the thoughts were highly similar for both types of thought. Furthermore, regression analysis identified interesting relationships between the strategies, the thought characteristics and appraisal. Thus, despite the ability to find differences between obsessive intrusive thoughts and worry, and even to accurately categorize them based on these differences, there may in fact exist common processes that are shared over much of a continuum. Sharp differences in the processes involved may only become clear in prototypical cases. The implications for models of cognitive intrusion are discussed.

Thought suppression in obsessive-compulsive disorder

The volitional suppression of thoughts andrelated increases in intrusions has been posited as amodel for clinical disorders, includingobsessive-compulsive disorder (OCD). Personallyrelevant, negative intrusive thoughts were elicited fromparticipants with OCD and nonclinical (NC) subjects. Thenegative thoughts reported by OCD patients were highlyrelated to core clinical obsessions. Participants with OCD reported more intrusive thoughts than didNC subjects regardless of whether they attempted tosuppress obsessional intrusions. Group- orexperimental-condition related thought enhancement orrebound was not found, but a greater percentage of theOCD suppression group experienced thought rebound thandid the NC suppression group. Volitional thoughtsuppression maybe but one of many response strategies employed by individuals with OCD when negativeintrusive thoughts occur.

Process characteristics of worry and obsessive intrusive thoughts

One hundred and twenty-five university students were administered a battery of self-report measures to assess worry disposition and content, frequency of obsessive intrusive thoughts, and 10 conceptually derived appraisal dimensions of worry and obsessional intrusions. Process ratings indicated that the worrisome thoughts were considered more disturbing than the ego-dystonic intrusive thoughts. Worry was also distinguished by a focus on the possible consequences of negative events, whereas concern about the personal meaning of the thought was a unique process dimension for obsessive intrusive thoughts. Both content and process variables are important in differentiating worry and obsessive-like intrusive thoughts in a nonclinical population.

The assessment of unwanted intrusive thoughts: A review and critique of the literature

In this paper we review the assessment and measurement of normal unwanted intrusive thoughts, images, and impulses that are considered the basis of clinical obsessions. After highlighting some difficulties with how the definition of cognitive intrusion has been applied to the development of assessment measures, we evaluate the construct validity of a number of retrospective self-report instruments such as the Intrusive Thoughts Questionnaire, Cognitive Intrusions Questionnaire, and Obsessional Intrusions Inventory, as well as interview and diary procedures. Measures of personal responsibility and meta-cognitive beliefs, which are still in the developmental phase, are also discussed. We conclude with a number of recommendations and areas of further research which would strengthen the construct validity of measures of intrusive thoughts and related constructs.

Perceived Control and Appraisal of Obsessional Intrusive Thoughts: A Replication and Extension

The present study had two purposes: 1) to examine the relationship between tendency to experience obsessional intrusive thoughts and tendency to worry; 2) to replicate and extend earlier findings (Purdon and Clark, 1993, 1994) on appraisal and thought suppression strategies in the persistence and control of obsessional intrusive thoughts. A sample of 160 college students were administered the Revised Obsessional Intrusions Inventory (ROII), the Penn State Worry Questionnaire (PSWQ), the Beck Depression Inventory (BDI), and the White Bear Suppression Inventory (WBSI). The ROII total score had minimal association with worry, trait thought suppression, or depressive symptoms, thereby supporting the distinctiveness of obsessional intrusive thoughts. Hierarchical multiple regression analyses revealed that cognitive appraisal, especially worries that the intrusion might come true in real life, accounted for a significant amount of variance in thought frequency and controllability. Thought suppression strategies accounted for substantially less variance in both frequency and control of intrusive thoughts. The results are discussed in terms of their support for Rachman's (1993) and Salkovskis' (1985, 1989) theories regarding the role of personal responsibility in the persistence of obsession-like intrusive thoughts.