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Modelling OCD: a test of the inflated responsibility model

Published online by Cambridge University Press:  31 October 2019

Ryan Mitchell ,
Donncha Hanna  and
Kevin F. W. Dyer
Ryan Mitchell*
Affiliation:
School of Psychology, The Queen’s University of Belfast, Belfast, BT9 5BN, Northern Ireland
Donncha Hanna
Affiliation:
School of Psychology, The Queen’s University of Belfast, Belfast, BT9 5BN, Northern Ireland
Kevin F. W. Dyer
Affiliation:
School of Psychology, The Queen’s University of Belfast, Belfast, BT9 5BN, Northern Ireland Psychological Therapies Service, Holywell Hospital, Northern HSC Trust, Antrim, BT41 2RJ, Northern Ireland
*
*Corresponding author. Email: [email protected]
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Abstract

Background:

The Salkovskis (1999) model of obsessive compulsive disorder (OCD), which emphasizes the role of inflated responsibility, has proven highly influential in both the understanding and treatment of OCD.

Aims:

This study aimed to empirically test several core processes of this model.

Method:

The individual components of the model were measured using multiple indicators in a sample of undergraduate students (n = 170), and confirmatory factor analyses were used to ascertain the most reliable, valid and theoretically consistent latent variables. Structural equation modelling was used to test proposed relations between latent constructs in the model.

Results:

The inflated responsibility model was a good fit for the data in the present sample. As predicted by the model, misinterpretations of intrusive thoughts as indicating personal responsibility fully mediated the relationships between responsibility beliefs and counterproductive safety strategies, neutralizing actions and mood changes.

Conclusions:

The Salkovksis (1999) inflated responsibility model of OCD is empirically supported in the present sample of undergraduate students, lending support to the proposed mechanisms in the model and supporting prior evidence.

Keywords

obsessive beliefsobsessive compulsive disorderresponsibilitystructural equation modelling
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 48 , Issue 3 , May 2020 , pp. 327 - 340
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019

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References

Abramowitz, J. S., Deacon, B. J., Olatunji, B. O., Wheaton, M. G., Berman, N. C., Losardo, D., Timpano, K. R., McGrath, P. B., Riemann, B. C., Adams, T., & Björgvinsson, T., 2010. Assessment of obsessive-compulsive symptom dimensions: development and evaluation of the Dimensional Obsessive-Compulsive Scale. Psychological Assessment, 22, 180–198.10.1037/a0018260CrossRefGoogle ScholarPubMed
Abramowitz, J. S., Fabricant, L. E., Taylor, S., Deacon, B. J., McKay, D., & Storch, E. A. (2014). The relevance of analogue studies for understanding obsessions and compulsions. Clinical Psychology Review, 34, 206–217.10.1016/j.cpr.2014.01.004CrossRefGoogle ScholarPubMed
Abramowitz, J. S., Khandker, M., Nelson, C. A., Deacon, B. J., & Rygwall, R. (2006). The role of cognitive factors in the pathogenesis of obsessive-compulsive symptoms: a prospective study. Behaviour Research and Therapy, 44, 1361–1374.10.1016/j.brat.2005.09.011CrossRefGoogle ScholarPubMed
Abramowitz, J. S., Schwartz, S. A., & Moore, K. M. (2003). Obsessional thoughts in postpartum females and their partners: content, severity and relationship with depression. Journal of Clinical Psychology in Medical Settings, 10, 157–164.10.1023/A:1025454627242CrossRefGoogle Scholar
Abramowitz, J. S., Tolin, D. F., & Street, G. P. (2001). Paradoxical effects of thought suppression: a meta-analysis of controlled studies. Clinical Psychology Review, 21, 683–703.CrossRefGoogle ScholarPubMed
Alcolado, G. M., & Radomsky, A. S. (2011). Believe in yourself: manipulating beliefs about memory causes checking. Behaviour Research and Therapy, 49, 42–49.10.1016/j.brat.2010.10.001CrossRefGoogle ScholarPubMed
Amir, N., Cashman, L., & Foa, E. B. (1997). Strategies of thought control in obsessive-compulsive disorder. Behaviour Research and Therapy, 35, 775.10.1016/S0005-7967(97)00030-2CrossRefGoogle ScholarPubMed
Amir, N., Najmi, S., & Morrison, A. S. (2009). Attenuation of attention bias in obsessive-compulsive disorder. Behaviour Research and Therapy, 47, 153–157.CrossRefGoogle ScholarPubMed
Anderson, J. C., & Gerbing, D. W. (1988). Structural equation modeling in practice: a review and recommended two-step approach. Psychological Bulletin, 103, 411.10.1037/0033-2909.103.3.411CrossRefGoogle Scholar
Arntz, A., Voncken, M., & Goosen, A. C. (2007). Responsibility and obsessive-compulsive disorder: an experimental test. Behaviour Research and Therapy, 45, 425–435.10.1016/j.brat.2006.03.016CrossRefGoogle ScholarPubMed
Baer, L., Brown-Beasley, M. W., Sorce, J., & Henriques, A. (1993). Computer-assisted telephone administration of a structured interview for obsessive-compulsive disorder. American Journal of Psychiatry, 150, 1737–1738.Google ScholarPubMed
Beck, A. T. (1976). Cognitive Therapy and the Emotional Disorders. New York, USA: International Universities Press,Google Scholar
Bentler, P. M. (1992). On the fit of models to covariances and methodology to the Bulletin. Psychological Bulletin, 112, 400–404.CrossRefGoogle ScholarPubMed
Bond, F. W., & Bunce, D. (2003). The role of acceptance and job control in mental health, job satisfaction, and work performance. Journal of Applied Psychology, 88, 1057.10.1037/0021-9010.88.6.1057CrossRefGoogle ScholarPubMed
Briggs, E. S., & Price, I. R. (2009). The relationship between adverse childhood experience and obsessive-compulsive symptoms and beliefs: the role of anxiety, depression, and experiential avoidance. Journal of Anxiety Disorders, 23, 1037–1046.CrossRefGoogle Scholar
Burnham, K. P., & Anderson, D. R. (2004). Multimodel inference: understanding AIC and BIC in model selection. Sociological Methods & Research, 33, 261–304.10.1177/0049124104268644CrossRefGoogle Scholar
Clark, D. A. (2004). Cognitive-Behavioral Therapy for OCD. New York, USA: Guilford Press.Google Scholar
Clark, D. A., & Beck, A. T. (2010). Cognitive Therapy of Anxiety Disorders. New York, USA: Guilford Press.Google Scholar
Clark, D. A., Purdon, C., & Byers, E. S. (2000). Appraisal and control of sexual and non-sexual intrusive thoughts in university students. Behaviour Research and Therapy, 8, 439–455.CrossRefGoogle Scholar
Coles, M. E., & Schofield, C. A. (2008). Assessing the development of inflated responsibility beliefs: the pathways to Inflated Responsibility Beliefs Scale. Behavior Therapy, 39, 322–33510.1016/j.beth.2007.09.003CrossRefGoogle ScholarPubMed
Coles, M. E., Pietrefesa, A. S., Schofield, C. A., & Cook, L. M. (2008). Predicting changes in obsessive compulsive symptoms over a six-month follow-up: a prospective test of cognitive models of obsessive compulsive disorder. Cognitive Therapy and Research, 32, 657–675.10.1007/s10608-007-9132-3CrossRefGoogle Scholar
Collins, L. M., & Coles, M. E. (2018). A preliminary investigation of pathways to inflated responsibility beliefs in children with obsessive compulsive disorder. Behavioural and Cognitive Psychotherapy, 46, 374–379.CrossRefGoogle ScholarPubMed
Curran, S. L., Andrykowski, M. A., & Studts, J. L. (1995). Short Form of the Profile of Mood States (POMS-SF): psychometric information. Psychological Assessment, 7, 80.CrossRefGoogle Scholar
De Putter, L. M., Van Yper, L., & Koster, E. H. (2017). Obsessions and compulsions in the lab: a meta-analysis of procedures to induce symptoms of obsessive-compulsive disorder. Clinical Psychology Review, 52, 137–147.CrossRefGoogle ScholarPubMed
Federici, A., Summerfeldt, L. J., Harrington, J. L., McCabe, R. E., Purdon, C. L., Rowa, K., & Antony, M. M. (2010). Consistency between self-report and clinician-administered versions of the Yale-Brown Obsessive–Compulsive Scale. Journal of Anxiety Disorders, 24, 729–733.CrossRefGoogle ScholarPubMed
Fenger, M. M., Mortensen, E. L., Rasmussen, J., & Lau, M. (2007). Group therapy with OCD: development and outcome of diagnosis specific treatment of patients with OCD in groups. Nordic Psychology, 59, 332.10.1027/1901-2276.59.4.332CrossRefGoogle Scholar
Fergus, T. A., & Wu, K. D. (2010). Is worry a thought control strategy relevant to obsessive-compulsive disorder? Journal of Anxiety Disorders, 24, 269–274.CrossRefGoogle ScholarPubMed
Foa, E. B., Huppert, J. D., Leiberg, S., Langner, R., Kichic, R., Hajcak, G., & Salkovskis, P. M. (2002). The Obsessive-Compulsive Inventory: development and validation of a short version. Psychological Assessment, 14, 485.10.1037/1040-3590.14.4.485CrossRefGoogle ScholarPubMed
Fornell, C., & Larcker, D. F. (1981). Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research, 18, 9–50.CrossRefGoogle Scholar
Frost, R. O., & Steketee, G. (eds) (2002). Cognitive Approaches to Obsessions and Compulsions: Theory, Assessment, and Treatment. Elsevier.Google Scholar
Gagné, J. P., Kelly-Turner, K., & Radomsky, A. S. (2018a). From the laboratory to the clinic (and back again): how experiments have informed cognitive-behavior therapy for obsessive-compulsive disorder. Journal of Experimental Psychopathology, 9. https://doi.org/10.1177/2043808718810030CrossRefGoogle Scholar
Gagné, J. P., Van Kirk, N., Hernandez-Vallant, A., Potluri, S., Krompinger, J. W., Cattie, J. E., Garner, L. E., Crosby, J. M., Brennan, B. P., & Elias, J. A. (2018b). Validating an abbreviated version of the Obsessive Beliefs Questionnaire. Journal of Clinical Psychology, 74, 1791–1807.10.1002/jclp.22629CrossRefGoogle ScholarPubMed
Green, B. L. (1996). Trauma history questionnaire. Measurement of Stress, Trauma, and Adaptation, 1, 366–369.Google Scholar
Hair, J., Black, W. C., Babin, B. J., & Anderson, R. E. (2010). Multivariate Data Analysis (7th edn). Upper Saddle River, New Jersey, USA: Pearson Education International.Google Scholar
Hajcak, G., Huppert, J. D., Simons, R. F., & Foa, E. B. (2004). Psychometric properties of the OCI-R in a college sample. Behaviour Research and Therapy, 42, 115–123.10.1016/j.brat.2003.08.002CrossRefGoogle Scholar
Hayes, S. C., Strosahl, K., Wilson, K. G., Bissett, R. T., Pistorello, J., Toarmino, D., … & McCurry, S. M. (2004). Measuring experiential avoidance: a preliminary test of a working model. Psychological Record, 54, 553–578.10.1007/BF03395492CrossRefGoogle Scholar
Hermans, D., Engelen, U., Grouwels, L., Joos, E., Lemmens, J., & Pieters, G. (2008). Cognitive confidence in obsessive-compulsive disorder: distrusting perception, attention and memory. Behaviour Research and Therapy, 46, 98–113.10.1016/j.brat.2007.11.001CrossRefGoogle Scholar
Kumar, A., Sharma, M. P., Kandavel, T., & Janardhan Reddy, Y. C. (2012). Cognitive appraisals and quality of life in patients with obsessive compulsive disorder. Journal of Obsessive-Compulsive and Related Disorders, 1, 301–305.10.1016/j.jocrd.2012.08.003CrossRefGoogle Scholar
Ladouceur, R., Rhéaume, J., Freeston, M. H., Aublet, F., Jean, K., Lachance, S., Langlois, F., & de Pokomandy-Morin, K., (1995). Experimental manipulations of responsibility: an analogue test for models of obsessive-compulsive disorder. Behaviour Research and Therapy, 33, 937–946.10.1016/0005-7967(95)00024-RCrossRefGoogle ScholarPubMed
Leonhart, M. W., & Radomsky, A. S. (2017). Responsibility causes reassurance seeking, too: an experimental investigation. Journal of Obsessive-Compulsive and Related Disorders, 20, 66–74.CrossRefGoogle Scholar
Lopatka, C., & Rachman, S. (1995). Perceived responsibility and compulsive checking: an experimental analysis. Behaviour Research and Therapy, 33, 673–684.10.1016/0005-7967(94)00089-3CrossRefGoogle ScholarPubMed
MacCallum, R. C. (2003). 2001 presidential address: working with imperfect models. Multivariate Behavioral Research, 38, 113–139.CrossRefGoogle ScholarPubMed
MacCallum, R. C., Browne, M. W., and Sugawara, H. M. (1996). Power analysis and determination of sample size for covariance structure modeling. Psychological Methods, 1, 130−149.CrossRefGoogle Scholar
Mantz, S. C., & Abbott, M. J. (2017). The relationship between responsibility beliefs and symptoms and processes in obsessive compulsive disorder: a systematic review. Journal of Obsessive-Compulsive and Related Disorders, 14, 13–26.CrossRefGoogle Scholar
Morillo, C., Belloch, A., & García-Soriano, G. (2007). Clinical obsessions in obsessive-compulsive patients and obsession-relevant intrusive thoughts in non-clinical, depressed and anxious subjects: where are the differences? Behaviour Research and Therapy, 45, 1319–1333.CrossRefGoogle ScholarPubMed
Mulaik, S. A., James, L. R., Van Alstine, J., Bennett, N., Lind, S., & Stilwell, C. D. (1989). Evaluation of goodness-of-fit indices for structural equation models. Psychological Bulletin, 105, 430.CrossRefGoogle Scholar
National Institute for Health and Care Excellence (NICE) (2005). Obsessive-compulsive disorder and body dysmorphic disorder: treatment. Clinical guideline (CG-31). Retrieved from: https://www.nice.org.uk/guidance/cg31Google Scholar
Obsessive Compulsive Cognitions Working Group (OCCWG) (1997). Cognitive assessment of obsessive-compulsive disorder. Behaviour Research and Therapy, 35, 667–681.CrossRefGoogle Scholar
Obsessive Compulsive Cognitions Working Group (OCCWG) (2001). Development and initial validation of the obsessive beliefs questionnaire and the interpretation of intrusions inventory. Behaviour Research and Therapy, 39, 987–1006.CrossRefGoogle Scholar
Obsessive Compulsive Cognitions Working Group (OCCWG) (2003). Psychometric validation of the Obsessive Beliefs Questionnaire and the Interpretation of Intrusions Inventory: Part I. Behaviour Research and Therapy, 41, 863–878.CrossRefGoogle Scholar
Obsessive Compulsive Cognitions Working Group (OCCWG) (2005). Psychometric validation of the obsessive belief questionnaire and interpretation of intrusions inventory – Part 2: Factor analyses and testing of a brief version. Behaviour Research and Therapy, 43, 1527–1542.CrossRefGoogle Scholar
Ólafsson, R. P., Snorrason, Í., & Smári, J. (2010). Yale-Brown Obsessive Compulsive scale: psychometric properties of the self-report version in a student sample. Journal of Psychopathology and Behavioral Assessment, 32, 226–235.CrossRefGoogle Scholar
Palm, K. M., & Strong, D. R. (2007). Using item response theory to examine the White Bear Suppression Inventory. Personality and Individual Differences, 42, 87–98.CrossRefGoogle Scholar
Parker, G., Tupling, H., & Brown, L. B. (1979). Parental bonding instrument (PBI). British Journal of Medical Psychology, 52, 1–10.CrossRefGoogle Scholar
Pleva, J., & Wade, T. D., (2006). The mediating effects of misinterpretation of intrusive thoughts on obsessive-compulsive symptoms. Behaviour Research and Therapy, 44, 1471–1479.CrossRefGoogle ScholarPubMed
Pozza, A., & Dèttore, D. (2014). The specificity of inflated responsibility beliefs to OCD: a systematic review and meta-analysis of published cross-sectional case-control studies. Research in Psychology and Behavioural Sciences, 2, 75–85.CrossRefGoogle Scholar
Preacher, K. J., & Merkle, E. C. (2012). The problem of model selection uncertainty in structural equation modeling. Psychological Methods, 17, 1.CrossRefGoogle ScholarPubMed
Purdon, C. (2001) Appraisal of obsessional thought recurrences: impact on anxiety and mood state. Behavior Therapy, 32, 47–64.CrossRefGoogle Scholar
Purdon, C., & Clark, D. A. (1994). Perceived control and appraisal of obsessional intrusive thoughts: a replication and extension. Behavioural and Cognitive Psychotherapy, 22, 269–285.CrossRefGoogle Scholar
Rachman, S. (1997). A cognitive theory of obsessions. Behaviour Research and Therapy, 35, 793–802.CrossRefGoogle ScholarPubMed
Rachman, S. (1998). A cognitive theory of obsessions: elaborations. Behaviour Research and Therapy, 36, 385–401.CrossRefGoogle ScholarPubMed
Rhéaume, J., Freeston, M. H., Léger, E., & Ladouceur, R. (1998). Bad luck: an underestimated factor in the development of obsessive-compulsive disorder. Clinical Psychology and Psychotherapy, 5, 1–12.3.0.CO;2-J>CrossRefGoogle Scholar
Romero-Sanchiz, P., Nogueira-Arjona, R., Godoy-Ávila, A., Gavino-Lázaro, A., & Freeston, M. H. (2015). Narrow specificity of responsibility and intolerance of uncertainty in obsessive-compulsive behavior and generalized anxiety symptoms. International Journal of Cognitive Therapy, 8, 239–257.CrossRefGoogle Scholar
Salkovskis, P. M. (1985). Obsessional-compulsive problems: a cognitive-behavioural analysis. Behaviour Research and Therapy, 23, 571–583.CrossRefGoogle ScholarPubMed
Salkovskis, P. M. (1989). Cognitive-behavioural factors and the persistence of intrusive thoughts in obsessional problems. Behaviour Research and Therapy, 27, 677–682.CrossRefGoogle ScholarPubMed
Salkovskis, P. M. (1999). Understanding and treating obsessive-compulsive disorder. Behaviour Research and Therapy, 37, S29–52.CrossRefGoogle ScholarPubMed
Salkovskis, P. M., Forrester, E., & Richards, C. (1998). Cognitive-behavioural approach to understanding obsessional thinking. British Journal of Psychiatry, supplement 35, 53–63.CrossRefGoogle Scholar
Salkovskis, P. M., Westbrook, D., Davis, J., Jeavons, A., & Gledhill, A. (1997). Effects of neutralizing on intrusive thoughts: an experiment investigating the aetiology of obsessive-compulsive disorder. Behaviour Research and Therapy, 35, 211–220.CrossRefGoogle Scholar
Salkovskis, P. M., Wroe, A. L., Gledhill, A. A., Morrison, N. N., Forrester, E. E., Richards, C. C., & Thorpe, S. S. (2000). Responsibility attitudes and interpretations are characteristic of obsessive compulsive disorder. Behaviour Research and Therapy, 38, 347–372.CrossRefGoogle ScholarPubMed
Sarason, I. G., Johnson, J. H., & Siegel, J. M. (1978). Assessing the impact of life changes: development of the Life Experiences Survey. Journal of Consulting and Clinical Psychology, 46, 932.CrossRefGoogle ScholarPubMed
Schreiber, J. B., Stage, F. K., King, J., Nora, A., & Barlow, E. A. (2006). Reporting structural equation modelling and confirmatory factor analysis results: a review. Journal of Educational Research, 99, 323–338.CrossRefGoogle Scholar
Shafran, R. (1997). The manipulation of responsibility in obsessive-compulsive disorder. British Journal of Clinical Psychology, 36, 397–407.CrossRefGoogle ScholarPubMed
Steketee, G., Frost, R., & Bogart, K. (1996). The Yale-Brown obsessive compulsive scale: interview versus self-report. Behaviour Research and Therapy, 34, 675–684.CrossRefGoogle ScholarPubMed
Taylor, S., Abramowitz, J. S., & McKay, D. (2007). Cognitive-behavioral models of obsessive-compulsive disorder. In Psychological Treatment of Obsessive-Compulsive Disorder: Fundamentals and Beyond, pp. 9–29.CrossRefGoogle Scholar
Taylor, S., Coles, M. E., Abramowitz, J. S., Wu, K. D., Olatunji, B. O., Timpano, K. R., … & Tolin, D. F. (2010). How are dysfunctional beliefs related to obsessive-compulsive symptoms? Journal of Cognitive Psychotherapy, 24, 165–176.CrossRefGoogle Scholar
Wegner, D. M., & Zanakos, S. (1994). Chronic thought suppression. Journal of Personality, 62, 615–640.CrossRefGoogle ScholarPubMed
Wells, A., & Davies, M. I. (1994) The Thought Control Questionnaire: a measure of individual differences in the control of unwanted thoughts. Behaviour Research and Therapy, 32, 871–878.CrossRefGoogle ScholarPubMed
Wheaton, M. G., Abramowitz, J. S., Berman, N. C., Riemann, B. C., & Hale, L. R. (2010). The relationship between obsessive beliefs and symptom dimensions in obsessive-compulsive disorder. Behavior Research and Therapy, 48, 949–954.CrossRefGoogle ScholarPubMed
Yorulmaz, O., Gençöz, T., & Woody, S. (2010). Vulnerability factors in OCD symptoms: cross-cultural comparisons between Turkish and Canadian samples. Clinical Psychology & Psychotherapy, 17, 110–121.Google ScholarPubMed
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