Aversive Intrusive Thoughts as Contributors to Inflated Responsibility, Intolerance of Uncertainty, and Thought-action Fusion

Three constructs considered to be important primary beliefs in the pathogenesis of OCD are inflated responsibility, intolerance of uncertainty and thought-action fusion. While there is evidence suggesting that these beliefs/appraisals can influence OCD symptoms, we conducted two experiments to determine whether manipulating aversive intrusive thoughts would conversely affect measures of these constructs. Using procedures in which nonclinical samples were asked to mentally rehearse either OCD-relevant aversive statements or neutral statements, Experiment 1 found that participants rehearsing aversive statements generated higher scores on measures of responsibility and thought-action fusion than a control condition. Experiment 2 found that rehearsing aversive statements raised scores on measures of responsibility, intolerance of uncertainty and thought-action fusion, but only when rehearsal was self-referent. Rehearsing aversive statements significantly increased measures of negative mood, and mediational analyses suggested that the present findings could be explained either by increases in some measures of negative mood mediating the observed increases in appraisal ratings or alternatively, increases in some appraisal ratings increasing negative mood. These findings indicate that experiencing frequent, uncontrollable aversive intrusive thoughts of an egodystonic nature may activate OCD-relevant appraisal processes representing causal factors for symptoms, and directly tackling these thoughts in psychological interventions may be a significant contributor to alleviating anxiety symptoms.