An investigation into inflated responsibility, thought action fusion and the role of unacceptability in Obsessive Compulsive Disorder

BACKGROUND The cognitive behavioural models of Obsessive Compulsive Disorder (OCD) suggest that the misinterpretation of the meaning of intrusive thoughts plays a key role in influencing obsessional behaviour (Salkovskis, 1985, 1989; Rachman, 1997, 1998). The constructs Responsibility, Thought Action Fusion and negative appraisals of intrusions have been linked to predisposing individuals to OCD. The present study reports an investigation into the specificity of these constructs with respect to OCD symptomatology. Although theoretically the role of these constructs have been accepted the ideas have yet to be empirically validated (Wilson, 1999). The value of the application of self -discrepancy theory (Higgins, 1987,1996; Carver, Lawrence, Scheier, 1999) to OCD is also explored.That is the role of the ought, ideal and feared selves were examined as to their potential to predict agitation and dejection-related affects. METHOD.The Research is questionnaire based and employed a number of measures within the OCD field. Responsibility beliefs were examined using the Responsibility Attitude Scale (RAS) and the Responsibility Interpretations Questionnaire (RIQ) both developed by Salkovskis, Wroe, Gledhill, Morrison et al (2000). Thought Action Fusion was examined using Shafran, Thordarson and Rachman's (1996) Thought Action Fusion Scale. However, the negative appraisals of intrusions was measured using a questionnaire specifically designed for this study, the Intrusion Related Self Inference Scale. 9.Finally the Selves Questionnaire developed by Carver et al (1999) enabled the examination of the discrepancies between various self guides and the actual self. This method also enabled the examination of beliefs about the unacceptability of the self by exploring actual-feared discrepancies.RESULTS Comparisons between Obsessive Compulsive individuals and Anxious and Non-Anxious Controls indicated the specificity of both responsibility assumptions and appraisals with respect to OCD. There was also good evidence for an association between responsibility cognitions and OCD symptomatology. With regard to TAF the findings cast some doubt on the specificity of this construct to individuals with OCD. The findings suggest that TAF may be a pervasive bias that may occur in a variety of anxiety disorders. Turning to negative appraisals of intrusions there was evidence that these appraisals were significantly elevated in obsessional participants compared to Controls. However there was no association between the Intrusion Related Self Inference Scale and OCD symptomatology for Obsessional individuals. However this scale was found to have questionable reliability, which may explain this finding. With regard to self -discrepancy theory the hypotheses that actual-ought discrepancies and actual-ideal discrepancies lead to agitation and dejection related affects respectively were partially supported. A content analysis of the feared self traits revealed that individuals with OCD have different parameters for evaluating their feared self as compared to controls and that they are more likely to generate moralistic traits in defining their feared selves. CONCLUSION The findings reported in this study largely support the cognitive behavioural models of OCD (Salkovskis, 1985, 1989; Rachman, 1997, 1998)