Ironic processes in the mental control of obsessive thinking in obsessive -compulsive disorder

The hyperaccessibility of suppressed thoughts (i.e., enhancement), and the suppression-induced rebound effect (i.e., more thoughts subsequent to suppression), have been viewed as potential models for the creation of ruminative thinking in Obsessive-Compulsive Disorder (OCD) (e.g., Gold & Wegner, 1995). The current study evaluated the impact of different thought control strategies (TCS) (Worry, Reappraisal, Distraction, Social Control and Punishment; TCQ; Wells & Davies, 1994) on the frequency, intensity and anxiety associated with intrusive thoughts, for individuals diagnosed with OCD. The three variables were expected to increase during and after attempted suppression. This study also investigated the extent that thought-action fusion (TAF; TAF scale; Shafran, Thordarson, & Rachman, 1996), the tendency to assume incorrect causal relationships between a given thought and external reality, moderated the rebound and enhancement effects. Three types of TAF, TAF-morality (TAF-M), TAF-likelihood-other (TAF-LO), and TAF-likelihood-self (TAF-LS) were assessed. Two groups (12 men & 12 women in each), varying in the order of suppression (S) and exposure (E) across three experimental intervals, were compared (ESE vs. SEE). During suppression, participants were instructed to avoid their target intrusion using the strategy most typical for them (TCQ). They were told to allow all thoughts to exist, without ritualizing in response to them, during exposure. Results did not support rebound or enhancement for any of the dependent variables. TAF-LO and TAF-LS both moderated the enhancement effect for thought intensity. All three types of TAF moderated the relationships between the intensity scores and the two groups. TAF-M also moderated the relationship between both anxiety score and both groups. TAF-M was associated with greater Obsessionality and Compulsivity (YBOCS; Goodman, Price, Rasmussen, & Mazure, 1989) for all participants. Although Punishment was expected to be the most commonly cited TCS, the order of frequency was Reappraisal, Social Control, Distraction, Punishment and Worry. Punishment and Worry were both positively associated with Compulsivity, TAF-LO and TAF-M. Worry was additionally associated with TAF-LS. Higher Obsessionality was associated with greater anxiety levels. Findings suggest that thought suppression experiments may not be models for intrusive thinking in those with OCD. Future research with an OCD sample, in real world settings, is advised