Developmental pathways to self-vulnerability and inflated sense of responsibility in obsessive-compulsive phenomena

The cognitive theory of obsessive-compulsive disorder (OCD) identifies inflated responsibility as the essential belief that underlies the development and maintenance of the disorder. While the association of inflated responsibility to OCD has been thoroughly investigated, less effort has been made into understanding its nature and developmental trajectories. The present study aimed to address these gaps. More specifically, it aimed to explore the concept of responsibility and its different dimensions. In addition, it combined several approaches to the development of inflated responsibility beliefs to create an integrated model. It also examined whether self-beliefs mediated the association between those developmental pathways, the presence of responsibility beliefs, and OCD symptoms. Finally, the present study investigated whether the pathways to inflated responsibility were also pathways to obsessive-compulsive (OC) phenomena. Participants in this study were a combined sample of first year undergraduate students from Swinburne University in Melbourne and community participants. A total of 504 participants, 378 females (M=26.08, SD=10.86) and 126 males (M=25.83, SD=10.56) completed a survey that included a range of questionnaires measuring inflated responsibility, childhood and parenting experiences, self-views and OC symptom severity. Study 1 comprised a factor analysis to identify dimensions of inflated responsibility from existing measures. Four factors were identified: responsibility for omissions, responsibility for thoughts and threat, responsibility for safety, and accountability. The factor structure was reliable and confirmatory analysis indicated a good model fit. In Study 2, associations were found between responsibility belief dimensions, OC symptom severity, and developmental factors. These factors included the experience of exaggerated responsibility in childhood, exposure to rigid rules, overprotective parenting, having experienced a pivotal role in an incident of misfortune, and recollections of having received ambivalent communication from parents. In addition, structural equation modelling revealed three pathways to inflated responsibility beliefs and OC phenomena. The first and the second were that each of two developmental factors-ambivalent parenting and pivotal experience-predicted self-ambivalence which in turn predicted responsibility and OC symptom severity. The third was that exaggerated responsibility in childhood predicted responsibility for safety, which in turn predicted OC symptoms. This study highlighted the important developmental factors in inflated responsibility and OC phenomena as well as the role of self-vulnerability as a mediator between early experiences, beliefs and psychopathology. It is suggested that the cognitive theory of OCD should be expanded to consider the different dimensions of inflated responsibility, developmental factors and the role of self-vulnerabilities. Implications for clinicians include the augmentation of CBT to include parental and familial interventions, as well as use of self-based frameworks in treating OCD patients