Examining the Role of Obsessive Beliefs in Obsessive-Compulsive Symptoms

According to prevailing cognitive models of Obsessive-compulsive Disorder (OCD), obsessions and compulsions arise largely due to a set of related dysfunctional beliefs. In developing a brief measure of these beliefs, The Obsessive-Compulsive Cognitions Working Group identified 3 belief dimensions associated with OCD symptoms: 1) Responsibility/Threat, 2) Importance and Control of Thoughts, and 3) Perfectionism/Certainty. While associations between these beliefs dimensions and obsessive-compulsive symptoms have been established, questions remain regarding these dimensions’ unique association with OCD. Data were collected from participants in a variety of clinical settings diagnosed with either OCD (N = 1339) or other anxiety disorders (N = 423). Obsessive-compulsive beliefs were assessed using the Obsessive Beliefs Questionnaire (OBQ-44), and obsessive-compulsive symptom severity was assessed using the Obsessive-Compulsive Inventory-Revised (OCI-R). Mean comparisons were assessed, and a series of model comparisons were conducted to determine whether OBQ-44 subscale scores (Responsibility/Threat, Perfectionism/Certainty, and Importance and Control of Thoughts) and diagnosis group produce a significant interactive effect on symptom severity. Those in the Anxiety group and the OCD group significantly differed in scores on the Responsibility/Threat subscale (t(338) = 3.29, p \u3c .001, Cohen’s d = .96) as well as the Importance and Control of Thoughts subscale (t(340) = 2.50, p \u3c .05, Cohen’s d = .73). Notably, scores on the Perfectionism/Certainty subscale did not significantly differ by diagnosis (t(341) = 0.81, p = .40, Cohen’s d = .24). A series of multiple regressions on symptom severity pertaining to each subscale were conducted, with the subscale of interest (R/T, PC, ICT) entered in Step 1, and an interaction term created from the product of the subscale and diagnosis group entered in Step 2. Across all models, steps containing the interaction term were not significant (p \u3e .05), indicating that participants with OCD and participants with other anxiety disorders did not differ in terms of the relationship between obsessive beliefs and symptom severity. These results mirror prior evidence indicating that obsessive belief dimensions are limited in their specificity to OCD. Until a more robust cognitive conceptualization of OCD can be demonstrated, scores on measures of obsessive beliefs should be interpreted with caution