Dysfunctional belief-based subgroups and inferential confusion in obsessive-compulsive disorder

Cognitive-behavioural models emphasize the mediating role of dysfunctional beliefs in obsessive-compulsive disorder (OCD). However, recent studies indicated that beliefs related to responsibility and threat-estimation, Importance and Control of Thoughts, and perfectionism and intolerance of uncertainty were not elevated in a substantial proportion of patients suffering from OCD. This study attempts to replicate these findings, and, in addition, explores the role of a cognitive process characteristic of OCD, i.e., inferential confusion. Participants suffering from OCD (n = 174), completed cognitive- and symptom measures. Cluster-analysis revealed a 2- and a 6-cluster solution, both which contained substantial low belief subgroups. The Perfectionism and Certainty beliefs cluster in the 6-cluster solution was distinct from the other high beliefs clusters, which is in line with the recently proposed distinction between harm related versus 'just right' related OC symptoms. Finally, the assessment of cognitive processes seems to have complimentary value in addition to assessing belief content, and therefore could further our understanding of OCD within a cognitive framework. (C) 2010 Elsevier Ltd. All rights reserved