Obsessional beliefs and the implicit and explicit morality of intrusive thoughts

Abstract

Cognitive models of obsessive-compulsive disorder (OCD) suggest that misinterpreting intrusive thoughts exacerbates obsessional thinking. To evaluate this hypothesis, healthy participants (N=91) were prompted to recollect their unwanted thoughts, and then beliefs about the immorality of these thoughts were manipulated. Next, participants completed implicit and explicit measures of self-evaluation and appraisals of unwanted thoughts. Results from structural regression analyses indicated that explicit responses to unwanted thoughts, such as evaluations of the significance of intrusive thoughts and state self-esteem, were predicted by pre-existing obsessional beliefs, but not by the morality instruction manipulation. In contrast, implicit responses, such as appraisals of unwanted thoughts as relatively important and evaluations of the self as relatively immoral and dangerous, were predicted by the interaction between specific obsessional beliefs (e.g., intolerance of uncertainty) and the morality instructions. Findings largely support cognitive models of OCD and suggest unique predictors of implicit and explicit responses to unwanted thoughts.

Acknowledgements

The authors are thankful for the feedback from Kimberly Wilson, and the research assistance provided by Erin Horn, Liza Schottinger and members of the Program for Anxiety Cognition & Treatment (PACT) Lab.

Notes

¹Two participants were excluded from this final sample—one reported a prior diagnosis of OCD, and the other reported having no unwanted thoughts.

²Only eight participants were not recruited through the psychology participant pool. There were no differences between the student and community groups on the key measures.

³IAT D scores reflect the difference in mean reaction time across critical blocks divided by the standard deviations across blocks, which is conceptually similar to Cohen's d (see Greenwald et al., 2003).

⁴These findings replicate those found by Teachman et al. (2006) regarding little effect of the manipulation as a main effect, with the exception of the results for the IAT unwanted thoughts-important task.

⁵Results across Teachman et al. (2006) and the current study showed very similar patterns. In both cases, pre-existing obsessional beliefs predicted all explicit (but not implicit) responses to unwanted thoughts, whereas the interaction between pre-existing obsessional beliefs and the instruction conditions predicted implicit (but not explicit) responses. Notwithstanding, there were some differences, including the finding of a main effect of instruction condition on the IAT unwanted thoughts-important task in Teachman et al. (2006), but not in the current study. In addition, the OBQ total score interacted with instructions condition to shift the IAT self-dangerous task in the earlier study (unfortunately, interactions with specific belief domains were not examined in that study), whereas it was specific belief domains (and not the total) that were predictive in the current study. Also, there were significant interactions observed for each of the IAT tasks in the present study (rather than with only one IAT task).