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The Expanded Version of the Inferential Confusion Questionnaire: Further Development and Validation in Clinical and Non-Clinical Samples

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Abstract

The current study represents the further development and validation of an expanded version of the Inferential Confusion Questionnaire (ICQ-EV) in non-clinical and clinical samples. Inferential confusion seems to be particularly relevant to Obsessive-Compulsive Disorder (OCD) and is defined as a failure to recognize the unrealistic nature of obsessions due to a subjective form of reasoning. Factor analysis of the item-set of the ICQ-EV indicated a one-dimensional solution in non-clinical and clinical samples. It was hypothesized that inferential confusion as measured by the ICQ-EV would be particularly relevant to participants with OCD. Results confirmed convergent validity with strong relationships between the ICQ-EV and obsessive-compulsive symptoms in all samples independent of other cognitive domains and general distress. In addition, those with OCD scored higher on the ICQ-EV than non-clinical controls and a mixed anxiety disorder group so confirming group-criterion validity. Finally, the ICQ-EV also showed clinical validity with change in ICQ-EV scores during treatment significantly related to successful treatment outcome.

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References

  • Aardema, F., & O’Connor, K. (2003). Seeing white bears that are not there: inference processes in obsessions. Journal of Cognitive Psychotherapy, 17, 23–37.

    Article  Google Scholar 

  • Aardema, F., & O’Connor, K. (2007). The menace within: obsessions and the self. Journal of Cognitive Psychotherapy, 21, 182–197.

    Article  Google Scholar 

  • Aardema, F., Emmelkamp, P. M. G., & O’Connor, K. (2005a). Inferential confusion, cognitive change and treatment outcome in obsessive-compulsive disorder. Clinical Psychology and Psychotherapy, 12, 337–345.

    Article  Google Scholar 

  • Aardema, F., O’Connor, K., Emmelkamp, P., Marchand, A., & Todorov, C. (2005b). Inferential confusion and obsessive-compulsive disorder: the Inferential Confusion Questionnaire. Behaviour Research and Therapy, 43, 293–308.

    Article  Google Scholar 

  • Aardema, F., Kleijer, T. M. R., Trihey, M., O’Connor, K., & Emmelkamp, P. (2006a). Inference processes, schizotypal thinking and obsessive-compulsive disorder. Psychological Reports, 99, 213–220.

    Article  Google Scholar 

  • Aardema, F., O’Connor, K. P., & Emmelkamp, P. M. G. (2006b). Inferential confusion and obsessive beliefs in obsessive-compulsive disorder. Cognitive Behaviour Therapy, 35, 138–147.

    Article  Google Scholar 

  • Aardema, F., Radomsky, A. S., O’Connor, K. P., & Julien, D. (2008). Inferential confusion, obsessive beliefs and obsessive-compulsive symptoms: a multidimensional investigation of cognitive domains. Clinical Psychology and Psychotherapy, 15, 227–238.

    Article  PubMed  Google Scholar 

  • Aardema, F., Pélissier, M. C., O’Connor, K. P., & Lavoie, M. (2009). The quantification of doubt in obsessive-compulsive disorder. International Journal of Cognitive Therapy, 2, 188–205.

    Article  Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (text rev.) (4th ed.). Washington, DC: Author.

    Google Scholar 

  • Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893–897.

    Article  PubMed  Google Scholar 

  • Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck depression inventory (2nd ed.). San Antonio: The Psychological Corporation.

    Google Scholar 

  • Brislin, R. (1986). The wording and translation of research instruments. In W. J. Lonner & J. W. Berry (Eds.), Field methods in cross-cultural psychology (pp. 137–164). Beverly Hills: Sage.

    Google Scholar 

  • Brown, T. A., DiNardo, P. A., & Barlow, D. H. (1994a). Anxiety disorders interview schedule for DSM-IV. Boulder: Graywind Publications.

    Google Scholar 

  • Brown, H. D., Kosslyn, S. M., Breiter, H. C., Baer, L., & Jenike, M. A. (1994b). Can patients with obsessive-compulsive disorder discriminate between percepts and mental images? A signal detection analysis. Journal of Abnormal Psychology, 103, 445–454.

    Article  Google Scholar 

  • Burns, G. L., Keortge, S. G., Formea, G. M., & Sternberger, L. G. (1996). Revision of the Padua Inventory of obsessive compulsive disorder symptoms: distinctions between worry, obsessions, and compulsions. Behaviour Research and Therapy, 34, 163–173.

    Article  PubMed  Google Scholar 

  • Costello, A. B., & Osborne, J. W. (2005). Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Practical Assessment Research & Evaluation, 10, Retrieved March 18, 2009 from http://pareonline.net/pdf/v10n7a.pdf.

  • Cota, A. A., Longman, R. S., Holden, R. R., Fekken, G. C., & Xinaris, S. (1993). Interpolating 95th percentile eigenvalues from random data: an empirical example. Educational & Psychological Measurement, 53, 585–596.

    Article  Google Scholar 

  • Éditions du Centre de Psychologie Appliquée. (1998). Inventaire de dépression de Beck, BDI-II [Beck Depression Inventory]. Paris: Éditions du Centre de Psychologie Appliquée.

    Google Scholar 

  • Emmelkamp, P. M. G., & Aardema, F. (1999). Metacognition, specific obsessive-compulsive beliefs and obsessive-compulsive behavior. Clinical Psychology and Psychotherapy, 6, 139–145.

    Article  Google Scholar 

  • Emmelkamp, P. M. G., Van Oppen, P., & Van Balkom, A. J. L. M. (2002). Cognitive changes in patients with obsessive-compulsive rituals treated with exposure in vivo and response prevention. In R. O. Frost & G. Steketee (Eds.), Cognitive approaches to obsessions and compulsions: Theory, assessment, and treatment. Oxford: Elsevier Science.

    Google Scholar 

  • Freeston, M. H., Ladouceur, R., Thibodeau, N., Gagnon, F., & Rhéaume, J. (1994). L’inventaire d’anxiété de Beck: propriétés psychométriques d’une traduction française. L’encéphale, 20, 47–55.

    PubMed  Google Scholar 

  • Gardiner, W. P., & Gettinby, G. (1998). Experimental design techniques in statistical practice: A practical software-based approach. Chichester: Horwood Publishing Limited.

    Google Scholar 

  • Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Delgado, P., Heninger, G. R., et al. (1989a). The yale-brown obsessive compulsive scale. II Validity. Validity Archives of General Psychiatry, 46, 1012–1016.

    Google Scholar 

  • Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Fleischman, R. L., Hill, C. L., et al. (1989b). The yale-brown obsessive compulsive scale. I. Development, use and reliability. Archives of General Psychiatry, 46, 1006–1011.

    Google Scholar 

  • Julien, D., O’Connor, K. P., & Aardema, F. (2007). Intrusive thoughts, obsessions and appraisals in obsessive-compulsive disorder: a critical review. Clinical Psychology Review, 27, 366–383.

    Article  PubMed  Google Scholar 

  • Julien, D., O’Connor, K., & Aardema, F. (2008). Intrusions related to obsessive-compulsive disorder: a question of content or context? Journal of Clinical Psychology, 65, 709–722.

    Article  Google Scholar 

  • Kawamura, K. Y., Hunt, S. L., Frost, R. O., & DiBartolo, P. (2001). Perfectionism, anxiety and depression: are the relationships independent? Cognitive Therapy and Research, 25, 291–301.

    Article  Google Scholar 

  • MacCallum, R. C., Widaman, K. F., Zhang, S., & Hong, S. (1999). Sample size in factor analysis. Psychological Methods, 4, 84–99.

    Article  Google Scholar 

  • Mineka, S., Watson, D., & Clark, L. A. (1998). Comorbidity of anxiety and unipolar mood disorders. Annual Review of Psychology, 49, 377–412.

    Article  PubMed  Google Scholar 

  • O’Connor, K. P., & Robillard, S. (1995). Inference processes in obsessive-compulsive disorder: some clinical observations. Behaviour Research and Therapy, 33, 887–896.

    Article  PubMed  Google Scholar 

  • O’Connor, K. P., & Robillard, S. (1999). A cognitive approach to modifying primary inferences in obsessive-compulsive disorder. Journal of Cognitive Psychotherapy, 13, 1–17.

    Google Scholar 

  • O’Connor, K., Aardema, F., Bouthillier, D., Fournier, S., Guay, S., Robillard, S., et al. (2005a). Evaluation of an inference based approach to treating obsessive-compulsive disorder. Cognitive Behaviour Therapy, 43, 1–16.

    Google Scholar 

  • O’Connor, K., Aardema, F., & Pélissier, M. C. (2005b). Beyond reasonable doubt: Reasoning processes in obsessive-compulsive and related disorders. Chichester: Wiley.

    Google Scholar 

  • Obsessive Compulsive Cognitions Working Group. (2005). Psychometric validation of the obsessive belief questionnaire and interpretation of intrusions inventory—Part 2: factor analyses and testing of a brief version. Behaviour Research and Therapy, 43, 1527–1542.

    Article  Google Scholar 

  • Preacher, K. J., & MacCallum, R. C. (2002). Exploratory factor analysis in behavior genetics research: factor recovery with small sample sizes. Behavior Genetics, 32, 153–161.

    Article  PubMed  Google Scholar 

  • Rachman, S., & Shafran, R. (1999). Cognitive distortions: Thought-action fusion. Clinical Psychology and Psychotherapy, 6, 80–85.

    Article  Google Scholar 

  • Radomsky, A. S., Ouimet, A. J., Ashbaugh, A. R., Lavoie, S. L., Parrish, C. L., & O’Connor, K. P. (2006). Psychometric properties of the French and English versions of the Vancouver obsessive-compulsive inventory and the symmetry ordering and arranging questionnaire. Cognitive Behaviour Therapy, 35, 164–173.

    Article  PubMed  Google Scholar 

  • Sanavio, E. (1988). Obsessions and compulsions: the Padua inventory. Behaviour Research and Therapy, 26, 169–177.

    Article  PubMed  Google Scholar 

  • Schwarz, N., Hippler, H. J., Deutsch, B., & Strack, F. (1985). Response scales: effects of category range on reported behavior and comparative judgments. The Public Opinion Quarterly, 49, 388–395.

    Article  Google Scholar 

  • Taillon, A., O’Connor, K. P, Aardema, F., & Laverdure, A. (2007). The impact of overvalued ideation on obsessive-compulsive disorder symptomatology and treatment outcome. Poster Session presented at the 41st Annual Meeting of the Association for Behavioral and Cognitive Therapy, Philadelphia, November.

  • Taylor, S., Thordarson, D. S., & Söchting, I. (2002). Obsessive-compulsive disorder. In M. M. Antony & D. H. Barlow (Eds.), Handbook of assessment and treatment planning for psychological disorders (pp. 182–214). New York: Guilford.

    Google Scholar 

  • Watson, D., & Clark, L. A. (1991). The mood and anxiety symptom questionnaire. Iowa City: University of Iowa. Unpublished manuscript.

    Google Scholar 

  • Watson, D., & Wu, K. D. (2005). Development and validation of the schedule of compulsions, obsessions and pathological impulses (SCOPI). Assessment, 12, 50–65.

    Article  PubMed  Google Scholar 

  • Watson, D., Clark, L. A., Weber, K., Assenheimer, J. S., Strauss, M. A., & McCormick, R. A. (1995a). Testing a tripartite model: II. Evaluating the symptom structure of anxiety and depression in student, adult and patient samples. Journal of Abnormal Pyschology, 104, 15–25.

    Article  Google Scholar 

  • Watson, D., Weber, K., Assenheimer, J. S., Clark, L. A., Strauss, M. A., & McCormick, R. A. (1995b). Testing a tripartite model: I. Evaluating the convergent and discriminant validity of anxiety and depression symptom scales. Journal of Abnormal Pyschology, 104, 3–14.

    Article  Google Scholar 

  • Wood, J. M., Tataryn, D. J., & Gorsuch, R. L. (1996). Effects of under- and overextraction on principal axis factor analysis with varimax rotation. Psychological Methods, 1, 354–365.

    Article  Google Scholar 

  • Wu, K. D., & Carter, S. A. (2008). Further investigation of the obsessive beliefs questionnaire: factor structure and specificity of relations with OCD symptoms. Journal of Anxiety Disorders, 22, 824–836.

    Article  PubMed  Google Scholar 

  • Wu, K. D., Aardema, F., & O’Connor, K. P. (2009). Inferential confusion, obsessive beliefs and obsessive-compulsive symptoms: a replication and extension. Journal of Anxiety Disorders, 23, 746–752.

    Article  PubMed  Google Scholar 

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Acknowledgements

The study was supported with a Fellowship Award from the Fond the la Recherche en Santé Quebec (FRSQ) and Grant No. MOP67059 from the Canadian Institutes of Health Research (CIHR).

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Correspondence to Frederick Aardema.

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Inferential Confusion Questionnaire—Expanded Version

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Aardema, F., Wu, K.D., Careau, Y. et al. The Expanded Version of the Inferential Confusion Questionnaire: Further Development and Validation in Clinical and Non-Clinical Samples. J Psychopathol Behav Assess 32, 448–462 (2010). https://doi.org/10.1007/s10862-009-9157-x

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