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A Prospective Test of Cognitive Vulnerability to Obsessive-compulsive Disorder

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Abstract

Cognitive models of Obsessive-Compulsive Disorder [OCD; e.g., Rachman, 1997, Behaviour Research and Therapy, 35, 793–802; Salkovskis, 1985, Behaviour Research and Therapy, 23, 571–583] propose that negative interpretations of intrusive thoughts and images are central to the development and maintenance of OCD. Despite consistent findings that specific interpretations (e.g., heightened responsibility) contribute to the maintenance of OC symptoms [see Salkovskis & Forrester, 2002, Theory, assessment, and treatment, New York: Pergamon], no research has examined the role of these interpretations in the development of OCD or whether OCD-related beliefs predict changes in symptom levels. In the current study, 377 undergraduate students participated in a 6-week prospective study for which they completed measures of OCD-related beliefs, life events, and OC symptoms. OCD-related beliefs and negative life events each significantly predicted residual change in OC symptoms over 6-weeks. However, there was not support for a cognitive–vulnerability–stress interaction. Exploratory analyses suggest that OCD-related beliefs may be more predictive of some particular types of OCD symptoms (e.g., neutralizing, ordering, and obsessing) than others (e.g., hoarding and washing). Findings from this study are important for clarifying predictors of changes in OCD symptom levels and for stimulating research on vulnerability to OCD.

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Notes

  1. As shown in Table 1, the mean OCI and OBQ-44 scores decreased from Time 1 to Time 2 as is typical of repeated assessments of negative affect. We therefore examined the nature of the change scores more thoroughly. Change scores were relatively normally distributed for both the OCI and OBQ-44. Regarding the OCI, 40.8% of subjects showed increases in OCD symptoms from Time 1 to Time 2, 3.7% of subjects had the same score at both time points, and 55.5% of subjects showed decreased scores from time 1 to 2. For the OBQ-44, 35.7% of subjects showed increases in OCD symptoms from Time 1 to Time 2, 1.9% of subjects had the same score at both time points, and 62.4% of subjects showed decreased scores from time 1 to 2.

  2. In all cases, the homogeneity of regression assumption (see Cohen & Cohen, 1983; Joiner, 1994) was tested and satisfied. These analyses indicated that the significant main effects reported were not moderated by initial OC symptom levels, and suggest that OCD-related beliefs and negative life events are related to both the development and maintenance of OC symptoms. Further, to control for the potential impact of gender on the results, we reran the regression presented in Table 3 entering gender in step 1 and the overall pattern of results was unchanged. Finally, we also reran the regression analyses using the impact of negative life events ratings, instead of the event counts, and found a nearly identical pattern of results to the original regression presented in Table 3.

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Authors and Affiliations

  1. Department of Psychology, Binghamton University (SUNY), Binghamton, NY, 13902-6000, USA

    Meredith E. Coles & Betty Horng

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  1. Meredith E. Coles
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  2. Betty Horng
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Correspondence to Meredith E. Coles.

Additional information

This paper was presented at the annual meeting of the Association for the Advancement of Behavior Therapy, New Orleans, Louisiana, 2004.

The authors would like to thank Brandon E. Gibb for statistical and design consultation, and Gail Steketee for her guidance and support of this research.

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Coles, M.E., Horng, B. A Prospective Test of Cognitive Vulnerability to Obsessive-compulsive Disorder. Cogn Ther Res 30, 723–734 (2006). https://doi.org/10.1007/s10608-006-9033-x

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