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Predicting Changes in Obsessive Compulsive Symptoms Over a Six-Month Follow-Up: A Prospective Test of Cognitive Models of Obsessive Compulsive Disorder

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Abstract

Cognitive models of obsessive compulsive disorder (OCD) propose that OCD-related beliefs (e.g., inflated responsibility) and negative life events should predict changes in OC symptoms over time (Rachman, 1997, Behaviour Research and Therapy, 35, 793–802; Rachman, 1998, Behaviour Research and Therapy, 36, 385–401; Rachman, 2002, Behaviour Research and Therapy, 40, 625–639; Salkovskis, 1985, Behaviour Research and Therapy, 23, 571–583; Salkovskis & Kirk, 1997, In The science and practice of cognitive behavior therapy. Oxford: Oxford University Press). However, very little research has tested these longitudinal predictions. The current study sought to replicate and extend findings by Coles and Horng (2006, Cognitive Therapy and Research, 30, 723–746) showing that OCD-related beliefs and negative life events significantly predicted changes in the frequency of OC symptoms over 6 weeks. Results of the current study, using a 6-month prospective longitudinal design, provided modest support for cognitive models of OCD. Negative life events significantly predicted residual change in both the frequency of, and distress associated with, OC symptoms. Initial OCD-related beliefs significantly predicted residual change in the distress associated with OC symptoms, but there was much additional variance to be accounted for. Additional data are presented that both examine the specificity of these predictors to changes in OC symptoms versus social anxiety and depressive symptoms, and explore particular types of life events in predicting symptom changes over time.

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Notes

  1. This age group is also appropriate for investigation given that well validated assessment measures are available for use in this age group. Although OCD can onset earlier than age 18 (see Libby, Reynolds, Derisley, & Clark, 2004), lack of well-validated measures of OC-related beliefs in children makes a study with children premature (see Barrett & Healy, 2003; Libby et al., 2004).

  2. We also considered the possibility of examining the domains of OCD-related beliefs separately. However, intercorrelations among the OBQ-44 subscales showed that the three OBQ-44 subscales were highly intercorrelated (r’s = .66 to .72), suggesting that a total score should be used in the current sample instead of the subscale scores.

  3. 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 they therefore suggest that OCD-related beliefs and negative life events are related to both the development and maintenance of OC symptoms. In addition, we also reran the regression analyses using the impact of negative life events ratings, instead of the event counts, and found nearly identical patterns of results to the original regressions presented in Tables 2 and 3. Finally, in order to address potential confounding due to inclusion of negative life events that may have been influenced by other factors such as depressive symptoms (e.g., changes in eating habits, changes in sleeping habits), these analyses were repeated using only events that were coded unanimously by 4 coders as “non-confounded”. The analyses using “non-founded” negative life events yielded nearly identical results to those from the original regressions.

  4. Further detail is available upon request.

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

    Meredith E. Coles, Ashley S. Pietrefesa, Casey A. Schofield & Laura M. Cook

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Coles, M.E., Pietrefesa, A.S., Schofield, C.A. et al. Predicting Changes in Obsessive Compulsive Symptoms Over a Six-Month Follow-Up: A Prospective Test of Cognitive Models of Obsessive Compulsive Disorder. Cogn Ther Res 32, 657–675 (2008). https://doi.org/10.1007/s10608-007-9132-3

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