Carmen Morillo

Symptom dimensions in obsessive–compulsive disorder: From normal cognitive intrusions to clinical obsessions

Cognitive behavioral models of obsessive-compulsive disorder (OCD) assume continuity between normal obsessional intrusive thoughts (OITs) and obsessions. However, this assumption has recently been criticized. This article examines this issue using a new instrument (the Obsessional Intrusive Thoughts Inventory, INPIOS) specifically designed to assess the frequency and content of 48 OITs, which was completed by 734 community subjects and 55 OCD patients. Confirmatory factor analysis suggests six first-order factors included in two second-order factors, one containing aggressive, sexual, religious, immoral and repugnant OITs, and the other containing contamination, doubts and checking, symmetry and order, and superstition OITs. This structure integrates the research on OC symptoms and OITs. The INPIOS showed excellent known-groups validity, and it adequately represented obsessions as well as OITs. OCD and community subjects experience OITs representative of all types of obsessional contents. The dimensional structure is discussed in terms of OIT/obsessive-compulsive symptom structures currently proposed.

Confirmatory Factor Analysis of the White Bear Suppression Inventory and the Thought Control Questionnaire

The White Bear Suppression Inventory (WBSI) was developed to assess chronic thought suppression, whereas the Thought Control Questionnaire (TCQ) measures different strategies to suppress unpleasant intrusive thoughts. The present study examines the latent factor structure of these instruments in a sample of 540 normal subjects using confirmatory factor analyses (CFA). Regarding the WBSI, the CFAs indicated that the tested models did not provide a good fit for the data. Data analysis showed that the TCQ with five factors and 30 items did not reach a reasonable fit. Therefore, in order to present a five-factor structure with an adequate fit, those items with problematic factor loadings were eliminated. Correlational analyses indicated that the WBSI had a significant association with depression, obsessive-compulsive symptoms, and pathological worry, whereas only two TCQ subscales, punishment and worry, were related to these psychopathological symptoms.

Dysfunctional Belief Domains Related to Obsessive-Compulsive Disorder: A Further Examination of their Dimensionality and Specificity

International consensus has been achieved on the existence of several dysfunctional beliefs underlying the development and/ or maintenance of the Obsessive-Compulsive Disorder (OCD). Nevertheless, questions such as the dimensionality of the belief domains and the existence of OCD-specific dysfunctional beliefs still remain inconclusive. The present paper addresses these topics through two different studies. Study 1: A series of confirmatory factor analyses (N = 573 non-clinical subjects) were carried out on the Obsessive Beliefs Spanish Inventory-Revised (OBSI-R), designed to assess dysfunctional beliefs hypothetically related to OCD. An eight-factor model emerged as the best factorial solution: responsibility, over-importance of thoughts, thought-action fusion-likelihood, thought action fusion-morality, importance of thought control, overestimation of threat, intolerance of uncertainty and perfectionism. Study 2: The OBSI-R and other symptom measures were administered to 75 OCD patients, 22 depressed patients, and 25 non-OCD anxious patients. Results indicated that, although OCD patients differed from their non-clinical counterparts on all of the OBSI-R subscales, no evidence of OCD-specificity emerged for any of the belief domains measured, as the OCD subjects did not differ from the other two clinical groups of patients.

Strategies to Control Unwanted Intrusive Thoughts: Which are Relevant and Specific in Obsessive- Compulsive Disorder?

Current cognitive-behavioral approaches to Obsessive-Compulsive Disorder (OCD) propose that chronic thought suppression and other dysfunctional strategies to control negative unwanted intrusions play an important role in the genesis and/or maintenance of the disorder. However, little empirical research has been devoted to investigating which control and/or suppression methods are used most often by OCD patients, and which could be considered specific to OCD. The purpose of the present study was to provide evidence with regard to these issues. With this end, 39 clinical OCD patients, 23 depressed patients, 25 non-obsessive anxious patients, and 30 community adults completed two measures of thought control/suppression strategies: the reduced Spanish version of the Thought Control Questionnaire (TCQ-r) and the White Bear Suppression Inventory (WBSI). Participants also completed measures of OCD, depressive and anxious symptoms. The results indicated that, in OCD patients, the chronic tendency to suppress negative unwanted thoughts (WBSI) was associated with Punishment (TCQ) and, to a lesser extent, with Worry and Reappraisal. When examining between-group differences, punishment for having negative intrusions proved to be OCD-relevant and OCD-specific, since OCDs were distinguishable from the other three groups on this measure. However, Distraction, Social control, Reappraisal, and Worry strategies were shown to be control strategies that were not specifically used by OCD participants or by those with anxiety and depressive disorders.