Development and initial validation of the obsessive beliefs questionnaire and the interpretation of intrusions inventory

doi:10.1016/S0005-7967(00)00085-1

Behaviour Research and Therapy

Volume 39, Issue 8, August 2001, Pages 987-1006

https://doi.org/10.1016/S0005-7967(00)00085-1 Get rights and content

Abstract

In 1995 the Obsessive Compulsive Cognitions Working Group initiated a collective process to develop two measures of cognition relevant to current cognitive–behavioural models of OCD. An earlier report (Behav. Res. Therapy, 35 (1997) 667) describes the original process of defining relevant domains. This article describes the subsequent steps of the development and validation process: item generation, scale reduction, and initial examination of reliability and validity. Two scales were developed. The Obsessive Beliefs Questionnaire consists of 87 items representing dysfunctional assumptions covering six domains: overestimation of threat, tolerance of uncertainty, importance of thoughts, control of thoughts, responsibility, and perfectionism. The Interpretation of Intrusions Inventory consists of 31 items that refer to interpretations of intrusions that have occurred recently. Three of the above domains are represented: importance of thoughts, control of thoughts, and responsibility. The item reduction and validation analyses were conducted on clinical and non-clinical samples from multiple sites. Initial examination of reliability and validity indicates excellent internal consistency and stability and encouraging evidence of validity. However, high correlations indicating overlap between some of the scales, particularly importance of thoughts, control of thoughts, and responsibility will need to be addressed in subsequent empirical and theoretical investigations.

Section snippets

Initial development of the OBQ and III

The development of the two cognitive measures described in this paper was driven by recent cognitive models hypothesizing the importance of appraisals (interpretations) of intrusive thoughts (obsessions) and of beliefs (assumptions, attitudes) regarding several realms in generating and maintaining OCD symptoms. Cognitive models for OCD have been articulated by Salkovskis, 1985, Salkovskis, 1989, Rachman, 1993, Rachman, 1997 and Freeston, Rheaume, and Ladouceur (1996) and Clark and Purdon (1993)

Participants

Participant volunteers were recruited at ten different sites. A summary of sites and samples is provided in Table 1. Three types of samples were sought: 1) people with OCD, 2) people with anxiety disorders but not OCD, and 3) non-clinical controls (community members and students). Criteria for inclusion in the OCD group were a diagnosis of OCD (according to DSM–IV; American Psychiatric Association, 1994) and absence of psychosis and substance abuse. Overall, 101 people with OCD, 374 student

Method

The participants and measures were the same as described previously for the scale construction. Because it can be difficult to interpret findings from scales using negative numbers, we transformed the OBQ item scale (originally ranging from −3 to +3) to a 1 to 7 scale. Likewise, the 0 to 100 scale for III items was also transformed arithmetically by dividing the total score by 10 to provide more familiar total scores ranging from 0 to 310. Such transformations have no effect on scale

Discussion

This paper describes the development and initial validation of two scales measuring assumptions and interpretations relevant to current cognitive–behavioural models of OCD. The initial step sought to maximise content validity by drawing on an international panel of experts who used a rigorous process to first identify and define key dimensions and then generate relevant items. The subsequent step reduced the item pool based on findings from both clinical and non-clinical samples to obtain high

Acknowledgements

The Padua meeting (September 1997) and parts of this study were supported by an unrestricted grant from Solvay Pharmaceuticals.

References (25)

A.T. Beck et al.
Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation
Clinical Psychology Review
(1988)
M.H. Freeston et al.
Cognitive intrusions in a non-clinical population. I. Response style, subjective experience, and appraisal
Behaviour Research and Therapy
(1991)
M.H. Freeston et al.
Correcting faulty appraisals of obsessional thoughts
Behaviour Research and Therapy
(1996)
S. Rachman
Obsessions, responsibility and guilt
Behaviour Research and Therapy
(1993)
S. Rachman
A cognitive theory of obsessions
Behaviour Research and Therapy
(1997)
P.M. Salkovskis
Obsessional-compulsive problems: a cognitive-behavioural analysis
Behaviour Research and Therapy
(1985)
P.M. Salkovskis
Cognitive behavioural factors and the persistence of intrusive thoughts in obsessional problems
Behaviour Research and Therapy
(1989)
P.M. Salkovskis et al.
Responsibility attitudes and interpretations are characteristics of obsessive compulsive disorder
Behaviour Research and Therapy
(2000)
E. Sanavio
Obsessions and compulsions: the Padua Inventory
Behaviour Research and Therapy
(1988)
R. Shafran et al.
Thought-action fusion in obsessive compulsive disorder
Journal of Anxiety Disorders
(1996)

S. Taylor

Assessment of obsessions and compulsions: reliability, validity and sensitivity to treatment effects

Clinical Psychology Review

(1995)

P. van Oppen et al.

Cognitive therapy and exposure in vivo in the treatment of obsessive compulsive disorder

Behaviour Research and Therapy

(1995)

Cited by (498)

Implicit aggressive self-concept in patients with obsessive-compulsive disorder: Results from an approach-avoidance task
2024, Journal of Behavior Therapy and Experimental Psychiatry
Patients with obsessive-compulsive disorder (OCD) have reported higher anger and aggression than healthy individuals in previous studies using explicit measures. However, studies using implicit measures have demonstrated mixed results. The aim of the present study was to investigate implicit aggressiveness in OCD using an approach-avoidance task (AAT).
Seventy-eight patients with OCD and 37 healthy controls underwent structured clinical interviews and measures of anger, OCD, and depressive symptoms as well as a computerized AAT that included aggressive, peaceful, negative, and positive stimuli.
In line with previous studies, patients with OCD reported higher scores on explicit anger. With respect to the implicit measure, repeated measures ANOVAs did not show any differences in mean reaction times for pushing compared to pulling aggressive versus peaceful and negative versus positive words. However, analyses of specific OCD symptom dimensions demonstrated significantly faster reaction times for pulling compared to pushing aggressive words for patients with high scores in the OCD symptom dimensions obsessing and hoarding.
Eighty percent of patients with OCD showed psychiatric comorbidities and all were seeking treatment.
The present study supports previous studies reporting the absence of higher aggressiveness in patients with OCD compared to healthy controls using implicit measures. However, in contrast to previous studies, we found an implicit approach bias towards aggressive self-statements for OCD patients scoring high in the symptom dimensions obsessing and hoarding compared to healthy controls. Future studies should further elucidate putative functional relationships between different OCD symptom dimensions and implicit aggressiveness.
Beliefs about losing control and other OCD-related cognitions: An experimental investigation
2024, Journal of Behavior Therapy and Experimental Psychiatry
Cognitive theories of obsessive-compulsive disorder (OCD) suggest that dysfunctional beliefs influence symptoms. However, well-established belief domains do not fully explain OCD symptomatology, suggesting other cognitive mechanisms may be involved. An additional belief domain which may play a role in OCD is beliefs about losing control. Indeed, these beliefs have been found to be associated with OCD symptoms. However, the relationships between beliefs about losing control and other OCD phenomena, including other relevant dysfunctional beliefs, is unclear. The aim of this study was to examine the relationships between beliefs about losing control and appraisals hypothesized to be relevant to OCD.
A total of 163 participants completed the experimental protocol, wherein they received false (positive or negative) feedback regarding the likelihood they may lose control and completed a vignette task asking them to read hypothetical scenarios relevant to OCD concerns (checking, and aggressive thoughts). Vignettes were followed by questions and prompts used to measure OCD-relevant appraisals.
Based on MANOVAs, beliefs about losing control had a significant impact on appraisals in the checking, F (151) = 5.55, p = .001, and aggressive thoughts, F (151) = 2.898, p = .037, vignettes. However, planned comparison indicated that in the aggressive thoughts vignettes, this effect was in the opposite direction than was hypothesized.
The losing control induction may have inadvertently influenced participants’ beliefs about the utility of thought control.
Findings provide preliminary evidence for an association between beliefs about losing control and OCD-relevant appraisals.
What's control got to do with it? A systematic review of control beliefs in obsessive-compulsive disorder
2024, Clinical Psychology Review
Current conceptualizations of control-related beliefs in Obsessive-Compulsive Disorder (OCD) have largely been limited to beliefs about the need to control thoughts. Although growing evidence supports the notion of considering broader control-related constructs in this disorder, there has been limited research aimed at integrating findings across studies, making it difficult to determine how different control-related beliefs may influence OCD symptoms. The current review sought to systematically analyze findings from all studies investigating the relationship between control beliefs and OCD. The systematic search identified 157 eligible articles that assessed the relationship between control beliefs and OCD symptoms. Results suggested that certain control beliefs (e.g., importance of/need to control of thoughts, sense of control, beliefs about losing control) may be more closely associated with OCD than others (e.g., locus of control, and desire for control). In general, control beliefs were positively associated with OCD, with effect sizes ranging from small to large depending on the symptom domain. Based on limited studies, the only control belief which demonstrated specificity to OCD was ICT. Findings support the importance of integrating additional control beliefs in conceptualizations of OCD and provide evidence to support the benefits of targeting these beliefs in cognitive behavioural therapy.
Benefits of Planning as an emotion regulation strategy in obsessions and compulsions (OC): Implication of the perfectionism level in the Planning-OC relationship
2023, Journal of Affective Disorders Reports
Obsessions and compulsions are characteristics of obsessive and compulsive (OC) disorders and are present to various extents in the population. Such symptoms were associated with difficulties in regulating the emotions triggered by the obsessions, which induce compulsions and use of maladaptive emotion regulation (ER) strategies. The present work gives an overview of the use of different ER strategies in all-comers presenting various levels of OC symptoms, with a focus onto the benefits of “Planning”, an adaptive ER strategy that shares common backgrounds with several obsessions, such as perfectionism, which was also explored. University students (N = 248) completed online questionnaires. The findings confirmed a positive relationship between OC symptoms and difficulties in ER and use of maladaptive ER strategies. Planning was negatively correlated with OC symptoms while perfectionism was positively associated with both OC symptoms and the use of Planning, which lowers the beneficial prospects of Planning implementation in sub-clinical obsessive-compulsive disorders (OCD). Hoarding not being associated with perfectionism, this particular symptom could however directly benefit from Planning. Altogether, this study highlights the importance of considering individualities in the efficiency of different ER strategies and provides potential benefits of Planning, a strategy that is likely to help alleviating OC symptoms, and particularly that of hoarding.
Improving adherence to unguided Internet-based therapy for obsessive-compulsive disorder: A randomized controlled trial
2023, Journal of Affective Disorders
Adherence to internet-based cognitive-behavioral therapy (iCBT) is often low, possibly reducing its potential. The current study set out to test whether adherence and effects of unguided iCBT for obsessive-compulsive disorder (OCD) could be improved by varying the degree of autonomy in which modules are completed (free choice vs. fixed order).
We randomized 151 individuals with OCD to either an unguided iCBT with a fixed (iCBTfixed) or a free-choice (iCBTfree+) order of the modules. We assessed participants at baseline (t0), eight weeks (t1), and 16 weeks (t2). Primary outcomes were adherence (utilization time, modules completed) and change in OCD severity (Y-BOCS). Secondary outcomes included depression, self-esteem, and treatment satisfaction. We calculated intent-to-treat (ITT) and complete case (CC) analyses.
Analyses showed that both iCBT programs significantly reduced OCD severity. While groups did not differ on the ITT analyses, for the CC analyses, a greater improvement was found in the iCBTfixed in comparison to the iCBTfree+ group regarding OCD severity and quality of life, with medium effect sizes from t0 to t1 (η_p² = 0.067–0.077). Time of utilization and number of modules completed did not differ between groups.
No placebo control group, short follow-up period, self-report assessment.
iCBT is effective in improving OCD. Despite similar adherence in the fixed versus the free-choice module order, the study offers tentative evidence that a fixed order of content is associated with better effects. More research on the effects of adherence on outcome is necessary.
The effect of aerobic exercise alone and in combination with cognitive behavioural therapy on obsessive compulsive disorder: A randomized control study
2023, Journal of Anxiety Disorders
Cognitive behavioural therapy (CBT) has been found to be an effective treatment for OCD, but there remains a significant proportion of individuals who fail to show a treatment response. Aerobic exercise has previously been associated with decreases in anxiety and depression, as well as improvements in OCD symptoms in small-scale studies. The purpose of the present research was to use a randomized control trial design to examine the effects of exercise alone and in combination with CBT, on OCD symptoms and secondary symptoms.
125 participants were randomly assigned to one of four treatment groups: waitlist control, exercise, CBT, and CBT with exercise. OCD symptom severity was measured at four points over the course of treatment, secondary outcome measures were gathered at three points over treatment.
CBT alone and combined with exercise was associated with significantly greater OCD symptom reduction than exercise alone or the control groups. Total exercise frequency predicted OCD symptom reduction in the groups in which exercise was measured. Group membership did not significantly predict reductions in secondary outcome measures.
Exercise frequency, rather than the presence or absence of exercise, appears to predict OCD symptom reduction, as did participation in CBT.

View all citing articles on Scopus

^⁎: Corresponding author: Gail Steketee (Scales and translated versions are available from the corresponding author. Tel.: +1-617-353-3750; fax: +1-617-353-5612. [email protected] (G. Steketee).

¹: Co-chairs: Gail Steketee and Randy Frost.The members of the working group who contributed to this study are (in alphabetical order): Nader Amir, Martine Bouvard, Cheryl Carmin, David A. Clark, Jean Cottraux, Paul Emmelkamp, Elizabeth Forrester, Mark Freeston, Randy Frost, Rense Hoekstra, Michael Kyrios, Robert Ladouceur, Fugen Neziroglu, Gilbert Pinard, C. Alec Pollard, Christine Purdon, S. Rachman, Josee Rheaume, Candida Richards, Paul Salkovskis, Ezio Sanavio, Roz Shafran, Claudio Sica, Gregoris Simos, Ingrid Sochting, Debbie Sookman, Gail Steketee, Steven Taylor, Dana Thordarson, Patricia van Oppen, Ricks Warren, Maureen Whittal, Jose Yaryura–Tobias. Special thanks to Steven Taylor who conducted the main analyses of the data and to Mark Freeston for drafting the manuscript.

View full text

Development and initial validation of the obsessive beliefs questionnaire and the interpretation of intrusions inventory

Abstract

Section snippets

Initial development of the OBQ and III

Participants

Method

Discussion

Acknowledgements

Clinical Psychology Review

Behaviour Research and Therapy

Behaviour Research and Therapy

Behaviour Research and Therapy

Behaviour Research and Therapy

Behaviour Research and Therapy

Behaviour Research and Therapy

Behaviour Research and Therapy

Behaviour Research and Therapy

Journal of Anxiety Disorders

Clinical Psychology Review

Behaviour Research and Therapy