Not just thinking, but believing: Obsessive beliefs and domains of cognitive fusion in the prediction of OCD symptom dimensions

Abstract

Cognitive fusion (CF) involves the tendency to "buy in" to thoughts and feelings and consists of three empirically established domains: somatic concerns, emotion regulation, and negative evaluation. CF is hypothesized to play a role in obsessivecompulsive disorder (OCD). The present study examined how well the CF domains, relative to traditional cognitive-behavioural constructs (i.e., obsessive beliefs such as inflated responsibility), predict OCD symptoms. Fifty-two treatment-seeking adults with OCD completed self-report measures of CF, obsessive beliefs, OCD symptoms, and general distress. Domains of CF were differentially associated with the responsibility for harm, symmetry, and unacceptable thoughts of OCD dimensions; yet after accounting for obsessive beliefs, only the negative evaluation domain of CF significantly predicted symmetry OCD symptoms. Obsessive beliefs significantly predicted all OCD dimensions except for contamination. These findings provide additional support for existing cognitive-behavioural models of OCD across symptom dimensions, with the exception of contamination symptoms, and suggest that the believability of thoughts and feelings about negative evaluation adds to the explanation of symmetry symptoms. Conceptual and treatment implications, study limitations, and future directions are discussed.

The interactive effect of mental contamination and cognitive fusion on anxiety

“…Cognitive fusion has shown itself to be a meaningful predictor of a wide range of anxiety and related symptoms, including trait anxiety (Bardeen & Fergus, 2016; Gillanders et al, 2014), social anxiety (Soltani et al, 2018), health anxiety (Fergus, 2015), posttraumatic stress (PTS) (Bardeen & Fergus, 2016), and obsessive‐compulsive symptoms (Hellberg et al, 2020; Reuman et al, 2016). Moreover, cognitive fusion has been shown to predict anxiety above and beyond key risk factors such as negative affect, experiential avoidance, and anxiety sensitivity (Fergus, 2015).…”