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

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 (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.

Obsessive Beliefs and Dimensions of Obsessive-Compulsive Disorder: An Examination of Specific Associations

“…Prior prospective research by Coles and Horng (2006) demonstrated that obsessive beliefs are more predictive of some OCD symptoms (e.g., obsessing) than others (e.g., hoarding) over a 6-week period. A similar investigation by Coles et al (2008) found that obsessive beliefs predicted changes in the distress associated with OC symptoms (despite much additional variance to be accounted for), but not their frequency. One limitation of this prospective research examining the association between obsessive beliefs and OCD is the absence of an identifiable stressor that has been implicated in the etiology of OCD symptoms.…”

In search of specificity: “Not just right experiences” and obsessive–compulsive symptoms in non-clinical and clinical Italian individuals

“…We chose an undergraduate nonclinical sample for this aim to provide a wide range of scores on measures of OCD symptoms (Coles et al, 2008;OCCWG, 2005), given theoretical assumptions that OC phenomena lie on a continuum from normality to psychopathology (e.g., Burns, Formea, Keortge, & Sternberger, 1995;Sternberger & Burns, 1990). Moreover, previous research has demonstrated the utility of student samples in advancing theories of OCD (see Gibbs, 1996, for a review).…”

“…One longitudinal study indicated that parents' tendency to negatively interpret intrusive infant-related thoughts early in the postpartum period mediated the relationship between pre-childbirth OC beliefs and late postpartum OC symptoms (Abramowitz, Nelson, Rygwall & Khandker, 2007). However, a recent 6-month longitudinal study found that OC-beliefs were of only modest value in predicting OC symptoms variation among college students (Coles, Pietrefesa, Schofield, & Cook, 2008).…”

Assessment of obsessive beliefs: Comparing individuals with obsessive-compulsive disorder to a medical sample

“…According to Christensen et al (1999), cognitive biases are considered important in the development and maintenance of several mental disorders and may have implications for specific disabilities in medical populations. Further, recent research has shown that a wide range of life stressors increase obsessional and compulsive behavior in a non-clinical sample (Coles, Pietrefesa, Schofield, & Cook, 2008). This makes a general medical sample a highly desirable comparison group to individuals with OCD as it would be expected that there would be elevated scores on several indices of cognitive biases associated with OCD such as concerns over contamination or perfectionism, but that these biases should not be as high as found in individuals with OCD.…”