Study suggests that obsessive beliefs and cognitive (in)flexibility are related

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Bradbury, C., Cassin, S. E., & Rector, N. A. (2011). Obsessive beliefs and neurocognitive flexibility in obsessive-compulsive disorder Psychiatry Research, 187(1-2), 160–165. doi:10.1016/j.psychres.2010.11.008

Cognitive models of OCD assign a central role to dysfunctional obsessive beliefs and maladaptive appraisals of intrusive thoughts. The most common obsessive beliefs are: 1) inflated responsibility and overestimation of threat, 2) perfectionism and intolerance of uncertainty, and 3) over-importance and over-control of thoughts.

In this study, the authors correlated OCD patients with high level of obsessive beliefs to the Winsconsin sorting card test (WCST) which is a measure of cognitive flexibility. The comparison groups were OCD patients with low obsessive beliefs and patients with panic disorder or social phobia. The High Beliefs OCD subgroup performed significantly poorer on WCST subscales compared to the other diagnostic groups. The results could also not be accounted for OCD severity or depressive symptoms. Thus, obsessive beliefs seem to have a unique role in the OCD phenotype.

What does this mean?

If obsessive beliefs indeed are correlated to cognitive factors, then perhaps it could be relevant to clinicians when conducting a behavior analysis. It seems that assessing obsessive beliefs before treatment can possibly give information about other cognitive factors that might contribute to the treatment outcome. The authors state that “Given that the Low Beliefs OCD subgroup performed better on the WCST than the High Beliefs OCD subgroup in the current study, it would be informative to examine whether cognitive behavioural therapy, which has been shown to reduce obsessive beliefs, might also improve cognitive flexibility.”

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