How Are Dysfunctional Beliefs Related to Obsessive-Compulsive Symptoms?

Contemporary cognitive models of obsessive-compulsive disorder (OCD) suggest that three types of dysfunctional beliefs contribute to the development and maintenance of obsessivecompulsive (OC) symptoms. These are beliefs characterized by themes of (a) inflated personal responsibility and the overestimation of threat (RT), (b) perfectionism and the intolerance of uncertainty (PC), and (c) overimportance of one’s thoughts and the need to control these thoughts (ICT). To better understand the relationship between symptoms and beliefs, we applied structural equation modeling to belief and symptom data from a large (N = 5,015) nonclinical sample. RT significantly predicted each of the six main types of OC symptoms (checking, hoarding, neutralizing, obsessing, ordering, and washing), beyond the effects attributable to ICT and PC. PC predicted ordering rituals beyond the effects due to ICT and RT. ICT predicted obsessing, neutralizing, and washing compulsions, beyond the effects attributable to RT and PC. The three types of beliefs were strongly correlated with one another, which is consistent with previous theorizing that one type of belief (e.g., RT) influences another (e.g., ICT), which in turn influences OC symptoms (i.e., the indirect effects of beliefs on symptoms). However, there are competing explanations for the strong correlations among beliefs. Research designs are proposed for disentangling the various explanations of the high correlation among beliefs.