Research consistently demonstrates that individuals with anxiety symptoms exhibit attentional biases toward threatening stimuli using various computer-based tasks. However, the presence of attentional biases across obsessive-compulsive symptom presentations has been mixed and requires clarification. This study was the first to use the dot probe paradigm to investigate the association between scrupulosity symptoms (obsessions and compulsions having to do with religion and morality) and selective attention to scrupulosity-relevant lexical stimuli. Contrary to hypotheses, individuals with higher levels of scrupulosity did not selectively attend (i.e., have faster reaction times) to scrupulosity-specific threat words (e.g., hell) more so than to general threat or neutral words. Various potential explanations for these null findings, as well as directions for future research, are discussed.

Thought–action fusion (TAF) refers to maladaptive beliefs about the relationship between mental events and behaviors, and is associated with obsessional problems. Currently, the self-report Thought–Action Fusion Scale (TAFS) is the most widely used measure of TAF, but a single assessment modality limits research that can be conducted on this phenomenon. This study evaluated the validity of an in vivo paradigm that assesses both Moral TAF (the belief that thoughts are the moral equivalent of actions) and Likelihood TAF (the belief that thinking about a negative event increases the probability of the event itself). In this paradigm, participants were asked to contemplate two negative events involving a beloved relative: (a) I hope (relative) is in a car accident today and (b) I hope I have sex with (relative). Participants then provided in vivo ratings of anxiety, estimates of likelihood, and moral wrongness related to the negative thoughts. Results provided evidence for the convergent validity of the in vivo ratings for both sentences. These findings are discussed in terms of clinical care, the assessment of TAF, and the implications for future research on this theoretically important construct.

Few studies have systematically examined the covert neutralizing strategies that serve to maintain and exacerbate the frequency and distress related to intrusive thoughts. Given the lack of research in this area, this study aimed to highlight development and maintenance factors for one such strategy, compensatory prayer, to inform assessment and treatment of related obsessional phenomena. We used a multimethod approach to examine the predictors and function of prayer when it is used in response to negative intrusive thoughts. Participants were 85 undergraduate students (ages 18–55 years) who self-identified with a branch of Christianity. In addition to self-report measures, participants were administered an in vivo negative thought induction and were subsequently asked about their use of compensatory prayer behaviors. Results indicated that religiosity, intrinsic religious motivation, and moral thought–action fusion (TAF) positively predicted the use of prayer, with moral TAF emerging as a unique predictor and a complete mediator between religiosity and the use of prayer. Regarding the function of prayer, results indicated that when prayer is used maladaptively (i.e., negative coping style), it is associated with higher scores on religious measures and moral TAF, as well as more frequent engagement in prayer, and a greater reduction in anxiety postprayer. Surprisingly, likelihood TAF was not found to be related to the use or function of prayer. Results are discussed in terms of certain religious teachings and TAF-related beliefs, neurobiological explanations for our pattern of findings, and clinical implications for religious-related intrusive thoughts. Future directions and limitations are also discussed.

Previous research has established that parents commonly experience intrusive harm-related thoughts pertaining to their infants (e.g., “My baby might die from SIDS”). Cognitive-behavioral models of obsessive-compulsive disorder (OCD) posit that maladaptive strategies for managing such thoughts play a role in the development and maintenance of obsessional problems. In the present study, we examined (1) the strategies parents used to manage unwanted infant-related thoughts and (2) the relationships between thought control strategies and obsessional and depressive symptoms. Non-treatment-seeking parents (n = 75) of healthy newborns completed measures of intrusive thoughts, thought control strategies, and obsessional and depressive symptoms. Mothers and fathers did not differ in their use of various thought control strategies. Strategies involving distraction, self-punishment, and reappraisal of the intrusive thought were positively related to the severity of obsessional symptoms. Punishment was also positively associated with depressive symptoms. Results are discussed in terms cognitive-behavioral models of OCD.

Anxiety sensitivity (AS) refers to a fear of arousal-related body sensations based on beliefs that such sensations are dangerous. Experiential (emotional) avoidance (EA) involves an unwillingness to endure upsetting emotions, thoughts, memories, and other private experiences. As both of these constructs are thought to be predictive of health anxiety, the present study examined their relative contribution in the prediction of health anxiety symptoms. A large sample of nontreatment-seeking participants completed measures of AS, EA, and health anxiety. An analogue sample of participants with clinical levels of health anxiety endorsed more AS and EA relative those with less health anxiety. Within the analogue sample, both AS and EA predicted health anxiety symptoms. However, whereas AS (specifically, the physical concerns domain) uniquely predicted health anxiety, EA did not contribute significantly over and above the contributions of AS. Results are also discussed in terms of the conceptualization and treatment of health anxiety.

Although hypochondriasis (HC) is considered a somatoform disorder in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision), some authors have pointed out that the symptoms of HC overlap with certain anxiety disorders, namely, panic disorder (PD) and obsessive-compulsive disorder (OCD). Few studies have empirically addressed this overlap. In the present investigation, we used discriminant function analysis to explore how patients with a principal diagnosis of HC, OCD, or PD varied with respect to cardinal symptoms of these disorders (i.e., health anxiety, obsessions and compulsions, and panic-related anxiety and avoidance) and key cognitive biases (i.e., intolerance of uncertainty, anxiety sensitivity, and body vigilance). Fifty treatment-seeking individuals with PD, 21 with OCD, and 23 with HC completed self-report measures of symptoms and cognitions during their clinic visit. Results indicated that whereas individuals with HC experience panic attacks, obsessions, and compulsions, these symptoms are markedly less pronounced than among those with PD and OCD. Conversely, overlaps were found in terms of cognitive biases, with HC patients demonstrating elevated levels of intolerance of uncertainty, body vigilance, and fear of cardiovascular symptoms. Implications for the conceptualization and treatment of HC are discussed.

Cognitive-behavioral models of obsessions, although widely accepted, do not entirely explain obsessive-compulsive (OC) symptoms. Constructs from relational frame theory (RFT; e.g., cognitive fusion—the tendency for behavior to be overly regulated and influenced by cognition) may improve our understanding of OC symptoms above and beyond cognitive-behavioral constructs (e.g., intolerance of uncertainty [IU]). This study examined the extent to which cognitive fusion accounts for unique variability in four OC symptom dimensions: contamination, responsibility for harm, unacceptable thoughts, and order/symmetry. Participants completed measures of cognitive fusion, general distress, thought action fusion, IU, and OC symptoms. Regression analyses showed that IU and thought-action fusion (TAF) were significant predictors across the OC symptom dimensions; however, cognitive fusion was only a unique predictor of the unacceptable thoughts symptom dimension. Results support the notion that RFT may best relate to the unacceptable thoughts domain of OCD. Study findings, limitations, and future directions are discussed.

Cognitive biases, such as thought–action fusion (TAF), play a crucial role in the cognitive-behavioral model of obsessional symptoms and have been shown to prospectively increase the risk of developing such symptoms. Much less research, however, has examined factors that might lead to the development of the cognitive biases themselves. This study aimed to replicate and extend existing work on correlates of moral (thinking about something is the moral equivalent of the corresponding action) and likelihood (thinking about a particular event increases the probability that this event will occur) TAF. A large sample of unscreened participants (N = 407) completed a measure of TAF, as well as measures of religiosity, motivation for religion, parental psychological control, and parental guilt induction. Results indicated that religion-related variables predicted the moral TAF, whereas parenting strategies were associated with likelihood TAF. Intrinsic motivation for religion also mediated the relationship between religiosity and moral TAF. Findings are discussed in terms of developmental psychopathology and limitations are addressed.

Interoceptive exposure (IE) is an effective procedure for reducing anxiety sensitivity (AS) and the symptoms of panic disorder. However, considerable variance exists in how IE is delivered among clinicians, and the extent to which IE is enhanced by the concurrent use of cognitive reappraisal (CR) and diaphragmatic breathing (DB) is unclear. Participants (N = 58) with high AS were randomly assigned to one of four single-session interventions: (a) IE only, (b) IE 1 CR, (c) IE 1 CR 1 DB, or (d) expressive writing control. IE was superior to expressive writing in reducing AS and associated anxiety symptoms. The addition of CR and DB did not enhance the benefits of IE at either posttreatment or 1-week follow-up. These findings highlight the specific efficacy of IE in reducing AS and call into question the common practice of combining IE with cognitive and breathing strategies. Theoretical and clinical implications are discussed.