Thought control strategies are implicated in the development and maintenance of obsessive-compulsive disorder (OCD). Regarding one strategy – worry – extant data provide equivocal conclusions as to its relevance to OCD. The current study examined whether worry is an OCD-relevant thought control strategy using data from a large (N = 376) nonclinical sample. This investigation tested whether worry interacted with obsessive beliefs (perfectionism/certainty; responsibility/threat estimation; importance/control of thoughts) to predict the occurrence of ego-dystonic intrusive thoughts. As expected, worry did interact with obsessive beliefs to predict more reported intrusions. Contrary to expectations, worry interacted with all three assessed belief dimensions. These results provide support for conceptualizing worry as an OCD-relevant thought control strategy, which has both conceptual and therapeutic implications.
Clark and Rhyno (2005) defined intrusive thoughts as “any distinct, identifiable cognitive event that is unwanted, unintended, and recurrent. It interrupts the flow of thought, interferes with task performance, is associated with negative affect, and is difficult to control” (p. 4). Intrusive thoughts are common, experienced by 80–99% of nonclinical individuals (Belloch, Morillo, Lucero, Cabedo, & Carrió, 2004). Their ubiquity has provided researchers with the opportunity to gain greater insight into related phenomena such as obsessions, which are conceptualized as extreme variants of intrusive thoughts (Clark & Rhyno, 2005).
Obsessions represent a core symptom of obsessive-compulsive disorder (OCD) (American Psychiatric Association [APA], 2000), and are believed to be distinguished from intrusive thoughts based on associated severity and distress. Clark (2004) noted that obsessions are more frequent, time-consuming, and are perceived as more uncharacteristic of the self (i.e., ego-dystonic) than intrusive thoughts. Despite these differences, however, intrusive thoughts and obsessions are similar in content, underlying beliefs, and thought control strategies (Clark and O’Connor, 2005 and Purdon and Clark, 1999). In fact, their close association has led to models in which obsessions develop from intrusions.
Limitations notwithstanding, the results of this study are consistent with the notion that worry is an OCD-relevant thought control strategy. Gaining greater insight into the role of worry within OCD seems particularly important given the frequent occurrence of worry within OCD, as well as the importance given to thought control strategies within current models of OCD and its treatment. Better understanding the extent to which, and under what circumstances, individuals use worry versus other thought control strategies (e.g., thought suppression) in response to intrusive thoughts and investigating additional effects worry might have on these cognitive events appear to be especially promising areas of investigation for future research. Such efforts will help elucidate the potential utility of worry in the conceptualization and treatment of OCD.
