Abstract
Current cognitive-behavioral approaches to Obsessive-Compulsive Disorder (OCD) propose that chronic thought suppression and other dysfunctional strategies to control negative unwanted intrusions play an important role in the genesis and/or maintenance of the disorder. However, little empirical research has been devoted to investigating which control and/or suppression methods are used most often by OCD patients, and which could be considered specific to OCD. The purpose of the present study was to provide evidence with regard to these issues. With this end, 39 clinical OCD patients, 23 depressed patients, 25 non-obsessive anxious patients, and 30 community adults completed two measures of thought control/suppression strategies: the reduced Spanish version of the Thought Control Questionnaire (TCQ-r) and the White Bear Suppression Inventory (WBSI). Participants also completed measures of OCD, depressive and anxious symptoms. The results indicated that, in OCD patients, the chronic tendency to suppress negative unwanted thoughts (WBSI) was associated with Punishment (TCQ) and, to a lesser extent, with Worry and Reappraisal. When examining between-group differences, punishment for having negative intrusions proved to be OCD-relevant and OCD-specific, since OCDs were distinguishable from the other three groups on this measure. However, Distraction, Social control, Reappraisal, and Worry strategies were shown to be control strategies that were not specifically used by OCD participants or by those with anxiety and depressive disorders.
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Abramowitz, J. S., Tolin, D. F., & Street, G. P. (2001). Paradoxical effects of thought suppression: A meta-analysis of controlled studies. Clinical Psychology Review, 21, 683–703.
Abramowitz, J. S., Whiteside, S., Kalsy, S. A., & Tolin, D. F (2003). Thought control strategies in obsessive-compulsive disorder: A replication and extension. Behaviour Research and Therapy, 41, 529–540.
Amir, N., Cashman, L., & Foa, E. B. (1997). Strategies of thought control in Obsessive-Compulsive Disorder. Behaviour Research and Therapy, 35, 775–777.
Avila, A. (1986). Una contribución a la evaluación de las obsesiones y compulsiones: revisión del inventario de obsesiones de Leyton (LOI) y del cuestionario obsesivo-compulsivo de Maudsley (MOCI). Psiquis, 7, 93–99.
Beck, A. T., Rush, A. J., Shaw B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press.
Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77–100.
Becker, E. S., Rinck, M., Roth, W. T., & Margraf, J. (1998). Don’t worry and beware of white bears: thought suppression in anxiety patients. Journal of Anxiety Disorders, 12, 39–55.
Beevers, Ch. G., Wenzlaff, R. M., Hayes, A. M., & Scott, W. D. (1999). Depression and the ironic effects of thought suppression: Therapeutic strategies for improving mental control. Clinical Psychology: Science and Practice, 6, 133–148.
Belloch, A., Morillo, C., & Giménez, A. (2004). Effects of suppressing neutral and obsession-like thoughts in normal subjects: Beyond frequency. Behaviour Research and Therapy, 42, 841–857.
Clark, D. A. (2004). Cognitive-behavioural therapy for OCD. New York: The Guilford Press.
Di Nardo, P. A., Brown, T. A., & Barlow, D. H. (1994). Anxiety Disorders Interview Schedule for DSM-IV: Lifetime version (ADIS-IV-L). New York: Graywind Publications Inc.
Fehm, L., & Hoyer, J. (2004). Measuring Thought control strategies: The Thought control questionnaire and a look beyond. Cognitive Therapy and Research, 28, 105–117.
Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Fleishman. R. J., Hill, C. L., Heninger, G. R., & Charney, D. S. (1989a). The Yale-Brown Obsessive-Compulsive Scale (I): Development, use and reliability. Archives of General Psychiatry, 46, 1006–1011.
Goodman, W. K., Price, L. H., Ramussen, S. A., Mazure, C., Delgado, Heninger, G. R., & Charney, D. S. (1989b). The Yale-Brown Obsessive-Compulsive Scale (II): Validity. Archives of General Psychiatry, 46, 1012–1016.
Guthrie, R., & Bryant, R. (2000). Attempting suppression of traumatic memories over extended periods in acute stress disorder. Behaviour Research and Therapy, 38, 899–907.
Harvey, A. G. (2003). The attempted suppression of pre-sleep cognitive activity in insomnia. Cognitive Therapy and Research, 27, 593–602.
Hodgson, R. J., & Rachman, S. (1977). Obsessional-compulsive complaints. Behaviour Research and Therapy, 15, 389–395.
Luciano, J. V., Belloch, A., Algarabel, S., Tomás, J. M., Morillo, C., & Lucero, M. (2006). Confirmatory factor analysis of the White Bear Suppression Inventory and the Thought Control Questionnaire: A comparison of alternative models. European Journal of Psychological Assessment, 22, 250–258.
McKay, D., & Greisberg, S. (2002). Specificity of measures of thought control. The Journal of Psychology, 136, 149–160.
Morillo, C., Belloch, A., & García-Soriano, G. (2006). Clinical obsessions in obsessive-compulsive patients and obsession-relevant intrusive thoughts in non-clinical, depressed and anxious subjects: where are the differences?. Behaviour Research and Therapy (2006), doi:10.1016/j.brat.2006.11.005.
Muris, P., Merckelbach, H., & Horselenberg, R. (1996). Individual differences in thought suppression. The White Bear Suppression Inventory: Factor structure, reliability, validity and correlates. Behaviour Research and Therapy, 34, 501–513.
Purdon, C. (1999). Thought suppression and psychopathology. Behaviour Research and Therapy, 37, 1029–1054.
Purdon, C. (2004). Empirical investigations of thought suppression in OCD. Journal of Behaviour Therapy and Experimental Psychiatry, 35, 121–136.
Purdon, C., & Clark, D. A. (2001). Suppression of obsession-like thoughts in non-clinical individuals: Impact on thought frequency, appraisal and mood state. Behaviour Research and Therapy, 39, 1163–1181.
Rachman, S. (1993). Obsessions, responsibility and guilt. Behaviour Research and Therapy, 31, 149–154.
Rachman, S. (1997). A cognitive theory of obsessions. Behaviour Research and Therapy, 35, 793–802.
Rachman, S. (1998). A cognitive theory of obsessions: elaborations. Behaviour Research and Therapy, 36, 385–401.
Rachman S. (2003). The treatment of obsessions. New York: Oxford University Press.
Rachman, S., & Hodgson, R. J. (1980) Obsessions and compulsions. New York: Prentice Hall.
Rafnsson, F. D., & Smári, J. (2000). Chronic thought suppression and obsessionality: The relationships between the White Bear Inventory and two inventories of obsessive-compulsive symptoms. Personality and Individual Differences, 30, 159–165.
Rassin, E., & Diepstraten, P. (2003). How to suppress obsessive thoughts. Behaviour Research and Therapy, 41, 97–103.
Reynolds, M., & Wells, A. (1999). The Thought Control Questionnaire—Psychometric properties in a clinical sample, and relationships with PTSD and depression. Psychological Medicine, 29, 1089–1099.
Salkovskis, P. M. (1985). Obsessional-compulsive problems: A cognitive-behavioral analysis. Behaviour Research and Therapy, 23, 571–583.
Salkovskis, P. M. (1999). Understanding and treating obsessive-compulsive disorder. Behaviour Research and Therapy, 37, 29–52.
Seisdedos, N. (1988). Cuestionario de Ansiedad Estado-Rasgo. Adaptación española. Madrid: TEA.
Smári, J. (2001). Fifteen years of supresión of white bears and other thoughts: What are the lessons for obsessive-compulsive disorder research and treatment?. Scandinavian Journal of Behaviour Therapy, 30, 147–160.
Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1970). STAI, Manual for the State-Trait Anxiety Inventory (Self evaluation Questionnaire). Palo Alto, CA: Consulting Psychologist Press.
Warda, G., & Bryant, R. A. (1998). Thought control strategies in acute stress disorder. Behaviour Research and Therapy, 36, 1171–1175.
Wegner, D. M., & Zanakos, S. (1994). Chronic thought suppression. Journal of Personality, 62, 615–640.
Wegner, D. M., Schneider, D. J., Carter, S. R., & White, T. L. (1987). Paradoxical effects of thought suppression. Journal of Personality and Social Psychology, 53, 5–13.
Wells, A., & Davies, M. I. (1994). The thought control questionnaire: a measure of individual differences in the control of unwanted thoughts. Behaviour Research and Therapy, 32, 871–878.
Acknowledgments
This study was supported by the Spanish Ministerio de Ciencia y Tecnología and EC FEDER funds (Grant no. SEJ2006/03893-PSIC). The third author has a grant from the Spanish Education Ministry for the promotion of new Ph.D. University teachers (AP2003-2630).
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Belloch, A., Morillo, C. & Garcia-Soriano, G. Strategies to Control Unwanted Intrusive Thoughts: Which are Relevant and Specific in Obsessive-Compulsive Disorder?. Cogn Ther Res 33, 75–89 (2009). https://doi.org/10.1007/s10608-007-9141-2
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DOI: https://doi.org/10.1007/s10608-007-9141-2