Thought–action fusion and its relationship to schizotypy and OCD symptoms
Introduction
Patients with obsessive-compulsive disorder (OCD) often manifest magical or superstitious qualities in their compulsive behavior. For instance, some OCD patients repeat meaningless numbers or phrases or engage in senseless overt acts with the belief that these will prevent some threatening outcome such as the death of a family member. Although compulsions are defined as either excessive or not connected in a realistic way with what they are designed to neutralize or prevent (DSM-IV, APA, 1994), some compulsions appear to be connected with their neutralizing targets in more magical ways than do other compulsions. For instance, repeating a meaningless phrase backward and forward 50 times to undo recurrent blasphemous thoughts appears to be more magical and superstitious when compared to checking a lock repeatedly to ensure the door is not unlocked. These magical or superstitious behaviors may be linked to certain cognitive biases.
Thought–action fusion (TAF) refers to a set of cognitive biases involving faulty causal relationships between one’s own thoughts and external reality, thereby increasing the sense of personal responsibility (Shafran, Thordarson, & Rachman, 1996). Two different types of TAF have been identified: (a) moral TAF is the belief that having unacceptable thoughts, images, or impulses are as bad as actually carrying them out, and (b) likelihood TAF is the belief that having an unacceptable or disturbing thought will increase the likelihood that the thought will occur in reality (Shafran et al., 1996). Several studies have demonstrated a significant relationship between TAF and OCD symptoms (Amir, Freshman, Ramsey, Neary and Brigidi, 2001, Coles, Mennin and Heimberg, 2001, Rassin, Diepstraten, Merckelbach and Muris, 2001, Shafran, Thordarson and Rachman, 1996).
It is possible that likelihood TAF is an extreme cognitive bias associated with magical thinking and schizotypal traits; whereas moral TAF is common among those adhering to a strict moral code, and therefore less associated with OCD symptoms and extreme magical thinking. To date, several findings appear to provide indirect support for this hypothesis. First, elevated moral TAF is frequently observed among nonclinical populations, whereas likelihood TAF is not (Shafran et al., 1996). Second, nonclinical subjects and OCD patients do not differ with respect to moral TAF but OCD patients score significantly higher than nonclinical subjects on likelihood TAF (Rassin, Merckelbach, Muris and Schmidt, 2001, Shafran, Thordarson and Rachman, 1996). Third, likelihood TAF is more strongly associated with OCD symptoms relative to moral TAF (Amir, Freshman, Ramsey, Neary and Brigidi, 2001, Coles, Mennin and Heimberg, 2001, Rassin, Diepstraten, Merckelbach and Muris, 2001, Rassin, Merckelbach, Muris and Schmidt, 2001, Shafran, Thordarson and Rachman, 1996). Finally, unlike moral TAF, likelihood TAF is positively associated with indices of anxiety and worry (Hazlett-Stevens, Zucker and Craske, 2002, Muris, Meesters, Rassin, Merckelbach and Campbell, 2001).
Despite evidence suggesting that OCD and schizophrenia are distinguishable (see Turner & Beidel, 1988), there is a line of research suggesting a possible linkage between OCD and schizotypy. About half of OCD patients exhibit mild to severe levels of schizotypal traits, which has led to the speculation that there may exist a schizotypy subtype of OCD (Sobin et al., 2000). Interestingly, OCD patients appear to be indistinguishable from schizophrenic patients and bipolar patients with respect to schizotypy, although all three groups score higher than unipolar depressive patients (Rossi & Daneluzzo, 2002). There has been some suggestion that OCD and the schizophrenic spectrum may be indirectly linked along a dimension of schizotypy (Pallanti, 2000). However, it should be noted that this line of investigation is at its infancy.
Both clinical observations and empirical investigations have conceptualized schizotypy as a multifactorial personality liability factor for schizophrenia falling along a continuum of severity (Lenzenweger, 1999, Lenzenweger and Korfine, 1995, Rossi and Daneluzzo, 2002). Factor analyses of the Schizotypal Personality Scale (STA; Claridge & Broks, 1984) point to three primary factors: (a) magical thinking, (b) paranoid ideation, and (c) unusual perceptual experiences. The magical thinking dimension may be particularly relevant to the magical thinking often observed in certain subtypes of OCD patients such as those displaying sexual, aggressive, or blasphemous obsessions (Lee, Kwon, Kwon, & Telch, submitted for publication). How are schizotypal traits related to OCD-relevant cognitive biases such as TAF? There has been a report that TAF is positively associated with various aspects of schizotypy (Muris & Merckelbach, 2003). However, to date research directly examining the relationship between TAF, schizotypy, and OCD symptoms is very scarce.
The aim of the present study was to investigate the possible connection between the two types of TAF, schizotypy traits, and OCD symptoms using a nonclinical student sample. We justify the use of a nonclinical sample based on previous research demonstrating that their obsessions, compulsions, and beliefs about intrusions are similar to those observed in clinical populations of OCD patients (see Gibbs, 1996, for a review). We hypothesized that likelihood TAF will be more strongly associated with schizotypal traits, especially magical thinking, and that the relationship between likelihood TAF and OCD symptom severity will in part be explained by the association between likelihood TAF and schizotypal traits.
Section snippets
Participants
Nine hundred and sixty-eight undergraduate students (659 women and 309 men) enrolled in introductory psychology classes at the University of Texas at Austin participated in the study. Participants ranged in age from 16 to 47 (M=19.07, SD=2.13) and were ethnically diverse. The sample consisted of Caucasus (62.1%), Asian/Pacific Islander (17.0%), Hispanic (14.0%), African American (3.4%), and other (3.4%). Participants received partial course credit for their participation.
The Thought–Action Fusion Scale-Revised (TAFS; Shafran et al.,1996)
The TAFS is a 19-item
Results
Means and standard deviations of study measures are presented in Table 1. The zero-order correlations among the measures, and their partial correlations after controlling for depression and anxiety are presented in Table 2. Consistent with prediction, likelihood TAF was more strongly associated with schizotypal traits, depression, general anxiety, and OCD symptoms, relative to moral TAF (p<0.001 for all of these correlation coefficient comparisons using Fisher Z-transformation). The association
Discussion
This study sought to examine the possible linkage between TAF and schizotypal characteristics. Our findings provide preliminary evidence for a positive association between likelihood TAF and schizotypal traits. Because several investigations have shown that likelihood TAF is related to general anxiety (Abramowitz, Whiteside, Lynam and Kalsy, 2003, Hazlett-Stevens, Zucker and Craske, 2002), we considered the possibility that the observed linkage between likelihood TAF and schizotypal traits was
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