Obsessional beliefs and the implicit and explicit morality of intrusive thoughts

Cognitive models of obsessive-compulsive disorder (OCD) suggest that misinterpreting intrusive thoughts exacerbates obsessional thinking. To evaluate this hypothesis, healthy participants (N=91) were prompted to recollect their unwanted thoughts, and then beliefs about the immorality of these thoughts were manipulated. Next, participants completed implicit and explicit measures of self-evaluation and appraisals of unwanted thoughts. Results from structural regression analyses indicated that explicit responses to unwanted thoughts, such as evaluations of the significance of intrusive thoughts and state self-esteem, were predicted by pre-existing obsessional beliefs, but not by the morality instruction manipulation. In contrast, implicit responses, such as appraisals of unwanted thoughts as relatively important and evaluations of the self as relatively immoral and dangerous, were predicted by the interaction between specific obsessional beliefs (e.g., intolerance of uncertainty) and the morality instructions. Findings largely support cognitive models of OCD and suggest unique predictors of implicit and explicit responses to unwanted thoughts.