DO WE NEED A COGNITIVE THEORY FOR OBSESSIVE-COMPULSIVE DISORDER? YES, WE DO

Nowadays a general trend in psychiatry and clinical psychology, claiming to explain mental illness and Obsessive-Compulsive Disorder (OCD) in particular as a neurological disease, seems to be in ascendant. The purpose of this position paper is to rebut this perspective on OCD and demonstrate that an Appraisal Theory (AT) of the disorder, is necessary and sufficient in order to account for proximal determinants in the genesis (proximal determinants) and maintenance of OC symptomatology. In the first part of this paper we shall rebut seven arguments against AT, while in the second part we shall answer two questions: 1) Are goals and beliefs necessary for OC symptoms? 2) Are goals and beliefs sufficient for OC symptoms? In the third part we shall answer three more questions: 1) Are cognitive deficits necessary for OC symptoms? 2) Are cognitive deficits sufficient for OC symptoms? 3) Do cognitive deficits really exist or are they better accounted for as cognitive biases? It will be demonstrated that goals and beliefs are necessary and sufficient as proximal determinants of OCD, whereas cognitive deficits appear neither necessary nor sufficient. Conceptualising OCD as a neurological disease founded on cognitive deficits does not add to the understanding of the disorder, since those problems which at a superficial level might look as cognitive deficits are much better accounted for by cognitive biases: distress caused by obsessional intrusions leads to a particular way of processing information, due to the person's goals and beliefs, therefore determining motivated, even though sometimes automatized, attempts at solution.