Emotion Regulation in Patients with Obsessive Compulsive Disorder: Unique Effects for Those with "Taboo Thoughts"

Emotion regulation (ER) is a modifiable and transdiagnostic construct that has been widely studied across the affective disorders; however, little research has evaluated the relationship between ER and obsessive-compulsive (OC) features (e.g., OC symptom dimensions, OC symptom severity, and obsessive beliefs). The current study therefore evaluates the relationship between ER difficulties and OC features in the largest sample of adults with OCD to date. Participants (N= 57) completed a clinician-administered diagnostic and OC symptom assessment, as well as self-report questionnaires. Results revealed a specific relationship between ER difficulties, the unacceptable thoughts dimension, and obsessive beliefs, even after controlling for co-occurring depressive symptomology. Specifically, patients with "taboo thoughts" and elevated obsessive beliefs experienced greater difficulties accepting unwanted emotions, engaging in goal-directed behaviors when upset, accessing ER strategies, and clarifying emotions. Pending replication with a longitudinal framework, results highlight the utility of integrating emotion regulation modules into typical behavior therapy protocols for patients with unacceptable thoughts. Additional clinical implications, limitations and future directions are discussed.