Exposure to unwanted intrusions, neutralizing and their effects on self-worth and obsessive-compulsive phenomena

Background: Although there is a growing body of literature to support the importance of understanding self processes in the experience of obsessive-compulsive disorder (OCD), no experimental research has directly examined the relationship between self-construals and phenomena central to OCD. The current study examined the effect that unwanted intrusions and neutralizing responses have on self-worth, distress and urge to neutralize. Methods: After listening to repeated audio recordings of idiosyncratic unwanted intrusions, a combined nonclinical and clinical OCD sample were asked to respond with either their chosen neutralizing strategy (experimental) or a refocus counting strategy (control). Each condition comprised of a 12-min responding period (respond) followed by an equivalent non-response period (listen). Participants completed each condition, and were randomly allocated into the condition completed first. Ratings of discomfort, urge to neutralize, and self-worth were measured throughout. Results: Neutralizing and refocussing responses were both associated with decreases in discomfort and higher self-worth. The expected rebound effect for discomfort and urge to neutralize for the listen period after neutralizing was found. Limitations: Methodological problems lead to missing data, although this was corrected with the use of Multi Level Modelling.(MLM) analysis on a combined sample. The small clinical sample meant that comparison between the two populations was not possible. Conclusions: Findings support cognitive accounts that neutralizing is involved in the development and maintenance of OCD, and suggest that neutralizing is a purposeful response aimed to help reinstate self-worth. Implications and directions for future research are discussed. (C) 2015 Elsevier Ltd. All rights reserved.