The relationship between responsibility beliefs and symptoms and processes in obsessive compulsive disorder: A systematic review

Background: Cognitive models of Obsessive Compulsive Disorder (OCD) suggest that responsibility appraisals contribute to the aetiology and maintenance of OCD symptoms. An accumulating body of evidence supports this notion, and preliminary data indicates that modifying responsibility appraisals in treatment can be beneficial in reducing obsessive-compulsive symptomatology in individuals with OCD. This systematic review aims to evaluate the existing experimental research on the effect of responsibility on symptoms and processes in OCD across both adult and paediatric samples. Method: The following databases were searched: PsycInfo, Medline, and Web of Science. Articles were limited to peer-reviewed, English language papers that examined the effect of responsibility on at least one behavioural measure related to OCD, during an experimental manipulation. Risk of bias and study results were reviewed for each study. Results: In the 16 studies that met inclusion criteria, the responsibility manipulation had a consistently adverse effect on responsibility and threat appraisals, and an inconsistent effect on self and observer-rated variables. Effects of responsibility were generally not significantly greater for OCD participants. Conclusions: Further research is warranted to determine the precise role of responsibility and other cognitive appraisals (e.g., threat appraisals) for both clinical and non-clinical individuals.