Prior Beliefs About the Importance and Control of Thoughts are Predictive But Not Specific to Subsequent Intrusive Unwanted Thoughts and Neutralizing Behaviors

Dysfunctional beliefs are the central element in cognitive-behavioral conceptualizations of obsessive–compulsive disorder (OCD). The purpose of this study was to further elucidate the etiological role of preexisting dysfunctional beliefs in the occurrence of unwanted intrusive thoughts and neutralizing behaviors after a critical event by examining their predictive value and specificity in a prospective study with undergraduate students. The dysfunctional belief domains importance/control of thoughts (ICT), responsibility/threat (RT), and perfectionism/certainty (PC) were assessed at baseline 8 weeks prior to the critical event “exam situation” in N = 169 students. Exam-related unwanted intrusive thoughts and neutralizing behaviors, anxiety, and depression were assessed during the week immediately before the exam. Complete data for both baseline and follow-up were available for 79 participants (46%). After controlling for baseline obsessive–compulsive symptoms, anxiety, and depression, ICT but not RT or PC prospectively predicted exam-related intrusive thoughts and neutralizing behaviors, ICT also prospectively predicted depressive symptoms but not anxiety, and RT and PC both prospectively predicted anxiety but not depressive symptoms. Findings are partially consistent with cognitive models of OCD. They support the idea that ICT is a cognitive vulnerability factor for unwanted intrusive thoughts and neutralizing behaviors during a stressful event. Its predictive power was small and not specific to unwanted intrusive thoughts and neutralizing behaviors.