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.