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Neutralizing increases discomfort associated with obsessional thoughts: an experimental study with obsessional
P M Salkovskis1, S J Thorpe, K Wahl
1Department of Psychology, Institute of Psychiatry, Kings College, London, England. p.salkovskis@iop.kcl.ac.uk
Journal of Abnormal Psychology
|December 17, 2003
Summary
Neutralizing intrusive thoughts in obsessive-compulsive disorder (OCD) initially reduces discomfort but leads to greater distress and urges later. This suggests neutralizing may prolong OCD symptoms.
Area of Science:
- Psychology
- Clinical Psychology
- Cognitive Behavioral Therapy
Background:
- Cognitive-behavioral theories posit that neutralizing is key to the development and maintenance of obsessive-compulsive disorder (OCD).
- Neutralizing behaviors are often employed by individuals with OCD to reduce the distress associated with intrusive thoughts.
Purpose of the Study:
- To investigate the immediate and delayed effects of neutralizing versus distraction on discomfort and urges in patients with OCD.
- To examine the role of neutralizing in the persistence of obsessive-compulsive symptoms.
Main Methods:
- Twenty-nine patients diagnosed with OCD were randomly assigned to either a neutralizing (experimental) or distraction (control) group.
- Participants were exposed to repeated recorded presentations of their intrusive thoughts.
- Discomfort and urges were assessed during exposure and a subsequent period without active coping strategies.
Main Results:
- The experimental group (neutralizing) reported similar discomfort during initial exposure compared to controls.
- However, the experimental group showed a significant reduction in discomfort over time during the exposure phase.
- In the subsequent phase without coping, the experimental group experienced significantly more discomfort and stronger urges to neutralize or distract compared to the control group.
Conclusions:
- While neutralizing may provide short-term relief from distress associated with intrusive thoughts in OCD, it appears to increase overall discomfort and urges in the longer term.
- These findings suggest that neutralizing behaviors may inadvertently maintain or exacerbate OCD symptoms, highlighting the importance of cognitive-behavioral interventions that target these behaviors.