A bifactor model of obsessive beliefs: Specificity in the prediction of obsessive-compulsive disorder symptoms

Although current cognitive-behavioral models suggest that maladaptive "obsessive beliefs" about threat, responsibility, uncertainty, perfectionism, importance, and control of thoughts contributes to the development of obsessive-compulsive disorder (OCD), the structure of such beliefs is unclear. The current study evaluated a bifactor model of obsessive beliefs, as assessed by the Obsessive Beliefs Questionnaire (OBQ-44), and its association with OCD symptoms in clinical (Study 1; N = 264) and nonclinical (Study 2; N = 437) samples. The goals were as follows: (a) to evaluate whether obsessive beliefs should be conceptualized as unidimensional or whether distinct dimensions should be interpreted, and (b) to use structural equation modeling to examine the extent to which distinct beliefs predict OCD symptoms above and beyond a general obsessive belief factor. Results revealed that in both clinical and nonclinical samples, a bifactor model fit the data well and significantly better than a standard three-factor model of the OBQ-44 that specified 3 separate, yet correlated factors (Responsibility/Threat Estimation, Perfectionism/Certainty, and Importance/Control of Thoughts). Despite evidence that the OBQ-44 consists of a general factor and the 3 specific factors, structural equation modeling showed that only the general factor uniquely predicted a broad OCD symptom latent factor in clinical and nonclinical samples. Although obsessive beliefs about Perfectionism/Certainty did predict symmetry and ordering symptoms of OCD when controlling for the general factor in both studies, the general factor was a more robust predictor of specific OCD symptoms than the 3 factors. These findings suggest that the general factor of the OBQ-44 may have more utility than its specific factors in predicting the heterogeneity of OCD symptoms. (PsycINFO Database Record (c) 2019 APA, all rights reserved).