The relationship between causal constructs related to obsessive-compulsive disorder
Obsessive-Compulsive Disorder (OCD) is characterised by intrusions into conscious thinking by repetitive, personally abhorrent, absurd and alien thoughts (obsessions) which lead to endless repetitive acts or rehearsal of irrational and sometimes bizarre mental and behavioural rituals (compulsions). Although a number of clinical constructs have been proposed to have a causal influence on OC symptoms, extremely little research exists examining how these constructs are related to each other and, further, how the relationships between these constructs influences each constructs relationship with OC symptoms (e.g. does a given construct have an independent role in influencing OC symptoms or is the constructs influence on OC symptoms being mediated by its influence on another intervening construct or constructs?). In the current thesis, the relationships between 5 clinical constructs were examined, as well as how the pattern of these relationships may affect each constructs influence on OC symptoms. A large questionnaire study suggested that the five constructs are best seen as separate constructs rather than indicators of one underlying construct. Separate experimental studies in which all 5 constructs were manipulated individually suggest that whilst inflated responsibility, intolerance of uncertainty and negative mood, respectively, all causally influence every other construct focused on in this thesis, not just right experiences and as many as can stop rules, respectively, do not casually influence any other construct. Subsequent regression analyses suggest that whilst some constructs directly influence OC symptoms, other constructs influence on OC symptoms are mediated by intervening constructs in the final model, whilst some constructs have little to no influence on OC symptoms when the influence of other constructs in the final model are taken into account. Implications of these findings for existing models of OCD, for studies examining the relationship between multiple constructs and OC symptoms and for the treatment of OCD are discussed.
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