The Cognitive Architecture of Obsessional Doubt: Inferential Confusion and Feared Selves in OCD‐Relevant Intrusions
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2025
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| author | Mohammad Aminaee Seyed Mohammadreza Taghavi Frederick Aardema Seyed Alireza Sadjadi Mehdi Reza Sarafraz Mohammad Ali Goodarzi |
| author_facet | Mohammad Aminaee Seyed Mohammadreza Taghavi Frederick Aardema Seyed Alireza Sadjadi Mehdi Reza Sarafraz Mohammad Ali Goodarzi Mohammad Aminaee Seyed Mohammadreza Taghavi Frederick Aardema Seyed Alireza Sadjadi Mehdi Reza Sarafraz Mohammad Ali Goodarzi |
| collection | Wiley Open Access |
| contents | The Cognitive Architecture of Obsessional Doubt: Inferential Confusion and Feared Selves in OCD‐Relevant Intrusions Mohammad Aminaee Seyed Mohammadreza Taghavi Frederick Aardema Seyed Alireza Sadjadi Mehdi Reza Sarafraz Mohammad Ali Goodarzi Clinical Psychology & Psychotherapy ABSTRACT Although previous research has examined the individual roles of unwanted intrusive thoughts (UITs), inferential confusion and feared selves in obsessive‐compulsive disorder (OCD), no study to date has evaluated their combined effects on OCD severity. This is particularly relevant given that the inference‐based approach (IBA) posits a close link between inferential confusion and feared selves in the context of obsessional doubt. The present study with a cross‐sectional design investigated the role of inferential confusion and feared selves in mediating the relationship between OCD‐relevant UITs and OCD severity. A clinical sample of 306 individuals with a primary diagnosis of OCD (mean age = 32.95, SD = 9.99, female = 58.8%) who also had some comorbid psychiatric disorders, with the exception of a current or previous history of personality disorders, psychotic disorders and substance use disorders, completed a battery of self‐reported measures—including the Questionnaire of Unpleasant Intrusive Thoughts, Fear of Self Questionnaire‐Multidimensional Version, Patient Health Questionnaire and Expanded Version of the Inference Confusion Questionnaire)—as well as the clinician‐administered version of the Yale‐Brown Obsessive‐Compulsive Scale. Bootstrapped mediation analyses (5000 resamples, 95% confidence interval) revealed that UITs were indirectly associated with OCD severity via inferential confusion and one specific dimension of feared selves: the feared corrupted self. Mediation was not supported for the feared culpable or malformed selves in this model. However, a serial mediation pathway emerged wherein inferential confusion and both feared corrupted and culpable selves sequentially mediated the link between UITs and clinician‐rated OCD severity. The findings suggest that inferential confusion, along with specific feared self domains, plays a critical role in differentiating intrusive thoughts that are common in the general population from obsessional doubt, as conceptualised in the IBA. Within the inference‐based framework, these processes do not merely escalate UITs; rather, they actively produce obsessional doubts that disconnect the individual from reality and render the imagined threat personally meaningful, persistent and in need of resolution. 10.1002/cpp.70164 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1002/cpp.70164 |
| format | Artículo Open Access |
| id | wiley_oa_10_1002_cpp_70164 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2025 |
| publisher | Wiley |
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| spellingShingle | The Cognitive Architecture of Obsessional Doubt: Inferential Confusion and Feared Selves in OCD‐Relevant Intrusions Mohammad Aminaee Seyed Mohammadreza Taghavi Frederick Aardema Seyed Alireza Sadjadi Mehdi Reza Sarafraz Mohammad Ali Goodarzi Clinical Psychology & Psychotherapy The Cognitive Architecture of Obsessional Doubt: Inferential Confusion and Feared Selves in OCD‐Relevant Intrusions Mohammad Aminaee Seyed Mohammadreza Taghavi Frederick Aardema Seyed Alireza Sadjadi Mehdi Reza Sarafraz Mohammad Ali Goodarzi Clinical Psychology & Psychotherapy ABSTRACT Although previous research has examined the individual roles of unwanted intrusive thoughts (UITs), inferential confusion and feared selves in obsessive‐compulsive disorder (OCD), no study to date has evaluated their combined effects on OCD severity. This is particularly relevant given that the inference‐based approach (IBA) posits a close link between inferential confusion and feared selves in the context of obsessional doubt. The present study with a cross‐sectional design investigated the role of inferential confusion and feared selves in mediating the relationship between OCD‐relevant UITs and OCD severity. A clinical sample of 306 individuals with a primary diagnosis of OCD (mean age = 32.95, SD = 9.99, female = 58.8%) who also had some comorbid psychiatric disorders, with the exception of a current or previous history of personality disorders, psychotic disorders and substance use disorders, completed a battery of self‐reported measures—including the Questionnaire of Unpleasant Intrusive Thoughts, Fear of Self Questionnaire‐Multidimensional Version, Patient Health Questionnaire and Expanded Version of the Inference Confusion Questionnaire)—as well as the clinician‐administered version of the Yale‐Brown Obsessive‐Compulsive Scale. Bootstrapped mediation analyses (5000 resamples, 95% confidence interval) revealed that UITs were indirectly associated with OCD severity via inferential confusion and one specific dimension of feared selves: the feared corrupted self. Mediation was not supported for the feared culpable or malformed selves in this model. However, a serial mediation pathway emerged wherein inferential confusion and both feared corrupted and culpable selves sequentially mediated the link between UITs and clinician‐rated OCD severity. The findings suggest that inferential confusion, along with specific feared self domains, plays a critical role in differentiating intrusive thoughts that are common in the general population from obsessional doubt, as conceptualised in the IBA. Within the inference‐based framework, these processes do not merely escalate UITs; rather, they actively produce obsessional doubts that disconnect the individual from reality and render the imagined threat personally meaningful, persistent and in need of resolution. 10.1002/cpp.70164 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | The Cognitive Architecture of Obsessional Doubt: Inferential Confusion and Feared Selves in OCD‐Relevant Intrusions |
| topic | Clinical Psychology & Psychotherapy |
| url | https://onlinelibrary.wiley.com/doi/10.1002/cpp.70164 |