Assessment of thought–shape fusion: initial validation of a short version of the trait thought–shape fusion scale

Objective: Thought–shape fusion (TSF) is a cognitive distortion that has been linked to eating pathology. Two studies were conducted to further explore this phenomenon and to establish the psychometric properties of a French short version of the TSF scale. Method: In Study 1, students (n 5 284) completed questionnaires assessing TSF and related psychopathology. In Study 2, the responses of women with eating disorders (n 5 22) and women with no history of an eating disorder (n 5 23) were compared. Results: The French short version of the TSF scale has a unifactorial structure, with convergent validity with measures of eating pathology, and good internal consistency. Depression, eating pathology, body dissatisfaction, and thought-action fusion emerged as predictors of TSF. Individuals with eating disorders have higher TSF, and more clinically relevant food-related thoughts than do women with no history of an eating disorder. Discussion: This research suggests that the shortened TSF scale can suitably measure this construct, and provides support for the notion that TSF is associated with eating pathology.

Mental contamination in obsessive–compulsive disorder

It was recently proposed that feelings of contamination can arise in the absence of physical contact with a contaminant. Currently, there are limited data regarding this construct of ‘mental contamination’ although it is hypothesised to be relevant to obsessive compulsive disorder(OCD) where compulsive washing in response to contamination fear is a common presentation (Rachman,2006). This research examined the presence of mental contamination in OCD. Participants (N=177) with obsessive compulsive symptoms completed questionnaires to assess mental contamination, OCD symptoms and thought-action fusion (TAF). Findings indicated that 46% of participants experienced mental contamination, and severity was associated with severity of OCD symptoms and TAF. Mental contamination in the absence of contact contamination was reported by 10.2% of participants. Similar findings were reported in a sub-sample of participants who had received a formal diagnosis of OCD (N=54). These findings suggest that mental contamination is a distinct construct that overlaps with, but is separate from, contact contamination, and provide preliminary empirical support for the construct.

Development and validation of the Morphing Fear Questionnaire (MFQ)

Morphing fears (also called transformation obsessions) involve concerns that a person may become contaminated by and acquire undesirable characteristics of others. These symptoms are found in patients with OCD and are thought to be related to mental contamination. Given the high levels of distress and interference morphing fears can cause, a reliable and valid assessment measure is needed. This article describes the development and evaluation of the Morphing Fear Questionnaire (MFQ), a 13-item measure designed to assess for the presence and severity of morphing fears. A sample of 900 participants took part in the research. Of these, 140 reported having a current diagnosis of OCD (SR-OCD) and 760 reported never having had OCD (N-OCD; of whom 24 reported a diagnosis of an anxiety disorder and 23 reported a diagnosis of depression). Factor structure, reliability, and construct and criterion related validity were investigated. Exploratory and confirmatory factor analyses supported a one-factor structure replicable across the N-OCD and SR-OCD group. The MFQ was found to have high internal consistency and good temporal stability, and showed significantly greater associations with convergent measures (assessing obsessive-compulsive symptoms, mental contamination, thought-action fusion and magical thinking) than with divergent measures (assessing depression and anxiety). Moreover, the MFQ successfully discriminated between the SR-OCD sample and the N-OCD group, anxiety disorder sample, and depression sample. These findings suggest that the MFQ has sound psychometric properties and that it can be used to assess morphing fear. Clinical implications are discussed.

Examining Cognitive Models of Obsessive Compulsive Disorder in Adolescents

Abstract. Three influential theoretical models of OCD focus upon the cognitive factors of inflated responsibility (Salkovskis, 1985), thought-action fusion (Rachman, 1993) and meta-cognitive beliefs (Wells and Matthews, 1994). Little is known about the relevance of these models in adolescents or about the nature of any direct or mediating relationships between these variables and OCD symptoms. This was a cross-sectional correlational design with 223 non-clinical adolescents aged 13 to 16 years. All participants completed questionnaires measuring inflated responsibility, thought-action fusion, meta-cognitive beliefs and obsessive-compulsive symptoms. Inflated responsibility, thought-action fusion and metacognitive beliefs were significantly associated with higher levels of obsessive-compulsive symptoms. These variables accounted for 35% of the variance in obsessive-compulsive symptoms, with inflated responsibility and meta-cognitive beliefs both emerging as significant independent predictors. Inflated responsibility completely mediated the effect of thoughtaction fusion and partially mediated the effect of meta-cognitive beliefs. Support for the downward extension of cognitive models to understanding OCD in a younger population was shown. Findings suggest that inflated responsibility and meta-cognitive beliefs may be particularly important cognitive concepts in OCD. Methodological limitations must be borne in mind and future research is needed to replicate and extend findings in clinical samples. Keywords: Obsessive compulsive disorder, adolescents, cognitive models.

Do Cognitive Models of Obsessive Compulsive Disorder Apply to Children and Adolescents?

Cognitive models of obsessive compulsive disorder (OCD) have been influential in understanding and treating the disorder in adults. Cognitive models may also be applicable to children and adolescents and would have important implications for treatment. The aim of this systematic review was to evaluate research that examined the applicability of the cognitive model of OCD to children and adolescents. Inclusion criteria were set broadly but most studies identified included data regarding responsibility appraisals, thought-action fusion or meta-cognitive models of OCD in children or adolescents. Eleven studies were identified in a systematic literature search. Seven studies were with non clinical samples, and 10 studies were cross-sectional. Only one study did not support cognitive models of OCD in children and adolescents and this was with a clinical sample and was the only experimental study. Overall, the results strongly supported the applicability of cognitive models of OCD to children and young people. There were, however, clear gaps in the literature. Future research should include experimental studies, clinical groups, and should test which of the different models provide more explanatory power.