The purpose of this study was to develop and provide a preliminary validation of a new measure of scrupulosity, the Scrupulous Thoughts and Behaviours Questionnaire (STBQ). More specifically, the STBQ was designed to assess a range of scrupulosity-related thoughts/obsessions and behaviours/compulsions. Following item development, a sample of non-referred college students completed the STBQ along with numerous validation measures. Based on factor analyses, a two-factor solution was retained. The first factor consisted of items that measure scrupulosity-themed obsessions and thoughts, and the second factor consisted of items that measure scrupulosity-themed compulsions and related behaviours. Support was found for the validity of STBQ, as both subscales were significantly and positively associated with measures of relevant constructs, including the Pennsylvania Inventory of Scrupulosity-Revised, the only other self-report measure of scrupulosity, thought–action fusion, religiosity, and obsessive–compulsive disorder symptoms. As the first known self-report measure to assess scrupulosity obsessions and compulsions, the STBQ has a potential utility in clinical practice and research.

Background: Obsessive beliefs account for substantial (but not all) obsessive-compulsive (OC) symptoms. Intolerance of internal experiences (IIE), which encompasses the constructs of experiential avoidance (EA) and distress tolerance (DT), refers to difficulty managing unwanted thoughts, emotions, and other internal states, and might add to current explanatory models. Although IIE appears to be conceptually relevant to obsessive-compulsive (OC) symptoms, scant research has examined this relationship empirically. Aim: The present study examined the relative contributions of EA and DT as predictors of OC symptom dimensions. Method: A nonclinical sample (n = 496) completed self-report questionnaires measuring general distress, EA, DT and OC symptom dimensions. Results: All variables of interest were significantly (all ps ≤ .001) correlated with one another, such that higher general distress, higher EA, and lower DT were associated with greater OC symptom severity for all symptom dimensions; however, only EA independently predicted obsessional symptoms, but not other OC symptom dimensions. Conclusions: One's willingness to endure (i.e. EA), rather than their ability to tolerate (i.e. DT) unpleasant internal experiences best predicts obsessional symptoms (i.e. obsessing) above and beyond general distress. Potential implications for understanding, assessing, and treating OC symptoms are discussed.

There are theoretical challenges in distinguishing obsessions from overvalued ideas (OVIs) and delusions. The latter can be defined by its rigid nature and unusual content, but obsessions and OVIs are also reported with such characteristics. Clinically, what are the implications when this distinction is not entirely clear? In this case study, these issues are explored with a man who presented with commonly reported symptoms of obsessive compulsive disorder (OCD) and a belief about transforming into a giant fly. Clinically meaningful gains were made following a course of 17 sessions of CBT, providing some additional support for the effectiveness of CBT for abnormal beliefs within OCD.

The present study examined whether patients with obsessive-compulsive disorder (OCD) focus on details at the expense of global aspects. A recent study of our group using Navon letters (e.g., the letter “S” composed out of “A” letters) did not yield differences between OCD patients and controls on local processing. However, the task used may have lacked sensitivity, because it did not involve a response conflict condition (i.e., global and local level associated with different responses). In the current study, we gradually varied between-level conflict. Twenty-eight OCD patients and 30 healthy controls had to attend to the global and the local level of each item. OCD patients displayed comparable performance: Patients neither displayed a preference to respond to the local level nor enhanced interference from the local level. In conclusion, the present study does not support the idea that a generalized bias to “miss the forest for the trees” forms part of the vulnerability to OCD. (JINS, 2008, 14, 489–493.)

A novel cognitive technique, termed “association splitting”, aimed at reducing obsessive thoughts, is introduced. Association splitting draws upon the so-called “fan effect” of associative priming. Transposing this principle to the treatment of obsessive-compulsive disorder (OCD), we hypothesize that the sprouting of new and the strengthening of existing neutral associations to core OCD cognitions will reduce their fear-evoking properties by depriving the chain of OCD-related cognitions of associative strength. To test the feasibility and efficacy of this approach, an internet intervention study was implemented. Initially, 38 subjects with OCD obsessions took part in a survey. After completion of the survey they were then sent a self-help manual. Three weeks later, participants were re-contacted. One-third of the participants responded to the treatment (at least 35% decline on the Y-BOCS scale). The completer analysis revealed a response rate of 42%. It is suggested that association splitting may lead to symptom relief in a subgroup of participants and may represent a useful addition to the tool box of cognitive-behavioural techniques.

A literature search yielded no studies investigating Wegner's (1989) proposal that repeated suppression attempts and rebound opportunities (indulgence cycles) lead to an escalation of intrusions, providing a mechanism whereby an unwanted intrusive thought may develop into a clinical obsession. It was predicted, based on Wegner's (1994) ironic process theory of mental control, that individuals high in trait obsessionality would exhibit an increase in thought frequency as a function of indulgence cycle and that those low in trait obsessionality would display a corresponding decrease in thought frequency. Participants (N=40) were asked to suppress and then express a personally relevant obsessive intrusive thought through two indulgence cycles. There was no significant escalation in thoughts across indulgence cycles for the high obsessionality group, but the low obsessionality group were significantly more successful at suppression. The results confirm previous research suggesting that trait obsessionality has an impact upon the effectiveness of thought suppression.

Recent cognitive behavioural models of obsessive compulsive disorder (OCD) suggest that the misinterpretation of the meaning of intrusive thoughts plays a pivotal role in the escalation of these thoughts to clinical obsessions, but less attention has been paid to why only certain intrusive thoughts become the focus of these misappraisals. Theoretical speculation suggests that thoughts that have relevance for an individual's value system or sense of self may be particularly salient and upsetting for people. The role of thought appraisal and contradiction of valued aspects of self were examined in a nonclinical population. It was hypothesized that participants reporting on upsetting intrusive thoughts would appraise these thoughts negatively and would report that these thoughts contradict important aspects of self to a greater degree than participants reporting on less upsetting intrusive thoughts. Participants (N = 64) were randomly assigned to report on either the most or least upsetting intrusive thought they had experienced. They completed questionnaires on appraisals of these thoughts, valued aspects of self, and contradiction of self. Consistent with predictions, participants reporting on more upsetting thoughts appraised these thoughts in a more negative manner and reported that these thoughts contradicted valued aspects of self to a greater degree than participants in the least upsetting thought group. These results support Salkovskis' (1985) and Rachman's (1997, 1998) cognitive behavioural models of OCD, and suggest that the degree of contradiction of self may help us understand why some obsessional thoughts are much more upsetting than others.

The unusual case of a young mathematics student is described. While studying and at other times he was troubled by intrusive thoughts about the logical foundations of mathematics. A treatment package involving the use of thought stopping, emotional processing and training in study skills is described and some ideas about the treatment of intrusive thought are considered.