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Transdiagnostic

The transdiagnostic conceptualization of intrusive thoughts: Emotional reactivity and control/interference

(PS10-C60) The Transdiagnostic Conceptualization of Intrusive Thoughts: Emotional Reactivity and Control/interference

Saturday, November 18, 2023
1:00 PM – 2:00 PM PST
Location: Regency Ballroom, Level 7
Intrusive thoughts (IT) are a shared feature of obsessive-compulsive disorder (OCD), major depressive disorder (MDD), and generalized anxiety disorder (GAD), experienced as obsessions, ruminations, and worries, respectively. Although there is robust literature on the role of ITs in the maintenance of these disorders individually, the conceptualization of IT as transdiagnostic is limited and findings are inconsistent. The Obsessional Intrusive Thoughts Inventory (OITI; Garcia-Soriano, 2008) was developed to measure corresponding emotional reactions (i.e., unpleasantness, anxiety, sadness, guilt, and shame) and difficulties controlling (i.e., difficulty controlling/suppressing, degree of success controlling, and interference) a participant’s most distressing obsessional thought in the context of OCD. However, to date, this measure has not been administered to participants with ruminations or worries as their primary IT. Thus, we explored the potential transdiagnostic nature of these characteristics in a sample of 60 participants (16 who identified an obsession as their most distressing IT, 15 with worries, 12 with ruminations and 15 non-psychiatric controls). The OITI Emotional Reactions and Difficulty Controlling subscales were strongly positively related to each other, r(58) = .56, p < .001, indicating patients with stronger emotional reactions to their ITs also reported less control over their IT and greater resulting interference. Individuals with obsessions, worries, and ruminations reported elevated scores on the Emotional Reactions and Difficulty Controlling OITI subscales compared to non-psychiatric controls (ps < .001, η2 > .53), but the strength of these emotional reactions were not significantly different from one another among the psychiatric groups. When individual OITI items were examined, the ruminations group reported higher levels of sadness in comparison to patients with obsessions (p = .049) and non-psychiatric controls (p = .001), but they reported a comparable level of sadness to those with worries (p = .17). The ruminations group also was the least successful at controlling/suppressing their IT in comparison to patients with obsessions (p= .04), worries (p = .03), and non-psychiatric controls (p < .001). In summary, the overall similar presentation of emotional reactions (unpleasantness, anxiety, guilt, shame) and degree of control/interference of ITs across psychiatric groups, supports a transdiagnostic conceptualization of OCD, MDD, and GAD and indicates that unified treatment approaches addressing the commonalities of these features may augment treatment outcomes. Additionally, we found evidence that ruminations in MDD have certain unique properties (i.e., sadness, low success controlling/suppressing) to be investigated further.