(PS7-C52) The Role of Self-concept in Motivational Dimensions of OCD

Background:

Previous research has linked OCD to various forms of self-concept, including self-ambivalence, self-doubt, and questions of self-worth (Bhar & Kyrios, 2007; Ferrier & Brewin, 2005). Guidano and Liotti (1983) suggested having conflicting or uncertain beliefs about one’s self-worth may make people particularly vulnerable to OCD. Although OCD is highly heterogeneous in symptom presentation, existing research does not investigate self-concept in different dimensions of OCD. Research has identified two specific motivational dimensions for OCD, harm avoidance and incompleteness, which may underlie a large portion of OCD symptoms. For example, harm avoidance (HA) has been associated with beliefs involving inflated responsibility and overestimated threat (Wheaton et al., 2010), and incompleteness (INC) has been associated with not just right experiences (NJREs), symmetry, and ordering (Ecker & Gönner, 2008). In this study, we aimed to learn about self-concept in OCD by exploring the relationship between self-worth and the motivational dimensions of HA and INC.  

Methods:

Participants included 98 individuals (M age = 30.5, SD = 11.7) seeking care at an intensive/residential treatment program for OCD and related disorders. Participant race/ethnicity was reported as 89% White, 4% Middle Eastern/North African, 3% Asian, 2% Black, and 2% Latinx/Hispanic. Gender was reported as 54% Woman, 41% Man, 2% Transgender, 2% “Not Listed,” and 1% Gender Non-Conforming.

At treatment admission, participants completed the Obsessive-Compulsive Trait Core Dimensions Questionnaire (OCTCDQ; Summerfeldt et al., 2014) to assess levels of HA and INC. Participants also completed the Quick Inventory of Depressive Symptomatology (QIDS; Rush et al., 2003), from which we examined item 11 (“View of Myself”).  Participants answered the item on a scale of 0 (“I see myself as equally worthwhile and deserving as other people”) to 3 (“I think almost constantly about major and minor defects in myself”).

Results:

We found that the sample had similar levels of HA (M = 34.7, SD = 9.3) and INC (M = 32.7, SD = 9.8). On QIDS item 11, the sample had a mean score of 1.8 (SD = 1.1) out of 3. We performed two correlation tests to examine associations between low self-worth (QIDS #11) and HA and INC. We found that HA had a medium-to-large positive correlation with low self-worth (r = .46, p < .001). Incompleteness did not have a significant correlation with low self-worth (r = .16, p = .115). 

Discussion:

This study adds to current research on the link between self-concept and OCD by exploring the associations that exist between self-worth and motivational dimensions of OCD. We found that harm avoidance was significantly associated with lower self-worth, whereas incompleteness was not associated with self-worth. These findings carry important clinical implications. If lower self-worth is particularly associated with individuals experiencing HA-related symptoms (e.g., inflated responsibility, overestimation of threat), it may be worthwhile to explore self-concept when working with these individuals. Further research should examine implications of different views of the self, as well as how self-concept relates to other manifestations of OCD.