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. 2024;17(4):946-966.
doi: 10.1007/s41811-024-00228-x. Epub 2024 Sep 3.

Toward a Better Understanding of Who Is Likely to Be Susceptible to the Effects of Rumination on Obsessive-Compulsive Symptoms: An Explorative Analysis

Karina Wahl  1 , Martin Kollárik  1 , Carlotta V Heinzel  1 , Stefan Koch  2 , Ulrich Voderholzer  2   3 , Roselind Lieb  1
Affiliations

Toward a Better Understanding of Who Is Likely to Be Susceptible to the Effects of Rumination on Obsessive-Compulsive Symptoms: An Explorative Analysis

Karina Wahl et al. Int J Cogn Ther. 2024.

Abstract

We previously found that rumination maintains obsessive-compulsive (OC) symptoms. Our goal was to explore the moderating roles of three characteristics in the immediate and intermediate effects of rumination on OC symptoms: trait rumination, severity of comorbid depressive symptoms, and the tendency to misinterpret the occurrence of unwanted intrusive thoughts as meaningful. We reanalyzed our previous study's data and explored in a sample of 145 individuals diagnosed with obsessive-compulsive disorder (OCD) whether any of the three characteristics moderated the observed immediate and intermediate effects of rumination on OC symptoms. Only the tendency to misinterpret unwanted intrusive thoughts moderated the immediate and intermediate effects of rumination on OC symptoms. If this result is confirmed in future studies, individuals with OCD and a high tendency to misinterpret unwanted intrusive thoughts might benefit particularly from supplemental interventions targeting the reduction of excessive rumination.

Keywords: Experimental studies; Obsessive–compulsive disorder (OCD); Rumination; Unwanted intrusive thoughts.

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Conflict of interest statement

Conflict of InterestThe authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Experimental procedure. BDI-II, Beck Depression Inventory, Revised; counter app, mobile application to count obsessive thoughts (OTs) on a smartphone; OCI-R, Obsessive–Compulsive Inventory, Revised; PANAS, Positive and Negative Affect Scale (Krohne et al., 1996) (The PANAS was administered in the original study but is not reported here.); RSQ, Response Style Questionnaire; RumMood, rumination about mood; RumOCD, rumination about obsessive–compulsive symptoms; T, time point; TAFS, Thought–Action Fusion Scale. The TAFS was not reported in the Wahl et al. (2021) study and is shown in bold. Adapted with permission from Wahl et al. (2021)
Fig. 2
Fig. 2
Graphical depiction of the immediate moderator analyses. T2 = Immediately before the experimental manipulation; T3 = immediately after the experimental manipulation; low tendency to misinterpret unwanted intrusive thoughts = 1 SD below mean value of the Thought–Action Fusion Scale (TAFS); moderate tendency to misinterpret unwanted intrusive thoughts = mean value of the TAFS; high tendency to misinterpret unwanted intrusive thoughts = 1 SD above mean value of the TAFS; RumMood = rumination about mood; RumOCD = rumination about obsessive–compulsive symptoms
Fig. 3
Fig. 3
Graphical depiction of the interaction between the planned contrast, time, and tendency to misinterpret unwanted intrusive thoughts, for the intermediate effects of rumination on OC symptoms. Planned contrast: Comparison between the RumOCD and the RumMood groups. OC, obsessive–compulsive; RumMood, rumination about mood; RumOCD, rumination about OC symptoms; low tendency to misinterpret unwanted intrusive thoughts = 1 SD below mean value of the Thought–Action Fusion Scale (TAFS); moderate tendency to misinterpret unwanted intrusive thoughts = mean value of the TAFS; high tendency to misinterpret unwanted intrusive thoughts = 1 SD above mean value of the TAFS
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