Radomsky et al. (2014) – You can run but you can’t hide: intrusive thoughts on 6
continents
One of the key tenets of most contemporary cognitive-behavioural theories of obsessive-compulsive
disorder (OCD) is that intrusive thoughts, images, and impulses are normative, common experienced by
individuals both with and without OCD.
These theories generally posit that the intrusions themselves are not problematic, but rather that the
ways we react to, interpret, appraise and/or attempt to control them can cause distress, fear, guilt,
avoidance, compulsions (both overt and covert), as well as other symptoms including an increase in the
frequency and/or duration of the intrusions themselves.
The content of the thought and impulses experienced by both clinical and non-clinical seems to be
largely indistinguishable. Although there are important differences between normal and abnormal
intrusions in terms of frequency and distress, there are important similarities in content, and crucially,
that unacceptable thoughts and impulses are very common among those without a clinical problem.
How can almost everyone experience unwanted intrusions while only some develop OCD?
Consistent with cognitive theory, the view is that it’s not the intrusion that is the problem, but the ways
that we interpret and try to control it that determine whether it will become problematic, more frequent,
more distressing over time.
Rachman (1997) obsessions are caused by catastrophic misinterpretations of the significance of
one's intrusive thoughts (images, impulses).
Beliefs about the importance and control over one’s thoughts are often the target of both behavioural
and cognitive interventions for OCD.
Aim of the study
Test the hypothesis that unwanted intrusive thoughts, images, and impulses are present and
common in nonclinical populations, across cultures, around the world.
Assess the prevalence and nature of not only the intrusions themselves, but also the
interpretations/appraisals of and control strategies used to attempt to regulate these intrusions.
Results
, 94.3% of the international sample reported at least one type of unwanted intrusive thought
(UIT)) in the previous three months.
Doubting intrusions were the most common, while UITs regarding sex, religion, and immorality
were least common. Repugnant UITs (sexual, immoral, blasphemous) were among the most
difficult to control while doubting UITs were the easiest to control.
There were many significant differences across sites with regard to the proportion of individuals
who endorsed each category across sites.
MD UIT =
most
distressing
unwanted
intrusive
thought
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