Inflated responsibility in obsessive compulsive disorder: validation of an operational definition.

Résumé

An excessive sense of responsibility has been identified in obsessive-compulsive disorder (OCD) where patients evaluate their thoughts in terms of the harm they could cause to themselves or others. In a new definition, responsibility was defined as the belief that one possesses pivotal power to provoke or prevent subjective crucial negative outcomes. In order to empirically test the validity of this definition, two studies used a semi-idiographic design to evaluate responsibility across ambiguous situations related to major OCD themes like contamination, verification, somatic concerns, loss of control, making errors, sexuality and magical thinking. In the first study, 397 volunteer adults participated in the experiment. For each situation, subjects briefly described a possible negative outcome and then rated this outcome on four dimensions: (1) probability; (2) severity; (3) influence; and (4) pivotal influence, using a 9-point Likert scale. Finally Ss rated perceived responsibility and personal relevance. Highly relevant situations were retained for the final analysis. Regression analysis suggested that influence and pivotal influence were better predictors of responsibility ratings than probability and severity. The second study examined the effect of the order of the questions on the responsibility ratings. A first group of Ss (n = 85) answered the Responsibility Questionnaire (RQ) in the original order, while a second group (n = 53) rated responsibility before the other ratings. Regression analysis showed that although proportion of variance explained diminished when the order was reversed, pivotal influence was still the best predictor of responsibility. Results are discussed in terms of current models of OCD and implications for future research and cognitive treatment are identified.