What makes an obsession? A systematic-review and meta-analysis on the specific characteristics of intrusive cognitions in OCD in comparison with other clinical and non-clinical populations.

The Diagnostic and Statistical Manual 5th ed. defines obsessions in obsessive-compulsive disorder (OCD) as frequent, persistent, intrusive, unwanted thoughts that provoke anxiety and distress and lead to attempts to neutralize them with either thoughts or actions. However, no systematic review has yet evaluated characteristics that are specific to obsessions occurring in OCD. The aim of the current systematic review and meta-analysis was to investigate the specific features of obsessions occurring in OCD by comparing them to both obsessionally and non-obsessionally-themed intrusions in non-clinical and other clinical populations. Based on a registered protocol, 832 records were found, of which 15 were included in the systematic review and meta-analysis, with a total of 1891 participants. Obsessionally-themed intrusions that occur among those with OCD caused more distress, guilt, negative emotion and interference as compared to similarly-themed intrusions that occur within the general population. The distinction between obsessionally-themed intrusions among those with OCD as compared to those occurring in anxiety and depressive disorder primarily revolves around a higher level of persistence, pervasiveness and distress associated with their occurrence. Further, unacceptability, uncontrollability, ego-dystonicity, alienness, guilt, the form of the intrusion, association with the self and lack of any basis in reality also differentiates between obsessions and intrusions occurring in other disorders. Obsessions share many characteristics with thoughts occurring in other disorders and can be distinguished using a combination of characteristics specific to individual disorders.

Effects of acceptance-based strategies on psychological responses to disorder-relevant stimuli in inpatients with obsessive-compulsive disorder: An experimental study.

BACKGROUND AND OBJECTIVES: Preliminary findings suggest that acceptance and commitment therapy-informed exposure therapy may be an effective treatment for obsessive-compulsive disorder (OCD). However, there is a lack of experimental studies that have examined immediate effects of acceptance-based strategies during exposure to disorder-relevant stimuli in persons with OCD. METHODS: Fifty-three inpatients (64% female) with OCD participated in an experimental study during which they were exposed to obsessive-compulsive washing-relevant pictures and were instructed to either passively view these pictures for 5 s (neutral condition), to accept their feelings (acceptance condition) or to intensify their feelings (exposure condition) for 90 s each. RESULTS: The acceptance condition led to higher acceptance and lower unpleasantness of patients' current feelings compared to the neutral condition and to lower strength of obsessions and urge to perform compulsions but only when compared to the exposure condition. Higher self-reported OCD symptom severity related to higher unpleasantness and strength of obsessions, particularly in the neutral condition. LIMITATIONS: Future studies need to test whether the current findings translate to other stimuli and other forms of obsessions and compulsions. Due to the short duration, the exposure condition might have only mimicked the early phase of exposure and response prevention. CONCLUSIONS: Acceptance-based strategies during cue exposure immediately increase acceptance of and reduce unpleasant feelings. In line with the rationale of acceptance-based treatment approaches, which do not aim at immediate disorder-specific symptom reductions, effects on obsessions and compulsions may be more delayed or require repeated training sessions.

Further validation of the Multidimensional Version of the Fear-of-Self Questionnaire in a Persian non-clinical and clinical obsessive-compulsive disorder sample.

Previous research has shown that vulnerable self-themes and feared self-perceptions may play an important role in the development and maintenance of obsessive-compulsive disorder (OCD). In particular, the recently validated Multidimensional Version of the Fear-of-Self Questionnaire (FSQ-MV) has shown strong relationships with OCD symptoms independent of cognitive constructs and negative mood in non-clinical samples. The current study aimed to further evaluate the validity and reliability of a Persian version of the FSQ-MV in OCD patients (N = 300), as well as non-clinical individuals (N = 300). Participants completed a set of scales evaluating feared self-perceptions and OCD-related symptoms/conditions. The results showed that the Persian version of the FSQ-MV replicated the three-factor structure of the original scale in non-clinical and OCD patients. The FSQ-MV and its subscales had excellent reliability. Additionally, the FSQ-MV was significantly associated with related cognitive constructs, as well as OCD symptoms and their severity, in both samples. The feared self, especially the corrupted feared self, was a significant unique predictor of OC symptomology, especially for repugnant obsessions, and OCD severity. The study confirmed the validity and reliability of the Persian version of the FSQ-MV. Moreover, cognitive conceptualizations may benefit from a consideration of the feared self in OCD, which may play an important role in its development, maintenance and severity.

Thriving through adversity: The role of passion and emotions in the resilience process.

OBJECTIVES: Two cross-sectional (Studies 1, N = 283 and 2, N = 275) and one prospective (Study 3, N = 238) studies investigated the role of passion (for academia) and emotions in the process of resilience in the education domain and in life in general. METHOD: Participants were examined when facing a stressful situation related to their passion for academia (end-of-term exam period and a timed education task). RESULTS: All three studies showed that harmonious passion, through its positive relationship with positive emotions, was positively associated with high positive outcomes in the education domain (satisfaction with one's studies, subjective and objective performance in one's studies) and in life in general via the subjective evaluation of one's life and general health indicators (subjective vitality and fewer negative physical symptoms). On the other hand, obsessive passion was related to mixed effects on resilience. Specifically, obsessive passion related to low levels of functioning (Studies 1 and 3) and also hindered the positive outcomes (Studies 1-3) through its positive relationships with positive and negative emotions, respectively. CONCLUSIONS: In sum, under stress, harmonious passion facilitates high resilience across life domains, whereas obsessive passion yields low resilience across the life or no resilience at all.

Obsessional intrusive thoughts in children: An interview based study.

OBJECTIVES: We aimed to investigate the experience of obsessional intrusive thoughts (OITs) in a sample of children aged 8 to 10 years old and to test the main tenets of the cognitive model of OCD. Specifically, we assessed: (1) the prevalence of OITs experienced by young children; (2) their frequency and content; (3) the emotions they evoke; (4) the reasons why they are upsetting; (5) how they are appraised (6) and what control strategies they use. METHODS: Forty-nine children (28 girls, 21 boys; mean age 9.1 years) from the community completed two self-report questionnaires assessing anxiety and obsessive-compulsive symptoms. Children were interviewed using the Children's Anxious Thoughts Interview, which assessed their experiences of OITs. RESULTS: From the 49 participants, 71.43% reported having experienced at least one OIT. The most frequent contents related to harm and doubt. Of the total sample, 28.6% reported having experienced one OIT recently with at least moderate frequency; these participants reported higher anxiety and obsessive-compulsive interference, described feeling nervous and anxious when experiencing their OIT, and rated their OIT as highly important and distracting. The most frequently reported control strategies were cognitive - suppression, distraction and thought replacement. CONCLUSIONS: Almost two thirds of community children reported experiencing OITs. The findings from this study provide preliminary support for the application of the cognitive model of OCD in children. Subtle differences from previous research with adults are discussed.

The causes and consequences of shame in obsessive-compulsive disorder.

Research into the aetiology, maintenance, and treatment of obsessive-compulsive disorder (OCD) has largely been informed by models of anxiety. However, non-experimental research suggests that some individuals may engage in compulsions to neutralise shame, with repugnant obsessions associated with more shame than other obsessions. Violent and sexual obsessions and shame have been linked with poorer treatment outcomes, and thus, treatment modifications are needed. This experimental study aimed to examine if and how shame fits into a cognitive behavioural model of OCD. Fifty-five individuals experiencing subclinical (n = 9) to clinical (n = 46) OCD symptoms were randomly administered four different obsession induction paradigms focused on harm, sexual, contamination, and symmetry obsessions. After each induction, participants reported on their emotional states, gave appraisal ratings regarding their urges to engage in compulsions and avoidant behaviour, and completed manipulation checks. Harm and sexual inductions elicited greater shame and anxiety and were considered more immoral than contamination and symmetry inductions. Shame responses were also independently associated with compulsion and avoidance behaviours in repugnant obsessions, controlling for anxiety. Theoretical models and treatment for OCD should be adapted to address shame.

The relationship between obsessions and the self: Feared and actual self-descriptions in a clinical obsessive-compulsive disorder sample.

Cognitive models of obsessive-compulsive disorder (OCD) posit the relevance of the self in OCD, although the nature of this association is still unclear. We aimed to explore actual and feared selves and its association with obsessions and intrusions in a group of OCD patients. A group of 58 patients with OCD identified their most upsetting obsession and intrusion (non-clinical obsession) experienced in the past 3 months. These cognitions were classified as either moral-based or autogenous (obsessions n = 32; intrusions n = 26) or non-moral-based or reactive, depending on their content. Next, patients described their actual self and their feared self, that is, the person they feared being or becoming, and whether they believed these descriptions were associated with their obsessions/intrusions. Results indicate that individuals with OCD described themselves as insecure, anxious and fearful, but also as good and nice. They particularly feared a selfish, aggressive, bad, liar, coward, insecure and arrogant self. Two-thirds of the patients believed that their obsessions said something about their actual self (65.52%) and that their obsessions brought them closer to the person they do not want to be (62.06%). A third of patients believed their intrusions said something about their actual self (actual self: 30.35%; feared self: 25%), which was a significantly lower percentage than for obsessions. These associations existed independent from the content of the obsession and/or intrusion, although patients with obsessions with moral-based contents more often tended to believe that their obsessions brought them closer to the person they do not want to be. Results suggest the relevance of the real and feared selves in the maintenance of obsessions.

Dysmorphic and illness anxiety-related unwanted intrusive thoughts in individuals with obsessive-compulsive disorder.

BACKGROUND/OBJECTIVE: Unwanted intrusive thoughts (UITs) are considered normal variants of the obsessions found in obsessive-compulsive disorder (OCD). Similarly, intrusive and persistent preoccupations about appearance defects in body dysmorphic disorder (BDD) and images and thoughts about illness in illness anxiety disorder (IAD) are abnormal variants of the thoughts and concerns about appearance and health found in non-clinical individuals. This study examines whether patients with OCD have frequent and distressing UITs with contents related to BDD and IAD, in addition to OCD-related UITs. METHOD: Thirty-nine participants with OCD (Mage = 32.45, standard deviation [SD] = 11.57; 63% men) completed the Questionnaire of Unpleasant Intrusive Thoughts (QUIT), designed to assess obsessional, dysmorphic and illness anxiety UITs and their associated functional consequences (emotions, appraisals, and neutralizing or control strategies). RESULTS: Up to 71% of the individuals with OCD experienced the three UIT modalities. As expected, OCD-related UITs were the most frequent, although were no differences among the three UIT contents in terms of the disturbance they caused. The OCD intrusions were the most interfering, egodystonic and dysfunctionally appraised, and they instigated more neutralizing behaviours. Nonetheless, all UITs instigate the need to do something to alleviate the discomfort caused by their intrusion and attempts to suppress them. CONCLUSION: UITs with different contents not always related to typical obsessive themes are a common experience in patients with OCD. These UITs could have detrimental consequences for the course of the disorder itself, and they should be adequately addressed in both the assessment and treatment of these patients.

Joint contributions of metacognition and self-beliefs to uncertainty-guided checking behavior.

Checking behavior is a natural and adaptive strategy for resolving uncertainty in everyday situations. Here, we aimed at investigating the psychological drivers of checking and its regulation by uncertainty, in non-clinical participants and controlled experimental settings. We found that the sensitivity of participants' explicit confidence judgments to actual performance (explicit metacognition) predicted the extent to which their checking strategy was regulated by uncertainty. Yet, a more implicit measure of metacognition (derived from asking participants to opt between trials) did not contribute to the regulation of checking behavior. Meanwhile, how participants scaled on questionnaires eliciting self-beliefs such as self-confidence and self-reported obsessive-compulsive symptoms also predicted participants' uncertainty-guided checking tendencies. Altogether, these findings demonstrate that checking behavior is likely the outcome of a core explicit metacognitive process operating at the scale of single decisions, while remaining influenced by general self-beliefs. Our findings are thus consistent with two mechanisms (micro vs. macro) through which this otherwise adaptive behavior could go awry in certain psychiatric disorders such as obsessive-compulsive disorder.

Pensamento fanático: 1984/2020 / Phantastic thinking: 1984/2020 / Pensamiento fanático: 1984/2020

O presente trabalho propõe o estudo de alguns aspectos relacionados aos preconceitos e ao pensamento fanático, partindo da descrição do "duplipensar" feita por George Orwell em seu livro 1984. Assim, o trabalho se detém no vértice que estuda esses fenômenos do ponto de vista de distúrbios nos processos de pensamento, destacando a dificuldade em estabelecer causas específicas. A importância dos fatores sócio-culturais é discutida, na medida em que não existimos isoladamente. Da mesma forma, a presença desses fenômenos nas instituições psicanalíticas também é abordada, concluindo com alguns tópicos para futuras discussões sobre o tema (AU)

This work proposes to study some aspects related to prejudices and fanatical thinking, having as a starting point the description of "doublethinking" made by George Orwell in his book 1984. The essay therefore focuses on the authors that study these phenomena from the point of view of abnormalities in the thought processes, highlighting the difficulty in establishing specific causes. The importance of socio-cultural factors is discussed, as we do not exist in isolation. Likewise, the presence of these phenomena in psychoanalytic institutions is also addressed, concluding with some topics for future discussions (AU)

El presente trabajo propone el estudio de algunos aspectos relacionados con los prejuicios y el pensamiento fanático, a partir de la descripción del doblepensar hecha por George Orwell en su libro 1984. Así, el trabajo se detiene en el vértice que estudia estos fenómenos desde el punto de vista de las perturbaciones en los procesos de pensamiento, destacando la dificultad para establecer causas específicas. Se discute la importancia de los factores socioculturales, ya que no existimos de forma aislada. Asimismo, se aborda también la presencia de estos fenómenos en las instituciones psicoanalíticas, concluyendo con algunos temas para futuras discusiones sobre la cuestión (AU)

The sociocognitive processes of ideological obsession: review and policy implications.

Understanding what motivates people to join violent ideological groups and engage in acts of cruelty against others is of great social and societal importance. In this paper, I posit that one necessary element is 'ideological obsession'-an ideological commitment fuelled by unmet psychological needs and regulated by inhibitory and ego-defensive mechanisms. Drawing from evidence collected across cultures and ideologies, I describe four processes through which ideological obsession puts individuals on a path towards violence. First, ideological obsession deactivates moral self-regulatory processes, allowing unethical behaviours to be carried out without self-recrimination. Second, ideologically obsessed individuals are easily threatened by information that criticises their ideology, which in turn leads to hatred and violent retaliation. Third, ideological obsession changes people's social interactions by making them gravitate towards like-minded individuals who support ideological violence. As these social networks become more interconnected, they amplify one's adherence to violent extremism. Finally, ideologically obsessed individuals are prone to psychological reactance, making them immune to communication strategies intended to dissuade them from using violence. In fact, messages espousing non-violence can have the opposite effect by reinforcing their violence-supporting ideology. I conclude by presenting evidence-based strategies to prevent radicalisation leading to violence for individuals in pre-criminal spaces. This article is part of the theme issue 'The political brain: neurocognitive and computational mechanisms'.

Worry and Rumination Have Distinct Associations with Nighttime versus Daytime Sleep Symptomology.

Objective: To assess whether worry and rumination differ in predicting nighttime sleep disturbance versus daytime sleep-related impairment, as assessed using short forms from the Patient Reported Outcomes Measurement Information System (PROMIS). Participants: Adults recruited from the United States population (N = 459) via an online crowdsourcing service. Methods: Factor analysis explored whether items comprising validated measures of worry and rumination loaded onto separate factors. Hierarchical multiple regression models entered worry and rumination in a stepwise fashion to assess their relative strength in predicting PROMIS sleep disturbance and sleep-related impairment, after controlling for 17 covariates. All analyses were run twice using sleep-specific and general measures of worry and rumination. Results: Worry and rumination items loaded onto separate factors. In the regression analysis of sleep-specific cognition, only worry entered the model predicting sleep disturbance, whereas rumination entered after worry in the model predicting sleep-related impairment. In the analysis of general cognition, both cognitive process variables significantly predicted the PROMIS outcomes. Worry was the stronger predictor of sleep disturbance, whereas rumination was the stronger predictor of sleep-related impairment. Conclusions: Worry and rumination were observed to be distinct constructs that separately contributed to predicting daytime sleep-related impairment. Future studies should more closely examine how cognitive processes relate to insomnia symptomology during the day.

Estilos de afrontamiento, esquemas disfuncionales y síntomas psicopatológicos relacionados con la dependencia emocional hacia la pareja agresora / Coping styles, dysfunctional schemes and psychopathological symptoms related to emotional dependence on the aggressor partner

Los estilos de afrontamiento, los esquemas disfuncionales y la sintomatología psicopatológica podrían resultar factores de vulnerabilidad que incrementan la probabilidad de que una persona desarrolle dependencia emocional hacia la pareja agresora. Delimitar los factores de riesgo es fundamental para su prevención y tratamiento. Consecuentemente, el presente estudio tuvo como objetivos principales analizar la relación entre los factores señalados, así como el papel mediador de los tres primeros en la relación entre la dependencia emocional y la violencia recibida. La muestra estuvo conformada por 657 mujeres procedentes de población clínica y general, con edades que oscilaron entre los 18 y 66 años (M= 23,38; DT= 8,24). Los resultados reflejaron la predominancia del empleo de estilos de afrontamiento inadecuados, tales como pensamiento desiderativo, aislamiento social y autocrítica, síntomas psicopatológicos de depresión, ansiedad, sensibilidad interpersonal, obsesión compulsión e ideación paranoide, así como esquemas de abandono y subyugación. Asimismo, estos factores explicaron una parte de la relación entre la dependencia emocional y la permanencia en relaciones violentas

Coping styles, dysfunctional schemes and psychopathological symptoms could be factors of vulnerability that increase the probability that a person develops emotional dependence on an aggressive partner. Delimiting the risk factors is fundamental for its prevention and treatment. Consequently, the main objectives of the present study were to analyze the relationship between the above-mentioned factors, as well as the mediating role of the first three in the relationship between emotional dependence and received violence. The sample was made up of 657 women from the clinical and general population, with ages ranging from 18 to 66 years of age (M= 23.38, SD= 8.24). The results reflected the predominance of inadequate coping styles, such as desiderative thinking, Estudio financiado anxiety, interpersonal sensibility, obsession-compulsion and paranoid ideation, as well as abandonment and subjugation schemes. These factors also explained part of the relationship between emotional dependence and staying in violent relationships

The Prevalence of Orthorexia Nervosa in Polish and Lebanese Adults and Its Relationship with Sociodemographic Variables and BMI Ranges: A Cross-Cultural Perspective.

The prevalence of orthorexia nervosa (ON) appears to be increasing, and more research into its cross-cultural aspects is required to provide culturally appropriate psychological treatment. Until now, there has been relatively little research published about ON across cultures. Therefore, the objectives of the present study were to determine: (1) the prevalence of ON in Polish and Lebanese adults and (2) the association between ON and sociodemographic variables and Body Mass Index (BMI) in two culturally different samples. One thousand two hundred and sixty-two adults participated in the present study (NPoland = 743 adults; NLebanon = 519 adults). The Düsseldorf Orthorexia Scale and the Eating Habits Questionnaire were used in the present study. Information about age, sex, anthropometry, and marital status was obtained from all participants as well. The Polish sample had an ON prevalence rate of 2.6%, while the Lebanese sample had an ON prevalence rate of 8.4%. No significant correlation was found between ON and age in both samples. A statistically significant difference was found between marital status and country on ON, with the highest mean score seen among Lebanese singles. In Lebanon, having a low of BMI ≤ 25 kg/m2 compared to a high BMI was significantly associated with lower ON tendencies, while this association was not significant among Polish participants. This study was the second to focus on the prevalence of ON in Western and non-Western countries and its association with sociodemographic characteristics and BMI ranges. Knowledge about ON and its correlates in diverse populations may inform the design of culturally tailored behavior change interventions and the development of culturally appropriate tools in various groups to improve their dietary patterns.

Stuck in my head: Musical obsessions and experiential avoidance.

Earworms refer to catchy tunes that run repeatedly through a person's mind. Empirical literature regarding earworms is scant; however, some researchers have conceptualized the phenomenon as an unwanted intrusion in the context of obsessive-compulsive disorder. The current study expands upon past research by characterizing the experience of earworms and examining associations of earworm-related distress and interference with theoretical constructs of interest, including obsessive beliefs and experiential avoidance. Two hundred forty participants completed an online survey regarding the experience of musical obsessions (e.g., duration, frequency, distress) and related theoretical constructs (e.g., experiential avoidance) of interest. Descriptive results regarding the frequency, duration, and associated distress and interference of earworms are presented. Furthermore, results reveal that experiential avoidance is a unique predictor of earworm-related distress and interference. Results suggest that interference and distress due to earworms may be related to attempts to suppress them. Study conclusions, limitations, and directions for future research are discussed.

Exacerbation of obsessive compulsive disorder symptoms in children and adolescents during COVID-19 pandemic.

OBJECTIVE: To investigate the effects of COVID-19 pandemic and related home confinement on symptom profile, symptom severity and exacerbation of obsessive compulsive disorder (OCD) symptoms and related factors among young subjects with OCD. METHOD: Young subjects who have been followed up with a primary diagnosis of OCD in a university hospital were reached by telephone or online programs to assess symptom profile, symptom severity and exacerbation during pandemic. Children's Yale-Brown Obsessive Compulsive (CY-BOCS) and Clinical Global Impression- Severity (CGI-S) Scales were used to rate symptom profile and severity before pandemic and during pandemic periods. RESULTS: There was a significant increase in the frequency of contamination obsessions (p=0.008) and cleaning/washing compulsions (p=0.039) during pandemic period. CY-BOCS obsessions (p<0.001), compulsions subscales (p<0.001) and total scores (p<0.001), and CGI-S scores (p<0.001) during pandemic period were statistically higher than before pandemic period. There was a significant relationship between the change in CY-BOCS scores with talking/searching in the social environment about COVID-19, daily preoccupation about COVID-19, duration of OCD diagnosis and diagnosis of COVID-19 in someone familiar. CONCLUSIONS: Young subjects with OCD may develop additional symptoms and worsen already existing symptoms of OCD during COVID-19 pandemic.

The relationship between death obsession and religiosity in non-demented Muslim residents of a nursing home in TunisiaDeath obsession and religiosity.

BACKGROUND: Death distress is a significant problem in the older population and may be more pronounced in certain vulnerable older people, including those living in nursing home facilities. We aimed to assess death obsession (DO) in elderly people without dementia living in nursing homes, and to examine the association between DO and religiosity. METHODS: We carried out a cross-sectional survey involving 42 elderly subjects living in a nursing home in Manouba, Tunisia. The "Mini-Mental State Examination", "Geriatric Depression Scale", "Activity of Daily Living", "Cumulative Illness Rating Scale-Geriatric", "Death Obsession Scale", "Brief Religious Coping Scale" and "Arabic Religiosity Scale" were used to assess cognitive functions, depression, level of dependency, comorbidities, death obsession, religious coping, and religiosity, respectively. RESULTS: We found relatively high death obsession scores, with no gender differences (mean scores = 33.1 ± 18.1). Death obsession was significantly and positively associated with comorbidity scores (p = 0.04). No significant correlation was found between death obsession scores and religiosity and religious coping scores based on the bivariate analysis. Similarly, multiple hierarchical regression revealed that religious variables (overall religiosity and religious coping) did not significantly contribute to variance in death obsession. CONCLUSION: Older people living in nursing homes have specific psychosocial and spiritual needs which health care providers should recognise, assess and treat appropriately, at an early stage.

Manipulating visual perspective for obsessional imagery and its impact on obsessive-compulsive symptoms in an analogue sample.

Visual perspective may have an important role in the phenomenology of intrusive images relevant to psychological disorders such as obsessive-compulsive disorder (OCD). The aim of the current study was to examine the subjective and behavioural effects of manipulating visual perspective, to either field or observer, on intrusive images related to doubting and contamination concerns. One hundred and twelve undergraduate participants with high levels OCD symptoms were asked to identify and imagine an intrusive image related to either doubting or contamination concerns. We then randomly assigned them to re-visualise their image from either a field (first-person) or observer (third-person) visual perspective. Participants shifted towards using an observer perspective demonstrated a greater decrease on ratings of subjective measures of image-related distress, prospective likelihood of the image occurring, and urges to suppress the image, relative to those shifted to a field perspective. In addition, those in the observer perspective evidenced a greater decrease on behavioural indices relevant to OCD, such as reduced frequency of the intrusive image and decreased efforts to neutralise the image. We discuss implications for imagery in OCD.

Beliefs about losing control, obsessions, and caution: An experimental investigation.

Fear of acting on unwanted impulses (e.g., stabbing a loved one) and avoidance of threatening stimuli (e.g., knives) are common phenomena in obsessive-compulsive disorder (OCD). Cognitive models of OCD suggest that maladaptive beliefs underlie the development and maintenance of symptoms. The goal of this experiment was to determine whether beliefs about losing control over one's behaviour lead to experiencing anxiety and intrusive thoughts while approaching stimuli that are commonly feared in OCD, and to behaving more cautiously while interacting with the stimuli. Undergraduate participants (N = 128) were provided with false feedback about the meaning of their intrusive thoughts: "having intrusive thoughts means that you are likely to lose control over your behaviour" versus "intrusive thoughts are normal". Participants were then asked to approach sharp knives in a stepwise manner (i.e., behavioural approach test; BAT). Afterwards, they sorted the stimuli in a knife block as quickly as possible. Participants with higher (versus lower) beliefs about losing control experienced significantly increasing anxiety throughout the BAT. They also remembered experiencing more intrusive thoughts throughout the protocol and perceived themselves as less cautious while sorting the knives. Interestingly, objective measures of intrusive thoughts and caution were not significantly different between conditions.