The Validation of the Rumination on Obsessions and Compulsions Scale (ROCS) in an Iranian Clinical and Non-Clinical Sample

Abstract

Rumination, as a cognitive process contributing to the persistence of obsessive–compulsive disorder (OCD), can be measured using the Rumination on Obsessions and Compulsions Scale (ROCS), a reliable measure of the scales of mental neutralizing, symptom rumination, and acceptance. However, the previous validation study had some limitations, including a relatively small sample size and a failure to evaluate the overall factor structure. The present study aimed to validate the ROCS and assess its ability to predict OCD symptoms in an Iranian sample of OCD (n = 300), major depressive disorder (MDD, n = 150), and healthy individuals (n = 300). The findings revealed a three-factor structure for both the 33-item ROCS and one of its subscales (i.e., mental neutralizing scale), with good reliability and validity. The ROCS exhibited strong correlations with corresponding measures and predicted OCD symptoms in a cross-sectional manner, particularly among OCD patients who had higher mental neutralizing and rumination, as well as lower acceptance, on the ROCS compared to the other groups. This research indicates that the ROCS is a reliable measure of three typical mental reactions to obsessions and/or compulsions: rumination, neutralizing, and acceptance, which are separate yet closely related and contribute to symptoms of OCD. Thus, theoretical models of OCD should place greater emphasis on rumination responses. The study also provides evidence supporting the validity of the acceptance scale. Future research should assess the temporal stability and re-evaluate the high inter-correlations between acceptance and the mental neutralizing and rumination scales.