Repetitive negative thinking in OCD: Evaluation of novel scenarios for cognitive bias modification training

Abstract

Background and objectives

Evidence suggests that repetitive negative thinking (RNT) is underpinned by interpretation bias which is heightened among individuals with OCD. Cognitive bias modification for interpretation training (CBM-I) may reduce RNT by modifying interpretation bias which could reduce OCD symptoms. This study evaluated novel scenarios in terms of appropriateness and validity for use in a future CBM-I study targeting OCD-related RNT. This included analysis of the associations between interpretation bias and OCD symptoms, RNT, and OCD-specific rumination, respectively.

Methods

Forty-four novel CBM-I scenarios targeting RNT in OCD were developed based on clinical expertise and interviews of people with lived experience. A general population sample ($N$ = 167) completed the missing word at the end of each scenario to resolve ambiguity. This provided a measure of interpretation bias, and item-level data on the materials’ ability to assess negative and benign interpretations. Participants also completed measures of OCD symptoms, general RNT and OCD-specific rumination.

Results

Most scenarios displayed strong item discrimination coefficients, and well-balanced valence of interpretation responses, with minimal improvements required for future use. Interpretation bias was moderately positively correlated with OCD symptoms, RNT, and OCD-specific rumination, indicating good criterion validity.

Limitations

The order of CBM-I scenarios was not randomised which may have led to order effects, and some participants failed to adhere to instructions causing missing data.

Conclusions

The evaluation of the CBM-I scenarios yielded encouraging results for their use in a future CBM-I single session study. This may lead the way for future interventions for OCD-related RNT.