458 TREATMENT OF SPECIFIC ANXIETY DISORDERS
definitions of six belief domains that are thought to characterize the schematic content
of OCD.
This schematic organization of OCD was originally proposed by the Obsessive
Compulsive Cognitions Working Group (OCCWG) (1997). Although researchers dif-
fer on which domains are most critical or specific to the disorder, they do agree that
together these beliefs capture the predominant schematic content of OCD. Further-
more, there probably are differences between the OCD subtypes in which of the schema
domains is more relevant in conferring maladaptive meaning to the intrusion. In fact
schematic differences will be evident even between individuals who have similar obses-
sional concerns. As discussed below, there is tremendous overlap between these belief
Obsession Faulty Appraisal“Did I completely shut
down my computer, turn
off the heat, lock the door,
turn off the stove?” —
repeatedly checks, seeks
reassurance“My work computer will be left on by mistake, someone
will get access to sensitive files and I’ll get fired.”
(overestimated threat)“It’s my primary responsibility to ensure the door is
locked.” (inflated responsibility)“I have to control this doubt; the best way to feel better,
less anxious is to eliminate any doubts in my mind.”
(importance/control of thought)“I have to be certain the computer is completely off or
the door is securely locked.” (intolerance of
uncertainty and perfectionism)“I could die young and leave this world a
wasted, unfulfilled life.” (overestimated
threat)“These thoughts are important, significant
because they make me feel so upset,
panicky.” (importance of thought)“I need to suppress these thoughts, prevent
myself from thinking this way.” (n eed to
control)“I can’t feel confident unless I am more
certain of the future.” (intolerance of
uncertainty)“Intrusive thoughts and
images of drowning, dying
in car accident or getting
hit by a car.” —self-reassurance,
distraction, rationalization,
cognitive avoidance (can’t
remember details of
the thoughts)figure 11.2. (cont.)