466 TREATMENT OF SPECIFIC ANXIETY DISORDERS
high responsibility condition experience more anxiety, greater perceived negative conse-
quences, increased doubt, and more checking behavior or urge to neutralize than those
in a low responsibility condition (Bouchard, Rhéaume, & Ladouceur, 1999; Ladouceur
et al., 1995; Mancini, D’Olimpio, & Cieri, 2004; Shafran, 1997). However, weaker
effects have also been reported, with the main difference attributed to a decrease in
responsibility (Lopatka & Rachman, 1995). In an experiment involving bogus EEG
feedback, nonclinical individuals randomly assigned to a high TAF—Likelihood condi-
tion reported more intrusions, discomfort, and resistance than participants in a control
condition (Rassin et al., 1999). Although these results are consistent with the cognitive
view that faulty appraisals may contribute to the transformation of a normal intrusion
into an obsession, there are limitations to this research. There have been inconsistencies
across the studies, most of the focus has been on inflated responsibility to the exclusion
of other appraisal domains, and most fail to control for general distress, which could
account for the observed effects (Julien et al., 2007).
Hypothesis 4
Individuals with OCD are significantly more likely to engage in neutralization and other
mental control strategies in response to obsession- relevant mental intrusions and this will
increase the frequency and distress of the obsession.
According to the cognitive model, attempts to neutralize or otherwise control the
occurrence and distress of obsessional intrusions contribute to the persistence of obses-
sional thinking. Individuals with OCD are more likely to engage in more compulsive
rituals, neutralization, and maladaptive thought control strategies in response to obses-
sional intrusions than nonclinical individuals but with less perceived effectiveness (Amir,
Cashman, & Foa, 1997; Freeston & Ladouceur, 1997a; Morillo et al., 2007; Rachman
& de Silva, 1978; Wroe, Salkovskis, & Richards, 2000). However, reliance on such
ineffective response strategies can be reduced with treatment (Abramowitz, Whiteside,
Kalsy, & Tolin, 2003a). The negative effects of neutralization were demonstrated in
a 3-day diary study in which individuals with OCD were found to engage in a high
frequency of suppression and neutralization of their obsession and these efforts were
associated with increased discomfort, limited perceived success, and faulty appraisals of
thought control, importance, and responsibility (Purdon, Rowa, & Antony, 2007).
Studies involving the experimental manipulation of neutralization indicate that it
has the same functional characteristics as overt compulsions, as made evident by an
immediate decrease in anxiety and perceived threat but a longer term increase in distress
and urge to neutralize (Rachman, Shafran, Mitchell, Trant, & Teachman, 1996; Salk-
ovskis, Thorpe, Wahl, Wroe, & Forrester, 2003; Salkovskis, Westbrook, Davis, Jeavons,
& Gledhill, 1997). Furthermore, correlational studies indicate that certain maladaptive
thought control strategies like self- punishment and worry may have a particularly close
relationship with OC-relevant appraisals and beliefs as well as OCD symptoms (Larsen
et al., 2006; Moore & Abramowitz, 2007).
Thought suppression experiments indicate that individuals with OCD may not be
as effective in using intentional suppression to prevent the occurrence of unwanted men-
tal intrusions when compared to nonclinical individuals (Janeck & Calamari, 1999;
Tolin, Abramowitz, Przeworski, et al., 2002). However the studies are inconsistent