Initial evidence highlights intolerance of uncertainty and anxiety sensitivity as second-order mediators in the pathway from the general risk factor of neuroticism to the specific expression of OCD symptoms. However, more research on potential mediational factors is needed to explain this relationship better.
Incorporating mediators like worry and brooding has helped explain links between neuroticism and general anxiety symptoms. However, their potential mediating roles in the development of OCD symptoms have been unexplored.
Neuroticism is a fundamental personality trait characterized by a chronic level of emotional instability and proneness to experiencing negative emotions such as anxiety, worry, self-consciousness, and vulnerability to stress. The more neurotic someone is, the more they tend to cope by suppressing intrusions, worrying about them, or brooding over them. And these mental habits make them more likely to keep experiencing unwanted thoughts.
Key Points
Rationale
Prior research has establishedneuroticismas a general risk factor for OCD and obsessive thinking specifically (Nishimura et al., 1998; Yorulmaz et al., 2010). However, how neuroticism influences the development of obsessive thoughts is unknown.
Understanding these pathways can inform etiological models andtreatment approaches for OCD(Taylor, 1998; Barlow, 2000).
While prior research shows neuroticism is linked to bothOCD/obsessionsand these faulty thought patterns, no study has tested if these second-order factors actually explain how neuroticism confers vulnerability for obsessive thoughts specifically.
Similarly, despite its prominence in OCD models,thought suppressionhas yet to be included as an intermediary variable in hierarchical models.
So, investigating these cognitive processes as parallel mediators can elucidate the pathway from the trait-like general risk factor of neuroticism to the intrusive thinking characteristic of OCD.
Results can refine theoretical models of OCD development and inform treatment targets.
Method
Cross-sectional correlational design.
Participants completed several questionnaires assessing neuroticism (NEO-FFI neuroticism subscale), thought suppression (WBSI), worry (PSWQ), brooding (RSQ), and obsessing (OCI-R obsessing subscale).
Mediator statistical modelstested whether the three cognitive processes mediated between neuroticism and obsessing in a multiple mediation model, first individually and then collectively.
Sample
The study included 238 German adult volunteers recruited online.
The sample was predominantly female (76.5%), with a mean age of 24.5 years. Most participants were university students (75.2%).
Measures
Statistical Analysis
Mediator models calculate the direct effect of the independent variable (neuroticism) on the dependent variable (obsessing) and the indirect effect via the mediators (cognitive processes).
If mediators significantly reduce the direct effect, this indicates the variables mediate the relationship.
The size of indirect effects shows the mediators’ contribution. Analyses used bootstrapping methods suitable for non-normal data.
Results
Insight
When examined in the multiple mediation model together, thought suppression, worry, and brooding each still significantly mediated the relationship between neuroticism and obsessing.
The analysis showed that all three unhelpful thought patterns contributed equally to explaining why highly neurotic people are prone to obsessions. No single process stood out as accounting for more of the link than the others.
So, thought suppression linked neuroticism to obsessing just as much as worry and brooding did. No one faulty thinking process stood out as accounting for more of the effect than the others when they were simultaneously tested.
Strengths
Limitations
Clinical Implications
By illuminating mechanisms linking neuroticism to obsessing, findings can inform theoretical models of OCD development and targets for treatment.
Demonstrating thought suppression’s mediating role argues for its inclusion in hierarchical models alongsideintolerance of uncertaintyand anxiety sensitivity.
No one faulty thinking process stood out as accounting for more of the effect than the others when they were simultaneously tested.
This suggests assessing and targeting only one or two of these factors could underestimate their combined influence. It highlights the value of concurrently measuring all three mediators in future research.
The equivalent effects also indicate addressing thought suppression and brooding may be just as vital as tackling worry in therapy for OCD-related conditions in highly neurotic individuals.
References
Primary reference
Pfaltz, M. C., Mörstedt, B., Meyer, A. H., Wilhelm, F. H., Kossowsky, J., & Michael, T. (2015). Why can’t I stop thinking about it?: Cognitive mediators in the relationship between neuroticism and obsessing.Swiss Journal of Psychology,74(2), 75-82.
Other References
Gönner, S., Leonhart, R., & Ecker, W. (2008). The Obsessive-Compulsive Inventory-Revised (OCI-R): Validation of the German version in a sample of patients with OCD, anxiety disorders, and depressive disorders.Journal of Anxiety Disorders, 22, 734–749.https://doi.org/10.1016/j.janxdis.2007.07.007
Nishimura, R., Hosoba, T., Ide, M., & Seiwa, H. (1998). The influence of obsessive-compulsive neurosis patients’ premorbid personality on obsessive-compulsive symptoms and efficacy of medication.Psychiatry and Clinical Neurosciences, 52,303-309. https://doi.org/10.1046/j.1440-1819.1998.00393.x
Stöber, J. (1995). Besorgnis: Ein Vergleich dreier Inventare zur Erfassung allgemeiner Sorgen [Worrying: A comparison of three questionnaires concerning everyday worries].Zeitschrift für Differentielle und Diagnostische Psychologie, 16,50–63.
Treynor, W., Gonzalez, R., & Nolen-Hoeksema, S. (2003). Rumination reconsidered: A psychometric analysis.Cognitive Therapy and Research, 27, 247–259.https://doi.org/10.1023/A%3A1023910315561
Taylor, S. (1998). The hierarchic structure of fears.Behavior Research and Therapy, 36,205-214.https://doi.org/10.1016/S0005-7967(98)00012-6
Yorulmaz, O., Gençöz, T., & Woody, S. (2010). Vulnerability factors in OCD symptoms: Cross-cultural comparisons between Turkish and Canadian samples.Clinical Psychology and Psychotherapy, 17,110-112.https://doi.org/10.1002/cpp.642
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Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
