The role of feared possible selves in the relationship between inferential confusion and obsessive‐compulsive symptoms: A replication and extension in a clinical sample

• Published in: British journal of clinical psychology 2024-11, Vol.63 (4), p.507-521
• Main Authors: Aminaee, Mohammad, Khosravani, Vahid, Moulding, Richard, Aardema, Frederick, Wong, Shiu Fung, Samimi Ardestani, Seyed Mehdi
• Format: Article
• Language: English
• Subjects: Clinical interviews; Comorbidity; Confusion; feared self; inferential confusion; obsessive beliefs; Obsessive compulsive disorder; Possible selves; Psychological distress
• ISSN: 0144-6657; 2044-8260
• DOI: 10.1111/bjc.12481

Objectives The feared possible self refers to an imagined version of self that one is afraid of being or becoming. Previous evidence has shown that dysfunctional reasoning (i.e., inferential confusion) is associated with obsessive‐compulsive disorder (OCD) symptoms, which is partially mediated by a feared self. However, the evidence is reliant on non‐clinical samples and a general measure of the feared self. Methods Using a cross‐sectional design, the current study attempted to replicate and extend this literature in a sample clinically diagnosed with OCD (n = 350) to assess the pathway from inferential confusion to OCD symptoms when feared self is accounted for as a mediator, particularly the individual dimensions of feared self (i.e., corrupted, culpable, and malformed feared selves). Participants completed a structured clinical interview for DSM‐5, as well as measures of inferential confusion (Dysfunctional Reasoning Processes Task), obsessive beliefs, feared self, OCD symptoms, and psychological distress. Results Inferential confusion directly, and indirectly through the feared corrupted self, affected OCD symptoms, even after adjusting for obsessive beliefs, psychological distress, and comorbidity. However, the feared culpable and malformed selves did not play a role in this pathway. Conclusions The study underscores that the feared corrupted self links inferential confusion to OCD symptoms, translating to the need to consider both dysfunctional reasoning processes and this specific feared self in clinical settings when treating OCD. Furthermore, the study provides more support for the inference‐based approach (IBA) to OCD.