Thought dismissability in obsessive-compulsive disorder versus panic disorder

This study sought to better understand the persistence of obsessive-compulsive disorder (OCD) by studying the dismissability of obsessional thoughts in individuals with OCD relative to the dismissability of panic-relevant thoughts in individuals with panic disorder with or without agoraphobia (PD/A). Individuals with a principal diagnosis of OCD (n = 25) or PD/A (n = 25) completed a thought replacement task in which they replaced a primary obsession (target thought for the OCD group) or a primary panic-relevant thought (target thought for the PD/A group), with a neutral thought, signaling when the target thought occurred and when the neutral thought was in mind. The OCD group had more target thoughts and appraised the recurrence of the target thought more negatively. Whereas mood state did not change in the PD/A group, it declined in the OCD group, and this change was predicted by negative appraisal of target thought recurrences, but not amount of time thinking the target thought. These findings suggest that in vivo appraisal of the recurrence of obsessions may be a unique, key mechanism in the persistence of OCD and that the identification and exploration of appraisal of thought recurrences may be an especially important target in its treatment.