(PS2-70) Differential Relations Between Inferential Confusion and OC Symptom Dimensions as Measured by the DOCS

Inferential confusion (IC) is a cognitive process proposed to play a key role in the development of obsessive-compulsive (OC) symptoms (Aardema et al., 2005). It describes an individual’s overreliance on imagined possibilities and a distrust of relevant sensory evidence when evaluating the likelihood of future outcomes. Research has examined the relations between IC (typically measured by the Inferential Confusion Questionnaire–Expanded Version; ICQ-EV) and obsessive-compulsive symptoms as measured by several symptom questionnaires. However, no study has paired the ICQ-EV with the Dimensional Obsessive-Compulsive Scale (DOCS). The DOCS is used broadly in the contemporary OC literature and holds certain conceptual advantages over other instruments (Abramowitz et al., 2010). We sought to address this gap. In the current study, we examined the pattern of correlations between the ICQ-EV and the four DOCS subscales (Contamination, Responsibility for Harm, Unacceptable Thoughts, and Symmetry). After first reviewing zero-order correlations, multiple regression provided a more stringent test via partial correlations between the ICQ-EV and DOCS controlling for anxiety and depression (using the Depression, Anxiety, and Stress Scale; DASS-21).

Our study (N = 257) included a diverse (44.6% White, 28.6% Black or African American, 26.4% Hispanic or Latino/a, 7% Asian, 1.2% American Indian or Alaska Native, 0.8% Native Hawaiian or Pacific Islander) sample of psychology undergraduates. All analyses were performed in R. Results indicated that the ICQ-EV was significantly (all ps < .001) correlated with all four DOCS subscales: Unacceptable Thoughts (r = .52), Responsibility for Harm (r = .49), Symmetry (r = .40), and Contamination (r = .36). As expected, the association was lowest for Contamination, but the magnitude of the correlation was not meaningfully lower than for Symmetry. We next regressed each DOCS subscale on the ICQ-EV while controlling for the DASS-21 Anxiety and Depression subscales. All four models were significant (R² = .16-.43, p < .001) and the ICQ-EV accounted for significant variance in each instance: Contamination (β = .35, p < .001), Responsibility for Harm (β = .33, p < .001), Symmetry, (β = .32, p < .001), and Unacceptable Thoughts (β = .25, p < .001).

The extant literature has reported empirical associations between IC and OC symptoms, and our results extend those findings to the widely-used DOCS. Namely, the ICQ-EV correlated significantly with each of the four major OC symptom dimensions provided by the DOCS, both before and after controlling for variance owing to depression and anxiety symptoms. These findings support the unique relevance of IC to the OC symptom experience across all dimensions. This is key because IC—and its parent model, the inference-based approach (IBA)—were articulated as a set of reasoning errors that distinguish obsessional symptoms from closely related conditions that involve mood and anxiety focused distress. As the study of OCD has shifted away from classic anxiety-centric conceptualizations, it is critical to identify and better understand the experiences that distinguish OCD from other disorders. Data such as these suggest that the IBA holds particular promise toward that goal.