A Test of the Cognitive Theory of Obsessions: Study of Internal Structure and Validity of the Obsessive Beliefs Questionnaire in Italian Individuals.

A widely-held theory is that obsessions arise from the misinterpretation of normal intrusive thoughts (e.g., misinterpreting unwanted harm-related thoughts as a sign that one is going to act on them). This leads the person to perform compulsions such as repeated checking. Misinterpretations are said to arise from various types of beliefs (e.g., the belief that thoughts inevitably give rise to actions). In support of this theory, some studies have shown that such beliefs are correlated with obsessive-compulsive (OC) symptoms. The Obsessive Beliefs Questionnaire (OBQ) is an 87-item self-report instrument developed by an international group (Obsessive Compulsive Cognitions Working Group - OCCWG) to assess cognitions thought to be relevant in the etiology and maintenance of obsessions and compulsions. The OBQ contains six scales measuring as many dysfunctional beliefs: Inflated responsibility, Overimportance of thoughts, Excessive concern about the importance of controlling one’s thoughts, Overestimation of threat, Intolerance of uncertainty, and Perfectionism. To date, the OBQ has been mainly studied in both clinical and nonclinical individuals drawn from English-language populations. Results showed that the questionnaire had generally a good internal consistency (Cronbach alpha coefficients equal or above .80) and an adequate test-retest reliability. However, three OBQ domains (Tolerance of uncertainty, Overestimation of threat and Perfectionism) appeared to be OCD-relevant but not OCD-specific since they did not discriminate individuals with OCD from anxiety controls. In addition, correlations with measures of OCD symptoms, mood and worry showed that the OBQ was as highly correlated with the non-OCD symptom measures (anxiety, depression and worry) as it was with OCD ones. Lastly, an exploratory factor analysis revealed that a three-factors solution best explained the internal structure of the questionnaire. In sum, such results raise doubts about the cognitive theory of obsessions and compulsions even though more studies are warranted before reformulating the theory. The present paper reports on the Italian validation of the OBQ: actually, the extent to which the psychometric properties of the OBQ (and, in particular, its internal structure) are equivalent to the original one may reveal interesting clues about the structure of beliefs and their relationships with OC symptoms. The OBQ was administered to 752 Italian undergraduate students along with the Padua Inventory (a measure of OC symptoms), the Beck Anxiety Inventory and Beck Depression Inventory. Results from exploratory factor analyses did not replicate the original six-factor structure of the OBQ nor the three factor-structure obtained by analyizing the original American sample. A confirmatory factor analysis revelead that the Italian version of the OBQ was best described by five factors and 46 items. Results from convergent and discriminant validity are also reported. Findings are discussed in terms of relevance and specificity of cognitive constructs to OC symptoms.