International consensus has been achieved on the existence of several dysfunctional beliefs underlying the development and/or maintenance of the Obsessive-Compulsive Disorder (OCD). Nevertheless, questions such as the dimensionality of the belief domains and the existence of OCD-specific dysfunctional beliefs still remain inconclusive. The present paper addresses these topics through two different studies. Study 1: A series of confirmatory factor analyses (N= 573 non-clinical subjects) were carried out on the Obsessive Beliefs Spanish Inventory-Revised (OBSI-R), designed to assess dysfunctional beliefs hypothetically related to OCD. An eight-factor model emerged as the best factorial solution: responsibility, over-importance of thoughts, thought-action fusion-likelihood, thought action fusion-morality, importance of thought control, overestimation of threat, intolerance of uncertainty and perfectionism. Study 2: The OBSI-R and other symptom measures were administered to 75 OCD patients, 22 depressed patients, and 25 non-OCD anxious patients. Results indicated that, although OCD patients differed from their non-clinical counterparts on all of the OBSI-R subscales, no evidence of OCD-specificity emerged for any of the belief domains measured, as the OCD subjects did not differ from the other two clinical groups of patients.

This study examined the relationships between obsessive-compulsive symptoms (OCs) and encoding style in a subclinical sample, by using a questionnaire that evaluates the extent to which preexisting schemata (versus cues from the outside world) affect encoding processes (Lewicki, 2005). Research on encoding style has revealed on one hand the existence of individual differences in the tendency to impose interpretive schemata in the process of encoding, and on the other hand the fact that an extremely internal mode of encoding has been found to be related to an increased propensity to self-perpetuate preexisting schemata. Furthermore, internal encoding may contribute to the development of psychopathological symptoms, through the self-perpetuation of dysfunctional schemata. The results confirmed that OCs are connected with an internal encoding style; specific relationships between obsessive-compulsive disorder (OCD) dimensions and internal encoding style were also found. These results are discussed in terms of the role of encoding style in the perpetuation of OCs, and its relationship to the dysfunctional beliefs characterising OCD.

Clinical significance analyses of controlled studies comparing Exposure and Response Prevention (ERP) and Cognitive Therapy (CT) in the treatment of Obsessive-Compulsive Disorder (OCD) are scarce. The objective of this study is to compare the clinical efficacy of ERP and CT for OCD patients, and the usefulness of each in changing dysfunctional beliefs and thought control strategies at post-treatment and at a one-year follow-up. The two treatments were delivered on the basis of a routine clinical practice in a public-mental health service. Thirty-three OCD patients were randomly assigned to ERP or CT, and 29 completed the treatments (13 in ERP and 16 in CT). The ERP applied was in vivo, gradual and therapist-guided. The CT was designed to challenge all the cognitive domains considered relevant for OCD, using cognitive techniques. The improvement and recovery rates (YBOCS) were slightly superior for CT than for ERP (ERP: 69.23% and 61.53%, respectively; CT: 81.25% and 68.75%, respectively). These therapeutic outcomes were maintained after the two treatments: at the one-year follow-up, 53.85% of the treated patients remained free of symptoms in ERP, and 65.5% in CT. Finally, the two treatments were equally effective in modifying dysfunctional beliefs, and the outcomes at the end of the treatments were maintained, or even increased, one year later.

It can be argued that an individual’s subjective experience and beliefs about a substance are important. Motives and expectancies regarding the use of alcohol and drugs are often that they are going to modify a cognitive state or help them cope with a particular situation. However, there are growing concerns in the U.S.A. and in the U.K. regarding individuals who experience psychosis and concurrently use substances. Correctly diagnosing individuals with dual presentation is said to be difficult, engagement in treatment is problematic, and medication adherence and prognosis poor. In this paper a cognitive-developmental model is proposed. I suggest that for individuals who experience psychosis and also use drugs or alcohol, the ability to identify the relationship between the substance use and the psychotic illness in terms of a case formulation/conceptualization would provide a good starting point for developing strategies and interventions that are most likely to succeed in treatment. Such an approach would explicitly address key cognitions. Unless the dysfunctional substance-related beliefs are addressed, adherence to medication and engagement with treatment services will be hindered and the possibility of relapsing to problematic substance use and acute psychosis remains. A cognitive treatment component, to target these beliefs, based on the cognitive model of substance misuse and the motivational interviewing approach will also be briefly outlined.