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    Part 3. A question of perspective : the association between intrusive thoughts and obsessionality in 11 countries
    (Elsevier, 2014) Clark, David A.; Abramowitz, Jon; Alcolado, Gillian M.; Alonso, Pino; Belloch, Amparo; İnözü, Müjgan
    A key assumption of contemporary cognitive-behavioral models of obsessive-compulsive disorder (OCD) is that obsessional thoughts exist on a continuum with "normal" unwanted intrusive thoughts. Recently, however, some authors have challenged this notion. The present study aimed to clarify (a) the extent that different types of intrusive thoughts in nonclinical individuals are associated with obsessionality, (b) the relative contribution of frequency, distress and control ratings to obsessionality, and (c) the extent that existing findings (primarily from North American or European samples) generalize to other countries in the world. Five hundred and fifty-four non clinical individuals from 11 different countries were administered an interview assessing the presence, frequency, distress, and perceived control of different types of intrusive thoughts. Participants also completed measures of obsessional beliefs, obsessive-compulsive (OC) symptoms, and depression. Results from data analyses supported the universality of unwanted intrusive thoughts, the continuity of normal and abnormal obsessions, and the specificity of dirt/contamination, doubt and miscellaneous intrusions to OC symptoms. Implications for intrusive thoughts as a potential vulnerability factor for OCD are discussed. (C) 2013 Elsevier Ltd. All rights reserved.
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    Unwanted intrusive thoughts : cultural, contextual, covariational, and characterological determinants of diversity
    (Elsevier Science Bv, 2014) Clark, David A.; İnözü, Müjgan
    Cognitive behavioral theories trace the origins' of clinical obsessions to common unwanted intrusive thoughts, images or impulses that are universally experienced in the general population. It is the erroneous interpretation of the intrusion as a personally significant threat that must be diminished or neutralized that result in the vicious escalation into a clinical obsession. This paper reviews four critical determinants of individuals' diverse experience of unwanted intrusive thoughts (UITs). First we consider the role that culture may play in the types of thoughts that become intrusive, repetitive and persistent. Next the role of context is considered and the differences found between UITs and obsessions that are externally precipitated versus those that are more autonomous. A third section considers the role of current clinical state and whether there is a specific relation between certain types of intrusions and obsessional states in particular. The final section examines the role of personality, enduring dysfunctional beliefs and self-view discrepancies as potential vulnerability factors for UITs and obsessions. The paper concludes with a summary of current status and future directions for research on UITs. (C) 2014 Elsevier Ltd. All rights reserved.