Attachment Security, Self-Concept Clarity and Beliefs in Obsessive-Compulsive Disorder

Abstract

Cognitive models of obsessive-compulsive disorder (OCD) suggest that an ambivalent self-concept and dysfunctional beliefs play an important role in the pathogenesis of OCD. Early attachment experience is argued to be the main process through which such ambivalent self-representations develop. The current study investigated self-concept clarity, a broader construct than ambivalence, attachment security, obsessive-compulsive (OC)-relevant beliefs and their relation to OC symptoms. Forty four people who reported experiencing OC symptoms were compared to 34 individuals who reported no mental health difficulties. People who experienced OC symptoms exhibited significantly less self-concept clarity, less attachment security and higher levels of OC-related beliefs. Once levels of depression were controlled for, no significant relationship between attachment security and self-concept clarity was found in the OCD group. OC symptoms were not significantly correlated with self-concept clarity in the OCD group, although significant negative relationships were found between self-concept clarity and specific OC symptoms. Evidence was found to support the notion that OC-relevant beliefs mediate the relationship between self-concept clarity and OC symptoms, in addition to mediating the relationship between attachment anxiety and OC symptoms. Implications for attachment theory and cognitive models of OCD are discussed, along with clinical and research implications.