Cognitive Therapy and Research

, Volume 43, Issue 2, pp 498–513 | Cite as

The Impact of Enhanced Responsibility and Threat Beliefs on Self-Report and Behavioural Indices During a Sorting Task for Young People with OCD

  • Sharlene C. Mantz
  • Margot O’Brien
  • Felicity A. Waters
  • Maree J. AbbottEmail author
Original Article


We aimed to experimentally assess the role of cognitive processes in provoking anxiety and compulsive behaviours in young people with OCD, and to determine whether specific cognitive appraisal subtypes (e.g., threat) best explain OCD symptoms. 29 young people with a principal diagnosis of OCD, 30 young people with an anxiety disorder other than OCD, and 25 young people meeting no diagnostic criteria completed a sorting task designed to increase or decrease responsibility/threat biases. We expected that OCD participants in the high responsibility/threat group would demonstrate higher scores on subjective (belief and anxiety ratings) and behavioural variables (e.g., urge to check, time taken to sort) compared to anxious and nonclinical control groups. Young people with OCD in the inflated responsibility/threat condition were more anxious and showed enhanced delay behaviours (e.g., slower on the task, more time checking) compared to control groups, who were not affected by the manipulation. Regression analyses revealed that threat appraisals played a more prominent role than responsibility beliefs in state anxiety ratings, overall time taken and time spent checking. The present study supports cognitive models of OCD showing a clear relationship between inflated responsibility beliefs, threat beliefs and perfectionism levels and OCD-related behaviours.


Obsessive compulsive disorder OCD Paediatric Beliefs Responsibility Threat Child Adolescent Anxiety 



We would like to thank the young people and their families who participated, Rivendell Hospital staff, as well as Benjamin Chen, Aberdine Donaldson, Alice Lo, and Chloe McGrath for their research assistance.


We have no funding sources to declare and have received no funding from external sources.

Compliance with Ethical Standards

Conflict of interest

Sharlene Mantz, Margot O’Brien, Felicity Waters and Maree Abbott declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Animal Rights

This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington: American Psychiatric Publishing.CrossRefGoogle Scholar
  3. Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998). Psychometric properties of the 42-item and 21-item versions of the depression anxiety stress scales in clinical groups and a community sample. Psychological Assessment, 10(2), 176.CrossRefGoogle Scholar
  4. Arntz, A., Voncken, M., & Goosen, A. C. (2007). Responsibility and obsessive–compulsive disorder: An experimental test. Behaviour Research and Therapy, 45, 425–435.CrossRefGoogle Scholar
  5. Barrett, P. M., & Healy, L. J. (2003). An examination of the cognitive processes involved in childhood obsessive–compulsive disorder. Behaviour Research and Therapy, 41, 285–299.CrossRefGoogle Scholar
  6. Barrett, P. M., & Healy-Farrell, L. J. (2003). Perceived responsibility in juvenile obsessive-compulsive disorder: An experimental manipulation. Journal of Clinical Child and Adolescent Psychology, 32, 430–441.CrossRefGoogle Scholar
  7. Beck, A., Emery, G., & Greenberg, R. (1985). Anxiety disorders and phobias: A cognitive perspective. New York: Basic Books.Google Scholar
  8. Boschen, M. J., & Vuksanovic, D. (2007). Deteriorating memory confidence, responsibility perceptions and repeated checking: Comparisons in OCD and control samples. Behaviour Research and Therapy, 45, 2098–2109.CrossRefGoogle Scholar
  9. Bouchard, C., Rhéaume, J., & Ladouceur, R. (1999). Responsibility and perfectionism in OCD: An experimental study. Behaviour Research and Therapy, 37, 239–248.CrossRefGoogle Scholar
  10. Carr, A. T. (1974). Compulsive neurosis: A review of the literature. Psychological Bulletin, 81, 311–318.CrossRefGoogle Scholar
  11. Coles, M. E., Wolters, L. H., Sochting, I., De Haan, E., Pietrefesa, A. S., & Whiteside, S. P. (2010). Development and initial validation of the obsessive belief questionnaire-child version (OBQ-CV). Depression and Anxiety, 27(10), 982–991.CrossRefGoogle Scholar
  12. Farrell, L. J., & Barrett, P. M. (2006). Obsessive–compulsive disorder across developmental trajectory: Cognitive processing of threat in children, adolescents and adults. British Journal of Psychology, 97, 95–114.CrossRefGoogle Scholar
  13. Faul, F., & Erdfelder, E. (1992). GPOWER: A priori-, post hoc-, and compromise power analyses for MS-DOS [Computer Program]. Bonn, Germany: Bonn University.Google Scholar
  14. Fitch, K. E., & Cougle, J. R. (2013). An evaluation of obsessive beliefs as predictors of performance on in vivo assessments of obsessive–compulsive symptoms. Cognitive Therapy and Research, 37, 207–220.CrossRefGoogle Scholar
  15. Freeston, M. H., Ladouceur, R., Gagnon, F., & Thibodeau, N. (1993). Beliefs about obsessional thoughts. Journal of Psychopathology and Behavioral Assessment, 15, 1–21.CrossRefGoogle Scholar
  16. Henry, J. D., & Crawford, J. R. (2005). The short-form version of the depression anxiety stress scales (DASS-21): Construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 44(2), 227–239.CrossRefGoogle Scholar
  17. Heyman, I., Fombonne, E., Simmons, H., Ford, T., Meltzer, H., & Goodman, R. (2003). Prevalence of obsessive-compulsive disorder in the British nationwide survey of child mental health. International Review of Psychiatry, 15, 178–184.CrossRefGoogle Scholar
  18. Jones, M. K., & Menzies, R. G. (1997a). The cognitive mediation of obsessive-compulsive handwashing. Behaviour Research and Therapy, 35, 843–850.CrossRefGoogle Scholar
  19. Jones, M. K., & Menzies, R. G. (1997b). Danger ideation reduction therapy (DIRT): Preliminary findings with three obsessive–compulsive washers. Behaviour Research and Therapy, 35, 955–960.CrossRefGoogle Scholar
  20. Jones, M. K., & Menzies, R. G. (1998). Danger ideation reduction therapy (DIRT) for obsessive–compulsive washers. A controlled trial. Behaviour Research and Therapy, 36, 959–970.CrossRefGoogle Scholar
  21. Julien, D., O’Connor, K. P., & Aardema, F. (2007). Intrusive thoughts, obsessions, and appraisals in obsessive–compulsive disorder: A critical review. Clinical Psychology Review, 27, 366–383.CrossRefGoogle Scholar
  22. Kovacs, M. (1992). Children’s depression inventory (CDI). Toronto: Multi-Health Systems Inc.Google Scholar
  23. Ladouceur, R., Rhéaume, J., & Aublet, F. (1997). Excessive responsibility in obsessional concerns: A fine-grained experimental analysis. Behaviour Research and Therapy, 35, 423–427.CrossRefGoogle Scholar
  24. Ladouceur, R., Rhéaume, J., Freeston, M. H., Aublet, F., Jean, K., Lachance, S., et al. (1995). Experimental manipulations of responsibility: An analogue test for models of obsessive-compulsive disorder. Behaviour Research and Therapy, 33, 937–946.CrossRefGoogle Scholar
  25. Libby, S., Reynolds, S., Derisley, J., & Clark, S. (2004). Cognitive appraisals in young people with obsessive–compulsive disorder. Journal of Child Psychology and Psychiatry, 45, 1076–1084.CrossRefGoogle Scholar
  26. Lopatka, C., & Rachman, S. (1995). Perceived responsibility and compulsive checking: An experimental analysis. Behaviour Research and Therapy, 33, 673–684.CrossRefGoogle Scholar
  27. Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the depression anxiety stress scales (2nd ed.). Sydney: The Psychology Foundation of Australia, Inc.Google Scholar
  28. Lyneham, H. J., Abbott, M. J., & Rapee, R. M. (2007). Interrater reliability of the anxiety disorders interview schedule for DSM-IV: Child and parent version. Journal of the American Academy of Child & Adolescent Psychiatry, 46(6), 731–736.CrossRefGoogle Scholar
  29. Lyneham, H. J., & Rapee, R. M. (2005). Agreement between telephone and in-person delivery of a structured interview for anxiety disorders in children. Journal of the American Academy of Child & Adolescent Psychiatry, 44(3), 274–282.CrossRefGoogle Scholar
  30. Magnúsdóttir, I., & Smári, J. (2004). Are responsibility attitudes related to obsessive–compulsive symptoms in schoolchildren? Cognitive Behaviour Therapy, 33, 21–26.CrossRefGoogle Scholar
  31. Mancini, F., D’Olimpio, F., & Cieri, L. (2004). Manipulation of responsibility in non-clinical subjects: Does expectation of failure exacerbate obsessive–compulsive behaviors? Behaviour Research and Therapy, 42, 449–457.CrossRefGoogle Scholar
  32. Mantz, S., & Abbott, M. J. (2016a). Obsessive compulsive disorder in paediatric and adult samples: Nature, treatment and cognitive processes. A review of the theoretical and empirical literature. Behaviour Change, 34, 1–34.CrossRefGoogle Scholar
  33. Mantz, S., & Abbott, M. J. (2016b). The relationship between responsibility beliefs and symptoms and processes in obsessive compulsive disorder: A systematic review. Journal of Obsessive–Compulsive and Related Disorders, 14, 13–26.CrossRefGoogle Scholar
  34. March, J. S., & Leonard, H. L. (1996). Obsessive-compulsive disorder in children and adolescents: A review of the past 10 years. Journal of the American Academy of Child & Adolescent Psychiatry, 35, 1265–1273.CrossRefGoogle Scholar
  35. Matthews, L., Reynolds, S., & Derisley, J. (2007). Examining cognitive models of obsessive compulsive disorder in adolescents. Behavioural and Cognitive Psychotherapy, 35, 149–163.CrossRefGoogle Scholar
  36. Nauta, M. H., Scholing, A., Rapee, R. M., Abbott, M., Spence, S. H., & Waters, A. (2004). A parent-report measure of children’s anxiety: Psychometric properties and comparison with child-report in a clinic and normal sample. Behaviour Research and Therapy, 42(7), 813–839.CrossRefGoogle Scholar
  37. Obsessive Compulsive Cognitions Working Group. (1997). Cognitive assessment of obsessive–compulsive disorder. Behaviour Research and Therapy, 35, 667–681.CrossRefGoogle Scholar
  38. Orgilés, M., Fernández-Martínez, I., Guillén-Riquelme, A., Espada, J. P., & Essau, C. A. (2016). A systematic review of the factor structure and reliability of the Spence Children’s Anxiety Scale. Journal of Affective Disorders, 190, 333–340.CrossRefGoogle Scholar
  39. Parrish, C. L., & Radomsky, A. S. (2006). An experimental investigation of responsibility and reassurance: Relationships with compulsive checking. International Journal of Behavioural Consultation and Therapy, 2, 174–191.CrossRefGoogle Scholar
  40. Pauls, D., Alsobrook, J., Goodman, W., Rasmussen, S., & Leckman, J. (1995). A family study of obsessive–compulsive disorder. The American Journal of Psychiatry, 152, 76–84.CrossRefGoogle Scholar
  41. Piacentini, J., Bergman, R. L., Keller, M., & McCracken, J. (2003). Functional impairment in children and adolescents with obsessive–compulsive disorder. Journal of Child and Adolescent Psychopharmacology, 13, 61–69.CrossRefGoogle Scholar
  42. Pişgin, İ, & Özen, D. (2010). Faulty appraisals and belief domains in obsessive compulsive disorder from childhood to adulthood. Current Approaches in Psychiatry, 2, 117–131.Google Scholar
  43. Rachman, S. (1993). Obsessions, responsibility and guilt. Behaviour Research and Therapy, 31, 149–154.CrossRefGoogle Scholar
  44. Rachman, S. (1997). A cognitive theory of obsessions. Behaviour Research and Therapy, 35, 793–802.CrossRefGoogle Scholar
  45. Rachman, S. (2002). A cognitive theory of compulsive checking. Behaviour Research and Therapy, 40, 625–639.CrossRefGoogle Scholar
  46. Reeves, J., Reynolds, S., Coker, S., & Wilson, C. (2010). An experimental manipulation of responsibility in children: A test of the inflated responsibility model of obsessive-compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry, 41, 228–233.CrossRefGoogle Scholar
  47. Reynolds, S., & Reeves, J. (2008). Do cognitive models of obsessive compulsive disorder apply to children and adolescents? Behavioural and Cognitive Psychotherapy, 36, 463–471.CrossRefGoogle Scholar
  48. Rhéaume, J., Freeston, M. H., Dugas, M. J., Letarte, H., & Ladouceur, R. (1995). Perfectionism, responsibility and obsessive–compulsive symptoms. Behaviour Research and Therapy, 33, 785–794.CrossRefGoogle Scholar
  49. Salkovskis, P. M. (1985). Obsessional-compulsive problems: A cognitive-behavioural analysis. Behaviour Research and Therapy, 23, 571–583.CrossRefGoogle Scholar
  50. Salkovskis, P. M. (1989). Cognitive behavioural factors and the persistence of intrusive thoughts in obsessional problems. Behaviour Research and Therapy, 27, 677–682.CrossRefGoogle Scholar
  51. Salkovskis, P. M., Richards, H., & Forrester, E. (1995). The relationship between obsessional problems and intrusive thoughts. Behavioural and Cognitive Psychotherapy, 23, 281–299.CrossRefGoogle Scholar
  52. Shafran, R. (1997). The manipulation of responsibility in obsessive–compulsive disorder. British Journal of Clinical Psychology, 36, 397–407.CrossRefGoogle Scholar
  53. Shafran, R., Frampton, I., Heyman, I., Reynolds, M., Teachman, B., & Rachman, S. (2003). The preliminary development of a new self-report measure for OCD in young people. Journal of Adolescence, 26(1), 137–142.CrossRefGoogle Scholar
  54. Shoenfelt, J. L., & Weston, C. G. (2007). Managing obsessive compulsive disorder in children and adolescents. Psychiatry, 4, 47–53.Google Scholar
  55. Sica, C., Coradeschi, D., Sanavio, E., Dorz, S., Manchisi, D., & Novara, C. (2004). A study of the psychometric properties of the obsessive beliefs inventory and interpretations of intrusions inventory on clinical Italian individuals. Journal of Anxiety Disorders, 18, 291–307.CrossRefGoogle Scholar
  56. Silverman, W. K., & Albano, A. M. (1996). Anxiety disorders interview schedule for DSM-IV: Parent version. San Antonio: Psychological Corporation.Google Scholar
  57. Silverman, W. K., Saavedra, L. M., & Pina, A. A. (2001). Test-retest reliability of anxiety symptoms and diagnoses with the anxiety disorders interview schedule for DSM-IV: Child and parent versions. Journal of the American Academy of Child & Adolescent Psychiatry, 40(8), 937–944.CrossRefGoogle Scholar
  58. Spence, S. H. (1998). A measure of anxiety symptoms among children. Behaviour Research and Therapy, 36(5), 545–566.CrossRefGoogle Scholar
  59. Spielberger, C. D., Edwards, C. D., Lushene, R. E., Montuori, J., & Platzek, D. (1973). The state trait anxiety inventory for children: Preliminary manual. Palo Alto: Consulting Psychiatric Press.Google Scholar
  60. Sun, S., & Wang, S. (2015). The children’s depression inventory in worldwide child development research: A reliability generalization study. Journal of Child and Family Studies, 24(8), 2352–2363.CrossRefGoogle Scholar
  61. Tolin, D. F., Worhunsky, P., & Maltby, N. (2006). Are “obsessive” beliefs specific to OCD? A comparison across anxiety disorders. Behaviour Research and Therapy, 44, 469–480.CrossRefGoogle Scholar
  62. Uher, R., Heyman, I., Turner, C. M., & Shafran, R. (2008). Self-, parent-report and interview measures of obsessive–compulsive disorder in children and adolescents. Journal of Anxiety Disorders, 22(6), 979–990.CrossRefGoogle Scholar
  63. Vaccaro, L. D., Jones, M. K., Menzies, R. G., & Clare, St, T (2010). Danger ideation reduction therapy (DIRT) for obsessive-compulsive checkers: A comprehensive guide to treatment. Brisbane: Australian Academic Press.Google Scholar
  64. Verhaak, L., & De Haan, E. (2007). Cognitions in children with OCD. European Child & Adolescent Psychiatry, 16, 353–361.CrossRefGoogle Scholar
  65. Whiteside, S. P., & Brown, A. M. (2008). Exploring the utility of the Spence Children’s Anxiety Scales parent-and child-report forms in a North American sample. Journal of Anxiety Disorders, 22(8), 1440–1446.CrossRefGoogle Scholar
  66. Wilson, K. A., & Chambless, D. L. (1999). Inflated perceptions of responsibility and obsessive-compulsive symptoms. Behaviour Research and Therapy, 37, 325–335.CrossRefGoogle Scholar
  67. Zohar, A. H. (1999). The epidemiology of obsessive-compulsive disorder in children and adolescents. Child and Adolescent Psychiatric Clinics of North America, 8, 445–460.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Sharlene C. Mantz
    • 1
  • Margot O’Brien
    • 2
  • Felicity A. Waters
    • 2
  • Maree J. Abbott
    • 1
    Email author
  1. 1.Clinical Psychology Unit (M02F), School of PsychologyThe University of SydneySydneyAustralia
  2. 2.Rivendell Child and Adolescent UnitConcord HospitalConcord WestAustralia

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