Wong Shiu F, Grisham Jessica R
School of Psychology, The University of New South Wales, Kensington, NSW, Australia.
School of Psychology, The University of New South Wales, Kensington, NSW, Australia.
J Behav Ther Exp Psychiatry. 2017 Dec;57:143-155. doi: 10.1016/j.jbtep.2017.06.001. Epub 2017 Jun 3.
The inference-based approach (IBA) is a cognitive account of the genesis and maintenance of obsessive-compulsive disorder (OCD). According to the IBA, individuals with OCD are prone to using inverse reasoning, in which hypothetical causes form the basis of conclusions about reality. Several studies have provided preliminary support for an association between features of the IBA and OCD symptoms. However, there are currently no studies that have investigated the proposed causal relationship of inverse reasoning in OCD.
In a non-clinical sample (N = 187), we used an interpretive cognitive bias procedure to train a bias towards using inverse reasoning (n = 64), healthy sensory-based reasoning (n = 65), or a control condition (n = 58). Participants were randomly allocated to these training conditions. This manipulation allowed us to assess whether, consistent with the IBA, inverse reasoning training increased compulsive-like behaviours and self-reported OCD symptoms.
Results indicated that compared to a control condition, participants trained in inverse reasoning reported more OCD symptoms and were more avoidant of potentially contaminated objects. Moreover, change in inverse reasoning bias was a small but significant mediator of the relationship between training condition and behavioural avoidance. Conversely, training in a healthy (non-inverse) reasoning style did not have any effect on symptoms or behaviour relative to the control condition.
As this study was conducted in a non-clinical sample, we were unable to generalise our findings to a clinical population.
Findings generally support the IBA model by providing preliminary evidence of a causal role for inverse reasoning in OCD.
基于推理的方法（IBA）是一种对强迫症（OCD）的成因及维持机制的认知解释。根据IBA，患有强迫症的个体倾向于使用反向推理，即假设的原因构成关于现实结论的基础。多项研究为IBA的特征与强迫症症状之间的关联提供了初步支持。然而，目前尚无研究调查反向推理在强迫症中所提出的因果关系。
在一个非临床样本（N = 187）中，我们使用一种解释性认知偏差程序来训练对使用反向推理（n = 64）、基于健康感官的推理（n = 65）或控制条件（n = 58）的偏差。参与者被随机分配到这些训练条件中。这种操作使我们能够评估，与IBA一致，反向推理训练是否会增加强迫样行为和自我报告的强迫症症状。
结果表明，与控制条件相比，接受反向推理训练的参与者报告了更多的强迫症症状，并且更回避潜在受污染的物体。此外，反向推理偏差的变化是训练条件与行为回避之间关系的一个小但显著的中介变量。相反，相对于控制条件，以健康（非反向）推理方式进行的训练对症状或行为没有任何影响。
由于本研究是在非临床样本中进行的，我们无法将研究结果推广到临床人群。
研究结果通过提供反向推理在强迫症中因果作用的初步证据，总体上支持了IBA模型。
