Inferential confusion moderates the effects of dissociative experiences on OCD symptoms severity in a clinical sample with obsessive-compulsive disorder

Objective: Recent research showed that greater OCD severity may be associated to stronger dissociation experiences. Higher dissociation was found to predict treatment resistance after cognitive behavioural therapy for OCD. Inferential Confusion (IC), a reasoning error where the person with OCD persists in his/her obsessional belief despite sense information to the contrary, might moderate the relation between dissociation and OCD severity. Using a clinical sample of patients with OCD, the current study investigated whether the relation between more severe dissociation and OCD severity might be moderated by IC. A second aim was to test whether IC might moderate the relation between more severe dissociation and OCD symptoms subtypes. Method: Sixty patients with primary OCD (mean age= 37.17, SD= 9.98, 53.30% females) completed the Inferential Confusion Questionnaire-Extended Version (ICQ-EV), Dissociative Experiences Scale-II (DES-II), Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Padua Inventory (PI), Beck Anxiety Inventory (BAI). Moderation effects of IC on the relation between dissociation and OCD severity and subtypes were tested through General Linear Models. Results: When Y-BOCS scores were considered as dependent variable, only an interaction effect emerged between ICQ-EV and DES-II Depersonalization/Derealization scores (B= 0.12, p<.05): patients with higher scores on ICQ-EV and higher scores on DES-II Depersonalization/Derealization scale had higher scores on Y-BOCS. When PI scores were considered as dependent variables, a main effect of DES-II Amnesia on PI Insufficient control of mental activities scores was found (F= 9.31, p<.01). In addition, an interaction effect between DES Amnesia and ICQ-EV scores was found (F= 7.46, p<.01) on PI Insufficient control of mental activities: patients with higher DES Amnesia scores and higher ICQ-EV scores had higher scores on PI Insufficient control of mental activities. Conclusions: The relation between depersonalization/derealization and OCD severity might be moderated by IC. Patients with such types of dissociative experiences, who typically are resistant to cognitive behavioural therapy, might benefit from inference-based approaches. Dissociative amnesia could be a dimension implicated in Insufficient control of mental activities, and its effects might be moderated by IC. Future research should assess inference-based treatments for resistant OCD with dissociative amnesia symptoms and Insufficient control of mental activities.