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Thesis (Ph.D.)--University of Central Florida, 2009. / Adviser: Charles Negy. Includes bibliographical references (p. 102-107).

The aim of this thesis was to consider the role of appraisals of intrusive thoughts in the development of Obsessive-Compulsive Disorder. A narrative literature review explored the hypothesis that 'normal' intrusive thoughts lie on a continuum with clinical obsessions. The review discussed previous research on intrusive thoughts in nonclinical samples and drew comparisons with characteristics of clinical obsessions. An internet-based empirical investigation employed a randomised controlled trial design in order to test the effectiveness of an intervention based on normalising information in reducing problematic meta-cognitive beliefs. A large sample (N = 148) of young adults (aged 18-20 years) was screened in to the study based on high levels of problematic meta-cognitive beliefs. Participants completed questionnaire measures of meta-cognitive beliefs, obsessive-compulsive symptoms, reactions to intrusive thoughts and experiential avoidance. Participants completed an interactive quiz based on normalising information (experimental condition) or pet information (control condition). Significant reductions in problematic meta-cognitive beliefs and experiential avoidance were observed in both conditions, thus no additional benefit of normalising information was indicated. The implications of these findings are discussed in the context of the potential normalising effects of symptom monitoring. Overall this thesis supports the comparison of 'normal' intrusive thoughts and obsessions and suggests that negative appraisals, such as problematic metacognitive beliefs, may not be the only defining factor in the development of Obsessive-Compulsive Disorder.

This thesis explores the role of guilt in post-traumatic stress disorder (PTSD) and ways of coping with guilt-related thoughts in a clinical sample. The thesis is presented as three papers that include a review of the literature, an empirical research study and critical appraisal of the research process. In the first paper, the author provides a systematic review of 27 studies to determine whether an association exists between guilt and symptoms of post-traumatic stress. Guilt remains an associated feature of PTSD; however, how these two constructs might be linked is not fully understood. Therefore the current review further evaluated the evidence for four competing models conceptualising the guilt-PTSD relationship. Overall, trauma-related guilt was positively related to PTSD symptomology even when controlling for depression. Guilt cognitions reflecting self-blame, perceived responsibility and wrongdoing were frequently associated with PTSD symptoms. Few studies found guilt was no longer related to PTSD symptomology when controlling for shame. Future studies ought to control for overlapping or confounding variables and further explore factors that may mediate the guilt-PTSD relationship such as coping. The second paper provided preliminary validation of a newly developed and unique measure of coping with guilty thoughts (GLAMS) in a clinical sample. A total of 67 participants from primary care services completed the GLAMS and measures of distress, guilt, coping and thought control. Eighteen completed the GLAMS and distress measure two weeks later. Overall the GLAMS evidenced moderate to high internal consistency and acceptable to good concurrent validity. Maladaptive subscales were found to be reliable over time. Higher self-punishment was related to greater guilt and distress and more mindful coping was related to a reduction in guilt supporting construct validity. Future research is required to test the stability of the GLAMS factor structure in a larger clinical sample. The GLAMS may have clinical utility in guiding psychological intervention towards more adaptive ways of coping with guilt. It may also provide a suitable outcome measure by monitoring the frequency in which clients engage in maladaptive ways of coping. The final paper provided a critical evaluation and reflection on the research process. Particular reference was made to the research rationale, methodological and ethical issues and considerations were given for future research and clinical practice. Conclusions drawn from this thesis are limited largely by the cross-sectional nature of most of the studies reviewed in paper 1 and insufficient numbers for the empirical study, which due to methodological and service-related constraints, limited further exploration of the data. Factor analysis and subsequent validation of the GLAMS in a larger sample is required to further support inferences drawn.

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Fairness theory represents a widely cited framework for modeling the cognitive processes that underlie the formation of fairness perceptions in the workplace. Nonetheless, imprecise language and scant empirical research limit its ability to further organizational justice research. Therefore, in this dissertation I provide a review and critique of fairness theory suggesting several revisions. I then build upon this revised model to develop a new model of fairness perception formation. The developed model is tested via a laboratory experiment and a field study, both of which provide initial evidence in favor of the proposed model.

Background: Worry is theorised to function as a form of cognitive or experiential avoidance wherein an individual uses repetitive thinking in an attempt to avoid a future event or an aversive internal experience. There is evidence of a closer link between non-verbal thought (e.g. mental images) and emotion, physiology and behaviour than with verbal thought. Based on findings that worry is predominantly a verbal-linguistic activity, with less imagery occurring during worry episodes than during relaxation; it is theorised that worriers may move from non-verbal to verbal thought in order to avoid the greater arousal associated with non-verbal thought intrusions. This carries with it the unintended consequence of reducing emotional processing, leading to a subsequent increase in intrusive thoughts. Whilst cognitive science has emphasised the content of cognition and how this links to emotion, the psychological flexibility model suggests that content is less important than how we relate to our cognitive events. The degree to which we get entangled in our thinking, lack perspective on our thoughts and the degree to which cognition comes to regulate our behaviour over other sources is known as cognitive fusion. It is postulated that some individuals may be more prone to avoiding internal experiences due to the stance they take toward these experiences. In the long-term, worry should lead to a reduction in the experience of intrusive images and memories and an increase in intrusive thoughts; and this relationship should vary depending on an individual’s stance in relation to their internal experiences. The purpose of the current study is to explore the experience of intrusive memories, images and thoughts in an older adult sample, and the relationship of these experiences to level of worry, cognitive fusion and psychological inflexibility. Method: Sixty-two community dwelling older adults were involved in the study. Each completed questionnaire measures to assess level of trait worry, depression, cognitive fusion and psychological inflexibility, as well as an interview to determine whether diagnostic criteria were met for any mood or anxiety disorder and to complete an interview exploring the experience of intrusive memories, thoughts and images. Findings: Higher levels of trait worry were strongly associated with higher levels of cognitive fusion and psychological inflexibility. Intrusive memories, images and thoughts were all reported in low levels across the sample. Level of worry was positively associated with the severity but not the occurrence of intrusive memories and thoughts. Higher levels of psychological inflexibility were associated with less occurrence of intrusive memories and images; whereas higher levels of cognitive fusion were associated with the increased occurrence of intrusive images. Higher levels of worry, cognitive fusion and psychological inflexibility were all associated with increased severity of intrusive thoughts. The findings are discussed in relation to previous research and to the Avoidance Theory and Acceptance Model of GAD. Implications are considered for further research and clinical applications.

Thought-action fusion (TAF) is the phenomenon whereby one has difficulty separating cognitions, particularly those that are intrusive and disturbing, from their corresponding behaviors. Recent work has suggested that TAF is malleable and amenable to change. The current study examined the effects of three different psychoeducational interventions on thought-action fusion, anxiety, thought suppression, magical thinking, and responsibility cognitions. Assessments were conducted both immediately following the interventions and after a two-week period. Results indicated that individuals who received a cognitive-based intervention that targeted irrational thoughts had significantly lower TAF scores than individuals who received an intervention that discussed thoughts from a non-evaluative framework and individuals in the control group, both immediately following the intervention and at the two-week follow-up. As hypothesized, all groups experienced a significant decrease in anxiety between the post-intervention and follow-up assessments; however, there was a trend towards significance for those who were exposed to the cognitive-based intervention to experience a greater decrease in anxiety than those in the control group. The cognitive-based intervention group was the only group that did not experience a significant increase in thought-suppression from baseline to post-intervention, and was also the only group to experience an increase in both frequency of and belief in low-responsibility thoughts from baseline to follow-up. No significant group differences were found for the construct of magical thinking. Implications are discussed.