Replacing intrusive thoughts: investigating thought control in relation to OCD symptoms

J Behav Ther Exp Psychiatry. 2014 Dec;45(4):506-15. doi: 10.1016/j.jbtep.2014.07.007. Epub 2014 Jul 31.


Background and objectives: Control of obsessive thoughts in Obsessive Compulsive Disorder (OCD) involves both avoidance and removal of undesirable intrusive thoughts. Thought suppression tasks tap both of these processes but experimental results have been inconsistent. Experimental tasks allowing more focused study of the processes involved in controlling intrusive thoughts may be needed. In two experiments, control over neutral, standardized intrusive and personal intrusive thoughts was investigated as participants attempted to replace them with neutral thoughts.

Methods: Non-selected university students (Experiment 1: N = 61) and university students scoring high and low on self-report measure of OC symptoms (Experiment 2: N = 40) performed a computerized thought replacement task.

Results: In experiment 1 replacing personal intrusive thoughts took longer than replacing neutral thoughts. Self-reports showed that intrusive thoughts were rated more difficult to replace and were associated with greater thought reoccurrence during replacement, larger emotional reaction and more discomfort. These results were largely replicated in experiment 2. Furthermore, the high OC symptom group experienced greater overall difficulty controlling thoughts on the replacement task, experienced more reoccurrences of personal intrusive thoughts, larger emotional reactions and discomfort associated with them, and felt a greater urge to remove them.

Limitations: All participants were non-clinical university students, and older adults with OCD should be tested.

Conclusions: The findings are in line with cognitive behavioural theories of OCD. They support the usefulness of thought replacement as a research paradigm to study thought control in OCD and possibly other psychological conditions characterized by repetitive thoughts.

Keywords: Cognitive-behavioural theories; Experimental investigation; Obsessive-compulsive disorder; Thought control; Thought suppression.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analysis of Variance
  • Emotions / physiology*
  • Female
  • Humans
  • Internal-External Control*
  • Middle Aged
  • Obsessive-Compulsive Disorder / psychology*
  • Psychiatric Status Rating Scales
  • Repression, Psychology*
  • Self Report
  • Statistics as Topic
  • Thinking / physiology*
  • Young Adult