Cognitive Mediators in the Relationship Between Neuroticism and Obsessing

Initial evidence highlights intolerance of uncertainty and anxiety sensitivity as second-order mediators in the pathway from the general risk factor of neuroticism to the specific expression of OCD symptoms. However, more research on potential mediational factors is needed to explain this relationship better.

Incorporating mediators like worry and brooding has helped explain links between neuroticism and general anxiety symptoms. However, their potential mediating roles in the development of OCD symptoms have been unexplored.

Pfaltz, M. C., Mörstedt, B., Meyer, A. H., Wilhelm, F. H., Kossowsky, J., & Michael, T. (2015). Why can't I stop thinking about it?: Cognitive mediators in the relationship between neuroticism and obsessing. Swiss Journal of Psychology, 74(2), 75-82.

Key Points

• The relationship between neuroticism and obsessing is mediated by thought suppression, worry, and brooding. These cognitive processes account for 75% of the total effect between neuroticism and obsessing.
• There were no gender differences found in the mediating role of thought processes between neuroticism and obsessing.
• The study supports the inclusion of thought suppression in hierarchical models of OCD development.
• Further research could explore additional mediators like perceived thought control ability to better understand the link between general and specific vulnerability factors.

Rationale

Prior research has established neuroticism as a general risk factor for OCD and obsessive thinking specifically (Nishimura et al., 1998; Yorulmaz et al., 2010). However, how neuroticism influences the development of obsessive thoughts is unknown.

This study aimed to test a hierarchical model where the relationship between the higher-order factor of neuroticism and obsessing is mediated by specific, second-order cognitive factors like thought suppression, worry, and brooding.

Understanding these pathways can inform etiological models and treatment approaches for OCD (Taylor, 1998; Barlow, 2000).

While prior research shows neuroticism is linked to both OCD/obsessions and these faulty thought patterns, no study has tested if these second-order factors actually explain how neuroticism confers vulnerability for obsessive thoughts specifically.

Similarly, despite its prominence in OCD models, thought suppression has yet to be included as an intermediary variable in hierarchical models.

So, investigating these cognitive processes as parallel mediators can elucidate the pathway from the trait-like general risk factor of neuroticism to the intrusive thinking characteristic of OCD.

Results can refine theoretical models of OCD development and inform treatment targets.

Method

Cross-sectional correlational design.

Participants completed several questionnaires assessing neuroticism (NEO-FFI neuroticism subscale), thought suppression (WBSI), worry (PSWQ), brooding (RSQ), and obsessing (OCI-R obsessing subscale).

Mediator models tested whether the three cognitive processes mediated between neuroticism and obsessing in a multiple mediation model, first individually and then collectively.

Sample

The study included 238 German adult volunteers recruited online.

The sample was predominantly female (76.5%), with a mean age of 24.5 years. Most participants were university students (75.2%).

Measures

• Neuroticism: NEO-FFI neuroticism subscale
• Thought suppression: White Bear Suppression Inventory (WBSI)
• Worry: Penn State Worry Questionnaire (PSWQ)
• Brooding rumination: Response Styles Questionnaire (RSQ)
• Obsessing: Obsessive Compulsive Inventory-Revised (OCI-R) obsessing subscale

Statistical Analysis

Mediator models calculate the direct effect of the independent variable (neuroticism) on the dependent variable (obsessing) and the indirect effect via the mediators (cognitive processes).

If mediators significantly reduce the direct effect, this indicates the variables mediate the relationship.

The size of indirect effects shows the mediators’ contribution. Analyses used bootstrapping methods suitable for non-normal data.

Results

• All three cognitive processes (thought suppression, worry, brooding) emerged as significant individual mediators, accounting for 31-47% of the total effect of neuroticism on obsessing.
• The multiple mediation model showed a cumulative indirect effect of the mediators equal to 75% of the total effect.
• There were no gender differences found in the mediating role of thought processes between neuroticism and obsessing.
• The direct effect of neuroticism on obsessing was no longer significant, indicating full mediation. All mediators contributed significantly and equivalently.

Insight

When examined in the multiple mediation model together, thought suppression, worry, and brooding each still significantly mediated the relationship between neuroticism and obsessing.

The analysis showed that all three unhelpful thought patterns contributed equally to explaining why highly neurotic people are prone to obsessions. No single process stood out as accounting for more of the link than the others.

So, thought suppression linked neuroticism to obsessing just as much as worry and brooding did. No one faulty thinking process stood out as accounting for more of the effect than the others when they were simultaneously tested.

Strengths

• Used established, validated measures of all constructs
• Good sample size compared to effect sizes
• Statistical analyses appropriate for non-normal data
• Simultaneously tested multiple mediators

Limitations

• The cross-sectional correlational design cannot confirm causal or temporal effects between variables. While theoretical frameworks and past research suggest the direction of effects, cognitive processes could also occur in response to obsessive thoughts.
• The reliance on nonclinical participants may limit generalizability to OCD populations. However, a sizable subgroup scored high on obsessing, supporting some clinical relevance.
• Further limitations include the use of short scales for some measures, self-reports only, and a predominance of female university students.

Clinical Implications

By illuminating mechanisms linking neuroticism to obsessing, findings can inform theoretical models of OCD development and targets for treatment.

Demonstrating thought suppression’s mediating role argues for its inclusion in hierarchical models alongside intolerance of uncertainty and anxiety sensitivity.

No one faulty thinking process stood out as accounting for more of the effect than the others when they were simultaneously tested.

This suggests assessing and targeting only one or two of these factors could underestimate their combined influence. It highlights the value of concurrently measuring all three mediators in future research.

The equivalent effects also indicate addressing thought suppression and brooding may be just as vital as tackling worry in therapy for OCD-related conditions in highly neurotic individuals.

References

Primary reference

Pfaltz, M. C., Mörstedt, B., Meyer, A. H., Wilhelm, F. H., Kossowsky, J., & Michael, T. (2015). Why can’t I stop thinking about it?: Cognitive mediators in the relationship between neuroticism and obsessing. Swiss Journal of Psychology, 74(2), 75-82.

Other References

Borkenau, P., & Ostendorf, F. (1993). NEO-Fünf-Faktoren Inventar (NEO-FFI) nach Costa und McCrae. Handanweisung [NEO Five-Factor Inventory (NEO-FFI) by Costa and McCrae: Manual]. Göttingen, Germany: Hogrefe.

Gönner, S., Leonhart, R., & Ecker, W. (2008). The Obsessive-Compulsive Inventory-Revised (OCI-R): Validation of the German version in a sample of patients with OCD, anxiety disorders, and depressive disorders. Journal of Anxiety Disorders, 22, 734–749. https://doi.org/10.1016/j.janxdis.2007.07.007

Nishimura, R., Hosoba, T., Ide, M., & Seiwa, H. (1998). The influence of obsessive-compulsive neurosis patients’ premorbid personality on obsessive-compulsive symptoms and efficacy of medication. Psychiatry and Clinical Neurosciences, 52, 303-309. https://doi.org/10.1046/j.1440-1819.1998.00393.x

Stöber, J. (1995). Besorgnis: Ein Vergleich dreier Inventare zur Erfassung allgemeiner Sorgen [Worrying: A comparison of three questionnaires concerning everyday worries]. Zeitschrift für Differentielle und Diagnostische Psychologie, 16, 50–63.

Treynor, W., Gonzalez, R., & Nolen-Hoeksema, S. (2003). Rumination reconsidered: A psychometric analysis. Cognitive Therapy and Research, 27, 247–259. https://doi.org/10.1023/A%3A1023910315561

Taylor, S. (1998). The hierarchic structure of fears. Behavior Research and Therapy, 36, 205-214. https://doi.org/10.1016/S0005-7967(98)00012-6

Yorulmaz, O., Gençöz, T., & Woody, S. (2010). Vulnerability factors in OCD symptoms: Cross-cultural comparisons between Turkish and Canadian samples. Clinical Psychology and Psychotherapy, 17, 110-112. https://doi.org/10.1002/cpp.642

Keep Learning

Here are some suggested Socratic discussion questions about this paper:

1. How might we design a study to establish the temporal order between the variables studied here? What would the limitations of such a design be?
2. Can we make causal claims from this mediational model testing? Why or why not? How might we strengthen the causal inferences?
3. What role might genetic or environmental factors play in the development of neuroticism and its relationships to cognitive processes and obsessive thinking? How could we test the relative contributions of nature and nurture?
4. If we could identify and intervene with people high in neuroticism early on, what treatment approaches might prevent later disordered thinking based on these findings? What would be the challenges of such preventative efforts?
5. How could the cognitive processes studied here develop into habitual, trait-like patterns for some people but not others? What might explain these individual differences?
6. Besides OCD, what other mental health conditions should be investigated regarding the potential mediating effects of thought suppression, worry, and brooding?