Obsessions, compulsions, motivation, and responsibility for harm

In a critique of current cognitive approaches to obsessional problems, R. O'Kearney (see record 1998-11660-007) suggested that there are significant problems with the theory and proposed an alternative conceptualization. He believes cognitive theories of obsessive-compulsive disorder (1) to be silent on motivational components specific to the disorder, (2) to not adequately explain why people are upset by their negative evaluation of intrusive thoughts, (3) to not provide an adequate account of the compulsive and repetitive quality of obsessional symptoms, and (4) to disregard the emotional concerns of the sufferer as influential factors in the etiology and maintenance of the disorder. The authors argue that O'Kearney's critique is mistaken as all of these issues are addressed by current cognitive theorizing. Specifically, (1) motivation is a central and crucial aspect of cognitive theories of anxiety disorders, (2) the link between responsibility beliefs concerning subjectively crucial negative events and distress is understandable, (3) compulsiveness and repetitiveness are readily accounted for by the cognitive theory, and (4) the cognitive theory regards the emotional concerns of the sufferer as central issues in both the etiology and maintenance of obsessional problems.