Experimental priming of feared self-perceptions increases obsessive-compulsive symptoms in a clinical OCD sample

Fear of self is a construct that has received an increasing amount of attention in recent years, which could add to our understanding of obsessive-compulsive disorder (OCD) and its treatment. However, no study has yet experimentally tested the role of feared self-perceptions in a clinical OCD sample. This study aims to test experimentally if priming specific fear of self-perceptions in OCD patients results in an increase in OCD symptoms and related distress. To this end, patients (n = 16) with a primary diagnosis of OCD completed a subtle priming task manipulation intended to prime personally relevant fear of self cognitions, as well as a control task during which a neutral theme was primed. Results showed that priming fear of self cognitions in OCD patients significantly increased strength of obsessions, urge to perform compulsions and anxiety levels, supporting a causal link between feared self-perceptions and obsessive-compulsive symptomatology. Clinical implications and key future directions are discussed. •Cognitive models have insufficiently addressed the role of the self.•Priming fear of self-perceptions immediately increased OC symptoms/distress.•A fear of self may apply to wide range of symptom domains.•Feared self-perceptions should be addressed in psychotherapy.