The Cognitive Architecture of Obsessional Doubt: Inferential Confusion and Feared Selves in OCD‐Relevant Intrusions
Bibliographic record
Abstract
Although previous research has examined the individual roles of unwanted intrusive thoughts (UITs), inferential confusion and feared selves in obsessive-compulsive disorder (OCD), no study to date has evaluated their combined effects on OCD severity. This is particularly relevant given that the inference-based approach (IBA) posits a close link between inferential confusion and feared selves in the context of obsessional doubt. The present study with a cross-sectional design investigated the role of inferential confusion and feared selves in mediating the relationship between OCD-relevant UITs and OCD severity. A clinical sample of 306 individuals with a primary diagnosis of OCD (mean age = 32.95, SD = 9.99, female = 58.8%) who also had some comorbid psychiatric disorders, with the exception of a current or previous history of personality disorders, psychotic disorders and substance use disorders, completed a battery of self-reported measures-including the Questionnaire of Unpleasant Intrusive Thoughts, Fear of Self Questionnaire-Multidimensional Version, Patient Health Questionnaire and Expanded Version of the Inference Confusion Questionnaire)-as well as the clinician-administered version of the Yale-Brown Obsessive-Compulsive Scale. Bootstrapped mediation analyses (5000 resamples, 95% confidence interval) revealed that UITs were indirectly associated with OCD severity via inferential confusion and one specific dimension of feared selves: the feared corrupted self. Mediation was not supported for the feared culpable or malformed selves in this model. However, a serial mediation pathway emerged wherein inferential confusion and both feared corrupted and culpable selves sequentially mediated the link between UITs and clinician-rated OCD severity. The findings suggest that inferential confusion, along with specific feared self domains, plays a critical role in differentiating intrusive thoughts that are common in the general population from obsessional doubt, as conceptualised in the IBA. Within the inference-based framework, these processes do not merely escalate UITs; rather, they actively produce obsessional doubts that disconnect the individual from reality and render the imagined threat personally meaningful, persistent and in need of resolution.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".