The Relationship Between Attachment Insecurity and OCD Symptom Severity: The Mediating Role of Fear of Compassion
Bibliographic record
Abstract
Obsessive-compulsive disorder (OCD) is characterized by distressing intrusive thoughts and compulsions implemented to neutralize the thoughts or mitigate potential harm. Attachment focused approaches to conceptualizing OCD are becoming more common, owing to the relationship between insecure attachment and OCD. However, the mechanism responsible for this relationship is unclear. Negative attachment experiences predict increased anxiety and fear of compassion (FOC) which can impede the expression and acceptance of affiliative emotions. FOC also mediates the relationship between attachment insecurity and emotional distress. Thus, we hypothesized that FOC may play a similar mediating role in the relationship between attachment insecurity and OCD. Two online survey studies were pre-registered and completed by undergraduate students. Study one (N=329) revealed that fear of self-compassion mediates the relationship between attachment anxiety and OCD symptom severity and that fear of receiving compassion mediates the relationship between attachment avoidance and OCD symptom severity. Contrary to our hypothesis, fear of expressing compassion was not a significant mediator. Study two (N=340) aimed to replicate and extend these findings in a new sample, while also controlling for depression. Consistent with our hypotheses, the results replicated. FOC is often related to beliefs that compassion will result in complacency. People with OCD may worry about becoming complacent in compulsions, which could ultimately result in being held responsible for harm. Our results suggest that FOC may be an important consideration when treating OCD, particularly among those with insecure attachment styles. Although cognitive-behavioural therapy (CBT) is the gold standard treatment for OCD, the efficacy is only about 50 percent. As such, research exploring adjunct treatment options and ways to incorporate attachment and compassion-focused approaches into case formulation is warranted.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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".