Cultural Issues in Understanding Obsessive-compulsive Disorder: Nature, Appraisals, and Control Strategies of Unwanted Intrusive Thoughts in Iranian Nonclinical Population

Recent developments in cognitive models of obsessive-compulsive disorder posits that nearly everyone experiences unwanted intrusive thoughts, images, and impulses from time to time. The intrusions are not particularly a problematic issue; it is more probably an interpretation or attempts to control in maladaptive or unrealistic ways. So, the present article aimed to assess the nature, prevalence, appraisal, and control strategies of intrusions in the Iranian population. 

We employed the international intrusive thoughts interview schedule in a sample of Iranian university students (n=50) selected by the convenient sampling method. 

Nearly all participants (100%) reported experiencing at least one type of unwanted intrusive thoughts during the previous three months. The highest prevalence of Unwanted Intrusive Thoughts (UITs) belonged to the doubt category, and a large proportion of other UITs were also detected. However, the lowest prevalence of UITs was observed in the sexual and victim categories, respectively. In all of the UIT categories, support for the importance of removing and frequency had the highest mean levels. The highest mean level of endorsement for frequency was for the doubt category. Victim category had the highest mean level for the importance of removing and mean levels of interference/distress, and difficulty removing were higher in the contamination category. Participants endorsed intolerance of anxiety, uncertainty, and responsibility more as a reason that they noticed the thought. Participants were more likely to use thought replacement, distraction, self-reassurance, and avoidance as thought control strategies. The results are discussed in terms of Iranian culture. 

Unwanted intrusive thoughts are reported by the majority of individuals in all countries, and significant cross-cultural differences, which are apparent in primary intrusive thought content, appraisals, and control strategies, are specifically related to obsessive-compulsive symptoms distress.