The incongruence model of OCD symptomatology : the relevance of superstitiousness and stress reactions from an evolutionary perspective

Abstract

An array of theoretical formulations has long been advanced in the literature in bids to elucidate obsessive compulsive disorder (OCD), a disabling mental condition that has profound adverse consequences on the personal, familial, and societal fronts. However, while many of these theories have been successful in explicating, to varying degrees, the processes underlying the maintenance of OCD symptoms, none has yet been capable of presenting a persuasive and empirically-validated account of why OCD came about in the first place (which would be crucial for preventative efforts). In view of these, the thesis sought to propound a novel evolutionary formulation which highlighted the important roles of prehistorically-adaptive coping strategies (e.g. superstitiousness and certain stressor-reactions) with regards to the origin of OCD as a result of the mismatch between the prehistoric world and the modern environment (termed the incongruence model); and to subject it to a series of examinations. Correspondingly, a meta-analysis of every published study investigating the superstition-OCD relationship from the year 1990 (inclusive) to the year 2012 (inclusive) was first conducted; with the resultant findings suggesting that OCD was indeed intricately linked to superstitiousness. In addition, a cross-sectional research design employed in Study 1 to appraise the influence of proposed stressor-reactions and superstitions on subsequent OCD symptoms has suggested that the condition was a consequence of superstitious coping by individuals who have typically reacted to uncertain stressors with intolerance and avoidance. Study 2 then proceeded to delve into the incongruence model's contrastive notion pertaining to the adaptiveness of these OCD-associated coping strategies (e.g. avoidance and superstitions) by means of mediation and moderation analyses. The findings suggested a lower risk of work distress, subsequent sleep disturbances and poor subjective health among avoidance-inclined persons who have engaged in considerable amount of superstitions as compared to their counterparts. Further, the model's proposition that the nature of a person's superstitiousness was instrumental in clarifying the conflicting outcomes of superstitious coping, was tested in Study 3 by means of a moderated mediation paradigm. The findings suggested that infrequent engagement of superstitions across fewer life domains (but not perceived acceptance of superstitiousness) among superstitious individuals would potentially be detrimental to well-being (e.g. more OCD symptoms, greater number of health ailments, and fewer off-springs); vice versa. Overall, results from this program of research have provided appreciable, albeit preliminary, endorsement for the incongruence model's account in relation to the origin of OCD. Such findings have potentially huge relevance for OCD risk-reduction efforts, which are conceivably more beneficial than post-affliction treatments. Complementarily, these results have also afforded the stress-coping literature with an explanation concerning the origin of humans' differing reactions to stressors; and have also contributed an evidence-based interpretation of the contradictory findings in the superstition literature. Show more