Does nonacceptance of emotions and the fear of guilt influence the association between trait guilt and obsessive-compulsive symptoms? A moderation analysis in a non-clinical sample

Objective
Although cognitive-behavioural theory suggests a link between guilt and obsessive-compulsive disorder (OCD), the evidence is mixed. Given that how we relate to our emotions can determine behavioural responses, it is possible that high fear of guilt and a nonacceptance of emotions might increase the effects of guilt on OCD, and therefore explain mixed findings in previous research.

Method
We investigated whether fear of guilt and nonacceptance of emotions moderated the association between trait guilt and obsessive-compulsive symptoms in a non-clinical online MTurk sample (n = 231) recruited from cloudresearch.com. Participants completed measures of OCD, trait guilt, fear of guilt, nonacceptance of emotions, depression, and anxiety.

Results
We found that fear of guilt and nonacceptance of emotions, but not trait guilt, significantly predicted obsessive-compulsive symptoms even after controlling for depression and anxiety. Nonacceptance of emotions moderated the relationship between trait guilt and obsessive-compulsive symptoms, however fear of guilt did not. Simple slopes analyses showed a significant positive association between trait guilt and obsessive-compulsive symptoms for individuals with high nonacceptance of emotions.

Conclusion
Results support findings that nonacceptance of emotions, and to a lesser extent fear of guilt, play important roles in subclinical OCD. Furthermore, they suggest that a stronger acceptance of emotions may be linked to more adaptive experiences of guilt and reductions in obsessive-compulsive behaviour.

KEY POINTS
What is already known about this topic:

(1) Cognitive models of OCD suggest that OCD is due to the misappraisal of intrusions that can result in an inflated sense of responsibility and guilt, which in turn drives the need to perform compulsions.

(2) However, research examining the association between guilt and OCD have shown mixed findings.

(3) The severity of obsessive compulsive symptoms is positively associated with the nonacceptance of emotions and the fear of guilt which may moderate the association between guilt and OCD.

What this topic adds:

(1) Our study provides further evidence of the role of nonacceptance of emotions in OCD.

(2) We found a positive association between guilt and OCD but only for people with high nonacceptance of emotions.

(3) The fear of guilt was also positively associated with OCD but did not interact with trait guilt.

© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

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