Psychological flexibility and inflexibility in obsessive-compulsive symptom dimensions, disability, and quality of life: An online longitudinal study

Early intervention in obsessive-compulsive disorder has recently gained traction. However, to address obsessive-compulsive (OC) symptoms before they progress to clinical levels, it is important to investigate potential processes involved in driving OC symptoms, as well as the processes driving the lower quality of life, impairments in functioning, and increased comorbidities that are already present in the subthreshold phase of the disorder. This study aimed to investigate the role of 12 psychological flexibility and inflexibility processes in predicting quality of life, disability, and OC symptoms over six months while controlling for psychological distress. An online community sample of 766 individuals from Amazon Mechanical Turk was evaluated at baseline and again at 6-month follow-up with a survey battery assessing OC symptom dimensions, psychological in/flexibility processes, psychological distress, and sociodemographic information. Results revealed that greater self-as-content was associated with more severe mental contamination and unacceptable thoughts at baseline. No other psychological inflexibility processes were associated with OC symptom severity or disability cross-sectionally or longitudinally. The study did not provide support for psychological flexibility processes being associated with quality of life at any time point. These findings suggest that self-as-content may be related to OC symptom severity, and potentially more so than other inflexibility processes. With this knowledge, self-as-content requires more research attention in relation to OC symptoms, as well as research on processes that have the potential to improve important non-psychiatric outcomes.