According to the cognitive-behavioral model of obsessive-compulsive disorder, which of the following evaluations is most likely to cause intrusive thoughts to evolve into obsessions?

Question

BlackTom AI · Accepted Answer

Inflated responsibility and thought–action fusion are central: when an individual evaluates an intrusive thought as something they must completely control to prevent harm, that appraisal transforms a harmless intrusive thought into a persistent obsession.

1. Relevant knowledge points and concepts
- Intrusive thoughts are common, unwanted mental events; obsessions are intrusive thoughts appraised as significant, dangerous, or personally meaningful.
- Cognitive-behavioral models (e.g., Salkovskis, Rachman) emphasize maladaptive appraisals: inflated responsibility, overestimation of threat, and thought–action fusion (believing thinking equals doing).
- Safety behaviors and thought suppression temporarily reduce anxiety but reinforce the appraisal and increase frequency/intensity (negative reinforcement and paradoxical rebound).

2. Step-by-step reasoning process
- Step 1: An intrusive thought arises (e.g., “What if I hurt someone?”).
- Step 2: Appraisal: the person interprets the thought as indicating real risk or moral failing and believes they must exert complete control to prevent harm.
- Step 3: Emotional response: anxiety, guilt, and responsibility increase because the thought is judged highly significant.
- Step 4: Behavioral response: attempts to neutralize or suppress the thought (compulsions, reassurance seeking) are performed.
- Step 5: Reinforcement: suppression/compulsions reduce anxiety short-term, reinforcing both the behavior and the dangerous appraisal, making the intrusive thought recurrent and more intrusive—thus evolving into an obsession.

3. Illustration of intermediate steps
- Intrusive thought → appraisal of necessity to control → anxiety → suppression/compulsion → short-term relief → strengthened belief that control is required → more intrusive thoughts.

4. Why the correct answer is correct
- Evaluating thoughts as requiring complete control reflects inflated responsibility and thought–action fusion; this appraisal increases distress and motivates neutralizing behaviors that maintain and intensify obsessions per cognitive-behavioral theory.

5. Why other options are incorrect
- Considering thoughts irrelevant or fleeting, or dismissing them as normal, are adaptive appraisals that reduce anxiety and prevent obsessions; they do not promote neutralization or reinforcement that would escalate intrusive thoughts.

Conclusion: Therefore, the correct choice is “Evaluating the thoughts as requiring complete control to prevent harm,” which matches the provided answer.

According to the cognitive-behavioral model of obsessive-compulsive disorder, which of the following evaluations is most likely to cause intrusive thoughts to evolve into obsessions?单项选择题

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