Behavioural and Cognitive Psychotherapy

Brief Clinical Reports

Pathways to Inflated Responsibility Beliefs in Adolescent Obsessive-Compulsive Disorder: A Preliminary Investigation

Peter J. Lawrencea1 c1 and Tim I. Williamsa2

a1 University of Oxford, UK

a2 University of Reading, UK


Background: An inflated sense of responsibility is characteristic of obsessive-compulsive disorder (OCD). No previous studies have investigated its origins. Five potential pathways to inflated responsibility beliefs have been proposed; these are tested in this study. Method: A novel measure, the Origins Questionnaire for Adolescents (OQA), was developed to assess experiences on these five pathways. Reliability of the OQA was investigated. The experiences on the five pathways to inflated responsibility beliefs of 16 adolescents with a history of OCD were compared to 16 adolescents with no history of OCD. Parents also reported on adolescents' experiences on the five pathways. Results: Test-retest reliability was high. The internal consistency of the subscales was only partly satisfactory. The groups differed on one pathway; the clinical group reported a higher sense of responsibility for significant incidents with a negative outcome prior to onset of OCD. Conclusions: An inflated sense of responsibility, in combination with the occurrence of specific incidents, might act as a vulnerability factor for development of OCD. Future research should consider how to measure the subtle effects of experiences of responsibility over the course of development.

(Online publication November 23 2010)


c1 Reprint requests to Peter Lawrence, Clinical Psychologist, Department of Psychiatry, University of Oxford Warneford Hospital, Oxford OX3 7JX, UK. E-mail:


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