Cognitive Fusion, Experiential Avoidance, and Obsessive Beliefs as Predictors of Obsessive-Compulsive Symptom Dimensions

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Preliminary Psychometric Properties of the Acceptance and Action Questionnaire–II: A Revised Measure of Psychological Inflexibility and Experiential Avoidance

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Psychometric validation of the obsessive belief questionnaire and interpretation of intrusions inventory—Part 2: Factor analyses and testing of a brief version

Obsessive Compulsive Cognitions Working Group (2005) · Behaviour Research and Therapy · doi:10.1016/j.brat.2004.07.010 · Cited by 880 · see citing works

Assessment of obsessive–compulsive symptom dimensions: development and evaluation of the Dimensional Obsessive–Compulsive Scale

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The development and initial validation of the cognitive fusion questionnaire

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A critical evaluation of obsessive–compulsive disorder subtypes: Symptoms versus mechanisms

McKay, D., Abramowitz, J. S., Calamari, J. E., Kyrios, M., Radomsky, A. S., Sookman, D., Taylor, S. J., & Wilhelm, S. (2004) · Clinical Psychology Review · doi:10.1016/j.cpr.2004.04.003 · Cited by 642 · see citing works

A cognitive theory of compulsive checking.

Rachman, S. (2002) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(01)00028-6 · Cited by 487 · see citing works

Fear of contamination

Rachman, S. (2004) · Behaviour Research and Therapy · doi:10.1016/j.brat.2003.10.009 · Cited by 461 · see citing works

Toward a definition of intolerance of uncertainty: A review of factor analytical studies of the Intolerance of Uncertainty Scale

Birrell, J., Meares, K., Wilkinson, A., & Freeston, M. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2011.07.009 · Cited by 459 · see citing works

A randomized clinical trial of acceptance and commitment therapy versus progressive relaxation training for obsessive-compulsive disorder

Twohig, M. P., Hayes, S. C., Plumb, J. C., Pruitt, L. D., Collins, A. B., Hazlett-Stevens, H., & Woidneck, M. R. (2010) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0020508 · Cited by 434 · see citing works

“Not just right experiences”: perfectionism, obsessive–compulsive features and general psychopathology

Coles, M. E., Frost, R. O., Heimberg, R. G., & Rhéaume, J. (2003) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(02)00044-x · Cited by 418 · see citing works

The relevance of analogue studies for understanding obsessions and compulsions

Abramowitz, J. S., Fabricant, L. E., Taylor, S. J., Deacon, B. J., McKay, D., & Storch, E. A. (2014) · Clinical Psychology Review · doi:10.1016/j.cpr.2014.01.004 · Cited by 380 · see citing works

Understanding and treating incompleteness in obsessive‐compulsive disorder

Summerfeldt, L. J. (2004) · Journal of Clinical Psychology · doi:10.1002/jclp.20080 · Cited by 288 · see citing works

Specificity of disgust sensitivity in the prediction of behavioral avoidance in contamination fear

Deacon, B. J., & Olatunji, B. O. (2007) · Behaviour Research and Therapy · doi:10.1016/j.brat.2007.03.008 · Cited by 237 · see citing works

Disgust domains in the prediction of contamination fear

Olatunji, B. O., Sawchuk, C. N., Lohr, J. M., & de Jong, P. J. (2003) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(03)00102-5 · Cited by 235 · see citing works

The role of cognitive factors in the pathogenesis of obsessive–compulsive symptoms: A prospective study

Abramowitz, J. S., Khandker, M., Nelson, C. A., Deacon, B. J., & Rygwall, R. (2006) · Behaviour Research and Therapy · doi:10.1016/j.brat.2005.09.011 · Cited by 223 · see citing works

Thought-action fusion: a review

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Do dysfunctional beliefs play a role in all types of obsessive–compulsive disorder?

Taylor, S. J., Abramowitz, J. S., McKay, D., Calamari, J. E., Sookman, D., Kyrios, M., Wilhelm, S., & Carmin, C. N. (2005) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2004.11.005 · Cited by 206 · see citing works

The relationship between obsessive beliefs and symptom dimensions in obsessive–compulsive disorder

Wheaton, M. G., Abramowitz, J. S., Berman, N. C., Riemann, B. C., & Hale, L. R. (2010) · Behaviour Research and Therapy · doi:10.1016/j.brat.2010.05.027 · Cited by 188 · see citing works

Assessing obsessive compulsive symptoms and cognitions on the internet: Evidence for the comparability of paper and Internet administration

Coles, M. E., Cook, L. M., & Blake, T. R. (2007) · Behaviour Research and Therapy · doi:10.1016/j.brat.2006.12.009 · Cited by 171 · see citing works

The latent structure of obsessive-compulsive symptoms: a taxometric study

Olatunji, B. O., Williams, B. J., Haslam, N., Abramowitz, J. S., & Tolin, D. F. (2007) · Depression and Anxiety · doi:10.1002/da.20387 · Cited by 155 · see citing works

Obsessive–compulsive symptoms: The contribution of obsessional beliefs and experiential avoidance

Abramowitz, J. S., Lackey, G. R., & Wheaton, M. G. (2009) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2008.06.003 · Cited by 130 · see citing works

Exposure therapy for OCD from an acceptance and commitment therapy (ACT) framework

Twohig, M. P., Abramowitz, J. S., Bluett, E. J., Fabricant, L. E., Jacoby, R. J., Morrison, K. L., Reuman, L., & Smith, B. M. (2015) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2014.12.007 · Cited by 103 · see citing works

Subtyping obsessive-compulsive disorder: A taxometric analysis

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An initial examination of emotion regulation and obsessive compulsive symptoms

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The Effect of Physical Cleaning on Threatened Morality in Individuals With Obsessive-Compulsive Disorder

Reuven, O., Liberman, N., & Dar, R. (2013) · Clinical Psychological Science · doi:10.1177/2167702613485565 · Cited by 62 · see citing works

The impact of experiential avoidance and obsessive beliefs on obsessive–compulsive symptoms in a severe clinical sample

Manos, R. C., Cahill, S. P., Wetterneck, C. T., Conelea, C. A., Ross, A. R., & Riemann, B. C. (2010) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2010.05.001 · Cited by 55 · see citing works

An Evaluation of Obsessive Beliefs as Predictors of Performance on In Vivo Assessments of Obsessive–Compulsive Symptoms

Fitch, K. E., & Cougle, J. R. (2012) · Cognitive Therapy and Research · doi:10.1007/s10608-012-9457-4 · Cited by 30 · see citing works

Obsessive beliefs, experiential avoidance, and cognitive fusion as predictors of obsessive-compulsive disorder symptom dimensions

Reuman, L., Buchholz, J. L., & Abramowitz, J. S. (2018) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2018.06.001 · Cited by 49 · see citing works

Experiential avoidance in the context of obsessions: Development and validation of the Acceptance and Action Questionnaire for Obsessions and Compulsions

Jacoby, R. J., Abramowitz, J. S., Buchholz, J. L., Reuman, L., & Blakey, S. M. (2018) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2018.07.003 · Cited by 43 · see citing works

Concurrent effects of different psychological processes in the prediction of depressive symptoms – the role of cognitive fusion

Pinto‐Gouveia, J., Dinis, A., Gregório, S., & Pinto, A. M. (2018) · Current Psychology · doi:10.1007/s12144-017-9767-5 · Cited by 38 · see citing works

Relationship Between Cognitive Fusion, Experiential Avoidance, and Obsessive–Compulsive Symptoms in Patients With Obsessive–Compulsive Disorder

Ai, X., Lai, X., Wu, S., Yuan, X., Tang, J., Chen, J., Liu, Y., & Hu, M. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.655154 · Cited by 29 · see citing works

Mental contamination: Relationship with psychopathology and transdiagnostic processes

Coughtrey, A. E., Shafran, R., Bennett, S. D., Kothari, R., & Wade, T. D. (2017) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2017.08.009 · Cited by 27 · see citing works

Uncertain and Fused: Cognitive Fusion, Thought-Action Fusion, and the Intolerance of Uncertainty as Predictors of Obsessive-Compulsive Symptom Dimensions

Reuman, L., Buchholz, J. L., Blakey, S. M., & Abramowitz, J. S. (2017) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.31.3.191 · Cited by 26 · see citing works

The moderating role of experiential avoidance on the relationship between cognitive fusion and psychological distress among Iranian students

Hekmati, I., Abdollahpour Ranjbar, H., Eskin, M., Drake, C. E., & Jobson, L. (2023) · Current Psychology · doi:10.1007/s12144-021-01539-4 · Cited by 22 · see citing works

A randomized controlled trial of group-based acceptance and commitment therapy for obsessive-compulsive disorder

Lee, S. W., Choi, M., & Lee, S. J. (2022) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2022.11.009 · Cited by 22 · see citing works

Insomnia and obsessive-compulsive symptom dimensions: The mediating role of anxiety and depression

Hellberg, S. N., Buchholz, J. L., & Abramowitz, J. S. (2019) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2019.100482 · Cited by 17 · see citing works

Not just thinking, but believing: Obsessive beliefs and domains of cognitive fusion in the prediction of OCD symptom dimensions

Hellberg, S. N., Buchholz, J. L., Twohig, M. P., & Abramowitz, J. S. (2019) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2409 · Cited by 15 · see citing works

Childhood emotional maltreatment, maladaptive coping and obsessive–compulsive symptoms in patients with obsessive–compulsive disorder

Kadivari, F., Najafi, M., & Khosravani, V. (2023) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2829 · Cited by 16 · see citing works

Experiential avoidance and the misinterpretation of intrusions as prospective predictors of postpartum obsessive-compulsive symptoms in first-time parents

Ojalehto, H. J., Hellberg, S. N., Butcher, M. W., Buchholz, J. L., Timpano, K. R., & Abramowitz, J. S. (2021) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2021.04.003 · Cited by 13 · see citing works

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

Thompson, E. M., Brierley, M., Destrée, L., Albertella, L., & Fontenelle, L. F. (2021) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2021.11.004 · Cited by 16 · see citing works

Relationship Between Experiential Avoidance and Cognitive Fusion to Social Interaction Anxiety in Students

Soltani, E., Hosseini, Z., & Naghizadeh, P. (2018) · Shiraz E-Medical Journal · doi:10.5812/semj.62496 · Cited by 11 · see citing works

Obsessive-compulsive symptom profiles vary by index trauma type in a trauma-exposed community sample

Ojalehto, H. J., Pinciotti, C. M., Hellberg, S. N., Myers, N. S., DuBois, C. M., Rodriguez, C. S., & Abramowitz, J. S. (2023) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2023.100827 · Cited by 8 · see citing works

Contrast avoidance as a diagnostic feature of OCD: A receiver-operator characteristic curve analysis of the contrast avoidance questionnaires

Swisher, V. S., & Newman, M. G. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.09.117 · Cited by 8 · see citing works

Childhood adversity affects symptomatology via behavioral inhibition in patients with obsessive-compulsive disorder

Kadivari, F., Najafi, M., & Khosravani, V. (2022) · Current Psychology · doi:10.1007/s12144-022-02718-7 · Cited by 9 · see citing works

Psychological Inflexibility, Cognitive Fusion, and Thought–Action Fusion as a Transdiagnostic Construct: Direct Comparisons Among Major Depressive Disorder, Obsessive–Compulsive Disorder, and Healthy Controls

Lee, S. W., Lee, S. J., & Choi, M. (2025) · Psychiatry Investigation · doi:10.30773/pi.2024.0209 · Cited by 9 · see citing works

Dual Frameworks for Understanding OCD: Cognitive Misappraisals and Psychological Inflexibility in Clinical and Non‐Clinical Populations

Soumee, Z. N., Rasouli, A., Krafft, J., & Mousavi, S. E. (2025) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.70065 · Cited by 5 · see citing works

The interactive effect of mental contamination and cognitive fusion on anxiety

Clauss, K. E., & Bardeen, J. R. (2021) · Journal of Clinical Psychology · doi:10.1002/jclp.23224 · Cited by 5 · see citing works

Stuck in my head: Musical obsessions and experiential avoidance

Reuman, L., Buchholz, J. L., & Abramowitz, J. S. (2020) · Bulletin of the Menninger Clinic · doi:10.1521/bumc.2020.84.suppa.48 · Cited by 3 · see citing works

Sexual Orientation Intrusive Thoughts and Well-Being: The Mediating Role of Psychological Inflexibility

Petersen, J. M., & Twohig, M. P. (2023) · Journal of Cognitive Psychotherapy · doi:10.1891/jcp-2021-0005 · Cited by 3 · see citing works

La influencia de la evitación experiencial y la fusión cognitiva en personas con diagnóstico de trastorno de pánico y agorafobia y TOC

Mellado-Pastor, S., Del-Río-Sánchez, C., & Morales, J. P. (2023) · APUNTES DE PSICOLOGÍA · doi:10.55414/ap.v41i2.1548 · Cited by 3 · see citing works

Using an Acceptance and Commitment Therapy Approach When Exposure and Cognitive Therapy Become Rituals in the Treatment of Obsessive-Compulsive Disorder

Buchholz, J. L., & Abramowitz, J. S. (2019) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.33.3.256 · Cited by 3 · see citing works

Socioeconomic status impacts Chinese late adolescents’ internalizing problems: risk role of psychological insecurity and cognitive fusion

Tao, Z., Wang, Z., Lan, Y., Zhang, W., & Qiu, B. (2025) · BMC Public Health · doi:10.1186/s12889-025-22628-0 · Cited by 3 · see citing works

Conceptual Understanding of Thought-Action Fusion and Cognitive Fusion : Focus on Obsessive-Compulsive Symptoms

Lee, S. W., Lee, K., 최미나, & Lee, S. J. (2019) · Anxiety and Mood · doi:10.24986/anxmod.2019.15.1.001 · Cited by 2 · see citing works

The relationship between symptom dimensions and cognitive features in obsessive compulsive disorder

Şahin, B., Şafak, Y., & Ozdel, K. (2022) · Current Psychology · doi:10.1007/s12144-021-02540-7 · Cited by 2 · see citing works

Personalized exposure and experience sampling method feedback versus exposure as usual for obsessive–compulsive disorder: a study protocol for a randomized controlled trial

Hoogerwerf, E., Greeven, A., Goekoop, R., & Spinhoven, P. (2024) · Trials · doi:10.1186/s13063-023-07780-5 · Cited by 1 · see citing works

Prefrontal dysfunction and neurotransmitter imbalances underlying cognitive fusion in first-episode drug-naïve obsessive-compulsive disorder

Suo, X., Zhang, Y., Li, X., Xu, Z., Zeng, L., Lei, L., Zhang, M., Luo, Z., Xia, L., Zeng, X., et al. (2025) · Behavioural Brain Research · doi:10.1016/j.bbr.2025.115962 · Cited by 1 · see citing works

Socioeconomic status impact Chinese youth’s internalizing problems: The risk role of psychological insecurity and cognitive fusionPreprint

Tao, Z., Wang, Z., Lan, Y., & Zhang, W. (2022) · Research Square · doi:10.21203/rs.3.rs-2267861/v1

Additional file 1 of Personalized exposure and experience sampling method feedback versus exposure as usual for obsessive–compulsive disorder: a study protocol for a randomized controlled trial

Hoogerwerf, E., Greeven, A., Goekoop, R., & Spinhoven, P. (2024) · Figshare · doi:10.6084/m9.figshare.24993705

Self-compassion and obsessive-compulsive disorder: A systematic review

Pandey, P., Ahmad, M., & Jha, S. (2026) · Industrial Psychiatry Journal · doi:10.4103/ipj.ipj_24_25

Momentary Obsessive Beliefs Exacerbate Obsessions but Fail to Sustain Them Over Time: An EMA Examination of the Cognitive Behavioral Model for Obsessive-Compulsive Disorder

Swisher, V. S., & Newman, M. G. (2026) · Behavior Therapy · doi:10.1016/j.beth.2026.06.004

Cognitive fusion-modulated structural covariance networks predict treatment response in drug-naive OCD: A multiscale neuroimaging-transcriptomic study

Suo, X., Yang, Z., Li, X., Liu, J., Xu, Z., Zeng, L., Lei, L., Zhang, M., Luo, Z., Min, Y., et al. (2026) · Psychological Medicine · doi:10.1017/s0033291726105583

Uncertain and Fused: Cognitive Fusion, Thought-Action Fusion, and the Intolerance of Uncertainty as Predictors of Obsessive-Compulsive Symptom Dimensions

Reuman, L., Buchholz, J. L., Blakey, S. M., & Abramowitz, J. S. (2017) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.31.3.191 · Cited by 26 · see citing works

Obsessive beliefs, experiential avoidance, and cognitive fusion as predictors of obsessive-compulsive disorder symptom dimensions

Reuman, L., Buchholz, J. L., & Abramowitz, J. S. (2018) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2018.06.001 · Cited by 49 · see citing works

Relationship Between Cognitive Fusion, Experiential Avoidance, and Obsessive–Compulsive Symptoms in Patients With Obsessive–Compulsive Disorder

Ai, X., Lai, X., Wu, S., Yuan, X., Tang, J., Chen, J., Liu, Y., & Hu, M. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.655154 · Cited by 29 · see citing works

Not just thinking, but believing: Obsessive beliefs and domains of cognitive fusion in the prediction of OCD symptom dimensions

Hellberg, S. N., Buchholz, J. L., Twohig, M. P., & Abramowitz, J. S. (2019) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2409 · Cited by 15 · see citing works

Thought-Action Fusion as Predictors of Obsessive-Compulsive Symptom Dimensions

Kim, J. E., & Lee, S. J. (2020) · Psychiatry Investigation · doi:10.30773/pi.2020.0292 · Cited by 7 · see citing works