![]() Some researchers have directly compared patients with OCD and patients with other anxiety disorders on TAF scores. In that study, subjects with partial/full GAD also scored higher on likelihood TAF than subjects without partial/full GAD. Significant associations between measures of worry and likelihood TAF have been found in an undergraduate sample ( Hazlett-Stevens, Zucker, & Craske, 2002). Patients with generalized anxiety disorder (GAD) have been shown to hold beliefs that their worries can influence events in the world ( Borkovec, Hazlet-Stevens, & Diaz, 1999). There is reason to believe that TAF may also play a role in non-OCD pathology. Overall, few of these studies have considered possible higher-order factors that may account for (some of) the elevations in TAF scores and their relationship to OCD symptomatology. In general, moral TAF has not been found to be reliably related to OCD symptoms, though it has been found to be related to depression ( Abramowitz et al., 2003 Shafran and Rachman, 2004). ![]() A study specifically aimed at determining whether all OCD patients have high levels of “dysfunctional OC beliefs” such as inflated responsibility and TAF found that OCD patients could be divided into a “low OC-beliefs” group and a “high OC-beliefs” group, indicating that these beliefs are not necessarily critical to OCD per se ( Taylor et al., 2006). Some researchers have found that after controlling for depression, TAF is no longer significantly correlated with OCD symptoms ( Jonsson et al., 2011 O'Leary et al., 2009). However, other studies have produced conflicting results. Indeed, several studies have found a relationship between TAF (particularly likelihood TAF) and OCD symptom level ( Amir, Freshman, Ramsey, Neary, & Brigidi, 2001 Rassin, Diepstraten, Merckelbach, & Muris, 2001 Shafran, Thordarson, & Rachman, 1996). TAF has also been assessed in adolescents and children ( Barrett & Healy, 2003 Muris et al., 2001).īecause TAF was first discussed in the context of OCD patients, and because it has been so central to one of the most prominent theories of OCD ( Rachman, 1997 1998), many have assumed that TAF had a unique association with obsessional symptoms. However, an assessment of test-retest reliability was somewhat disappointing, with 3-month correlations between scores of 0.52 and a substantial decrease in scores indicating levels of TAF over time ( Rassin et al., 2001). The scale has been found to have good predictive validity for patients selected to be high in TAF ( Rachman et al., 1996), and good internal consistency ( Shafran et al., 1996). ![]() Most studies have found moderate correlations between the moral and likelihood subscales ( Shafran & Rachman, 2004). In a student sample, a three-factor solution (moral, likelihood-self, and likelihood-other) was optimal ( Shafran et al., 1996). In clinical samples, a two-factor solution (likelihood and moral) has been supported, with the two factors together accounting for up to 71% of the variance ( Shafran et al., 1996 Rassin et al., 2001b). The scale consists of 12 items measuring moral TAF and 7 items measuring likelihood TAF. The Thought-Action Fusion Scale (TAFS Shafran, Thordarson, & Rachman, 1996) has been the measure that is most widely used in the study of TAF. In addition to likelihood TAF, there is “Moral TAF,” which is the belief that thinking about an action or behavior is morally equivalent to actually performing that behavior (“Thinking about hitting my girlfriend is as morally wrong as actually hitting her”). This has been further broken down into “likelihood-self TAF” (“If I think about getting into a car accident, it makes it more likely that I will get into a car accident”) and “likelihood-other TAF” (“If I think about my brother getting into a car accident, it makes it more likely that he will get into a car accident”). “Likelihood TAF” is the belief that simply having a thought about an event makes that event more likely to occur. TAF is currently considered one of several misinterpretations of thought that may underlie OCD, but it is not necessarily a factor for all OCD patients, nor is it sufficient alone to account for OCD symptoms ( Obsessive Compulsive Cognitions Working Group, OCCWG, 1997). Rachman's model (1997, 1998) proposes that attributions of significance are critical in transforming normal intrusive thoughts into obsession. Cognitive processes such as TAF are thought to form an intermediate step between the occurrence of an intrusive obsessional thought and the performance of a compulsion, because they represent underlying beliefs about the meaning or effect of obsessions. Thought-action fusion (TAF) is a cognitive variable that has been heavily researched in the past 10 or 15 years, particularly in relation to obsessive-compulsive disorder (OCD).
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