Distinguishing features of intrusive images in obsessive–compulsive disorder

Intrusive imagery is considered to be an important feature in obsessive–compulsive disorder (OCD). The aim of the present study was to investigate whether this imagery has distinctive features relative to other anxiety disorders. Twenty out of twenty-one (95%) individuals with OCD and twenty out of twenty-two (90%) anxious controls reported intrusive images. The groups were compared on the prevalence, number, frequency, characteristics and content of the images, together with associated beliefs, interpretations, and memories of earlier adverse events. Intrusive images in OCD were distinguished from those in other anxiety disorders by their greater frequency, more frequent adoption of a field perspective, and lesser degree of association with memories. Their content more often contained themes of ‘unacceptable ideas of harm’, and implied a ‘dangerous self’. These findings have implications for the use of therapeutic interventions in OCD and suggest that imagery rescripting may have a useful role to play.