Unwanted intrusive thoughts: Cultural, contextual, covariational, and characterological determinants of diversity

•Review of cultural, context, affect and personality effects on intrusive thoughts.•Culture influences intrusive thought content.•Dysfunctional importance and control beliefs contribute to intrusion vulnerability.•Self-worth discrepancies may prime incongruent intrusions.

Cognitive behavioral theories trace the origins of clinical obsessions to common unwanted intrusive thoughts, images or impulses that are universally experienced in the general population. It is the erroneous interpretation of the intrusion as a personally significant threat that must be diminished or neutralized that result in the vicious escalation into a clinical obsession. This paper reviews four critical determinants of individuals׳ diverse experience of unwanted intrusive thoughts (UITs). First we consider the role that culture may play in the types of thoughts that become intrusive, repetitive and persistent. Next the role of context is considered and the differences found between UITs and obsessions that are externally precipitated versus those that are more autonomous. A third section considers the role of current clinical state and whether there is a specific relation between certain types of intrusions and obsessional states in particular. The final section examines the role of personality, enduring dysfunctional beliefs and self-view discrepancies as potential vulnerability factors for UITs and obsessions. The paper concludes with a summary of current status and future directions for research on UITs.