Imagery in mental contamination: A questionnaire study

•Intrusive imagery can evoke feelings of dirtiness and trigger washing behaviour in people with a fear of contamination and OCD.•Some people with contamination fears may use imagery as a form of ‘mental cleansing’.•Further research is needed to explore the role of imagery in the maintenance of contamination fears and OCD.•This study requires replication with a large OCD sample and comparison with an anxious control group.

ObjectivesIntrusive imagery is hypothesised to evoke feelings of contamination and urges to wash. This study aimed to (1) develop a questionnaire to assess imagery associated with contamination fears; and (2) compare contamination imagery in a sample of people with contamination based obsessive–compulsive disorder (C-OCD) with a non-clinical student sample.MethodsNon-clinical students (n=45) and people with C-OCD and contamination fears (n=45) completed a self-report questionnaire designed to assess images associated with contamination.ResultsCompared to non-clinical participants, people with C-OCD reported images associated with contamination that were more vivid, harder to dismiss and distressing. Participants with contamination fears reported images that directly evoked feelings of dirtiness and triggered compulsive washing behaviours. A small number of participants reported beneficial images that reduced feelings of contamination.ConclusionsThese preliminary findings indicate that imagery can evoke feelings of contamination. However, future research is needed to establish the nature and causative role of imagery in mental contamination. Questionnaire methods may be useful for clinical assessment of imagery associated with contamination fears.