It is Clean, but It Still Seems Dirty to Me: Implicit and Explicit Truth of Imagined Contamination As an Explanation of Ego-Dystonic Experience of Obsessions

Individuals suffering from obsessive-compulsive disorder often experience obsessions as ego-dystonic- knowing that a mental event does not reflect reality but acting as if it does. Imagination has been suggested as an important process involved in this mismatch about the actual truth value of obsessions. Imagining false events has been found to impact spontaneous truth evaluations (implicit truth value; ITV), even when people explicitly acknowledged the imagined event as false (explicit truth value; ETV; Shidlovski et al., 2014). The current study examined discrepancies between ITV and ETV along with effects of imagination and their relationship to obsessive-compulsive contamination symptoms. Sixty-two students, recruited across the range of contamination symptoms, participated in this study. First, a table, at which participants were seated, was cleaned in their presence. Next, in a double-categorization autobiographical implicit association test (aIAT), participants classified true or false autobiographical statements together with ‘clean’ or ‘contaminated’ statements regarding the table. Then, they imagined that the table was contaminated prior to the second aIAT administration. ETV was measured by classifying the statements explicitly as true or false. Imagination was associated with reduced ITV, this association did not depend on symptoms, contrary to our predictions. However, symptoms were associated with elevated ETV evaluations of the contaminated statements. Finally, ETV correlated with ITV only for low symptom participants. This correlation was no longer significant following the imagination induction. In conclusion, individuals with contamination symptoms may be more likely to overweigh their explicit evaluations in the presence of contradictory implicit evaluations, creating a discrepancy. This process may account for ego-dystonic experiences reported by OCD patients.