Abstract
Introduction. Mindful attention (MA) training is a brief computerized intervention that instructs participants to nonjudgmentally observe thoughts and sensations in lieu of reflexively reacting to them. Experimental studies have demonstrated that MA training decreases appetitive urges with regards to unhealthy eating and risky sexual behaviors. It remains unclear whether MA would have a similar effect on aversive urges, such as compulsive urges arising from intrusive thoughts. The current study investigated the effects of MA training on compulsive urges associated with two obsessive-compulsive symptom (OCS) dimensions, and examined the moderating roles of OCS severity and cognitive flexibility on urge-related clinical indicators. Method. Using a 2 (training condition: MA; Control) x 2 (OC stimulus condition: Harm; Contamination) factorial design, we examined the effects of MA training on responses to OCS-provoking tasks in an at-risk sample of young adults (N= 97). A picture viewing task and a behavioral task were designed to elicit intrusive thoughts associated with one of two OCS dimensions: either unacceptable thoughts/neutralizing or contamination/cleaning. Picture viewing task outcomes included perceived aversiveness of task stimuli and compulsive urges; behavioral task outcomes included distress, urge strength, and compulsive behaviors. Results. Contrary to hypotheses, MA training did not consistently produce more adaptive responses across the picture viewing or behavioral tasks compared to Control training. However, participants in the Harm condition reported lower distress, urge strength, and compulsive behaviors on the behavioral tasks compared to those in the Contamination condition. Specifically, the MA/Harm group reported significantly weaker compulsive urges than both the MA/Contamination and Control/Contamination groups, as well as lower distress than the MA/Contamination group. However, these effects did not remain significant after controlling for dysfunctional OC beliefs. For individuals low on OCS severity, MA training led to higher disgust ratings and stronger cleaning urges compared to Control training on the contamination picture viewing task. Cognitive flexibility did not moderate the effect of OCS severity on any of the picture viewing or behavioral task outcomes. Discussion. This was the first study to experimentally examine the effects of MA training on compulsive urges. Results did not support the use of MA training over and above a relaxation-based Control training for either OCS dimension. Preliminary evidence supported the efficacy of MA in overriding harm-related urges compared to contamination-related urges. The present findings suggest that MA training works differently for compulsive urges that motivate avoidance behavior than it does for approach-driven appetitive urges. Understanding the interplay between MA, OC beliefs, and OCS dimensions would be a meaningful next step towards increasing the benefits of MA training, either as a tool to increase engagement in OCD exposures or as a stand-alone intervention.