Modeling Obsessive Beliefs Based on Attentional Cognitive Syndrome and Inferential Confusion with the Mediating Role of Fear of Self

Abstract

This study aimed to model obsessive beliefs based on attentional cognitive syndrome and inferential confusion, examining the mediating role of fear of self among individuals diagnosed with obsessive–compulsive disorder (OCD). The research employed a descriptive–correlational design using structural equation modeling (SEM). The statistical population comprised individuals referred to psychology clinics and psychiatrists’ offices in Shiraz in 2024 who had been clinically diagnosed with OCD. A random sample of 130 participants was selected. Data were collected using the Obsessive Beliefs Questionnaire (OBQ-44), the Cognitive Attentional Syndrome Scale (CAS-91), the Inferential Confusion Questionnaire – Extended Version (ICQ-EV), the Fear of Self Questionnaire (FSQ), and the Maudsley Obsessive–Compulsive Inventory (MOCI). Data analysis was conducted using SPSS-26 and AMOS-26 software, employing path analysis within a structural equation framework. The results revealed significant positive correlations among attentional cognitive syndrome, inferential confusion, fear of self, and obsessive beliefs. The direct effect of attentional cognitive syndrome on obsessive beliefs was significant (β = 0.33, p < 0.01), as was the direct effect of inferential confusion (β = 0.41, p < 0.01). Fear of self showed a significant mediating effect, with indirect effects for attentional cognitive syndrome (β = 0.17, p < 0.001) and inferential confusion (β = 0.32, p < 0.001). Model fit indices (CFI = 0.97, GFI = 0.93, RMSEA = 0.06) indicated an excellent model fit. Findings demonstrated that fear of self functions as a key mediating mechanism linking maladaptive cognitive processes—specifically attentional cognitive syndrome and inferential confusion—to obsessive beliefs. These results underscore the necessity of therapeutic approaches targeting both cognitive–attentional mechanisms and self-related fear to effectively reduce obsessive beliefs and obsessive–compulsive symptoms.