Adam S. Radomsky

Background: Cognitive behavioural therapy (CBT) for eating disorders (EDs) does not yield consistent long-term recovery for all patients, highlighting the need to better understand underlying cognitive mechanisms. Recent work suggests that beliefs about losing control – particularly anticipated catastrophic consequences – may serve as key etiological and maintenance factors. Aim: This study examined whether negative beliefs about losing control predict general ED symptomatology in an undergraduate sample. Method: Data were drawn from a larger psychometric study on control-related constructs and obsessive-compulsive symptoms. A total of 262 undergraduate participants completed the Beliefs About Losing Control Inventory – Second Edition (BALCI-II), Eating Disorder Examination Questionnaire (EDE-Q 6.0), and Depression, Anxiety and Stress Scale (DASS-21). Results: Simple linear regression indicated that BALCI-II total scores significantly predicted EDE-Q total scores ( adj. R ² =.08, F _1,260 =23.61, p <.001). However, in a hierarchical regression, BALCI-II scores did not account for additional variance in ED symptoms beyond depression ( ΔR ² =.18, ΔF _1,259 =.624, p =.43). Subscale analyses showed that fears of losing control leading to overwhelming emotions significantly predicted ED symptoms ( β =.22, t ₂₅₉ =3.03, p =.006), whereas fears related to madness and dangerous behaviours were not significant predictors. Conclusion: Beliefs about losing control – especially fears of overwhelming emotions – appear to contribute to ED symptom maintenance. These findings provide initial psychometric support for prior qualitative research and suggest such beliefs may represent a meaningful treatment target within CBT. Future research should investigate causal relationships between these beliefs and ED psychopathology.

Since the publication of the original Vancouver Obsessional Compulsive Inventory (VOCI), a large body of evidence demonstrating the prevalence and importance of newer symptom domains in obsessive-compulsive disorder (OCD) (e.g. mental contamination, reassurance seeking, and symmetry, ordering, and arranging) has emerged. Although the VOCI has excellent psychometric properties, these developments point to the need for a revision. The present study aimed to revise the VOCI to provide a brief and up-to-date measure to assess OCD symptomatology. The development of the VOCI-2 is discussed, along with information about its reliability, validity and factor structure. An exploratory factor analysis was conducted on data obtained from 1108 non-clinical participants who completed the VOCI, the Vancouver Obsessional Compulsive Inventory – Mental Contamination Scale (VOCI-MC), the Symmetry Ordering and Arranging Questionnaire (SOAQ), and the Covert and Overt Reassurance Seeking Inventory (CORSI) to arrive at an updated measure, and clinical samples (primary diagnosis of OCD, n =59; anxious controls, n =42; depressed controls, n =18) completed the VOCI-2 to assess known-groups validity. The VOCI-2 consists of six distinctive factors reflecting symptom categories: Symmetry, Ordering and Arranging; Reassurance Seeking; Checking; Mental Contamination; Obsessions; and Contact Contamination. The updated questionnaire is characterized by strong reliability and validity, face valid items and subscales, is easy to administer and reflects a current understanding of the heterogeneous presentations of OCD. Future directions include additional validation in larger clinical samples and in other (e.g. treatment) contexts.

Background: Fear of losing control may play an important role in multiple anxiety disorders. However, the disorder relevance/ specificity of the construct has not been examined. The authors previously developed the novel Fear of Losing Control Inventory (FOLCI), with which the present study aimed to investigate the disorder relevance/ specificity of fear of losing control in OCD and panic disorder. Methods: The FOLCI, the Beliefs About Losing Control Inventory-II (BALCI-II) and a battery of psychological measures were administered to three groups: OCD ( N = 36), panic disorder ( N = 31) and healthy controls ( N = 33). Mixed model ANOVAs tested for differences between groups in terms of FOLCI and BALCI-II subscales. Results: As hypothesised, the OCD and panic groups reported greater fear of losing control than healthy controls across all FOLCI and BALCI-II subscales. Contrary to hypotheses, there were no significant differences between the OCD and panic groups in terms of the FOLCI’s Agent of Harm, Delayed Catastrophe and Imminent Catastrophe subscales. As hypothesised, the panic group scored significantly higher than the OCD group on the Bodily Sensations subscale. Non-hypothesised differences were also observed, with the panic group scoring significantly higher than the OCD group on the Escape and Avoidance subscale, and the Thoughts and Feelings subscale. Discussion: Findings suggest fear of losing control is relevant to both OCD and panic disorder. The findings suggest some aspects—specifically fear of losing control of bodily sensations, emotions (and thoughts) and escape and avoidance behaviours driven by feared loss of control, may be specific to panic disorder. The present findings extend previous research by demonstrating the relevance of feared loss of control—and of the FOLCI and BALCI-II as measures—within clinical groups.