From Stress to Obsession: The Role of Inferential Confusion and Obsessive Beliefs in Adolescent Obsessive‐Compulsive Symptoms

Adolescence is a critical developmental period during which obsessive-compulsive disorder (OCD) frequently emerges. This study examined cognitive models of OCD, the associations between stressful life events (SLEs) and symptom severity, and the unique challenges faced by adolescents living with OCD symptoms. Two indirect pathways were tested: one involving SLEs and the other perceived stress, with both pathways including inferential confusion and obsessional beliefs as mediators. A sample of adolescents presenting with OCD symptoms completed validated measures assessing stress, obsessive beliefs, inferential confusion, and symptom severity. Results indicated that inferential confusion showed a significant indirect association between perceived stress and OCD symptom severity, whereas obsessional beliefs did not emerge as significant mediators. These findings suggest that inferential confusion represents an important cognitive factor associated with OCD symptoms in youth and may be especially salient under conditions of elevated stress. They also underscore the value of further investigating interventions that address inferential confusion in early OCD-focused treatments for adolescents.