Autism and Schizotypal Traits in Relation to Thought-Action Fusion in Obsessive-Compulsive Disorder

BACKGROUND: Thought-Action Fusion (TAF) is one of the cognitive variables and thought misinterpretations that have been extensively studied in Obsessive-Compulsive Disorder (OCD). However, further research is needed on the specific factors contributing to the development of TAF in patients with OCD. Since autistic traits and TAF are related to cognitive processes, we hypothesized in this study that autistic traits as well as schizotypal traits and obsessive-compulsive symptoms may be associated with TAF severity in OCD patients. METHODS: In this cross-sectional study, eighty-three patients (aged 18 to 65) with OCD were assessed using the Yale Brown Obsessive-Compulsive Scale (Y-BOCS), Schizotypal Personality Questionnaire (SPQ), Autism Spectrum Quotient (AQ), Thought-Action Fusion Scale (TAFS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). RESULTS: We found that attention switching, attention to detail, and communication dimensions of the AQ were associated with higher TAF-Likelihood/Self. There was a significant association between attention shifting and TAF-Moral, while attention to detail was significantly associated with TAF Likelihood/Others. Y-BOCS-Total (β = 0.338, p = 0.001), and cognitive-perceptual traits (β = 0.295, p = 0.018) were significantly associated with TAF-Moral. Likelihood/Self dimension of TAF was significantly associated with Y-BOCS-total (β = 0.386, p < 0.001), BDI (β = -0.333, p = 0.017), AQ-Total (β = 0.250, p < 0.001) and Cognitive-Perceptual schizotypal traits (β = 0.289, p = 0.016). The severity of TAF-Likelihood/Others was significantly associated with Y-BOCS-Total (β = 0.279, p = 0.012). CONCLUSIONS: We suggest that in addition to the severity of OCD and cognitive-perceptual traits, higher autistic traits may also contribute to increased levels of TAF-Likelihood/Self.