Current cognitive-behavioral research has emphasized different appraisal processes in the development of OCD. Although differing in the specific focus for the cause of OCD, cognitive-behavioral theorists generally stipulate the importance of the personal relevance of the intrusion and the significance of perceptions of self and the world in the determination of responses to intrusions. However, relatively little research has directly examined cognitive-affective structures such as self concept and beliefs about the nature of the world. An examination of the relationship between such structures and OC phenomena may help in suggesting additional factors that are important in the dynamic of OCD or in identifying factors that may underlie beliefs that have been found to be important in OCD. Further, while traditional cognitive models have facilitated knowledge and treatment of OCD and theoretical discourse has considered the origins of OCD-related beliefs (Bhar & Kyrios, 2000; Salkovskis et al., 1999), there has been a general neglect of developmental issues, such as early attachment and parenting (Guidano & Liotti, 1983; Safran, 1990) and the role they play in the development and maintenance of dysfunctional beliefs (Bhar & Kyrios, 2000). Thus, examining additional cognitive-affective structures and their developmental origins may broaden our understanding of OC related phenomena.
In the next chapter, we discuss the link between attachment theory and psychopathology. It is argued that internal representations of self and other, resulting from attachment related experiences, may increase vulnerability to the development of OCD. In particular it is proposed that enduring cognitive-affective structures, stemming from attachment related experiences and consisting of particular structures of self coupled with specific beliefs about the world, may increase vulnerability for OCD.