Inferential confusion

Inferential confusion is a meta-cognitive state of confusion that becomes pathological when an individual fails to perceive reality correctly and considers an obsessional belief or subjective reality as an actual probability. It causes an individual to mistrust their senses and relies on self-created narratives. This is because one eliminates evidence and the objectivity of events and tends to rely on the hypothetical reality that stems from memories, information, and associations that aren't related- therefore, it deals with the fictional nature of obsessions. This causes the individual to overestimate the threat.

Inverse inference, the inverse of normal inference, is critical inferential confusion. A person starts out believing in the truthfulness of a theory even though evidence suggests otherwise. This type of inverse processing weakens the role of the senses and limits the part of sensory information, creating uncertainty about an actual state.

Inferential confusion and OCD

Inferential confusion is a predictor of OCD symptoms since value is not placed on the content of the imaginative obsessions but rather on how they are interpreted.The inference-based approach suggests that OCD is a product of distorted inductive thinking where the obsessions are conceptualised as conclusions about possible states of affairs, based on an inductive narrative that holds distinctive emotional themes. Individuals with OCD also report that their obsessions are largely based on a hypothetical reality lacking direct sensory evidence leading to feelings of distress. The role of inferential confusion therefore leads to formations of obsessions that include a probability of imagined, frightened selves. A person tends to fear the development of this attribute for which there is again no direct evidence- this fear of oneself and inferential confusion are attributes of those with OCD.Several reasoning errors have been identified by O'Connor & Robillard (1995), which could provide credence to the obsessional inference. Specifically, category errors, drawing inferences from irrelevant memories, facts, and unconnected associations, and a dismissal of actual data while basing action on a hypothetical reality. These reasoning errors bring about inferential confusion where an individual mixes an imagined possibility with a genuine probability leading to more severe symptoms of OCD. Therefore, OCD is considered as a belief disorder alike delusion highlighting the role of non-phobic factors in the onset and maintenance of this disorder.

Inferential confusion is defined by OCD-specific maladaptive reasoning techniques that reinforce the dependability of the initial uncertainty. The individuals equips these dysfunctional techniques to justify their thoughts which comes in the form of an inductive narrative. Aardema et al (2005) developed the inferential questionnaire to further expand on the construct of inferential confusion by collecting data from participants suffering from OCD. The questionnaire involved two critical thinking strategies: Inverse reasoning and a distrust of senses. The results from the questionnaire demonstrated a strong correlation between inferential confusion and OCD symptoms.

Diagnosis: The Inference Based Approach (IBA)

The IBA (inference-based approach) is a common technique to treat highly OCD symptoms that are usually explained by inferential confusion. It conceptualizes OCD as a belief disorder that highlights the remoteness of obsessional cognitive representation from the frightening object or event and signifies the reasoning process behind OCD. This approach suggests how a person reacts to a possibility of what might happen and not what is actually happening or even an exaggerated version of it. One of the treatments of OCD involve cognitive-behaviour therapy which conceptualises that a person holding pre-existing beliefs may be more sensitized to strongly reacting to intrusive thoughts. However even though this treatment has gained recognition there are still a substantial number of patients who haven't improved. Therefore, over the past 10 years an improved model called the inference-based approach (IBA) was developed which suggested that obsessions can come in various degrees of belief and practicality.

Recently, a series of psychological experiments in the 2000s have explored the Inference based approach and thereby inferential confusion as well. A study conducted by Aardema, Connor, Delorme, and Audet tested the inference-based approach treatment on OCD patients and its symptom subtypes. Later this study was replicated, and extensions were added to test ideas further and expand on the findings- the studies concluded that the inference-based approach treatment was effective in improving OCD patients who had overvalued ideation

Cultural Differences

Religion

Culture tends to influence several aspects of an individual’s psychology, including their perceptions, beliefs, and interpretations of the situation around them and their symptoms. Evolutionarily these cultural groups tend to socially boycott and avoid individuals that are ‘contaminated or sinful’- these group norms have led to an ongoing need to remain clean and pure to stay as a part of the ingroup. Due to gene-culture co-evolution, these deep-rooted beliefs have been passed on over generations creating exaggerated obsessions in few individuals. These excessive obsessions to remain ‘pure’ create a subjective reality where an individual persistently feels ‘contaminated’ even though direct sensory evidence suggests otherwise.Some religions' rigorous and meticulous rules may cause misinterpretation of intrusive thoughts, as well as a persistent desire to control these ideas and guilt. The person then takes steps to eliminate intrusive ideas which may be considered sinful by his or her faith, thus relieving the feeling of guilt. Because the person does not have perfect control over their thoughts, they are more likely to engage in behaviours that they feel will eradicate such thoughts. Therefore, these ideas cause the individual to obsess over hypothetical reality even though their sensory evidence suggests otherwise in order to maintain being ‘virtuous’ and an ingroup member. In many cases the severity of these obsessions may vary, causing the degree of inferential confusion to differ. Religious OCD patients have a strong belief in and fear of punishment from a divine person or deity.These three processes, main threat evaluations of intrusions, increased mental control effort, and misunderstanding of unsuccessful thought control, are regarded to be especially important in strongly religious people who value personal control over undesired and undesirable intrusive thoughts and pictures.

Further reading

• Wong, S. F., & Grisham, J. R. (2018). Factors leading to immersion in obsessions. Journal of Experimental Psychopathology. Factors leading to immersion in obsessions
• Aardema, Frederick & O'Connor, Kieron. (2003). Seeing White Bears That Are Not There: Inference Processes in Obsessions. Journal of Cognitive Psychotherapy. 17. 23-37. 10.1891/jcop.17.1.23.58270.
• Vladimir Kalinin (2014). Obsessive-Compulsive Disorder: The Old and the New Problems. BoD – Books on Demand. ISBN 978-953-51-1238-9.