{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T09:04:24Z","timestamp":1784279064413,"version":"3.55.0"},"update-to":[{"DOI":"10.12688\/wellcomeopenres.26104.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000}}],"reference-count":34,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["222060"],"award-info":[{"award-number":["222060"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["wellcomeopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Wellcome Open Res"],"abstract":"<ns5:p>Background Obsessive-compulsive disorder (OCD) is a common mental illness which involves intrusive thoughts and compulsive behaviours. Thought control strategies are a common factor in OCD, yet they are understudied and under-addressed in existing treatments. Excessive rationalisation is a novel conceptualisation of OCD-related thought control, describing a stressful process of arguing with or attempting to explain away unwanted thoughts. Investigation of this concept could offer a new perspective on the cognitive experience of OCD which may be missed or unappreciated within existing treatments. Method The Delphi method was used to develop a pool of items that could describe this new concept. Twenty people with lived experience of OCD took part in four rounds. In the first round, responses to open-ended questions were used to generate a list of items which described the concept. In Rounds 2 and 3 participants rated the items so as to refine the initial list. In Round 4 participants ranked the items in order of how well they described excessive rationalisation. Results Across the rounds a total of 61 items were generated. Thirty-one items were then discarded, either because they did not reach consensus, did not describe excessive rationalisation, or were redundant. Ninety per cent of participants (strongly) agreed that the final pool of 30 items described the concept of excessive rationalisation. Conclusions The present research drew on lived experience to conceptualise a novel concept which may be important for understanding OCD and its persistence.<\/ns5:p>","DOI":"10.12688\/wellcomeopenres.26104.2","type":"journal-article","created":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T06:04:06Z","timestamp":1783145046000},"page":"282","update-policy":"https:\/\/doi.org\/10.12688\/wellcomeopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Conceptualisation of a novel cognitive process in obsessive-compulsive disorder: A Delphi study on excessive rationalisation"],"prefix":"10.12688","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9813-3201","authenticated-orcid":false,"given":"Elizabeth J.","family":"Kirkham","sequence":"first","affiliation":[{"name":"Clinical and Applied Psychology Edinburgh Scotland The University of Edinburgh School of Health in Social Science"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2026,7,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"529-540","DOI":"10.1016\/s0005-7967(02)00026-8","article-title":"Thought control strategies in obsessive-compulsive disorder: a replication and extension.","volume":"41","author":"J Abramowitz","year":"2003","journal-title":"Behav. 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Please see below for the updates I have made in relation to your suggestions.  1.&nbsp;This is a very helpful point, and I have added a diagram to this effect. As discussed further below, a large portion of the screening form responses appeared to be from bots, as they came in at exactly the same time (the pattern of responses from genuine participants was more spread out).  2.&nbsp;This is a good point. It was difficult to decipher this&nbsp;because there were a large number of unfinished responses that came in at exactly the same time that were apparently bot responses (e.g. on 12\/11\/23 there were 15 responses at 12:14, 19 responses at 12:21, and 20 responses at 12:26). I have added a sentence to the paper to that effect. In future research I will endeavour to ask people with OCD whether or not they find excessive rationalisation to be relevant to their own experience. As the second reviewer felt that the screening phase should be less thoroughly described, I hope that this approach is a satisfactory compromise.  3.&nbsp;Thank you for raising this \u2013 I did consider sample size when planning the project, but it was missing from the first version of the paper. I have now added information on appropriate Delphi sample sizes. A data-saturation focused approach would have been difficult to implement in this particular project due to the limited time available to recruit new participants between Survey 1 and Survey 2. Nevertheless, having checked the \u201cQualitative coding of Survey 1\u201d file within the supplementary materials I am confident that appropriate data saturation was achieved.  4.&nbsp;I have added this suggestion \u2013 in fact this is an area I would like to investigate further in the future.  5.&nbsp;This is a limitation of the present work which has been added to the discussion.  6.&nbsp;Thank you for this suggestion! I have added this to the end of the paper.","URL":"https:\/\/wellcomeopenresearch.org\/articles\/11-282\/v2#referee-comment-6632","order":1,"name":"referee-comment-6632","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.29897.r159872, Marketa Ciharova, Vrije Universiteit Amsterdam, Amsterdam, North Holland, 17 Jul 2026, version 2, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/11-282\/v2#referee-response-159872","order":2,"name":"referee-response-159872","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This work was supported by Wellcome [222060]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}