Can Obsessive Compulsive Disorder be Considered a Disorder of Imagination? A Psychological Perspective

Obsessive-compulsive disorder (OCD) has long been understood using cognitive-behavioral and neurobiological models, highlighting maladaptive thought processes and the hyperactivation of core brain areas, such as the orbitofrontal cortex, amygdala, and default mode network (DMN). However, the role of imagination, which has not been explored much, may have a crucial role in the development and maintenance of OCD symptoms. This review examines the crossroads between OCD and imagination, determining whether OCD should be considered a disorder of imagination. A systematic review was conducted using academic databases, including Google Scholar, PubMed, Scopus, PsycINFO, Web of Science, MEDLINE, Cochrane Library, Embase, DOAJ, and ScienceDirect, to analyze the cognitive and neurobiological mechanisms underlying the relationship between imagination and OCD. The current review sought to present a comprehensive analysis of how imagination is involved in OCD-related cognitive processes, such as intrusive mental imagery, maladaptive mental stimulation, and cognitive inflexibility. In addition, this review emphasizes how investigating this neglected dimension of OCD may result in better management approaches and new therapeutic approaches aiming at imaginative dysfunctions in OCD.