Journal of Cognitive Psychotherapy: An International Quarterly Volume฀25,฀Number฀3฀•฀2011 ©฀2011฀Springer฀Publishing฀Company 189 DOI: 10.1891/0889-8391.25.3.189 Distress From Sexual Thoughts: Do Religiosity, Emotions, and Thought Appraisal Matter? Chad T. Wetterneck, PhD Angela H. Smith, MA Angela J. Burgess, MA University of Houston-Clear Lake, Houston John M. Hart, PhD Center for Anxiety and Depression Treatment of Houston The Menninger Clinic, Houston Sexually intrusive thoughts (SITs) are commonly experienced; yet, there is a paucity of research on distress related to them. Given that the content is similar for intrusive thoughts and obses- sions, examining factors related to obsessions in obsessive-compulsive disorder (e.g., thought appraisal and relationships to emotions) may help explain distress from SITs in nonclinical populations. Differences in affective experiences and religiosity may also explain variations in distress from SITs. Nonclinical participants (N 5 291) completed questionnaires about frequency of, and distress from, SITs, thought appraisal, beliefs about sexual desire, and emo- tions. Distress from SITs was correlated with thought appraisal and beliefs about sexual desire, but not with religiosity. In regression analyses, beliefs about sexual desire and the frequency of SITs each predicted distress from SITs. Although thought appraisal is often implicated in obsessive-compulsive symptoms, these results indicate that beliefs about emotions may have a greater impact on distress. Keywords: obsessive-compulsive disorder; intrusive thoughts; emotions; experiential avoidance; thought appraisal; religion A lthough sexual thoughts are often solicited and pleasurable, research has indicated that sexual thoughts also can be distressing and intrusive. Until recently, the term fantasy was used to describe sexual cognitions regardless of the affect elicited by the thought, appraisal of the thought, or frequency and duration of the thought (Renaud & Byers, 2001). Current research refers to sexual thoughts or sexual cognitions, rather than fantasies, in response to a growing body of research that has found that it is common for sexual thoughts to be repug- nant and distressing (Byers, Purdon, & Clark, 1998; Clark, Purdon, & Byers, 2000; Little & Byers, 2000; Renaud & Byers, 1999, 2001). In addition to pleasure, feelings of guilt, disgust, and embar- rassment are elicited from sexual thoughts for many individuals (Davidson & Hoffman, 1986; Gold, Balzano, & Stamey, 1991; Knoth, Boyd, & Singer, 1988). Although it is clear that sexual