151
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De Putter LMS, Koster EHW. Can selective attention and inhibition (interactively) predict future obsessive compulsive symptoms? A prospective study. J Behav Ther Exp Psychiatry 2018; 61:150-157. [PMID: 30081256 DOI: 10.1016/j.jbtep.2018.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 06/02/2018] [Accepted: 07/27/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVES The current study set out to investigate whether obsessive beliefs, selective attention, inhibition, and the interaction between selective attention and inhibition can prospectively predict contamination obsessive compulsive (OC) symptoms. METHODS Obsessive beliefs, inhibition, and selective attention were assessed in a student sample (n = 89) during a baseline session in the beginning of the first semester. Their predictive value was examined by assessing symptoms after an OC symptom induction in the lab and by assessing OC symptoms during a period of increased stress (the examination period) 68-80 days after baseline. RESULTS Results showed that obsessive beliefs did not consistently predict OC symptoms and there was no predictive effect of attentional bias, attentional bias variability, and inhibition in isolation. However, attentional bias variability and inhibition in the context of contamination-related stimuli interacted, in which only the combination of poor inhibition and large attentional bias variability predicted contamination OC symptoms during the examination period. LIMITATIONS Future research should investigate whether similar results are found in clinical populations, as the current sample consisted of a convenience sample of undergraduate students. CONCLUSION These results support the notion that information processing biases interact in predicting contamination OC symptoms.
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Affiliation(s)
- Laura M S De Putter
- Psychopathology and Affective Neuroscience Lab, Department of Experimental Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium.
| | - Ernst H W Koster
- Psychopathology and Affective Neuroscience Lab, Department of Experimental Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium.
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152
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My Child's thoughts frighten me: Maladaptive effects associated with parents' interpretation and management of children's intrusive thoughts. J Behav Ther Exp Psychiatry 2018; 61:87-96. [PMID: 29990683 DOI: 10.1016/j.jbtep.2018.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 04/18/2018] [Accepted: 06/24/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVES Environmental factors explain substantial variance in youth's obsessive-compulsive symptoms (OCS) and much of this research has focused upon overt parenting behaviors (e.g., accommodation). No work, however, has examined how parents' internal processes (e.g., perception of children's intrusions) influence youth's OCS. Based upon the cognitive theory of obsessions, we propose that parents' misappraisal of children's intrusions as threatening will be positively associated with (a) the number of maladaptive intrusion management strategies recommended by the parent, as well as (b) children's obsessive beliefs, (c) interpretation biases, and (d) OCS severity. METHODS Twenty-seven children (M = 12.81; SD = 3.43) and the parent most involved in childcare completed diagnostic interviews and self-report questionnaires. In the laboratory, we induced obsessional anxiety in youth through a standardized in vivo paradigm (e.g., think about a personalized harm-related negative event occurring). Parents rated how they interpreted their children's unwanted thought and the intrusion management strategies they would recommend. RESULTS Parents who interpreted their children's intrusions as threatening recommended more maladaptive intrusion management strategies and their misappraisal positively and significantly correlated with the severity of children's obsessive beliefs, interpretation biases, and OCS, even after controlling for co-occurring internalizing symptoms. LIMITATIONS Small sample and cross-sectional design precludes causal conclusions. CONCLUSIONS Parents' misinterpretation of children's intrusions may operate as a mechanism by which OCS are generationally transmitted. Results can inform OC prevention programs that target parents' cognitive biases in their own psychotherapy.
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153
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Esmaeilian B, Wang B, Lewis K, Duarte F, Ratti C, Behdad S. The future of waste management in smart and sustainable cities: A review and concept paper. WASTE MANAGEMENT (NEW YORK, N.Y.) 2018; 81:177-195. [PMID: 30527034 DOI: 10.1016/j.wasman.2018.09.047] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 09/19/2018] [Accepted: 09/27/2018] [Indexed: 05/03/2023]
Abstract
The potential of smart cities in remediating environmental problems in general and waste management, in particular, is an important question that needs to be investigated in academic research. Built on an integrative review of the literature, this study offers insights into the potential of smart cities and connected communities in facilitating waste management efforts. Shortcomings of existing waste management practices are highlighted and a conceptual framework for a centralized waste management system is proposed, where three interconnected elements are discussed: (1) an infrastructure for proper collection of product lifecycle data to facilitate full visibility throughout the entire lifespan of a product, (2) a set of new business models relied on product lifecycle data to prevent waste generation, and (3) an intelligent sensor-based infrastructure for proper upstream waste separation and on-time collection. The proposed framework highlights the value of product lifecycle data in reducing waste and enhancing waste recovery and the need for connecting waste management practices to the whole product life-cycle. An example of the use of tracking and data sharing technologies for investigating the waste management issues has been discussed. Finally, the success factors for implementing the proposed framework and some thoughts on future research directions have been discussed.
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Affiliation(s)
- Behzad Esmaeilian
- Industrial Engineering and Engineering Management, Western New England University, 1215 Wilbraham Road, Springfield, MA 01119, USA.
| | - Ben Wang
- The H. Milton Stewart School of Industrial & Systems Engineering, Georgia Institute of Technology, 755 Ferst Drive, NW, Atlanta, GA 30332, USA.
| | - Kemper Lewis
- Mechanical and Aerospace Engineering Department, University at Buffalo, SUNY, 318 Jarvis Hall, Buffalo, NY 14260, USA.
| | - Fabio Duarte
- Urban Management, Pontificia Universidade Católica do Paraná, Curitiba, Brazil; The Senseable City Lab, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA.
| | - Carlo Ratti
- The Senseable City Lab, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA.
| | - Sara Behdad
- Mechanical and Aerospace Engineering Department, University at Buffalo, SUNY, 318 Jarvis Hall, Buffalo, NY 14260, USA; Industrial and Systems Engineering Department, University at Buffalo, SUNY, 243 Bell Hall, Buffalo, NY 14260, USA.
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154
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Development of a Picture-Based Measure for “Not Just Right” Experiences Associated with Compulsive Sorting, Ordering, and Arranging. COGNITIVE THERAPY AND RESEARCH 2018. [DOI: 10.1007/s10608-018-9969-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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155
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Boysan M, Yıldırım A, Beşiroğlu L, Kefeli MC, Kağan M. Development and Preliminary Psychometric Properties of an Instrument for the Measurement of Obsessional Dissociative Experiences: The Van Obsessional Dissociation Questionnaire (VOD-Q). Psychiatr Q 2018; 89:549-568. [PMID: 29302772 DOI: 10.1007/s11126-017-9555-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A growing body of research evidence documents the substantial associations between obsessive-compulsive disorder (OCD) and dissociation. This article describes the development and preliminary psychometric properties of the Van Obsessional Dissociation Questionnaire (VOD-Q). Obsessional dissociation is defined as a tendency to dissociate in reaction to distressing, unwanted and intrusive thoughts, images and impulses. The screening tool is conceptualized to tap obsessional dissociation across three dimensions: obsessional absorption, obsessional depersonalization/ derealization and obsessional amnesia. The VOD-Q, the Padua Inventory-Revised (PI-R), the Dissociative Experiences Scale (DES), and the Obsessive Belief Questionnaire (OBQ-44) were administered in this study. The results showed that the VOD-Q had excellent test-retest reliability (ranging from 0.73 to 0.90) and internal consistency (ranging from 0.90 to 0.97). The VOD-Q total and subscale scores were significantly associated with measures of obsessive-compulsive symptoms and dissociative experiences. OCD patients scored significantly higher on the VOD-Q than community participants. Based on the present findings, the VOD-Q appears to be a reliable and valid instrument for the measurement of obsessional dissociative experiences.
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Affiliation(s)
- Murat Boysan
- Department of Psychology, Yüzüncü Yıl University Faculty of Social Sciences, Van, Turkey
| | - Abdullah Yıldırım
- Department of Psychiatry, Yüzüncü Yıl University School of Medicine, Van, Turkey.
| | - Lütfullah Beşiroğlu
- Department of Psychiatry, Kâtip Çelebi University School of Medicine, İzmir, Turkey
| | - Mehmet Celal Kefeli
- Department of Psychiatry, Yüzüncü Yıl University School of Medicine, Van, Turkey
| | - Mücahit Kağan
- Department of Psychological Counseling, Erzincan University Faculty of Education, Erzincan, Turkey
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156
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Mantz SC, O’Brien M, Waters FA, Abbott MJ. The Impact of Enhanced Responsibility and Threat Beliefs on Self-Report and Behavioural Indices During a Sorting Task for Young People with OCD. COGNITIVE THERAPY AND RESEARCH 2018. [DOI: 10.1007/s10608-018-9946-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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157
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Knapton O. The linguistic construction of the self in narratives of obsessive-compulsive disorder. QUALITATIVE RESEARCH IN PSYCHOLOGY 2018. [DOI: 10.1080/14780887.2018.1499834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Olivia Knapton
- King’s College London, Centre for Language, Discourse and Communication, School of Education, Communication and Society, Waterloo Bridge Wing, Franklin-Wilkins Building, Waterloo Campus, London, UK
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158
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Bragdon LB, Gibb BE, Coles ME. Does neuropsychological performance in OCD relate to different symptoms? A meta-analysis comparing the symmetry and obsessing dimensions. Depress Anxiety 2018; 35:761-774. [PMID: 29920848 DOI: 10.1002/da.22785] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 04/05/2018] [Accepted: 05/29/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Investigations of neuropsychological functioning in obsessive-compulsive disorder (OCD) have produced mixed results for deficits in executive functioning (EF), attention, and memory. One potential explanation for varied findings may relate to the heterogeneity of symptom presentations, and different clinical or neurobiological characteristics may underlie these different symptoms. METHODS We investigated differences in neuropsychological functioning between two symptoms groups, obsessing/checking (O/C) and symmetry/ordering (S/O), based on data suggesting an association with different motivations: harm avoidance and incompleteness, respectively. Ten studies (with 628 patients) were included and each investigation assessed at least one of 14 neuropsychological domains. RESULTS The S/O domain demonstrated small, negative correlations with overall neuropsychological functioning, performance in EF, memory, visuospatial ability, cognitive flexibility, and verbal working memory. O/C symptoms demonstrated small, negative correlations with memory and verbal memory performance. A comparison of functioning between symptom groups identified large effect sizes showing that the S/O dimension was more strongly related to poorer neuropsychological performance overall, and in the domains of attention, visuospatial ability, and the subdomain of verbal working memory. CONCLUSIONS Findings support existing evidence suggesting that different OCD symptoms, and their associated core motivations, relate to unique patterns of neuropsychological functioning, and, potentially dysfunction in different neural circuits.
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Affiliation(s)
- Laura B Bragdon
- Department of Psychology, Binghamton University, Binghamton, NY
| | - Brandon E Gibb
- Department of Psychology, Binghamton University, Binghamton, NY
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159
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Rector NA, Richter MA, Katz D, Leybman M. Does the addition of cognitive therapy to exposure and response prevention for obsessive compulsive disorder enhance clinical efficacy? A randomized controlled trial in a community setting. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2018; 58:1-18. [DOI: 10.1111/bjc.12188] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Neil A. Rector
- Frederick W. Thompson Anxiety Disorders Centre; Sunnybrook Health Sciences Centre; Toronto Ontario Canada
- Department of Psychiatry; University of Toronto; Ontario Canada
| | - Margaret A. Richter
- Frederick W. Thompson Anxiety Disorders Centre; Sunnybrook Health Sciences Centre; Toronto Ontario Canada
- Department of Psychiatry; University of Toronto; Ontario Canada
| | - Danielle Katz
- Frederick W. Thompson Anxiety Disorders Centre; Sunnybrook Health Sciences Centre; Toronto Ontario Canada
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160
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Giraldo-O'Meara M, Belloch A. Escalation from normal appearance related intrusive cognitions to clinical preoccupations in Body Dysmorphic Disorder: A cross-sectional study. Psychiatry Res 2018; 265:137-143. [PMID: 29704773 DOI: 10.1016/j.psychres.2018.04.047] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 03/22/2018] [Accepted: 04/13/2018] [Indexed: 10/17/2022]
Abstract
Current cognitive approaches to Body Dysmorphic Disorder (BDD) assume that appearance-related intrusive cognitions and their functional consequences characterize the disorder, in a similar way that obsessive intrusive thoughts characterize the Obsessive-Compulsive Disorder (OCD). This study explores whether normal but unwanted appearance-related intrusive thoughts (AITs), escalate to clinical AITs when they are dysfunctionally appraised and instigate counterproductive neutralizing strategies. From a sample of 344 non-clinical individuals who reported a highly upsetting AIT during the past three months two subgroups were extracted according to their high (n = 68) and low (n = 276) vulnerability to BDD. The subjects in the high-risk group obtained significantly higher scores on the frequency of the most disturbing AIT and its emotional impact, interference, and appraisals evaluated with the Appearance Intrusions Questionnaire (AIQ). Additionally, two subgroups of 15 subjects each, with high and low risk to BDD, were formed and their scores were compared to 10 patients with BDD. The AIT had a greater emotional negative impact and more severe consequences on individuals with BDD compared to individuals at high-risk of BDD, which in turn, reported worse consequences of the AIT than those at low-risk. These results empirically support the similarities between BDD and OCD regarding their functional and phenomenological characteristics.
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Affiliation(s)
- Martha Giraldo-O'Meara
- Department of Personality Psychology, Research Unit for Obsessive-Compulsive and Related Disorders (I'TOC), Facultad de Psicología, Universidad de Valencia, Spain. http://www.itoc.org.es
| | - Amparo Belloch
- Department of Personality Psychology, Research Unit for Obsessive-Compulsive and Related Disorders (I'TOC), Facultad de Psicología, Universidad de Valencia, Spain.
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161
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Reuman L, Buchholz J, Abramowitz JS. Obsessive beliefs, experiential avoidance, and cognitive fusion as predictors of obsessive-compulsive disorder symptom dimensions. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2018. [DOI: 10.1016/j.jcbs.2018.06.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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162
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Gjelsvik B, Kappelmann N, von Soest T, Hinze V, Baer R, Hawton K, Crane C. Thought-Action Fusion in Individuals with a History of Recurrent Depression and Suicidal Depression: Findings from a Community Sample. COGNITIVE THERAPY AND RESEARCH 2018; 42:782-793. [PMID: 30416229 PMCID: PMC6208973 DOI: 10.1007/s10608-018-9924-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Although suicidal ideation is one of the most consistent symptoms across recurrent episodes of depression, the mechanisms underpinning its maintenance are poorly understood. In order to develop effective treatments for suicidally depressed patients, understanding what maintains suicidal distress is critical. We hypothesised that Thought–Action Fusion (TAF), i.e., to assume that having a thought has real world consequences, originally described in Obsessive–Compulsive Disorder, might be a bias in recurrently suicidally depressed people. To assess this, we revised the original TAF scale, and assessed TAF in three samples: healthy controls, recurrently depressed individuals with no history of suicidality (D-NS) and individuals with a history of recurrent suicidal depression (D-S). Exploratory and confirmatory factor analyses indicated a three-factor solution of TAF: (1) TAF for uncontrollable events, (2) self-suicidal TAF for suicidal acts related to oneself, and (3) TAF for positive controllable events. Compared to healthy controls, the D-NS group reported significantly higher total TAF, TAF uncontrollable, and TAF self-suicidal subscales, whilst positive controllable TAF was lower compared to healthy controls. Both D-S and D-NS samples reported higher TAF for suicidal thought compared to healthy controls, i.e., believing that having suicidal thoughts means they will act on them, however in the context of low mood this became more pronounced for the D-S group. These findings suggest that targeting TAF both in suicidal and non-suicidal depression has merit.
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Affiliation(s)
- B Gjelsvik
- 1Department of Psychiatry, University of Oxford, Oxford, UK.,2Department of Psychology, University of Oslo, Oslo, Norway.,3Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, OX37JX UK
| | - N Kappelmann
- 1Department of Psychiatry, University of Oxford, Oxford, UK
| | - T von Soest
- 2Department of Psychology, University of Oslo, Oslo, Norway
| | - V Hinze
- 1Department of Psychiatry, University of Oxford, Oxford, UK
| | - R Baer
- 2Department of Psychology, University of Oslo, Oslo, Norway.,4University of Kentucky, Lexington, USA
| | - K Hawton
- 1Department of Psychiatry, University of Oxford, Oxford, UK
| | - C Crane
- 1Department of Psychiatry, University of Oxford, Oxford, UK
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163
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Conley SL, Wu KD. Experimental modification of dysfunctional interpretations in individuals with contamination concerns. J Behav Ther Exp Psychiatry 2018; 59:56-64. [PMID: 29161610 DOI: 10.1016/j.jbtep.2017.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 10/18/2017] [Accepted: 11/14/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Dysfunctional interpretations of intrusive thoughts are implicated in the etiology and maintenance of Obsessive-Compulsive Disorder (OCD). Cognitive Bias Modification training for interpretations (CBM-I) has successfully modified dysfunctional interpretations in the context of several disorders, including OCD. However, research regarding CBM-I's impact on symptom reduction and behavior is mixed, which limits its clinical application. Further, support for the specific efficacy of CBM-I in individuals with contamination concerns is limited. The current study aimed to modify dysfunctional interpretations in individuals with contamination concerns, and examine the effect of the modification on both interpretation bias and performance on a behavioral approach task (BAT). METHODS Participants (N = 74) completed a word-sentence association task by indicating whether a threatening or benign word was related to an ambiguous scenario. The active condition received feedback designed to reduce maladaptive interpretations; the control condition received random feedback. RESULTS Findings revealed that the active-but not the control-condition showed a significant decrease in interpretation bias for threat cues. Analyses of behavioral effects indicated that when ceiling effects were accounted for, the active condition completed more BAT steps than the control condition (p = 0.06; d = 0.45). LIMITATIONS The current study is preliminary and requires replication with a clinical sample. CONCLUSIONS Completion of the CBM-I was beneficial for reducing dysfunctional interpretations relevant to naturally-occurring contamination concerns and, importantly, this reduction may help those individuals approach feared situations.
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Affiliation(s)
- Sara L Conley
- Department of Psychology, Northern Illinois University, United States
| | - Kevin D Wu
- Department of Psychology, Northern Illinois University, United States.
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164
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Botta F, Vibert N, Harika-Germaneau G, Frasca M, Rigalleau F, Fakra E, Ros C, Rouet JF, Ferreri F, Jaafari N. Visual search for verbal material in patients with obsessive-compulsive disorder. Psychiatry Res 2018; 264:244-253. [PMID: 29655967 DOI: 10.1016/j.psychres.2018.03.054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 02/26/2018] [Accepted: 03/22/2018] [Indexed: 11/28/2022]
Abstract
This study aimed at investigating attentional mechanisms in obsessive-compulsive disorder (OCD) by analysing how visual search processes are modulated by normal and obsession-related distracting information in OCD patients and whether these modulations differ from those observed in healthy people. OCD patients were asked to search for a target word within distractor words that could be orthographically similar to the target, semantically related to the target, semantically related to the most typical obsessions/compulsions observed in OCD patients, or unrelated to the target. Patients' performance and eye movements were compared with those of individually matched healthy controls. In controls, the distractors that were visually similar to the target mostly captured attention. Conversely, patients' attention was captured equally by all kinds of distractor words, whatever their similarity with the target, except obsession-related distractors that attracted patients' attention less than the other distractors. OCD had a major impact on the mostly subliminal mechanisms that guide attention within the search display, but had much less impact on the distractor rejection processes that take place when a distractor is fixated. Hence, visual search in OCD is characterized by abnormal subliminal, but not supraliminal, processing of obsession-related information and by an impaired ability to inhibit task-irrelevant inputs.
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Affiliation(s)
- Fabiano Botta
- Unité de Recherche Clinique Pierre Deniker du Centre Hospitalier Henri Laborit, Poitiers, France.
| | - Nicolas Vibert
- Centre de Recherches sur la Cognition et l'Apprentissage, CNRS, Université de Poitiers, Université de Tours, Poitiers, France
| | - Ghina Harika-Germaneau
- Unité de Recherche Clinique Pierre Deniker du Centre Hospitalier Henri Laborit, Poitiers, France
| | - Mickaël Frasca
- Centre de Recherches sur la Cognition et l'Apprentissage, CNRS, Université de Poitiers, Université de Tours, Poitiers, France
| | - François Rigalleau
- Centre de Recherches sur la Cognition et l'Apprentissage, CNRS, Université de Poitiers, Université de Tours, Poitiers, France
| | - Eric Fakra
- Service Hospitalo-Universitaire de Psychiatrie, Secteur Saint-Etienne, Hôpital Nord, Saint-Etienne, France
| | - Christine Ros
- Centre de Recherches sur la Cognition et l'Apprentissage, CNRS, Université de Poitiers, Université de Tours, Poitiers, France
| | - Jean-François Rouet
- Centre de Recherches sur la Cognition et l'Apprentissage, CNRS, Université de Poitiers, Université de Tours, Poitiers, France
| | - Florian Ferreri
- Département de Psychiatrie et de Psychologie Médicale, Hôpital Saint-Antoine, Université Pierre et Marie Curie Paris 6, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Nematollah Jaafari
- Unité de Recherche Clinique Pierre Deniker du Centre Hospitalier Henri Laborit, Poitiers, France; Laboratoire de Neurosciences Expérimentales et Cliniques, INSERM U 1084, Université de Poitiers, INSERM CIC-P 1402; CHU de Poitiers, Poitiers, France
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165
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Thoughts and Thoughts about Thoughts: the Relative Contribution of Obsessive Beliefs and Metacognitive Beliefs in Predicting Obsessive-Compulsive Symptom Dimensions. Int J Cogn Ther 2018. [DOI: 10.1007/s41811-018-0013-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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166
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Abramowitz JS, Blakey SM, Reuman L, Buchholz JL. New Directions in the Cognitive-Behavioral Treatment of OCD: Theory, Research, and Practice. Behav Ther 2018; 49:311-322. [PMID: 29704962 DOI: 10.1016/j.beth.2017.09.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 09/02/2017] [Accepted: 09/04/2017] [Indexed: 01/01/2023]
Abstract
The beneficial effects of cognitive-behavioral interventions (particularly exposure and response prevention) for OCD are among the most consistent research findings in the mental health literature. Nevertheless, even after an adequate trial, many individuals experience residual symptoms, and others never receive adequate treatment due to limited access. These and other issues have prompted clinicians and researchers to search for ways to improve the conceptual and practical aspects of existing treatment approaches, as well as look for augmentation strategies. In the present article, we review a number of recent developments and new directions in the psychological treatment of OCD, including (a) the application of inhibitory learning approaches to exposure therapy, (b) the development of acceptance-based approaches, (c) involvement of caregivers (partners and parents) in treatment, (d) pharmacological cognitive enhancement of exposure therapy, and (e) the use of technology to disseminate effective treatment. We focus on both the conceptual/scientific and practical aspects of these topics so that clinicians and researchers alike can assess their relative merits and disadvantages.
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167
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Gagné JP, Van Kirk N, Hernandez-Vallant A, Potluri S, Krompinger JW, Cattie JE, Garner LE, Crosby JM, Brennan BP, Elias JA. Validating an abbreviated version of the Obsessive Beliefs Questionnaire. J Clin Psychol 2018; 74:1791-1807. [PMID: 29696644 DOI: 10.1002/jclp.22629] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 01/18/2018] [Accepted: 03/09/2018] [Indexed: 11/05/2022]
Abstract
OBJECTIVES A shorter version of the Obsessive Beliefs Questionnaire (OBQ-44) is needed to promote the use of this measure in research and increase our understanding of cognitive phenomena maintaining obsessive-compulsive disorder (OCD). Additionally, an abbreviated version of the OBQ-44 would encourage frequent monitoring of dysfunctional beliefs in intensive care settings. This study aimed to validate a nine-item version of the questionnaire (OBQ-9). METHOD Participants seeking intensive/residential treatment for OCD (N = 311) completed relevant measures on a weekly basis and at admission and discharge. RESULTS A confirmatory factor analysis revealed that the OBQ-9's factor structure replicated the three-factor solution of the OBQ-44. The OBQ-9 demonstrated good psychometric properties and convergent validity and was sensitive to treatment effects. Finally, the OBQ-9 subscales predicted specific OCD dimensions over and above depressive symptoms. CONCLUSION The OBQ-9 appears to be a psychometrically sound tool for routine outcome monitoring of dysfunctional beliefs in hospital-based settings.
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Affiliation(s)
- Jean-Philippe Gagné
- Department of Psychology, Concordia University.,Office of Clinical Assessment and Research, Obsessive-Compulsive Disorder Institute, McLean Hospital/Harvard Medical School
| | - Nathaniel Van Kirk
- Office of Clinical Assessment and Research, Obsessive-Compulsive Disorder Institute, McLean Hospital/Harvard Medical School
| | - Alexandra Hernandez-Vallant
- Office of Clinical Assessment and Research, Obsessive-Compulsive Disorder Institute, McLean Hospital/Harvard Medical School
| | - Sriramya Potluri
- Office of Clinical Assessment and Research, Obsessive-Compulsive Disorder Institute, McLean Hospital/Harvard Medical School
| | - Jason W Krompinger
- Office of Clinical Assessment and Research, Obsessive-Compulsive Disorder Institute, McLean Hospital/Harvard Medical School
| | - Jordan E Cattie
- Office of Clinical Assessment and Research, Obsessive-Compulsive Disorder Institute, McLean Hospital/Harvard Medical School.,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
| | - Lauryn E Garner
- Office of Clinical Assessment and Research, Obsessive-Compulsive Disorder Institute, McLean Hospital/Harvard Medical School.,Department of Psychology, Fordham University
| | - Jesse M Crosby
- Office of Clinical Assessment and Research, Obsessive-Compulsive Disorder Institute, McLean Hospital/Harvard Medical School
| | - Brian P Brennan
- Office of Clinical Assessment and Research, Obsessive-Compulsive Disorder Institute, McLean Hospital/Harvard Medical School.,Biological Psychiatry Laboratory, McLean Hospital/Harvard Medical School.,Department of Psychiatry, Harvard Medical School
| | - Jason A Elias
- Office of Clinical Assessment and Research, Obsessive-Compulsive Disorder Institute, McLean Hospital/Harvard Medical School
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168
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Berman NC, Shaw AM, Wilhelm S. Emotion Regulation in Patients with Obsessive Compulsive Disorder: Unique Effects for Those with “Taboo Thoughts”. COGNITIVE THERAPY AND RESEARCH 2018. [DOI: 10.1007/s10608-018-9911-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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169
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Selchen S, Hawley LL, Regev R, Richter P, Rector NA. Mindfulness-Based Cognitive Therapy for OCD: Stand-Alone and Post-CBT Augmentation Approaches. Int J Cogn Ther 2018. [DOI: 10.1007/s41811-018-0003-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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170
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Katz D, Laposa JM, Rector NA. Anxiety Sensitivity, Obsessive Beliefs, and the Prediction of CBT Treatment Outcome for OCD. Int J Cogn Ther 2018. [DOI: 10.1007/s41811-018-0007-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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171
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Davis ML, McCann M, Goodman WK, Storch EA. Impact of the 2016 US presidential election on OCD symptom presentation: A case illustration. J Clin Psychol 2018. [PMID: 29528496 DOI: 10.1002/jclp.22605] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A recent survey of Americans found that the majority experienced stress during and after the 2016 United States presidential election. Psychosocial, environmental stressors can have a unique impact on symptom presentation in mental health disorders. This manuscript details a case illustration of an individual whose symptoms of obsessive-compulsive disorder were directly linked to the election, as well as how these symptoms were addressed via treatment with intensive exposure and response prevention.
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Affiliation(s)
- Michelle L Davis
- Baylor College of Medicine, Menninger Department of Psychiatry and Behavioral Sciences, Houston, TX
| | | | - Wayne K Goodman
- Baylor College of Medicine, Menninger Department of Psychiatry and Behavioral Sciences, Houston, TX
| | - Eric A Storch
- Baylor College of Medicine, Menninger Department of Psychiatry and Behavioral Sciences, Houston, TX
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172
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Fink J, Pflugradt E, Stierle C, Exner C. Changing disgust through imagery rescripting and cognitive reappraisal in contamination-based obsessive-compulsive disorder. J Anxiety Disord 2018; 54:36-48. [PMID: 29421371 DOI: 10.1016/j.janxdis.2018.01.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 01/05/2018] [Accepted: 01/07/2018] [Indexed: 01/16/2023]
Abstract
Contamination-related obsessive-compulsive disorder (C-OCD) is characterized by strongly experienced disgust and fear, in response to potentially contaminating stimuli. Both emotions differ in their susceptibility for change by habituation and extinction, which are important processes for the success of exposure therapy. Even though the response rates for exposure therapy for C-OCD are very good, it seems promising to test additional therapeutic techniques which target disgust more directly. Therefore, imagery rescripting and cognitive reappraisal were evaluated for their potential to change levels of disgust (within-subject), in the two-session laboratory study with 30 participants, with diagnosed C-OCD, and 30 matched, healthy controls (between-subject), presented. The results show that both emotion-regulation strategies reduced disgust better than a non-intervention control task (counting fishes), across all the participants. Therefore, both strategies seem to be applicable and effective for reducing disgust, in the short term, in participants with diagnosed C-OCD. The implications of these findings for the experimental approach and for the clinical treatment of C-OCD, are discussed.
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Affiliation(s)
- Jakob Fink
- University of Leipzig, Clinical Psychology and Psychotherapy, Neumarkt 9-19, 04081 Leipzig, Germany.
| | - Elisa Pflugradt
- University of Leipzig, Clinical Psychology and Psychotherapy, Neumarkt 9-19, 04081 Leipzig, Germany.
| | - Christian Stierle
- Schön Klinik Bad Bramstedt, Birkenweg 10, 24576 Bad Bramstedt, Germany.
| | - Cornelia Exner
- University of Leipzig, Clinical Psychology and Psychotherapy, Neumarkt 9-19, 04081 Leipzig, Germany.
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173
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Skapinakis P, Caldwell D, Hollingworth W, Bryden P, Fineberg N, Salkovskis P, Welton N, Baxter H, Kessler D, Churchill R, Lewis G. A systematic review of the clinical effectiveness and cost-effectiveness of pharmacological and psychological interventions for the management of obsessive-compulsive disorder in children/adolescents and adults. Health Technol Assess 2018; 20:1-392. [PMID: 27306503 DOI: 10.3310/hta20430] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a relatively common and disabling condition. OBJECTIVES To determine the clinical effectiveness, acceptability and cost-effectiveness of pharmacological and psychological interventions for the treatment of OCD in children, adolescents and adults. DATA SOURCES We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Trials Registers, which includes trials from routine searches of all the major databases. Searches were conducted from inception to 31 December 2014. REVIEW METHODS We undertook a systematic review and network meta-analysis (NMA) of the clinical effectiveness and acceptability of available treatments. Outcomes for effectiveness included mean differences in the total scores of the Yale-Brown Obsessive-Compulsive Scale or its children's version and total dropouts for acceptability. For the cost-effectiveness analysis, we developed a probabilistic model informed by the results of the NMA. All analyses were performed using OpenBUGS version 3.2.3 (members of OpenBUGS Project Management Group; see www.openbugs.net ). RESULTS We included 86 randomised controlled trials (RCTs) in our systematic review. In the NMA we included 71 RCTs (54 in adults and 17 in children and adolescents) for effectiveness and 71 for acceptability (53 in adults and 18 in children and adolescents), comprising 7643 and 7942 randomised patients available for analysis, respectively. In general, the studies were of medium quality. The results of the NMA showed that in adults all selective serotonin reuptake inhibitors (SSRIs) and clomipramine had greater effects than drug placebo. There were no differences between SSRIs, and a trend for clomipramine to be more effective did not reach statistical significance. All active psychological therapies had greater effects than drug placebo. Behavioural therapy (BT) and cognitive therapy (CT) had greater effects than psychological placebo, but cognitive-behavioural therapy (CBT) did not. BT and CT, but not CBT, had greater effects than medications, but there are considerable uncertainty and methodological limitations that should be taken into account. In children and adolescents, CBT and BT had greater effects than drug placebo, but differences compared with psychological placebo did not reach statistical significance. SSRIs as a class showed a trend for superiority over drug placebo, but the difference did not reach statistical significance. However, the superiority of some individual drugs (fluoxetine, sertraline) was marginally statistically significant. Regarding acceptability, all interventions except clomipramine had good tolerability. In adults, CT and BT had the highest probability of being most cost-effective at conventional National Institute for Health and Care Excellence thresholds. In children and adolescents, CBT or CBT combined with a SSRI were more likely to be cost-effective. The results are uncertain and sensitive to assumptions about treatment effect and the exclusion of trials at high risk of bias. LIMITATIONS The majority of psychological trials included patients who were taking medications. There were few studies in children and adolescents. CONCLUSIONS In adults, psychological interventions, clomipramine, SSRIs or combinations of these are all effective, whereas in children and adolescents, psychological interventions, either as monotherapy or combined with specific SSRIs, were more likely to be effective. Future RCTs should improve their design, in particular for psychotherapy or combined interventions. STUDY REGISTRATION The study is registered as PROSPERO CRD42012002441. FUNDING DETAILS The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
| | - Deborah Caldwell
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | | | - Peter Bryden
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Naomi Fineberg
- University of Hertfordshire and Hertfordshire Partnerships Mental Health Trust, Hatfield, UK
| | | | - Nicky Welton
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Helen Baxter
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - David Kessler
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Rachel Churchill
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Glyn Lewis
- Division of Psychiatry, University College London, London, UK
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174
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Bruce SL, Ching THW, Williams MT. Pedophilia-Themed Obsessive-Compulsive Disorder: Assessment, Differential Diagnosis, and Treatment with Exposure and Response Prevention. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:389-402. [PMID: 28822003 DOI: 10.1007/s10508-017-1031-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 06/12/2017] [Accepted: 06/28/2017] [Indexed: 06/07/2023]
Abstract
Fears of sexually harming children are fairly common among clients suffering from obsessive-compulsive disorder (OCD), yet these symptoms are largely unrecognized and frequently misdiagnosed by mental health professionals. Specifically, clients with pedophilia-themed OCD (P-OCD) experience excessive worries and distressing intrusive thoughts about being sexually attracted to, and sexually violating, children. Expressing these concerns may provoke misjudgments from uninformed mental health professionals that a client is presenting instead with pedophilic disorder. This misdiagnosis and subsequent improper interventions can then contribute to increased fear, anxiety, and in many cases, depression, in affected clients. Therefore, it is imperative that mental health professionals first possess a good understanding of this common manifestation of OCD. As such, in this article, we described obsessions and compulsions typical of P-OCD, in order to inform the reader of the distinctive differences between P-OCD and pedophilic disorder. Information about how to assess for P-OCD symptoms is then provided, followed by suggestions on how to tailor aspects of exposure and response prevention to treat this specific form of OCD.
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Affiliation(s)
- Simone Leavell Bruce
- Department of Psychology, Spalding University, Louisville, KY, 40203, USA.
- Louisville OCD Clinic, Louisville, KY, USA.
| | - Terence H W Ching
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Monnica T Williams
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
- Louisville OCD Clinic, Louisville, KY, USA
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175
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Sevincok D, Sevincok L, Memis CO, Dogan B. A misidentification ritual in a patient with obsessive-compulsive disorder: clinical and pharmacotherapeutic implications. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2017.1360830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Doga Sevincok
- Department of Child and Adolesence Psychiatry, Dr Behcet Uz Child Diseases and Surgery Research and Training Hospital, Izmir, Turkey
| | - Levent Sevincok
- Department of Psychiatry, Adnan Menderes University, Medical School, Aydin, Turkey
| | - Cagdas O. Memis
- Department of Psychiatry, Adnan Menderes University, Medical School, Aydin, Turkey
| | - Bilge Dogan
- Department of Psychiatry, Adnan Menderes University, Medical School, Aydin, Turkey
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176
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Veale D, Freeston M, Krebs G, Heyman I, Salkovskis P. Risk assessment and management in obsessive–compulsive disorder. ACTA ACUST UNITED AC 2018. [DOI: 10.1192/apt.bp.107.004705] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SummarySome people with obsessive–compulsive disorder (OCD) experience recurrent intrusive sexual, aggressive or death-related thoughts and as a result may be subjected to lengthy or inappropriate risk assessments. These apparent ‘primary’ risks can be dealt with relatively easily through a careful understanding of the disorder's phenomenology. However, there are other, less obvious ‘secondary’ risks, which require more careful consideration. This article discusses the differentiation of intrusive thoughts and urges in people with OCD from those experienced by sexual or violent offenders; assessing the risk of self-harm and suicide; discussing the nature of repugnant obsessions with a patient; assessing risk of harm and violence to the dependents and family living with someone with the disorder; and assessing the lack of insight and the use of the Mental Health Act. Issues specifically related to children and young people with OCD are also highlighted.
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177
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Abstract
SummaryObsessive–compulsive disorder (OCD) is one of the most debilitating psychiatric conditions in young people. In DSM-5 it is no longer characterised as an anxiety disorder, but instead is part of a group of ‘obsessive–compulsive and related disorders'. In the past 10 years, cognitive—behavioural therapy (CBT) has become well established as the first-choice treatment. This article explains some of the elements of CBT and describes new directions in research which might improve interventions.
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178
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Tibi L, van Oppen P, van Balkom AJLM, Eikelenboom M, Hendriks GJ, Anholt GE. The relationship between cognitions and symptoms in obsessive-compulsive disorder. J Affect Disord 2018; 225:495-502. [PMID: 28865371 DOI: 10.1016/j.jad.2017.08.072] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 08/18/2017] [Accepted: 08/27/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND The cognitive theory of obsessive-compulsive disorder (OCD) ascertains that catastrophic (mis)interpretations of normally occurring intrusive thoughts are related to the maintenance of OCD. Nonetheless, findings supporting the relationship between cognitive biases and OCD symptoms are largely inconsistent. In the present study we examined the relationship between OCD cognitions and symptoms among 382 OCD patients participating in the longitudinal Netherlands Obsessive Compulsive Disorder Association (NOCDA) study. METHODS OCD cognitions and OC, anxiety and depressive symptoms were assessed using self-report questionnaires at baseline and at two-year follow-up. Baseline multiple regression analyses assessed the specificity of OC cognitions to OCD symptoms. Cross-lagged analyses examined whether cognitions predict OCD symptoms at two-year follow up. RESULTS Baseline analyses demonstrated significant relationships between comorbid anxiety, depressive severity and OC cognitions, adjusted for OCD symptoms (β = .283, p < .001 and β = .246, p < .001, respectively). OCD severity adjusted for comorbid symptoms was unrelated to cognitions at baseline (β = .040, p = n.s). Unique associations were found between cognitions and two OCD symptom subtypes (Impulses: β = .215, p < .001; Rumination/doubting: β = .205, p < .001). Longitudinal analyses yielded non-significant associations between OCD cognitions and symptom severity. Prospective analyses of cognitions and OCD symptom subtypes yielded significant effects for both bidirectional and unidirectional associations (β = .11-.16, p < .05). LIMITATIONS Given the naturalistic design of the study, we did not assess therapeutic interventions between baseline and follow-up. CONCLUSIONS Results only partially concord with the predictions of the cognitive theory of OCD. Future studies should focus on mechanisms alternative to cognitions when investigating the course of OCD.
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Affiliation(s)
- Lee Tibi
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Patricia van Oppen
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, GGZ InGeest, Amsterdam, The Netherlands
| | - Anton J L M van Balkom
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, GGZ InGeest, Amsterdam, The Netherlands
| | - Merijn Eikelenboom
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, GGZ InGeest, Amsterdam, The Netherlands
| | - Gert-Jan Hendriks
- Institute of Integrated Mental Health Care "Pro Persona", Centre for Anxiety Disorders "Overwaal", Lent, The Netherlands; University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Psychiatry, Radboud University Medical Centre, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Gideon E Anholt
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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179
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Causal role for inverse reasoning on obsessive-compulsive symptoms: Preliminary evidence from a cognitive bias modification for interpretation bias study. J Behav Ther Exp Psychiatry 2017; 57:143-155. [PMID: 28601693 DOI: 10.1016/j.jbtep.2017.06.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 05/23/2017] [Accepted: 06/01/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVES The inference-based approach (IBA) is a cognitive account of the genesis and maintenance of obsessive-compulsive disorder (OCD). According to the IBA, individuals with OCD are prone to using inverse reasoning, in which hypothetical causes form the basis of conclusions about reality. Several studies have provided preliminary support for an association between features of the IBA and OCD symptoms. However, there are currently no studies that have investigated the proposed causal relationship of inverse reasoning in OCD. METHODS In a non-clinical sample (N = 187), we used an interpretive cognitive bias procedure to train a bias towards using inverse reasoning (n = 64), healthy sensory-based reasoning (n = 65), or a control condition (n = 58). Participants were randomly allocated to these training conditions. This manipulation allowed us to assess whether, consistent with the IBA, inverse reasoning training increased compulsive-like behaviours and self-reported OCD symptoms. RESULTS Results indicated that compared to a control condition, participants trained in inverse reasoning reported more OCD symptoms and were more avoidant of potentially contaminated objects. Moreover, change in inverse reasoning bias was a small but significant mediator of the relationship between training condition and behavioural avoidance. Conversely, training in a healthy (non-inverse) reasoning style did not have any effect on symptoms or behaviour relative to the control condition. LIMITATIONS As this study was conducted in a non-clinical sample, we were unable to generalise our findings to a clinical population. CONCLUSIONS Findings generally support the IBA model by providing preliminary evidence of a causal role for inverse reasoning in OCD.
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180
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Jiujias M, Kelley E, Hall L. Restricted, Repetitive Behaviors in Autism Spectrum Disorder and Obsessive-Compulsive Disorder: A Comparative Review. Child Psychiatry Hum Dev 2017; 48:944-959. [PMID: 28281020 DOI: 10.1007/s10578-017-0717-0] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This review paper critically examines literature regarding restricted and repetitive behaviors (RRBs) in Autism Spectrum Disorder (ASD) and Obsessive-Compulsive Disorder (OCD). The similar behavioral profiles of these disorders presents the potential for confusion regarding diagnoses and intervention efforts. As such, this review highlights the similarities and differences between RRBs in ASD and OCD. The developmental trajectories of RRBs are presented, followed by an exploration of three constructs implicated in RRB manifestation: anxiety, executive functioning, and sensory phenomena. While RRBs tend to develop with some similarity in both disorders, the differing role of anxiety highlights important distinctions between ASD and OCD. We urge researchers and clinicians to think critically about the dimensions that affect RRB presentation. Future research should use this review as a starting point to further elucidate the differences between RRBs in these two populations.
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Affiliation(s)
- Marina Jiujias
- Psychology Department, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Elizabeth Kelley
- Psychology Department, Queen's University, Kingston, ON, K7L 3N6, Canada. .,Queen's University, Humphrey Hall Room 351, 62 Arch Street, Kingston, ON, K7L 3N6, Canada.
| | - Layla Hall
- Psychology Department, Queen's University, Kingston, ON, K7L 3N6, Canada
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181
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Blakey SM, Abramowitz JS, Reuman L, Leonard RC, Riemann BC. Anxiety sensitivity as a predictor of outcome in the treatment of obsessive-compulsive disorder. J Behav Ther Exp Psychiatry 2017; 57:113-117. [PMID: 28505489 DOI: 10.1016/j.jbtep.2017.05.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 02/20/2017] [Accepted: 05/02/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVES To address the fact that not all individuals who receive cognitive-behavioral therapy (CBT) for obsessive-compulsive disorder (OCD) exhibit complete symptom reduction, research has examined factors that predict outcome; however, no studies have examined anxiety sensitivity (AS) as a predictor of outcome of CBT for OCD. AS refers to the fear of anxious arousal that results from mistaken beliefs about the dangerousness of anxiety-related body sensations. It is important to understand whether AS influences OCD treatment outcome, considering that (a) some obsessions directly relate to AS, and (b) OCD patients with high AS may be reluctant to engage in anxiety-provoking components of CBT for OCD. METHODS Patients (N = 187) with a primary diagnosis of OCD who received residential CBT for OCD participated in this study, which involved completing a self-report battery at pre- and post-treatment. RESULTS Results supported study hypotheses, in that (a) baseline AS positively correlated with baseline OCD severity, and (b) greater baseline AS prospectively predicted higher posttreatment OCD symptom severity even after controlling for pretreatment OCD and depression severity. LIMITATIONS The study was limited by its use of an older measure of AS, reliance on self-report measures, and nonstandardized treatment across participants. CONCLUSIONS Findings highlight the importance of AS in the nature and treatment of OCD. Clinical implications and future directions are discussed.
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Affiliation(s)
- Shannon M Blakey
- University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | | | - Lillian Reuman
- University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Emerson LM, Heapy C, Garcia-Soriano G. Which Facets of Mindfulness Protect Individuals from the Negative Experiences of Obsessive Intrusive Thoughts? Mindfulness (N Y) 2017; 9:1170-1180. [PMID: 30100933 PMCID: PMC6061236 DOI: 10.1007/s12671-017-0854-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Obsessive intrusive thoughts (OITs) are experienced by the majority of the general population, and in their more extreme forms are characteristic of obsessive–compulsive disorder (OCD). These cognitions are said to exist on a continuum that includes differences in their frequency and associated distress. The key factors that contribute to an increased frequency and distress are how the individual appraises and responds to the OIT. Facets of mindfulness, such as nonjudgment and nonreactivity, offer an alternative approach to OITs than the negative appraisals and commonly utilised control strategies that often contribute to distress. Clarifying the role of facets of mindfulness in relation to these cognitions offers a means to elucidate individual characteristics that may offer protection from distress associated with OITs. A sample of nonclinical individuals (n = 583) completed an online survey that assessed their experiences of OITs, including frequency, emotional reaction and appraisals, and trait mindfulness. The findings from a series of multiple regression analyses confirmed that specific facets of mindfulness relating to acting with awareness and acceptance (nonjudgment and nonreactivity) consistently predicted less frequent and distressing experiences of OITs. In contrast, the observe facet emerged as a consistent predictor of negative experiences of OITs. These findings suggest that acting with awareness and acceptance may confer protective characteristics in relation to OITs, but that the observe facet may reflect a hypervigilance to OITs. Mindfulness-based prevention and intervention for OCD should be tailored to take account of the potential differential effects of increasing specific facets of mindfulness.
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Affiliation(s)
- Lisa-Marie Emerson
- 1Clinical Psychology Unit, Department of Psychology, University of Sheffield, Floor F, Cathedral Court, 1 Vicar Lane, Sheffield, S1 2LT UK
| | - Connor Heapy
- 1Clinical Psychology Unit, Department of Psychology, University of Sheffield, Floor F, Cathedral Court, 1 Vicar Lane, Sheffield, S1 2LT UK
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183
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Shaw AM, Carbonella JY, Arditte Hall KA, Timpano KR. Obsessive-Compulsive and Depressive Symptoms: The Role of Depressive Cognitive Styles. THE JOURNAL OF PSYCHOLOGY 2017; 151:532-546. [PMID: 29077549 DOI: 10.1080/00223980.2017.1372341] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Obsessive-compulsive disorder (OCD) commonly co-occurs with depression, resulting in heightened severity and poorer treatment response. Research on the associations between specific obsessive-compulsive symptoms (OCS) and depressive symptoms has utilized measures that have not fully considered the relationship across OCS dimensions. Little is known about which factors explain the overlap between OCS and depressive symptoms. OCS and depressive symptoms may be related via depressive cognitive styles, such as rumination or dampening (i.e., down-regulating positive emotions). We evaluated the associations of OCS dimensions with depressive symptoms and cognitive styles. We also examined the indirect effects of rumination and dampening in the relationship between OCS and depressive symptoms. Participants (N = 250) completed questionnaires online. Greater depressive symptoms, rumination, and dampening were associated with greater levels of all OCS dimensions. Path analysis was utilized to examine a model including the direct effect of depressive symptoms on overall OCS and two indirect effects (through rumination and dampening). There was a significant indirect effect of depressive cognitive styles on the relationship between OCS and depressive symptoms, through rumination and dampening. Replication in a clinical sample and experimental manipulations may bear important implications for targeting depressive cognitive styles in treatments for OCD and depression.
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184
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Sugarman MA, Kirsch I, Huppert JD. Obsessive-compulsive disorder has a reduced placebo (and antidepressant) response compared to other anxiety disorders: A meta-analysis. J Affect Disord 2017; 218:217-226. [PMID: 28477500 DOI: 10.1016/j.jad.2017.04.068] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 04/19/2017] [Accepted: 04/28/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Previous studies have indicated that obsessive-compulsive disorder (OCD) might have a reduced placebo response compared to other anxiety-related disorders including generalized anxiety disorder, panic disorder, post-traumatic stress disorder, and social anxiety disorder. No previous analysis has directly compared antidepressant and placebo responses between OCD and these conditions. METHOD We analyzed pre-post change scores within drug and placebo groups as well as between-groups change scores (i.e., drug compared to placebo) for all FDA-approved antidepressants for the treatment of these five anxiety-related disorders. Antidepressants included duloxetine, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, and venlafaxine. Random effects meta-analysis was used to examine all trials submitted to the FDA, plus additional post-approval trials available from manufacturer-sponsored clinical trial registers. Clinician-rated symptom inventories were the outcome measures for all conditions to facilitate comparisons across diagnoses. RESULTS Fifty-six trials met inclusion criteria. OCD had significantly lower pre-post effect sizes (ps<0.003) for both placebo (Hedges' g=0.49) and antidepressants (g=0.84) compared to the other four conditions (gs between 0.70 and 1.10 for placebo and 1.11 and 1.40 for antidepressants). However, the drug-placebo effect sizes did not significantly differ across diagnoses (Q(4)=6.09, p=0.193, I2 =34.3% [95% CI: -7.0,59.7]), with gs between=0.26 and 0.39. CONCLUSIONS Overall pre-post change scores were smaller for OCD compared to other anxiety disorders for both antidepressants and placebo, although drug-placebo effects sizes did not significantly differ across disorders. Theoretical and clinical implications for the understanding and treatment of OCD are discussed.
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Affiliation(s)
- Michael A Sugarman
- Department of Psychology, Bedford Veterans Affairs Medical Center, United States.
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185
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The role of feared possible selves in obsessive-compulsive and related disorders: A comparative analysis of a core cognitive self-construct in clinical samples. Clin Psychol Psychother 2017; 25:e19-e29. [DOI: 10.1002/cpp.2121] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 07/03/2017] [Accepted: 07/05/2017] [Indexed: 11/07/2022]
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186
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Romero-Sanchiz P, Nogueira-Arjona R, Godoy-Ávila A, Gavino-Lázaro A, Freeston MH. Differences in clinical intrusive thoughts between obsessive-compulsive disorder, generalized anxiety disorder, and hypochondria. Clin Psychol Psychother 2017; 24:O1464-O1473. [PMID: 28744937 DOI: 10.1002/cpp.2107] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 06/12/2017] [Accepted: 06/15/2017] [Indexed: 11/11/2022]
Abstract
Differences and similarities between intrusive thoughts typical of obsessive-compulsive disorder, generalized anxiety disorder, and hypochondriasis are relevant for their differential diagnosis, formulation, and psychological treatment. Previous research in non-clinical samples pointed out the relevance of some process variables, such as responsibility, guilt, or neutralization strategies. This research is aimed to investigate the differences and similarities between clinical obsessions, worries, and illness intrusions in some of these process variables. A second aim is to identify models based on these variables that could reliably differentiate between them. Three groups of patients with obsessive-compulsive disorder (n = 35; 60% women, mean age 38.57), generalized anxiety disorder (n = 36; 61.1% women, mean age 41.50), and hypochondriasis (n = 34; 70.6% women, mean age 31.59) were evaluated using the Cognitive Intrusions Questionnaire-Transdiagnostic Version (Romero-Sanchiz, Nogueira-Arjona, Godoy-Ávila, Gavino-Lázaro, & Freeston, ). The results showed that some appraisals (e.g., responsibility or egodystonicity), emotions (e.g., guilt or insecurity), neutralization strategies, and other variables (e.g., verbal content or trigger from body sensation) are relevant for the discrimination between obsessions, worries, and illness intrusions. The results also showed 3 stable models based on these variables for the discrimination between these thoughts. The implication of these results in the diagnosis, formulation, and psychological treatment of obsessive-compulsive disorder, generalized anxiety disorder, and hypochondriasis is discussed.
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Affiliation(s)
- Pablo Romero-Sanchiz
- Personality, Assessment,and Psychological Treatments Department, School of Psychology, University of Malaga, Malaga, Spain.,Mental Health Clinical Management Unit, Biomedical Research Institute of Malaga (IBIMA) Regional University Hospital Carlos Haya, Malaga, Spain
| | - Raquel Nogueira-Arjona
- Personality, Assessment,and Psychological Treatments Department, School of Psychology, University of Malaga, Malaga, Spain
| | - Antonio Godoy-Ávila
- Personality, Assessment,and Psychological Treatments Department, School of Psychology, University of Malaga, Malaga, Spain
| | - Aurora Gavino-Lázaro
- Personality, Assessment,and Psychological Treatments Department, School of Psychology, University of Malaga, Malaga, Spain
| | - Mark H Freeston
- School of Psychology, University of Newcastle, Newcastle upon Tyne, UK
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187
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188
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Cludius B, Schmidt AF, Moritz S, Banse R, Jelinek L. Implicit aggressiveness in patients with obsessive-compulsive disorder as assessed by an Implicit Association Test. J Behav Ther Exp Psychiatry 2017; 55:106-112. [PMID: 28113062 DOI: 10.1016/j.jbtep.2017.01.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 01/02/2017] [Accepted: 01/04/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND OBJECTIVES Cognitive models of obsessive-compulsive disorder (OCD) highlight the role of cognitive biases for the development of the disorder. One of these biases, an inflated sense of responsibility has been associated with higher anger scores and latent aggression on self-report scales, especially in patients with compulsive checking. Validity of self-report assessment is, however, compromised by inaccuracy, social desirability, and low metacognitive awareness of traits and behaviors in patients. The aim of the present study was to extend the research on latent aggression in individuals with OCD by using an indirect, implicit measure of aggression. METHODS Fifty-eight patients with OCD and 25 healthy controls were assessed with an Aggressiveness-Implicit Association Test (IAT), which is a reaction time task that assesses the strength of associations between the concept of "aggressiveness" and "me" compared to others. RESULTS Contrary to our expectation, OCD patients with checking symptoms showed a more peaceful implicit self-concept than healthy controls. This result was corroborated by negative correlations between checking symptoms and implicit aggressiveness in the OCD sample. LIMITATIONS No self-report measures on aggression or anger were included in the study. CONCLUSIONS In comparison to previous research using self-report measures, our study indicates that implicit aspects of aggression do indeed differ from controlled aspects in patients with checking compulsions. Future research is necessary to better understand the role of aggressiveness in OCD and to derive implications for therapy.
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Affiliation(s)
- Barbara Cludius
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistr. 52, Hamburg, Germany.
| | | | - Steffen Moritz
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistr. 52, Hamburg, Germany
| | - Rainer Banse
- Department of Psychology, Social and Legal Psychology, University of Bonn, Germany
| | - Lena Jelinek
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistr. 52, Hamburg, Germany
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189
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Body Dysmorphic, Obsessive-Compulsive, and Social Anxiety Disorder Beliefs as Predictors of In Vivo Stressor Responding. J Nerv Ment Dis 2017; 205:471-479. [PMID: 28141632 DOI: 10.1097/nmd.0000000000000656] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study tested the potential transdiagnostic nature of body dysmorphic disorder (BDD), obsessive-compulsive disorder (OCD), and social anxiety disorder (SAD) beliefs, in addition to testing the specificity of those beliefs, in predicting how individuals responded to symptom-specific stressors. Participants included 127 adults (75% women) with a broad range of symptom severity. Path analysis was used to evaluate whether specific maladaptive beliefs predicted distress in response to symptom-relevant stressors over and above other beliefs and baseline distress. SAD beliefs emerged as a significant predictor of distress in response to a mirror gazing (BDD-relevant), a thought (OCD-relevant), and a public speaking (SAD-relevant) task, controlling for other disorder beliefs and baseline distress. BDD beliefs were also a robust predictor of BDD stressor responding. Results suggest that social anxiety-relevant beliefs may function as a transdiagnostic risk factor that predicts in vivo symptoms across a range of problem areas.
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190
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Banting R, Lloyd S. A case study integrating CBT with narrative therapy externalizing techniques with a child with OCD: How to flush away the Silly Gremlin. A single-case experimental design. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2017; 30:80-89. [DOI: 10.1111/jcap.12173] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 04/27/2017] [Accepted: 05/05/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Rosemary Banting
- Clinical Department of Psychology; University of Bath; Calverton Down; Bath UK
| | - Susannah Lloyd
- Melksham Child and Adolescent Mental Health Service; Melksham Hospital; Melksham Bath UK
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191
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Obsessive-Compulsive Disorder in Paediatric and Adult Samples: Nature, Treatment and Cognitive Processes. A Review of the Theoretical and Empirical Literature. BEHAVIOUR CHANGE 2017. [DOI: 10.1017/bec.2017.6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The appraisal model of obsessive-compulsive disorder (OCD) suggests that six key appraisal domains contribute to the aetiology and maintenance of OCD symptoms. An accumulating body of evidence supports this notion and suggests that modifying cognitive appraisals may be beneficial in reducing obsessive-compulsive symptomatology. This literature review first summarises the nature of OCD and its treatment, followed by a summary of the existing correlational and experimental research on the role of cognitive appraisal processes in OCD across both adult and paediatric samples. While correlational data provide some support for the relationship between cognitive appraisal domains and OCD symptoms, results are inconclusive, and experimental methods are warranted to determine the precise causal relationship between specific cognitive appraisal domains and OCD symptoms.
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192
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Modifying Obsessive-Compulsive Beliefs about Controlling One’s Thoughts. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2017. [DOI: 10.1007/s10862-017-9603-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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193
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Olatunji BO, Ebesutani C, Kim J, Riemann BC, Jacobi DM. Disgust proneness predicts obsessive-compulsive disorder symptom severity in a clinical sample of youth: Distinctions from negative affect. J Affect Disord 2017; 213:118-125. [PMID: 28222359 DOI: 10.1016/j.jad.2017.02.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 01/09/2017] [Accepted: 02/13/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Although studies have linked disgust proneness to the etiology and maintenance of obsessive-compulsive disorder (OCD) in adults, there remains a paucity of research examining the specificity of this association among youth. METHOD The present study employed structural equation modeling to examine the association between disgust proneness, negative affect, and OCD symptom severity in a clinical sample of youth admitted to a residential treatment facility (N =471). RESULTS Results indicate that disgust proneness and negative affect latent factors independently predicted an OCD symptom severity latent factor. However, when both variables were modeled as predictors simultaneously, latent disgust proneness remained significantly associated with OCD symptom severity, whereas the association between latent negative affect and OCD symptom severity became nonsignificant. Tests of mediation converged in support of disgust proneness as a significant intervening variable between negative affect and OCD symptom severity. Subsequent analysis showed that the path from disgust proneness to OCD symptom severity in the structural model was significantly stronger among those without a primary diagnosis of OCD compared to those with a primary diagnosis of OCD. LIMITATIONS Given the cross-sectional design, the causal inferences that can be made are limited. The present study is also limited by the exclusive reliance on self-report measures. CONCLUSIONS Disgust proneness may play a uniquely important role in OCD among youth.
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Affiliation(s)
| | | | - Jingu Kim
- Konkuk University, Republic of Korea
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194
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Potter K, Coyle A. Psychotherapeutic practitioners’ views of the efficacy of mindfulness for the treatment of obsessive compulsive disorder: A qualitative key informant analysis. EUROPEAN JOURNAL OF PSYCHOTHERAPY & COUNSELLING 2017. [DOI: 10.1080/13642537.2017.1313879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Kate Potter
- School of Psychology, University of Surrey, Guildford, UK
| | - Adrian Coyle
- Department of Psychology, Kingston University, London, UK
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195
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Wong SF, Grisham JR. Inverse reasoning processes in obsessive-compulsive disorder. J Anxiety Disord 2017; 47:75-82. [PMID: 28057396 DOI: 10.1016/j.janxdis.2016.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 11/08/2016] [Accepted: 12/23/2016] [Indexed: 12/01/2022]
Abstract
The inference-based approach (IBA) is one cognitive model that aims to explain the aetiology and maintenance of obsessive-compulsive disorder (OCD). The model proposes that certain reasoning processes lead an individual with OCD to confuse an imagined possibility with an actual probability, a state termed inferential confusion. One such reasoning process is inverse reasoning, in which hypothetical causes form the basis of conclusions about reality. Although previous research has found associations between a self-report measure of inferential confusion and OCD symptoms, evidence of a specific association between inverse reasoning and OCD symptoms is lacking. In the present study, we developed a task-based measure of inverse reasoning in order to investigate whether performance on this task is associated with OCD symptoms in an online sample. The results provide some evidence for the IBA assertion: greater endorsement of inverse reasoning was significantly associated with OCD symptoms, even when controlling for general distress and OCD-related beliefs. Future research is needed to replicate this result in a clinical sample and to investigate a potential causal role for inverse reasoning in OCD.
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Affiliation(s)
- Shiu F Wong
- School of Psychology, The University of New South Wales, Kensington, NSW, 2052, Australia.
| | - Jessica R Grisham
- School of Psychology, The University of New South Wales, Kensington, NSW, 2052, Australia
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196
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Matthews AJ, Maunder R, Scanlan JD, Kirkby KC. Online computer-aided vicarious exposure for OCD symptoms: A pilot study. J Behav Ther Exp Psychiatry 2017; 54:25-34. [PMID: 27308724 DOI: 10.1016/j.jbtep.2016.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 04/18/2016] [Accepted: 06/02/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES Computer-aided vicarious exposure (CAVE) for obsessive-compulsive disorder (OCD) is an intervention in which participants learn and rehearse exposure with response prevention (ERP) by directing a character around a virtual world. This study aimed to pilot an online CAVE program for OCD in a community sample with high OCD symptomatology. METHODS Participants (n = 78) were allocated to an intervention group (three 45-min weekly CAVE sessions) or to a waitlist control group. The treatment group were asked to complete three 45-min sessions over a four week period. RESULTS Those who completed at least one CAVE session showed greater improvement on measures of OCD symptomatology at one-month post-treatment (d = 0.49-0.81) compared to waitlist (d = 0.01-0.1). Older age, past treatment and higher symptom severity were associated with non-adherence. LIMITATIONS These findings should be considered preliminary due to sample size limitations and an absence of an active control group. However, the findings suggest that further development and evaluation of the program is warranted. CONCLUSIONS Preliminary findings suggest that online CAVE programs have potential to bridge treatment gaps among those reluctant to attend treatment or engage with in vivo exposure exercises. These programs may also have potential applications as an adjunct to face-to-face or online cognitive behavioural therapy.
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Affiliation(s)
- Allison J Matthews
- School of Medicine, University of Tasmania, Private Bag 30, Hobart, Tasmania, 7000, Australia.
| | - Rosie Maunder
- School of Medicine, University of Tasmania, Private Bag 30, Hobart, Tasmania, 7000, Australia
| | - Joel D Scanlan
- School of Computing and Information Systems, University of Tasmania, Private Bag 87, Hobart, Tasmania, 7000, Australia
| | - Kenneth C Kirkby
- School of Medicine, University of Tasmania, Private Bag 30, Hobart, Tasmania, 7000, Australia
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197
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Uncertain and Fused: Cognitive Fusion, Thought-Action Fusion, and the Intolerance of Uncertainty as Predictors of Obsessive-Compulsive Symptom Dimensions. J Cogn Psychother 2017; 31:191-203. [DOI: 10.1891/0889-8391.31.3.191] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cognitive-behavioral models of obsessions, although widely accepted, do not entirely explain obsessive-compulsive (OC) symptoms. Constructs from relational frame theory (RFT; e.g., cognitive fusion—the tendency for behavior to be overly regulated and influenced by cognition) may improve our understanding of OC symptoms above and beyond cognitive-behavioral constructs (e.g., intolerance of uncertainty [IU]). This study examined the extent to which cognitive fusion accounts for unique variability in four OC symptom dimensions: contamination, responsibility for harm, unacceptable thoughts, and order/symmetry. Participants completed measures of cognitive fusion, general distress, thought action fusion, IU, and OC symptoms. Regression analyses showed that IU and thought-action fusion (TAF) were significant predictors across the OC symptom dimensions; however, cognitive fusion was only a unique predictor of the unacceptable thoughts symptom dimension. Results support the notion that RFT may best relate to the unacceptable thoughts domain of OCD. Study findings, limitations, and future directions are discussed.
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198
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He W, Zheng Q, Ji Y, Shen C, Zhu Q, Wang W. Development of a Body Image Concern Scale using both exploratory and confirmatory factor analyses in Chinese university students. Neuropsychiatr Dis Treat 2017; 13:1419-1425. [PMID: 28603420 PMCID: PMC5457153 DOI: 10.2147/ndt.s138762] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The body dysmorphic disorder is prevalent in general population and in psychiatric, dermatological, and plastic-surgery patients, but there lacks a structure-validated, comprehensive self-report measure of body image concerns, which is established through both exploratory and confirmatory factor analyses. METHODS We have composed a 34-item matrix targeting the body image concerns and trialed it in 328 male and 365 female Chinese university students. Answers to the matrix dealt with treatments including exploratory factor analyses, reserve of qualified items, and confirmatory factor analyses of latent structures. RESULTS Six latent factors, namely the Social Avoidance, Appearance Dissatisfaction, Preoccupation with Reassurance, Perceived Distress/Discrimination, Defect Hiding, and Embarrassment in Public, were identified. The factors and their respective items have composed a 24-item questionnaire named as the Body Image Concern Scale. Each factor earned a satisfactory internal reliability, and the intercorrelations between these factors were in a median level. Women scored significantly higher than men did on the Appearance Dissatisfaction, Preoccupation with Reassurance, and Defect Hiding. CONCLUSION The Body Image Concern Scale has displayed its structure validation and gender preponderance in Chinese university students.
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Affiliation(s)
- Wenxin He
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, People's Republic of China
| | - Qiming Zheng
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, People's Republic of China
| | - Yutian Ji
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, People's Republic of China
| | - Chanchan Shen
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, People's Republic of China
| | - Qisha Zhu
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, People's Republic of China
| | - Wei Wang
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, People's Republic of China
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Alam Dianati F, Moheb N, Amiri S. Is mindfulness a mediator factor in obsessive compulsive disorder? JOURNAL OF ANALYTICAL RESEARCH IN CLINICAL MEDICINE 2016. [DOI: 10.15171/jarcm.2016.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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200
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Bouvard M, Fournet N, Denis A, Sixdenier A, Clark D. Intrusive thoughts in patients with obsessive compulsive disorder and non-clinical participants: a comparison using the International Intrusive Thought Interview Schedule. Cogn Behav Ther 2016; 46:287-299. [PMID: 28004982 DOI: 10.1080/16506073.2016.1262894] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The International Intrusive Thought Interview Schedule (IITIS) was used to assess and compare the unwanted intrusive thoughts (UITs) reported in a group of patients with obsessive compulsive disorder (OCD) and a non-clinical group. Although all participants reported at least one type of intrusion, OCD patients experienced more intrusive thoughts than non-clinical participants, and this difference was statistically significant. In the OCD group, intrusive thoughts were more frequent, interfered more with daily life, were considered to be more important to get out of the mind, and were more difficult to stop than in non-clinical participants. The two groups did not differ significantly in terms of five appraisals of the most distressing intrusive thought. One appraisal (importance) was used far more by the OCD group than the non-clinical group. For three appraisals (intolerance of anxiety, need to control, and intolerance of uncertainty), the difference was smaller. Only two of the strategies for controlling the most upsetting intrusive thought (ritual and avoidance) were of value in differentiating between the two groups. The IITIS (an instrument used to assess intrusions in non-clinical samples) appears to be of value for the assessment of patients with OCD.
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Affiliation(s)
- Martine Bouvard
- a Universite De Savoie UFR Lettres Langues et Sciences Humaines , Jacob-Bellecombette 73011 , France
| | - Nathalie Fournet
- a Universite De Savoie UFR Lettres Langues et Sciences Humaines , Jacob-Bellecombette 73011 , France
| | - Anne Denis
- a Universite De Savoie UFR Lettres Langues et Sciences Humaines , Jacob-Bellecombette 73011 , France
| | - Adelaide Sixdenier
- a Universite De Savoie UFR Lettres Langues et Sciences Humaines , Jacob-Bellecombette 73011 , France
| | - David Clark
- b Psychology , University of New Brunswick , 38 Dineen Drive, Fredericton E3B 5A3 , New Brunswick , Canada
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