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Rizzo A, Sorrenti L, Commendatore M, Mautone A, Caparello C, Maggio MG, Özaslan A, Karaman H, Yıldırım M, Filippello P. Caregivers of Children with Autism Spectrum Disorders: The Role of Guilt Sensitivity and Support. J Clin Med 2024; 13:4249. [PMID: 39064288 PMCID: PMC11278243 DOI: 10.3390/jcm13144249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/12/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024] Open
Abstract
Background/Objectives: Burden Syndrome, also known as Caregiver Syndrome, particularly affects those who serve in the role of informal caregiver in the presence of family members with conditions. The ABCX dual model examines the impact on the caregiver of the diagnosis of autism spectrum disorder (ASD) on the family. This model considers the severity of the stressor (A), the additional demands of life stress (aA), the family's internal resources (B), the family's external resources (bB), the family's assessment of the situation (C), coping strategies (cC), and outcome (X). The purpose of the present study is to investigate the relationships between resilience, guilt, and burden of care in caregivers of children with ASD. Methods: Various assessment instruments were used, including the "Caregiver Burden Inventory" to measure burden, the "Brief Resilience Scale" to assess resilience, the "Guilt Sensitivity Questionnaire" to examine guilt sensitivity, and the "DA.L.I.A." to collect information on parent and child characteristics. A total of 80 parents/caregivers participated in the research, including 53 women (Age M = 41.72; SD = 7.8) and 27 men (Age M = 43.35; SD = 6.29). Results: The findings indicate that individuals' resilience to stressful events correlates negatively with burden, a developmental subtype. However, guilt seems not to play a significant role in the overall perception of burden. In contrast, it was found that the use of informal supports is associated with higher levels of guilt and emotional burden, whereas the use of formal supports is correlated with higher emotional burden, but not higher perceptions of guilt. Conclusions: This study provides important information about the support needed by caregivers and suggests how to address emotional burdens to prevent burnout and support families with children with ASD.
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Affiliation(s)
- Amelia Rizzo
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (L.S.); (M.C.); (A.M.); (P.F.)
- Department of Cognitive Sciences, Pedagogical Psychological and Cultural Studies, University of Messina, 98122 Messina, Italy
| | - Luana Sorrenti
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (L.S.); (M.C.); (A.M.); (P.F.)
| | - Martina Commendatore
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (L.S.); (M.C.); (A.M.); (P.F.)
| | - Aurora Mautone
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (L.S.); (M.C.); (A.M.); (P.F.)
| | - Concettina Caparello
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy;
| | | | - Ahmet Özaslan
- Child and Adolescent Psychiatry Department, Gazi University Medical Faculty, 06560 Ankara, Turkey;
- Child Protection Research and Application Center, Gazi University, 06560 Ankara, Turkey
| | - Hakan Karaman
- Department of Social Work, Faculty of Health Sciences, İstanbul Üniversitesi—Cerrahpaşa, 34320 İstanbul, Turkey;
| | - Murat Yıldırım
- Department of Psychology, Faculty of Science and Letters, Ağrı İbrahim Çeçen University, 04100 Ağrı, Turkey;
- Department of Social and Educational Sciences, Lebanese American University, Beirut 03797751, Lebanon
| | - Pina Filippello
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (L.S.); (M.C.); (A.M.); (P.F.)
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Hellberg SN, DuBois C, Myers NS, Rodriguez C, Butcher M, Ojalehto HJ, Riemann B, Abramowitz JS. The contribution of guilt sensitivity in the prediction of obsessive-compulsive disorder symptom dimensions: Replication and extension. J Anxiety Disord 2023; 97:102728. [PMID: 37236070 DOI: 10.1016/j.janxdis.2023.102728] [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: 06/08/2022] [Revised: 02/05/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is associated with particular cognitive processes, such as beliefs about the importance of intrusive thoughts. The present study examined the explanatory power of guilt sensitivity to OCD symptom dimensions after controlling for well-established cognitive predictors. METHODS 164 patients with OCD completed self-reported measures of OCD and depressive symptoms, obsessive beliefs, and guilt sensitivity. Bivariate correlations were examined, and latent profile analysis (LPA) was used to generate groups based on symptom severity scores. Differences in guilt sensitivity were examined across latent profiles. RESULTS Guilt sensitivity was most strongly associated with unacceptable thoughts and responsibility for harm OCD symptoms, and moderately with symmetry. After controlling for depression and obsessive beliefs, guilt sensitivity added explanatory power to the prediction of unacceptable thoughts. LPA identified 3 profiles; profile-based subgroups significantly differed from one another in terms of guilt sensitivity, depression, and obsessive beliefs. CONCLUSIONS Guilt sensitivity is relevant to various OCD symptom dimensions. Above and beyond depression and obsessive beliefs, guilt sensitivity contributed to the explanation of repugnant obsessions. Theory, research, and treatment implications are discussed.
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Affiliation(s)
| | - Chase DuBois
- University of North Carolina at Chapel Hill, United States
| | | | | | - Megan Butcher
- University of North Carolina at Chapel Hill, United States
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How much are they predictive for obsessive-compulsive symptom dimensions: beliefs, emotions, emotional schemas? CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03969-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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4
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Randomized Trial on the Effects of a Mindfulness Intervention on Temperament, Anxiety, and Depression: A Multi-Arm Psychometric Study. Behav Sci (Basel) 2022; 12:bs12030074. [PMID: 35323393 PMCID: PMC8945710 DOI: 10.3390/bs12030074] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 02/05/2023] Open
Abstract
Mindfulness is a mental state that can be achieved through meditation. So far, studies have shown that practicing mindfulness on a consistent and regular basis can improve attentional functions and emotional well-being. Mindfulness has recently begun to be used in the field of child development. The goal of this study is to assess if a mindfulness program may help primary school students in reducing anxiety and depression while also improving their temperamental characteristics. This multi-arm pre-post study included 41 subjects recruited in the fifth year of two primary school classes. Participants were randomly assigned to the experimental and control groups. The experimental group, but not the control group, underwent an eight-week mindfulness training. Every week, the program included 60-min group sessions. QUIT (Italian Questionnaires of Temperament) and TAD (Test for Anxiety and Depression in Childhood and Adolescence) were used to assess temperament, and anxiety and depression, respectively. Both groups were administered both instruments before and after mindfulness intervention. The mindfulness program lowered anxiety levels and was effective in changing temperament dimensions: there was an increase in social orientation (SO), positive emotionality (PE), and attention (AT), as well as a decrease in inhibition to novelty (IN) and negative emotionality. Path analysis revealed that AT may promote the improvement of both SO and IN. Similarly, PE may be promoted by the decrease of IN. Clinical implications are discussed.
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Poli A, Gemignani A, Soldani F, Miccoli M. A Systematic Review of a Polyvagal Perspective on Embodied Contemplative Practices as Promoters of Cardiorespiratory Coupling and Traumatic Stress Recovery for PTSD and OCD: Research Methodologies and State of the Art. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11778. [PMID: 34831534 PMCID: PMC8619958 DOI: 10.3390/ijerph182211778] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/03/2021] [Accepted: 11/05/2021] [Indexed: 12/12/2022]
Abstract
Baseline respiratory sinus arrhythmia (RSA) has been proposed as a transdiagnostic biomarker of stress vulnerability across psychopathologies, and a reliable association between PTSD, OCD and lower resting RSA was found. Contemplative practices have been linked to the activation of the vagus as well as to an increased RSA that, according to the polyvagal theory, reflects the activation of the ventral vagal complex (VVC) and may promote PTSD and OCD recovery. PubMed and Scopus databases were selected to conduct a search following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) 2020 guidelines, and A MeaSurement Tool to Assess systematic Reviews-2 (AMSTAR-2) was used to appraise the methodological quality for this systematic review. Six articles met the inclusion criteria (one cross-sectional study, one study with pre-post measurements, two cohort studies and two RCT studies). Mindfulness-related interventions promoted parasympathetic activity, an increased vagal tone and improvements in PTSD and OCD symptoms. According to the polyvagal theory, mindfulness-related and compassion-related meditations would be conceptualized as neural exercises expanding the capacity of the ventral vagal complex to regulate the present state and to promote resilience. Clinical and methodological issues are discussed.
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Affiliation(s)
- Andrea Poli
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy;
| | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology and of Critical Care Medicine, University of Pisa, 56126 Pisa, Italy;
| | | | - Mario Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy;
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Psychometric Properties of the Italian Version of the Distress Tolerance Scale (DTS). JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2021. [DOI: 10.1007/s10862-021-09876-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lee SW, Kim E, Chung Y, Cha H, Song H, Chang Y, Lee SJ. Believing is seeing: an fMRI study of thought-action fusion in healthy male adults. Brain Imaging Behav 2021; 15:300-310. [PMID: 32125617 DOI: 10.1007/s11682-020-00257-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Thought-action fusion (TAF) is a tendency of individuals to establish causal relations between their own thoughts and external reality. TAF can lead to maladaptive behaviors typically observed in obsessional thoughts. However, neural mechanisms underlying TAF are still unknown. In this study, 38 healthy men were informed that MR signals were able to detect thoughts of the word 'apple' and that this recognition could result in the administration of electrical shocks to a person outside the scanner. During MR acquisition, they were asked to suppress or not suppress the thought of 'apple' while sham electrical shocks were or were not administered to the other person. The main effect of the sham administration of electrical shock to another person was shown in the bilateral lingual gyri, fusiform gyri, and middle occipital cortices (FDR corrected p < 0.05). Also, fusiform gyrus, lingual gyrus, and middle occipital cortex activity correlated with scores of guilty feeling only when participants consciously tried to think of apple as less as possible. Our study demonstrates that visual association areas may play primary roles in TAF. The simple belief and visual imagery that one's thought may lead to someone's injury activated visual areas of the brain where, in turn, brain activity is associated with feelings of guilt.
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Affiliation(s)
- Sang Won Lee
- Department of Psychiatry, Kyungpook National University Chilgok Hospital, Daegu, South Korea.,Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Eunji Kim
- Department of Medical & Biological Engineering, Kyungpook National University, Daegu, South Korea
| | - Younjae Chung
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, South Korea.,Department of Psychiatry, Kyungpook National University Hospital, Daegu, South Korea
| | - Hyunsil Cha
- Department of Medical & Biological Engineering, Kyungpook National University, Daegu, South Korea
| | - Huijin Song
- Institute of Biomedical Engineering Research, Kyungpook National University, Daegu, South Korea
| | - Yongmin Chang
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea. .,Department of Radiology, Kyungpook National University Hospital, Daegu, South Korea.
| | - Seung Jae Lee
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, South Korea. .,Department of Psychiatry, Kyungpook National University Hospital, Daegu, South Korea.
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Poli A, Maremmani AGI, Chiorri C, Mazzoni GP, Orrù G, Kolacz J, Porges SW, Conversano C, Gemignani A, Miccoli M. Item Reduction, Psychometric and Biometric Properties of the Italian Version of the Body Perception Questionnaire-Short Form (BPQ-SF): The BPQ-22. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3835. [PMID: 33917552 PMCID: PMC8038843 DOI: 10.3390/ijerph18073835] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 12/12/2022]
Abstract
Body awareness disorders and reactivity are mentioned across a range of clinical problems. Constitutional differences in the control of the bodily state are thought to generate a vulnerability to psychological symptoms. Autonomic nervous system dysfunctions have been associated with anxiety, depression, and post-traumatic stress. Though interoception may be a transdiagnostic mechanism promoting the improvement of clinical symptomatology, few psychometrically sound, symptom-independent, self-report measures, informed by brain-body circuits, are available for research and clinical use. We validated the Italian version of the body perception questionnaire (BPQ)-short form and found that response categories could be collapsed from five to three and that the questionnaire retained a three-factor structure with items reduced from 46 to 22 (BPQ-22). The first factor was loaded by body awareness items; the second factor comprised some items from the body awareness scale and some from the subdiaphragmatic reactivity scale (but all related to bloating and digestive issues), and the third factor by supradiaphragmatic reactivity items. The BPQ-22 had sound psychometric properties, good convergent and discriminant validity and test-retest reliability and could be used in clinical and research settings in which the body perception assessment is of interest. Psychometric findings in light of the polyvagal theory are discussed.
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Affiliation(s)
- Andrea Poli
- Department of Surgical, Medical and Molecular Pathology and of Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (G.O.); (C.C.); (A.G.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy;
- Verdi Clinical Center, 59100 Prato, Italy
- Florence Cognitive School, 50144 Florence, Italy;
| | - Angelo Giovanni Icro Maremmani
- Department of Psychiatry, North-Western Tuscany Region NHS Local Health Unit, Versilia Zone, 55049 Viareggio, Italy;
- Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), 55045 Pietrasanta, Italy
- G. De Lisio Institute of Behavioral Sciences, 56100 Pisa, Italy
| | - Carlo Chiorri
- Department of Educational Sciences, University of Genova, 16121 Genova, Italy;
| | | | - Graziella Orrù
- Department of Surgical, Medical and Molecular Pathology and of Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (G.O.); (C.C.); (A.G.)
| | - Jacek Kolacz
- Traumatic Stress Research Consortium at the Kinsey Institute, Indiana University, Bloomington, IN 47405, USA; (J.K.); (S.W.P.)
| | - Stephen W. Porges
- Traumatic Stress Research Consortium at the Kinsey Institute, Indiana University, Bloomington, IN 47405, USA; (J.K.); (S.W.P.)
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC 27514, USA
| | - Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology and of Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (G.O.); (C.C.); (A.G.)
| | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology and of Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (G.O.); (C.C.); (A.G.)
| | - Mario Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy;
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Vanzhula IA, Kinkel-Ram SS, Levinson CA. Perfectionism and Difficulty Controlling Thoughts Bridge Eating Disorder and Obsessive-Compulsive Disorder Symptoms: A Network Analysis. J Affect Disord 2021; 283:302-309. [PMID: 33578342 DOI: 10.1016/j.jad.2021.01.083] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 01/10/2021] [Accepted: 01/30/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Eating disorders (ED) and obsessive-compulsive disorder (OCD) are highly comorbid, but little is known about how this comorbidity is maintained. Prior research suggests that obsessive thoughts and perfectionism may be shared maintenance factors for EDs and OCD. METHODS The current study used network analysis to (1) identify bridge pathways in an ED-OCD comorbidity network and (2) test if perfectionism symptoms bridge between ED-OCD symptoms in a combined network model including ED, OCD, and Perfectionism symptoms. Participants (N = 1,619) were a mixed sample of undergraduate students and individuals diagnosed with EDs. RESULTS Difficulty controlling thoughts was the symptom with the highest bridge centrality in both models, connecting with ED-related worry and doubts. In the ED-OCD-Perfectionism comorbidity network, doubts about simple everyday things and repeating things over and over bridged between ED and OCD symptoms. Additionally, specific and distinct pathways were identified between OCD and two types of ED pathology: restricting (checking compulsions and rigidity around food) and binge eating (hoarding and binge eating symptoms). LIMITATIONS Due to the cross-sectional nature of the data, no directional inferences can be made. Due to a higher OCD symptom prevalence rate than reported in previous studies, our undergraduate sample may not be representative of other college populations. CONCLUSIONS The presence of intrusive cognitions and maladaptive perfectionism may contribute to the maintenance of co-occurring ED and OCD symptoms. These findings begin to delineate specific pathways among OCD and ED symptoms, which can be used in the development of interventions to disrupt connections among these disorders.
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Affiliation(s)
- Irina A Vanzhula
- University of Louisville, Department of Psychological & Brain Sciences
| | | | - Cheri A Levinson
- University of Louisville, Department of Psychological & Brain Sciences.
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Emotion generation and regulation following an intrusion induction: Implications for taboo or autogenous obsessions. J Behav Ther Exp Psychiatry 2020; 69:101593. [PMID: 32574801 DOI: 10.1016/j.jbtep.2020.101593] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/26/2020] [Accepted: 06/05/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Research demonstrates that autogenous (AO) and reactive obsessions (RO) differ in obsessional content; however, no experimental research has examined differences in emotion generation and regulation. Characterizing this taxonomy with respect to emotion generation and regulation could refine conceptualizations of obsessionality and optimize clinical interventions. METHODS Seventy undergraduates were randomly assigned to imagine a personally-relevant AO or RO. Subsequently, emotional reactivity was assessed. Participants then rated their emotion regulation efforts and the degree to which the intrusion violated their values. RESULTS Broadly aligning with expectations, bootstrapped linear regression models indicated that AOs led to a significant increase in self-conscious emotions (guilt, shame, and embarrassment), and these effects were stronger for those whose values were more severely threatened by the intrusion. A conditional process analysis revealed that the relationship between the AO condition and emotion regulation difficulties was explained by an increase in negative emotional reactivity, and the strength of this effect depended upon the degree of conflict with participants' values. LIMITATIONS The use of an analogue sample, and minimal emotional reactivity in the RO condition, threaten the ecological and external validity of the study. CONCLUSIONS The current study employed a novel experimental design demonstrating a meaningful relationship between AOs and both emotional activation and regulation. Results highlight the relevance of self-conscious emotions to the conceptualization of AOs and the utility of addressing them in the context of exposure therapy.
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Khosravani V, Samimi Ardestani SM, Mohammadzadeh A, Sharifi Bastan F, Amirinezhad A. The Emotional Schemas and Obsessive-Compulsive Symptom Dimensions in People with Obsessive-Compulsive Disorder. Int J Cogn Ther 2020. [DOI: 10.1007/s41811-020-00075-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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12
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Melli G, Moulding R, Puccetti C, Pinto A, Caccico L, Drabik MJ, Sica C. Assessing beliefs about the consequences of not just right experiences: Psychometric properties of the Not Just Right Experience-Sensitivity Scale (NJRE-SS). Clin Psychol Psychother 2020; 27:847-857. [PMID: 32378795 DOI: 10.1002/cpp.2468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 04/20/2020] [Accepted: 05/03/2020] [Indexed: 11/07/2022]
Abstract
Although current cognitive conceptualizations of obsessive-compulsive disorder (OCD) emphasize that rituals are performed in order to avoid overtly threatening outcomes, it has also been noted that there are individuals for whom the attempt to correct "not just right experiences" (NJREs) rather than dangerous outcomes per se appear important. This article examines the idea that individuals have differing tolerances for-or sensitivity to-NJREs, in a similar manner as occurs regarding for other experience such as the distinction between disgust propensity and disgust sensitivity. In Study 1, using a nonclinical Italian sample, the NJRE-Sensitivity Scale (NJRE-SS) was created and refined. Its final version consisted of eight items loading on two subscales-an intolerance of NJREs due to their perceived interference with cognitive tasks and due to their interference with enjoyment of life. In Study 2, the factor structured was confirmed in a separate sample. The measure was found to have convergent validity with related measures including a separate measure assessing the severity and frequency of NJREs themselves. However, the NJRE-SS predicted OCD symptoms over-and-above the general NJRE measure, with particularly the interference with cognitive tasks subscale being of importance. Clinical implications are discussed.
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Affiliation(s)
- Gabriele Melli
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence, Florence, Italy
| | - Richard Moulding
- Centre for Mental Health and Wellbeing Research, Deakin University, Melbourne, Australia
| | - Camilla Puccetti
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence, Florence, Italy
| | - Antonio Pinto
- Cognitive and Behavioral Psychotherapy Center, Naples, Italy
| | - Laura Caccico
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence, Florence, Italy
| | - Marta Joanna Drabik
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence, Florence, Italy
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Poli A, Melli G, Radomsky AS. Different Disgust Domains Specifically Relate to Mental and Contact Contamination Fear in Obsessive-Compulsive Disorder: Evidence From a Path Analytic Model in an Italian Clinical Sample. Behav Ther 2019; 50:380-394. [PMID: 30824253 DOI: 10.1016/j.beth.2018.07.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 07/11/2018] [Accepted: 07/22/2018] [Indexed: 11/17/2022]
Abstract
Both contact contamination (CC) and mental contamination (MC) fears-which combined represent the most common manifestation of obsessive-compulsive disorder (OCD)-have been widely associated with disgust propensity. However, extant research explored this relationship using measures assessing only pathogen-related disgust, not taking into account the potential role played by sexual and moral disgust, despite literature about MC suggesting that this might be particularly relevant. In Study 1, the psychometric properties of the Italian version of the Three Domains of Disgust Scale (TDDS) were assessed in a large Italian community sample. Exploratory and confirmatory factor analyses confirmed the three-factor structure of the TDDS. The scale also showed good internal consistency and construct validity. In Study 2, the differential patterns of relationships between CC and MC and the three disgust domains were explored in an Italian clinical OCD sample using a path analytic approach. The TDDS-Pathogen subscale was a unique predictor of CC while the TDDS-Sexual subscale was a unique predictor of MC, after controlling for anxiety and depression. Surprisingly, the TDDS-Moral subscale was not a predictor of either domain of contamination fear. Limitations and clinical implications are discussed.
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Affiliation(s)
- Andrea Poli
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence (IPSICO).
| | - Gabriele Melli
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence (IPSICO); University of Pisa
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Senderecka M, Kossowska M, Sekerdej M, Szewczyk J. Religious fundamentalism is associated with hyperactive performance monitoring: ERP evidence from correct and erroneous responses. Biol Psychol 2018; 140:96-107. [PMID: 30552949 DOI: 10.1016/j.biopsycho.2018.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 10/26/2018] [Accepted: 12/11/2018] [Indexed: 11/18/2022]
Abstract
The aim of the current study was to examine whether action monitoring is associated with religious fundamentalism. Participants performed a stop-signal task that required response inhibition to a simple auditory tone. The level of their religious fundamentalism was measured on a scale. Analysis with mixed-effects linear models revealed significantly larger error-related negativity, correct-related negativity, and post-error positivity components in individuals scoring higher on religious fundamentalism, pointing to their increased engagement in response monitoring. However, it was not accompanied by improved behavioral performance. The electrophysiological results of our study suggest that individuals high in religious fundamentalism engage more in monitoring for conflict between outcomes of their actions and standards of correct behavior. Our findings also point to a possible association between a fundamentalist mindset and higher levels of negative affect, uncertainty, anxiety, and distress, as measured by response-related brain activity.
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Affiliation(s)
- Magdalena Senderecka
- Institute of Philosophy, Jagiellonian University, Grodzka 52, 31-044 Kraków, Poland.
| | - Małgorzata Kossowska
- Institute of Psychology, Jagiellonian University, Ingardena 6, 30-060 Kraków, Poland
| | - Maciej Sekerdej
- Institute of Psychology, Jagiellonian University, Ingardena 6, 30-060 Kraków, Poland
| | - Jakub Szewczyk
- Institute of Psychology, Jagiellonian University, Ingardena 6, 30-060 Kraków, Poland
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Brennan BP, Wang D, Li M, Perriello C, Ren J, Elias JA, Van Kirk NP, Krompinger JW, Pope HG, Haber SN, Rauch SL, Baker JT, Liu H. Use of an Individual-Level Approach to Identify Cortical Connectivity Biomarkers in Obsessive-Compulsive Disorder. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 4:27-38. [PMID: 30262337 DOI: 10.1016/j.bpsc.2018.07.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 07/25/2018] [Accepted: 07/26/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Existing functional connectivity studies of obsessive-compulsive disorder (OCD) support a model of circuit dysfunction. However, these group-level observations have failed to yield neuroimaging biomarkers sufficient to serve as a test for the OCD diagnosis, predict current or future symptoms, or predict treatment response, perhaps because these studies failed to account for the substantial intersubject variability in structural and functional brain organization. METHODS We used functional regions, localized in each of 41 individual OCD patients, to identify cortical connectivity biomarkers of both global and dimension-specific symptom severity and to detect functional connections that track changes in symptom severity following intensive residential treatment. RESULTS Global OCD symptom severity was directly linked to dysconnectivity between large-scale intrinsic brain networks-particularly among the dorsal attention, default, and frontoparietal networks. Changes within a subset of connections among these networks were associated with symptom resolution. Additionally, distinct and nonoverlapping cortical connectivity biomarkers were identified that were significantly associated with the severity of contamination/washing and responsibility for harm/checking symptoms, highlighting the contribution of dissociable neural networks to specific OCD symptom dimensions. By contrast, when we defined functional regions conventionally, using a population-level brain atlas, we could no longer identify connectivity biomarkers of severity or improvement for any of the symptom dimensions. CONCLUSIONS Our findings would seem to encourage the use of individual-level approaches to connectivity analyses to better delineate the cortical and subcortical networks underlying symptom severity and improvement at the dimensional level in OCD patients.
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Affiliation(s)
- Brian P Brennan
- Biological Psychiatry Laboratory, McLean Hospital, Belmont, Massachusetts; Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
| | - Danhong Wang
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Meiling Li
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu
| | - Chris Perriello
- Biological Psychiatry Laboratory, McLean Hospital, Belmont, Massachusetts
| | - Jianxun Ren
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jason A Elias
- Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Nathaniel P Van Kirk
- Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Jason W Krompinger
- Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Harrison G Pope
- Biological Psychiatry Laboratory, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Suzanne N Haber
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Scott L Rauch
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Justin T Baker
- Psychotic Disorders Division, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Hesheng Liu
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China; Institute for Research and Medical Consultations, Imam Abdulahman Bin Faisal University, Dammam, Saudi Arabia.
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16
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Fontenelle LF, Frydman I, Hoefle S, Oliveira-Souza R, Vigne P, Bortolini TS, Suo C, Yücel M, Mattos P, Moll J. Decoding moral emotions in obsessive-compulsive disorder. Neuroimage Clin 2018; 19:82-89. [PMID: 30035005 PMCID: PMC6051311 DOI: 10.1016/j.nicl.2018.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 03/07/2018] [Accepted: 04/01/2018] [Indexed: 11/20/2022]
Abstract
Background Patients with obsessive-compulsive disorder (OCD) exhibit abnormal neural responses when they experience particular emotions or when they evaluate stimuli with emotional value. Whether these brain responses are sufficiently distinctive to discriminate between OCD patients and healthy controls is unknown. The present study is the first to investigate the discriminative power of multivariate pattern analysis of regional fMRI responses to moral and non-moral emotions. Method To accomplish this goal, we performed a searchlight-based multivariate pattern analysis to unveil brain regions that could discriminate 18 OCD patients from 18 matched healthy controls during provoked guilt, disgust, compassion, and anger. We also investigated the existence of distinctive neural patterns while combining those four emotions (herein termed multiemotion analysis). Results We found that different frontostriatal regions discriminated OCD patients from controls based on individual emotional experiences. Most notably, the left nucleus accumbens (NAcc) discriminated OCD patients from controls during both disgust and the multiemotion analysis. Among other regions, the angular gyrus responses to anger and the lingual and the middle temporal gyri in the multi-emotion analysis were highly discriminant between samples. Additional BOLD analyses supported the directionality of these findings. Conclusions In line with previous studies, differential activity in regions beyond the frontostriatal circuitry differentiates OCD from healthy volunteers. The finding that the response of the left NAcc to different basic and moral emotions is highly discriminative for a diagnosis of OCD confirms current pathophysiological models and points to new venues of research.
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Affiliation(s)
- Leonardo F Fontenelle
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil; Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia; Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil.
| | - Ilana Frydman
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil; Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
| | - Sebastian Hoefle
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | | | - Paula Vigne
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil; Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
| | - Tiago S Bortolini
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Chao Suo
- Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia
| | - Murat Yücel
- Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia
| | - Paulo Mattos
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Jorge Moll
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
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17
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Gazzillo F, Gorman B, De Luca E, Faccini F, Bush M, Silberschatz G, Dazzi N. Preliminary Data about the Validation of a Self-Report for the Assessment of Interpersonal Guilt: The Interpersonal Guilt Rating Scales-15s (IGRS-15s). Psychodyn Psychiatry 2018; 46:23-48. [PMID: 29480782 DOI: 10.1521/pdps.2018.46.1.23] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The aim of this article is to present validation data about a self-report rating scale for the assessment of interpersonal guilt according to Control-Mastery Theory (CMT; Silbershatz, 2005; Weiss, 1993; Weiss, Sampson, & The Mount Zion Psychotherapy Research Group, 1986), the Interpersonal Guilt Rating Scale-15s (IGRS-15s). In order to perform the validation of this tool in an Italian sample we have collected a sample of 645 nonclinical subjects. They had to complete the IGRS-15s, the Scale for the Measurement of the Impending Punishment (SMIP; Caprara et al., 1990), the Interpersonal Guilt Questionnaire-67 (IGQ-67; O'Connor et al., 1997), the Psychological General Well-Being Index (PGWBI; Dupuy, 1984), and the Affective Neuroscience Personality Scales (ANPS; Davis, Panksepp, & Normansell, 2003), together with an ad-hoc questionnaire for collecting demographic data, the Socio-Demographical Schedule. We have performed a confirmatory factor analysis to verify if the four-factor solution based on CMT and replicated in previous research (Gazzillo et al., 2017) was confirmed. Then, we checked the retest reliability of IGRS-15s after four weeks in a random subsample of 54 subjects. In order to assess its concurrent and discriminant validity, we calculated the correlations between IGRS-15s assessment and SMIP and IGQ-67. Finally, to test its construct validity, we assessed the relationships between the IGRS-15s and the affective systems using the ANPS and the wellbeing assessed with the PGWBI. The data collected support the retest reliability and the concurrent and discriminant validity of the measure, and we have collected preliminary data about its construct validity. Examples of the possible clinical and research applications of this tool are discussed.
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Affiliation(s)
- Francesco Gazzillo
- Researcher, Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Italy
| | - Bernard Gorman
- Professor Emeritus, Derner Institute of Advanced Psychological Studies, Adelphi University, Garden City, New York
| | - Emma De Luca
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Italy
| | - Filippo Faccini
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Italy
| | - Marshall Bush
- San Francisco Psychotherapy Research Group, San Francisco, CA
| | | | - Nino Dazzi
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Italy
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18
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Parsing sensitivity to negative affect in borderline personality disorder: A comparison of anxiety and disgust. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2017.06.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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