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Sher A, Wootton BM, Paparo J. A preliminary investigation of the mediating roles of self-compassion and emotion dysregulation in the relationship between maladaptive perfectionism and obsessive-compulsive behaviors. J Clin Psychol 2024; 80:591-609. [PMID: 38236198 DOI: 10.1002/jclp.23640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 11/02/2023] [Accepted: 12/27/2023] [Indexed: 01/19/2024]
Abstract
INTRODUCTION Recent research has highlighted an association between maladaptive perfectionism and obsessive-compulsive disorder (OCD). However, the mechanisms underlying this relationship are not well understood. The primary aim of this preliminary study was to investigate whether self-compassion and emotion dysregulation independently mediated this relationship. The secondary aim was to determine whether serial mediation existed between these factors. Whether these relations held for overall obsessive-compulsive (OC) symptoms, versus distinct dimensions of OCD, was also of interest. METHOD Three hundred and ninety-two university students (Mage = 21.81, SD = 8.01), predominantly female (79.18%), participated in an online questionnaire that included a dimensional measure of OCD. Scales assessing maladaptive perfectionism, self-compassion, emotion dysregulation, and negative emotion states were also included. RESULTS Greater maladaptive perfectionism was related to more severe OCD. Emotion dysregulation, but not self-compassion, independently mediated this relationship. A serial mediation relationship was found, in that greater maladaptive perfectionism was associated with lower self-compassion, which was linked to greater emotion dysregulation, and in turn related to more severe OC behaviors. In addition, distinct patterns emerged for separate OC dimensions. CONCLUSIONS These findings highlight emotion regulation and self-compassion as potential targets for OCD prevention, especially in individuals with symptoms in the symmetry and unacceptable thoughts dimensions.
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Affiliation(s)
- Alyssa Sher
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Bethany M Wootton
- Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Josephine Paparo
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
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2
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Miegel F, Daubmann A, Moritz S, Balzar A, Yassari AH, Jelinek L. Obsessive-Compulsive Symptom Dimensions and Their Relationships with Obsessive Beliefs: A Structural Equation Modeling Analysis. Psychiatr Q 2023; 94:345-360. [PMID: 37410191 DOI: 10.1007/s11126-023-10037-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/13/2023] [Indexed: 07/07/2023]
Abstract
Dysfunctional beliefs are central in the development and maintenance of obsessive-compulsive disorder (OCD) as well as its treatment. Yet, research suggests that not all dysfunctional beliefs are equally important for each of the symptom dimensions of OCD. However, results are inconsistent in that studies contradict each other regarding the associations between specific symptom dimensions and belief domains. The aim of the present study was to clarify which belief domain is specifically associated with which OCD symptom dimension. Results could help to tailor treatments more specifically to the patient's OCD symptom dimension. In- and outpatients with OCD (N = 328; 43.6% male and 56.4% female) filled out questionnaires on symptom dimensions of OCD (Obsessive-Compulsive Inventory Revised) and dysfunctional beliefs (Obsessive Beliefs Questionnaire). A structural equation model analysis was conducted to identify the associations between dysfunctional beliefs and symptom dimensions. Our results showed that perfectionism/intolerance of uncertainty was associated with hoarding and symmetry/ordering, (2) overestimation of threat/inflated responsibility was associated with checking compulsions, and (3) importance of thoughts/control of thoughts was associated with obsessing. These results were largely supported by a backward selection. Our results demonstrated associations of specific dysfunctional beliefs and specific OCD symptom dimensions. However, future studies are necessary to replicate these findings with other measures (e.g., clinician ratings).
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Affiliation(s)
- Franziska Miegel
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
| | - Anne Daubmann
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Alicia Balzar
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Amir-Hosseyn Yassari
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
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Dostal AL, Pilkington PD. Early maladaptive schemas and obsessive-compulsive disorder: A systematic review and meta-analysis. J Affect Disord 2023; 336:42-51. [PMID: 37217101 DOI: 10.1016/j.jad.2023.05.053] [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: 01/12/2023] [Revised: 05/10/2023] [Accepted: 05/16/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a condition with poor treatment outcomes. Improved understanding of the aetiology can inform prevention and treatment approaches; hence several studies have assessed early maladaptive schemas (EMSs) in OCD. This systematic review and meta-analysis aimed to synthesise the evidence on relationships between the 18 EMSs and OCD. METHODS The study was conducted according to PRISMA guidelines and registered on PROSPERO (CRD42022329337). A systematic search of PubMed, PsycINFO, and CINAHL Complete was conducted on 4 June 2022. Studies in peer-reviewed journal articles were included if they assessed EMSs and OCD (diagnosis or symptom severity) in adults with a mean age of 18 years or older. Studies were excluded if they were not in English, did not include original quantitative data, or reported on case studies. Study details were tabulated and the meta-analysis findings were presented using forest plots. Methodological quality was assessed using the Appraisal tool for Cross-Sectional Studies (AXIS). RESULTS Based on 22 studies (pooled N = 3699), all 18 EMSs were positively correlated with OCD. The largest associations were with the dependence/incompetence (r = 0.40 95 % CI [0.32, 0.47]), vulnerability to harm or illness (r = 0.40 95 % CI [0.32, 0.48]), and negativity/pessimism schemas (r = 0.42 95 % CI [0.22, 0.58]). LIMITATIONS Several meta-analyses showed considerable heterogeneity and publication bias. CONCLUSIONS The findings suggest all EMSs, particularly those relating to disproportionate negative expectations and a perceived inability to cope, are implicated in OCD. Psychological prevention and treatment for OCD may benefit from targeting these schemas.
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Affiliation(s)
- Amy L Dostal
- School of Behavioural and Health Sciences, Australian Catholic University, Australia.
| | - Pamela D Pilkington
- School of Behavioural and Health Sciences, Australian Catholic University, Australia
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4
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Destrée L, Albertella L, Jobson L, McGorry P, Chanen A, Ratheesh A, Davey C, Polari A, Amminger P, Yuen HP, Hartmann J, Spooner R, Fontenelle LF, Nelson B. The association between stressful experiences and OCD symptoms in young adults at transdiagnostic risk. J Affect Disord 2023; 328:128-134. [PMID: 36812805 DOI: 10.1016/j.jad.2023.02.059] [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: 09/17/2022] [Revised: 12/06/2022] [Accepted: 02/14/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND It is unclear whether there is a specific association between stressful experiences and obsessive-compulsive symptoms or whether this relationship is due to stressful experiences increasing risk for psychopathology generally. AIMS The current study examined the association between stressful experiences and obsessive-compulsive symptom dimensions, while adjusting for coexisting psychiatric symptoms and psychological distress in a young adult transdiagnostic at-risk sample. METHODS Forty-three participants completed self-report measures assessing obsessive-compulsive symptoms, stressful experiences, and a range of other psychiatric symptoms. Regression models examined the relationship between stressful experiences and different obsessive-compulsive symptoms dimensions (i.e., symmetry, fear of harm, contamination, and unacceptable thoughts), adjusting for the influence of coexisting psychiatric symptoms and psychological distress. RESULTS The results showed that there was an association between stressful experiences and obsessive-compulsive symptoms dimension of symmetry. Symptoms of borderline personality disorder were positively associated with the obsessive-compulsive symptom dimensions of symmetry and fear of harm symptoms. Symptoms of psychosis were found to be negatively associated with the obsessive-compulsive symptoms dimension of fear of harm. CONCLUSIONS These findings have implications for understanding the psychological mechanisms that underlie symmetry symptoms and highlight the need to study OCS dimensions separately to inform more precise, mechanism-targeted interventions.
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Affiliation(s)
- Louise Destrée
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Victoria, Australia; Orygen, Parkville, VIC, Australia.
| | - Lucy Albertella
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Victoria, Australia
| | - Laura Jobson
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Victoria, Australia
| | - Patrick McGorry
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Andrew Chanen
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Aswin Ratheesh
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Christopher Davey
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Andrea Polari
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Paul Amminger
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Hok Pan Yuen
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Jessica Hartmann
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Rachael Spooner
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Leonardo F Fontenelle
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Brazil; D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Barnaby Nelson
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
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Fernandez SJ, Daffern M, Moulding R, Nedeljkovic M. Exploring predictors of aggressive intrusive thoughts and aggressive scripts: Similarities and differences in phenomenology. Aggress Behav 2023; 49:141-153. [PMID: 36408970 PMCID: PMC10100145 DOI: 10.1002/ab.22061] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 10/27/2022] [Accepted: 11/07/2022] [Indexed: 11/23/2022]
Abstract
Experiencing a thought about harming or injuring another person is commonly reported by the general population. Aggressive intrusive thoughts (AITs) and aggressive scripts are two constructs commonly used to define the experience of thinking about harming another person. However, they are generally investigated separately and with two significantly different population groups; respectively, individuals with obsessive-compulsive disorder and people with a history of violent behavior. AITs and aggressive scripts are assumed to have very different implications for violence risk assessment, but conceptual overlap and an absence of empirical research renders this assumption premature. Using a battery of self-report measures, this study aimed to investigate the differential predictors of AITs and aggressive script rehearsal in a nonclinical sample. Additionally, using regression analyses, the predictors of self-reported aggressive behavior were explored in a sample of 412 adults (73% females; Mage = 31.96 years, SD = 11.02). Violence-supportive beliefs and frequency of anger rumination predicted the frequency of aggressive script rehearsal, and aggressive script rehearsal, anger rumination, and violence-supportive beliefs predicted a history of aggressive behavior. In contrast, obsessive beliefs were predictive of AITs, and only AITs were related to ego-dystonicity. Both AITs and aggressive script rehearsal were related to the use of thought control strategies. These findings support the contributions that maladaptive beliefs have in the experience of aggressive scripts and AITs. Beliefs about violence, a history of aggressive behavior, and ego-dystonicity appear to differentiate aggressive scripts from AITs.
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Affiliation(s)
- Stephanie J Fernandez
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Melbourne, Australia.,Centre for Forensic Behavioural Science, Swinburne University of Technology, Alphington, Melbourne, Australia
| | - Michael Daffern
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Melbourne, Australia.,Centre for Forensic Behavioural Science, Swinburne University of Technology, Alphington, Melbourne, Australia
| | | | - Maja Nedeljkovic
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Melbourne, Australia
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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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7
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Moreton SG, Burden-Hill A, Menzies RE. Reduced death anxiety and obsessive beliefs as mediators of the therapeutic effects of psychedelics on obsessive compulsive disorder symptomology. CLIN PSYCHOL-UK 2022. [DOI: 10.1080/13284207.2022.2086793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Sam G. Moreton
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - Amber Burden-Hill
- School of Psychology, University of Wollongong, Wollongong, Australia
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8
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Cervin M, McNeel MM, Wilhelm S, McGuire JF, Murphy TK, Small BJ, Geller DA, Storch EA. Cognitive Beliefs Across the Symptom Dimensions of Pediatric Obsessive-Compulsive Disorder: Type of Symptom Matters. Behav Ther 2022; 53:240-254. [PMID: 35227401 PMCID: PMC9397538 DOI: 10.1016/j.beth.2021.08.001] [Citation(s) in RCA: 2] [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] [Received: 03/12/2021] [Revised: 08/06/2021] [Accepted: 08/12/2021] [Indexed: 02/03/2023]
Abstract
The cognitive model of obsessive-compulsive disorder (OCD) posits that dysfunctional cognitive beliefs are crucial to the onset and maintenance of OCD; however, the relationship between these cognitive beliefs and the heterogeneity of OCD symptoms in children and adolescents remains unknown. We examined how the major belief domains of the cognitive model (inflated responsibility/threat estimation, perfectionism/intolerance of uncertainty, importance/control of thoughts) and dysfunctional metacognitions were related to OCD symptoms across the following dimensions: doubting/checking, obsessing, hoarding, washing, ordering, and neutralization. Self-report ratings from 137 treatment-seeking youth with OCD were analyzed. When cognitive beliefs and symptom dimensions were analyzed in tandem, inflated responsibility/threat estimation and dysfunctional metacognitions were uniquely related to doubting/checking, obsessing, and hoarding and perfectionism/intolerance of uncertainty to ordering. Cognitive beliefs explained a large proportion of variation in doubting/checking (61%) and obsessing (46%), but much less so in ordering (15%), hoarding (14%), neutralization (8%), and washing (3%). Similar relations between cognitive beliefs and symptom dimensions were present in children and adolescents. Cognitive beliefs appear to be relevant for pediatric OCD related to harm, responsibility, and checking, but they do not map clearly onto contamination and symmetry-related symptoms. Implications for OCD etiology and treatment are discussed.
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Affiliation(s)
| | | | - Sabine Wilhelm
- Massachusetts General Hospital and Harvard Medical School
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9
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The relationship between symptom dimensions and cognitive features in obsessive compulsive disorder. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-021-02540-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Radomsky AS, Alcolado GM, Dugas MJ, Lavoie SL. Responsibility, probability, and severity of harm: An experimental investigation of cognitive factors associated with checking-related OCD. Behav Res Ther 2022; 150:104034. [DOI: 10.1016/j.brat.2022.104034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 11/12/2021] [Accepted: 01/05/2022] [Indexed: 11/02/2022]
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11
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Dar R, Lazarov A, Liberman N. Seeking proxies for internal states (SPIS): Towards a novel model of obsessive-compulsive disorder. Behav Res Ther 2021; 147:103987. [PMID: 34688103 DOI: 10.1016/j.brat.2021.103987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 10/04/2021] [Accepted: 10/07/2021] [Indexed: 12/17/2022]
Abstract
The Seeking Proxies for Internal States (SPIS) model of obsessive-compulsive disorder (OCD) proposes an account of OCD symptoms in terms of two core components: attenuation of access to internal states and seeking proxies for internal states. Specifically, the SPIS model posits that OCD is associated with difficulty in accessing various internal states, including feelings, preferences, memories, and even physiological states. This difficulty drives obsessive-compulsive individuals seek and rely on compensatory proxies, or substitutes, for their internal states. These proxies are perceived by the individual with OCD to be more easily discernible or less ambiguous compared to the internal states for which they substitute, and can take the form of fixed rules, rituals, or reliance on external sources of information. In the present article we first provide a detailed explanation of the SPIS model, and then review empirical studies that examined the model in a variety of domains, including bodily states, emotions, and decision-making. Next, we elaborate on the SPIS model's novel account of compulsive rituals, obsessions and doubt and relate them to extant theoretical accounts of OCD. To conclude, we highlight open questions that can guide future research and discuss the model's clinical implications.
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Affiliation(s)
- Reuven Dar
- School of Psychological Sciences, Tel Aviv University, Israel.
| | - Amit Lazarov
- School of Psychological Sciences, Tel Aviv University, Israel
| | - Nira Liberman
- School of Psychological Sciences, Tel Aviv University, Israel
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12
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Candelari AE, Wojcik KD, Wiese AD, Goodman WK, Storch EA. Expert opinion in obsessive-compulsive disorder: Treating patients with obsessive-compulsive disorder during the COVID-19 pandemic. PERSONALIZED MEDICINE IN PSYCHIATRY 2021. [PMCID: PMC8012101 DOI: 10.1016/j.pmip.2021.100079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This commentary outlines assessment and treatment of patients with OCD during the era of COVID-19. The ongoing COVID-19 pandemic has required providers to make important considerations in treatment, including how usual risk is defined, as well as the use of personal protective equipment and telehealth services. These considerations have allowed providers to continue using both reliable and valid assessment procedures, as well as previously established and efficacious interventions. These adjustments create a context in which patient care for OCD remains fundamentally unchanged; however, important considerations should still be made because of the COVID-19 pandemic.
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13
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Pinciotti CM, Riemann BC, Abramowitz JS. Intolerance of uncertainty and obsessive-compulsive disorder dimensions. J Anxiety Disord 2021; 81:102417. [PMID: 33991818 DOI: 10.1016/j.janxdis.2021.102417] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 04/23/2021] [Accepted: 05/04/2021] [Indexed: 01/23/2023]
Abstract
Intolerance of uncertainty (IU), which can include prospective (i.e., desire for predictability) and inhibitory (i.e., uncertainty paralysis) IU, is widely understood to be a central underlying component of obsessive-compulsive disorder (OCD). IU has several treatment implications, yet research on the differences in IU underlying OCD dimensions is limited and does not account for covarying effects of overlapping symptoms, shared variance in IU, demographic variables, and comorbid psychiatric conditions like generalized anxiety disorder (GAD) and posttraumatic stress disorder (PTSD). A sample of 974 patients with diagnosed OCD enrolled in residential, partial hospitalization, and intensive outpatient treatment programs for OCD and anxiety completed self-report measures of OCD symptoms and IU at admission. Structural equation modeling included prospective. inhibitory IU, and common IU and covariates (i.e., race, ethnicity, level of care, and comorbid GAD and PTSD) as predictors of four common OCD dimensions found that contamination and unacceptable thoughts symptoms evidenced a unique relationship with IU. Specifically, whereas a common IU factor predicted all four OCD symptom dimensions, inhibitory IU uniquely predicted contamination and unacceptable thoughts symptoms over and above covarying effects. Individuals with contamination and unacceptable thoughts symptoms may be more likely to feel "paralyzed" by uncertainty due to overreliance on overt immediate rituals, outright avoidance, rumination, or difficulties with emotion regulation, and may benefit from additional psychoeducation, problem-solving, and accountability. Broadly, individuals with OCD may benefit from explicit discussions about IU-related expectancies and disconfirmation of fears.
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Affiliation(s)
| | - Bradley C Riemann
- Rogers Behavioral Health, 34700 Valley Rd., Oconomowoc, WI, 53066, USA
| | - Jonathan S Abramowitz
- Department of Psychology and Neuroscience, University of North Carolina-Chapel Hill, 235 E. Cameron Ave, Chapel Hill, NC, 27514, USA
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Technology supported mindfulness for obsessive compulsive disorder: The role of obsessive beliefs. J Anxiety Disord 2021; 81:102405. [PMID: 33910091 DOI: 10.1016/j.janxdis.2021.102405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 11/21/2022]
Abstract
The current study examined the association of OCD symptoms and OCD belief domains, for individuals engaged in Technology Supported Mindfulness training (TSM) using an EEG-based biofeedback device (called "Muse") that permits individuals to engage in home based mindfulness meditation practices. In this randomized controlled study, treatment-seeking participants with a principal DSM-5 diagnosis of OCD (N = 71) were randomly assigned to eight weeks of: 1) a meditation program involving daily use of the "Muse" device, or 2) wait list control. At weeks 1, 4, and 8, participants completed self-report measures of OCD symptoms (YBOCS: Yale-Brown Obsessive Compulsive Scale) and OCD beliefs (OBQ; OCCWG, 2005). Latent Difference Score (LDS) models indicated that there was no significant longitudinal relationship between OBQ "Responsibility/Threat" (OBQ R/T) scores and OCD symptoms. The analysis of OBQ "Perfectionism/Certainty" (OBQ P/C) and OCD symptoms demonstrated a significant reciprocal relationship between these two variables, in which OCD symptoms predicted subsequent increases in OBQ P/C and vice versa. The analysis of OBQ "Importance/Control of Thoughts" (OBQ I/C) and OCD symptoms demonstrated a significant reciprocal relationship between these two variables, in which OCD symptoms predicted subsequent increases in OBQ I/C and vice versa. The analysis of OBQ domains and EEG derived attentional changes demonstrated a significant association between OBQ P/C and Alpha band frequencies. These results clarify the association of OBQ belief domains, OCD symptom change and EEG derived indicators of attention during TSM.
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Hudiburgh SE, Reese HE, Carver CS, Çek D, Timpano KR. A multi-method examination of the link between obsessive-compulsive symptomatology and emotion-related impulsivity. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 60:293-311. [PMID: 33836094 DOI: 10.1111/bjc.12290] [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: 08/31/2020] [Revised: 02/06/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Obsessive-compulsive disorder (OCD) is a condition marked by recurrent and distressing thoughts, images, and urges accompanied by repetitive physical or mental rituals. An emerging line of work suggests that emotion may be an important consideration when looking at the role of impulsivity across the spectrum of psychopathology, including OCD. The current study examined the relationship between obsessive-compulsive symptomatology (OCS) and impulsive cognitive and behavioural reactions to emotion using a multi-study, multi-method approach. DESIGN Data were collected cross-sectionally online (Study 1) or via an in-person laboratory visit (Study 2). METHODS In Study 1, self-report measures of impulsivity and OCS were administered to a large, non-selected community sample (N = 386). Study 2 extended these findings with a young adult sample (N = 107) with clinically elevated OCS using self-report measures, clinical interview, and two behavioural symptom provocation tasks. RESULTS Emotion-related impulsivity, but not non-emotion-related impulsivity, was associated with greater severity of OCS across symptom domains and across all modes of assessment. Impulsive cognitive responses to emotion were associated with greater obsession severity, while impulsive behavioural reactions to emotion were associated with greater compulsions. Emotion-related impulsivity also acted synergistically with a belief in the importance and control of thoughts, such that this established risk factor for OCD was associated with greater OCS severity only when behavioural reactivity to emotion was also present. CONCLUSIONS Results highlight the importance of considering emotional context when studying impulsivity in OCD, and point to the potentially differential relationship between OCS and behavioural versus cognitive impulsive reactions to emotion. PRACTITIONER POINTS Emotion-related impulsivity (ERI) reflects a tendency to act impulsively in the context of strong emotions. ERI was associated with greater OCS across symptom domains and type of symptom assessment (self-report, interview, or symptom provocation). ERI also interacted with an established OCS risk factor, a belief in the importance and control of thoughts, to predict symptom severity, suggesting that it may be important to evaluate and address ERI alongside unhelpful beliefs in patients with OCS. Given the present study's cross-sectional nature, we cannot draw conclusions about the directionality of the ERI - OCS relationship, and while our study included individuals with clinically elevated OCS, results should be replicated in a fully clinical sample.
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Affiliation(s)
| | | | | | - Demet Çek
- University of Miami, Coral Gables, Florida, USA
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16
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Ching THW, Wetterneck CT, Williams MT, Chase T. Sexual Trauma, Cognitive Appraisals, and Sexual Intrusive Thoughts and Their Subtypes: A Moderated Mediation Analysis. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:2907-2917. [PMID: 32914249 DOI: 10.1007/s10508-020-01809-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 06/11/2023]
Abstract
The relationships between sexual trauma, cognitive appraisals, and subtypes of sexual intrusive thoughts have not been adequately examined in the context of obsessive-compulsive concerns. We employed variations of a moderated mediation model to test these relationships, situating sexual trauma as the predictor, sexual intrusive thoughts as the outcome, cognitive appraisals of these thoughts as the mediator, and subtypes of sexual intrusive thoughts as the moderator of the predictor-mediator link. Based on the continuum perspective, 180 individuals (159 females, 21 males) with or without a history of sexual trauma were recruited to complete measures assessing their most distressing sexual intrusion, cognitive appraisals, and severity of sexual intrusive thoughts. The results indicated that individuals with a history of sexual trauma reported more intrusions with sexual harm content, greater distress with sexual intrusions, more dysfunctional appraisals, and more severe sexual intrusions. The trauma-sexual intrusions link was also separately mediated by responsibility and importance/control appraisals (and when combined), with medium-to-large effect sizes, although this model was not moderated by whether intrusions contained sexual harm content or not. These findings shed light on the posttraumatic effects of sexual violence on sexual intrusions, their appraisals, and level of distress and functional impairment associated with sexual intrusive thoughts, with key clinical and research implications.
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Affiliation(s)
- Terence H W Ching
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269, USA.
| | | | - Monnica T Williams
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269, USA
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Tannah Chase
- The Anxiety Counseling Clinic, New Braunfels, TX, USA
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Do you believe in magical thinking? Examining magical thinking as a mediator between obsessive-compulsive belief domains and symptoms. Behav Cogn Psychother 2020; 48:454-462. [PMID: 32178750 DOI: 10.1017/s1352465820000132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Despite substantial research attention on obsessive beliefs, more research is needed to understand how these beliefs serve as aetiological or maintaining factors for obsessive-compulsive (OC) symptoms. Magical thinking may allow individuals to gain a sense of control when experiencing intrusive thoughts and corresponding obsessive beliefs, potentially accounting for why OC belief domains are often related to OC symptoms. AIMS This study examines magical thinking as a mediating variable in the relationship between OC belief domains and symptoms. METHOD Undergraduate students (n = 284) reported their obsessive beliefs, magical thinking, and OC symptoms. RESULTS As expected, there were significant indirect effects for the belief domain of inflated responsibility and over-estimation of threat on OC symptoms via magical thinking. There was also an indirect effect for the belief domain of importance and control of thoughts on OC symptoms via magical thinking. Unexpectedly, there was no indirect effect involving the belief domain of perfectionism and intolerance of uncertainty. CONCLUSIONS Magical thinking may be one mechanism through which certain OC beliefs lead to OC symptoms. It may be that magical thinking serves as a coping mechanism in response to elevated beliefs. Future studies should extend these findings across time and clinical samples.
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Prior Beliefs About the Importance and Control of Thoughts are Predictive But Not Specific to Subsequent Intrusive Unwanted Thoughts and Neutralizing Behaviors. COGNITIVE THERAPY AND RESEARCH 2019. [DOI: 10.1007/s10608-019-10046-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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Raines AM, Carroll MN, Mathes BM, Franklin CL, Allan NP, Constans JI. Examining the Relationships Between Perfectionism and Obsessive-Compulsive Symptom Dimensions Among Rural Veterans. J Cogn Psychother 2019; 33:58-70. [DOI: 10.1891/0889-8391.33.1.58] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Perfectionism, a trait-like individual difference variable reflecting the tendency to set extremely high standards along with critical evaluations of one's own behavior, has long been regarded as a risk and maintenance factor for obsessive-compulsive disorder (OCD). However, research exploring the relationship between these constructs is mixed. One explanation for these equivocal findings is the heterogeneous nature of OCD. Indeed, there is increasing evidence for distinct symptom dimensions that are more homogenous than the broad OCD phenotype. The current study examined the associations between self-reported perfectionism and OCD symptom dimensions controlling for probable depression status. The sample included 67 rural veterans. Results revealed a unique association between perfectionism and the unacceptable thoughts dimension of OCD. These findings are consistent with a growing body of literature demonstrating that OCD symptom dimensions have unique underlying dysfunctional beliefs.
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20
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Tripathi A, Avasthi A, Grover S, Sharma E, Lakdawala BM, Thirunavukarasu M, Dan A, Sinha V, Sareen H, Mishra KK, Rastogi P, Srivastava S, Dhingra I, Behere PB, Solanki RK, Sinha VK, Desai M, Reddy YCJ. Gender differences in obsessive-compulsive disorder: Findings from a multicentric study from India. Asian J Psychiatr 2018; 37:3-9. [PMID: 30086467 DOI: 10.1016/j.ajp.2018.07.022] [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: 02/26/2018] [Accepted: 07/31/2018] [Indexed: 11/28/2022]
Abstract
Obsessive-compulsive disorder (OCD) is phenotypically heterogeneous. Gender is an important factor mediating this heterogeneity. We examined gender differences in a large sample (n = 945) of OCD patients under a multi-centric study in India. Cross-sectional assessments were done on consecutive adult (>18 years) treatment-seeking patients with a DSM-5 diagnosis of OCD. Subjects were assessed on Structured Clinical Interview for DSM-5-Research Version for comorbid psychiatric illnesses, Yale Brown Obsessive Compulsive Scale for OCD phenomenology and symptom severity, Brown Assessment of Beliefs Scale for insight, Beck's Depression Inventory for severity of depressive symptoms, and the Obsessive Beliefs Questionnaire. On multivariate backward Wald logistic regression analysis, males (59.7%) had more years of education, had a higher rate of checking compulsions and comorbid substance use disorders. Women were more likely to be married, more commonly reported precipitating factors, had a higher rate of hoarding compulsions and comorbid agoraphobia. Findings from this large study validate gender as an important mediator of phenotypic heterogeneity in OCD. The mechanistic basis for these differences might involve complex interactions between biological, cultural and environmental factors.
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Affiliation(s)
| | - Ajit Avasthi
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeep Grover
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Eesha Sharma
- National Institute of Mental Health and Neurosciences, Bangalore, India.
| | | | - M Thirunavukarasu
- SRM Medical College Hospital & Research Center, Kattankulathur, Kanchipuram District, 603203, India
| | | | | | | | | | - Pali Rastogi
- MGM Medical College & MYH Hospital, Indore, India
| | - Shruti Srivastava
- University College of Medical Sciences and GTBH, Dilshad Garden, Delhi, India
| | | | - Prakash B Behere
- Dr D.Y. Patil University Kasba Bawda, Kolhapur 416006, Maharashtra, India
| | | | - Vinod K Sinha
- Central Institute of Psychiatry, Ranchi, Jharkhand, India
| | - Mahesh Desai
- Karnataka Institute of Medical Sciences (KIMS), Hubli, Karnataka India
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21
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Kanehisa M, Kawashima C, Nakanishi M, Okamoto K, Oshita H, Masuda K, Takita F, Izumi T, Inoue A, Ishitobi Y, Higuma H, Ninomiya T, Akiyoshi J. Gender differences in automatic thoughts and cortisol and alpha-amylase responses to acute psychosocial stress in patients with obsessive-compulsive personality disorder. J Affect Disord 2017; 217:1-7. [PMID: 28363118 DOI: 10.1016/j.jad.2017.03.057] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 03/06/2017] [Accepted: 03/26/2017] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Obsessive-compulsive personality disorder (OCPD) has a pervasive pattern of preoccupation with orderliness, perfection, and mental and interpersonal control at the expense of flexibility, openness, and efficiency. The aims of the present study were to explore the relationship between OCPD and psychological stress and psychological tests. METHODS We evaluated 63 OCPD patients and 107 healthy controls (HCs). We collected saliva samples from patients and controls before and after a social stress procedure, the Trier Social Stress Test (TSST), to measure the concentrations of salivary alpha-amylase (sAA) and salivary cortisol. The Childhood Trauma Questionnaire (CTQ), Profile of Mood State (POMS), State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), Social Adaptation Self-Evaluation Scale (SASS), and Depression and Anxiety Cognition Scale (DACS) were administered to patients and HCs. RESULTS Following TSST exposure, the salivary amylase and cortisol levels were significantly decreased in male patients compared with controls. Additionally, OCPD patients had higher CTQ, POMS, STAI, and BDI scores than HCs and exhibited significantly higher anxiety and depressive states. OCPD patients scored higher on future denial and threat prediction as per the DACS tool. According to a stepwise regression analysis, STAI, POMS, and salivary cortisol responses were independent predictors of OCPD. CONCLUSIONS Our results suggested that attenuated sympathetic and parasympathetic reactivity in male OCPD patients occurs along with attenuated salivary amylase and cortisol responses to the TSST. In addition, there was a significant difference between OCPD patients and HCs in child trauma, mood, anxiety, and cognition. The finding support the modeling role of cortisol (20min) on the relationships between STAI trait and depression among OCPD.
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Affiliation(s)
- Masayuki Kanehisa
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan
| | - Chiwa Kawashima
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan
| | - Mari Nakanishi
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan
| | - Kana Okamoto
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan
| | - Harumi Oshita
- Department of Applied Linguistics, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan
| | - Koji Masuda
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan
| | - Fuku Takita
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan
| | - Toshihiko Izumi
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan
| | - Ayako Inoue
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan
| | - Yoshinobu Ishitobi
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan
| | - Haruka Higuma
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan
| | - Taiga Ninomiya
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan
| | - Jotaro Akiyoshi
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan.
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22
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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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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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Anxiety sensitivity and obsessive-compulsive symptom dimensions: Further evidence of specific relationships in a clinical sample. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2017.01.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Kashyap H, Kumar JK, Kandavel T, Reddy YCJ. Relationships between neuropsychological variables and factor-analysed symptom dimensions in obsessive compulsive disorder. Psychiatry Res 2017; 249:58-64. [PMID: 28063400 DOI: 10.1016/j.psychres.2016.12.044] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 12/12/2016] [Accepted: 12/28/2016] [Indexed: 10/20/2022]
Abstract
Despite mounting evidence for the distinctiveness of symptom dimensions in obsessive-compulsive disorder, neuropsychological studies have been few, focused on small samples, and relying on classification of participants based on mutually exclusive symptom categories, resulting in lack of concordance across neuropsychological and imaging studies. Neuropsychological assessment was undertaken with 150 individuals with DSM IV OCD, and neuropsychological variables were analysed in relation to symptom dimension scores derived from factor analysis. Five dimensions were derived from principal components analysis with varimax rotation - contamination/washing, doubts/checking, symmetry/ordering, forbidden thoughts, and hoarding. After controlling for severity of depression and OCD, antipsychotic and benzodiazepine use, and all other symptom dimensions, washing was associated with poorer attention/working memory, visuo-spatial construction and better planning time; checking was related to poorer alternation learning; symmetry linked with poorer verbal fluency; forbidden thoughts with better visuospatial scanning and working memory; hoarding with poorer immediate verbal recall and better visuospatial working memory. The neuropsychological associations are explained in the context of existing neuroimaging evidence, and the clinical picture of each symptom dimension. The use of factor-analysed symptom dimensions and a large sample of individuals with OCD are strengths of the study.
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Affiliation(s)
- Himani Kashyap
- Neuropsychology Unit, Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India; Obsessive Compulsive Disorder Clinic, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India.
| | - J Keshav Kumar
- Neuropsychology Unit, Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Thennarasu Kandavel
- Department of Biostatistics, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Y C Janardhan Reddy
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India; Obsessive Compulsive Disorder Clinic, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
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26
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Melli G, Carraresi C, Poli A, Marazziti D, Pinto A. The role of guilt sensitivity in OCD symptom dimensions. Clin Psychol Psychother 2017; 24:1079-1089. [PMID: 28093822 DOI: 10.1002/cpp.2071] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 09/29/2016] [Accepted: 12/15/2016] [Indexed: 11/10/2022]
Abstract
Although some studies have found that guilt may precede, motivate, or be a consequence of obsessive-compulsive disorder (OCD), the relationship between guilt and OCD has been under investigated. The studies that explored the role of trait guilt (guilt propensity) in OCD reported inconsistent findings and failed to support its predictive role. Since it has been suggested that OCD patients perceive guilt in a more threatening manner, it might also be relevant to test to what extent they negatively evaluate the experience of guilt (i.e., guilt sensitivity; GS). Study 1 investigated the psychometric properties of a new 10-item Italian measure developed to assess GS-named Guilt Sensitivity Questionnaire-in a nonclinical sample (N = 473). Results from exploratory factor analyses supported the unidimensionality of the scale. It also showed excellent internal consistency and good discriminant validity. Study 2 investigated the role of GS in OCD symptoms, in particular with regard to responsibility for harm obsessions and checking compulsions, using a heterogeneous OCD sample (N = 61) and a control group of patients with anxiety disorders (N = 47). GS was the unique significant predictor of checking related OCD symptoms independent of negative mood states and obsessive beliefs. Guilt Sensitivity Questionnaire scores of patients with responsibility for harm concerns were significantly higher than those of patients with other kinds of obsessive concerns and with anxiety disorders. Findings supported the hypothesis that GS plays a relevant role in OCD symptoms when checking rituals are primarily involved. Implications for current cognitive behavioral models are discussed. KEY PRACTITIONER MESSAGE Guilt sensitivity may play a role in checking-related OCD symptoms. We developed a psychometrically sound unidimensional 10-item scale to assess guilt sensitivity. Guilt sensitivity was a unique predictor of checking-related OCD symptoms. Targeting beliefs about the intolerability/dangerousness of experiencing guilt may be useful. Acceptance-based approaches may be helpful as they promote the acceptance of guilt.
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Affiliation(s)
- Gabriele Melli
- Institute for Behavioral and Cognitive Psychology and Psychotherapy (IPSICO), Florence, Italy
| | - Claudia Carraresi
- Institute for Behavioral and Cognitive Psychology and Psychotherapy (IPSICO), Florence, Italy
| | - Andrea Poli
- Institute for Behavioral and Cognitive Psychology and Psychotherapy (IPSICO), Florence, Italy
| | | | - Antonio Pinto
- Cognitive and Behavioral Psychotherapy Center, Naples, Italy
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Smulevich AB, Romanov DV, Mukhorina AK, Atadzhikova JA. «Verschroben»-phenomenon in schizophrenia and schizophrenia spectrum disorders: aspects of systematics. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 117:5-16. [DOI: 10.17116/jnevro2017117115-16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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28
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Diedrich A, Sckopke P, Schwartz C, Schlegl S, Osen B, Stierle C, Voderholzer U. Change in obsessive beliefs as predictor and mediator of symptom change during treatment of obsessive-compulsive disorder - a process-outcome study. BMC Psychiatry 2016; 16:220. [PMID: 27388205 PMCID: PMC4937602 DOI: 10.1186/s12888-016-0914-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 06/08/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Cognitive models of obsessive-compulsive disorder suggest that changes in obsessive beliefs are a key mechanism of treatments for obsessive-compulsive disorder. Thus, in the present process-outcome study, we tested whether changes in obsessive beliefs during a primarily cognitive behavioral inpatient treatment predicted treatment outcome and whether these changes mediated symptom changes over the course of treatment. METHODS Seventy-one consecutively admitted inpatients with obsessive-compulsive disorder were assessed with the Yale-Brown Obsessive-Compulsive Scale and the Obsessive Beliefs Questionnaire at treatment intake, after six weeks of treatment and at discharge, and with the Beck-Depression-Inventory-II at intake and discharge. RESULTS Changes in obsessive beliefs during the first six weeks of treatment predicted obsessive-compulsive symptoms at discharge when controlling for obsessive-compulsive and depressive symptoms at intake in a hierarchical regression analysis. Multilevel mediation analyses showed that reductions in obsessive beliefs partially mediated improvements in obsessive-compulsive symptoms over time. CONCLUSIONS Our findings indicate that decreasing obsessive beliefs in inpatient cognitive behavioral therapy for obsessive-compulsive disorder might be a promising treatment approach.
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Affiliation(s)
- Alice Diedrich
- Department of Psychiatry and Psychotherapy, University of Munich (LMU), Nußbaumstr. 7, 80336, Munich, Germany.
| | - Philipp Sckopke
- Department of Psychology, University of Munich (LMU), Leopoldstr. 13, 80802 Munich, Germany
| | - Caroline Schwartz
- Department of Psychiatry and Psychotherapy, University of Munich (LMU), Nußbaumstr. 7, 80336 Munich, Germany
| | - Sandra Schlegl
- Department of Psychiatry and Psychotherapy, University of Munich (LMU), Nußbaumstr. 7, 80336 Munich, Germany
| | - Bernhard Osen
- Schön Clinic Bad Bramstedt, Birkenweg 10, 24576 Bad Bramstedt, Germany
| | - Christian Stierle
- Schön Clinic Bad Bramstedt, Birkenweg 10, 24576 Bad Bramstedt, Germany
| | - Ulrich Voderholzer
- Schön Clinic Roseneck, Am Roseneck 6, 83209 Prien am Chiemsee, Germany ,Department of Psychiatry and Psychotherapy, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany
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The structure of obsessive compulsive symptoms and beliefs: A correspondence and biplot analysis. J Anxiety Disord 2016; 38:79-87. [PMID: 26851748 DOI: 10.1016/j.janxdis.2016.01.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 12/26/2015] [Accepted: 01/05/2016] [Indexed: 11/21/2022]
Abstract
Research has suggested that obsessive-compulsive (OC) beliefs are differentially predictive of OC symptom dimensions. One additional way in which beliefs and symptoms may be related is by severity; that is, the role of beliefs may vary as a function of symptom severity. In order to evaluate this possibility, correspondence analysis with biplot was applied to evaluate the association between OC beliefs and OC symptom severity across three subsamples, individuals with obsessive-compulsive disorder (OCD; N=398), individuals with anxiety disorders (N=104), and undergraduate students (N=285). To do so, we generated five row categories of symptom severity and six columns based on the Obsessive Compulsive Beliefs Questionnaire (OBQ) for three subsamples. Unlike factor analyses of inter-variable correlations (or covariances), the CA-biplot paradigm calibrates simultaneously row and column information and estimates dimensional coordinates (analogous to factor loadings) separately for rows and columns. We used the first two dimensions from each subsample because they accounted for most variance (on average 89%) so as to construct a hypothetical plane with them. Then, we visually inspected associations among five severity categories (rows) and six OBQ subscales (columns) in the plane and also calculated their correlations. The visual configurations and numerical correlations were consistent across three subsamples, indicating that inflated responsibility was significantly associated with OC symptoms, but only for those with the least severe symptoms. Importance and control of thoughts were associated with OC symptoms across all levels of symptom severity. The implications of these findings for the cognitive model of OCD are considered.
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Abstract
BACKGROUND Although severe hoarding symptoms have been considered rare among obsessive-compulsive disorder (OCD) samples, the prevalence of animal hoarding in OCD is unknown. To help clarifying this issue, we searched for cases of animal hoarding among patients attending a university OCD clinic (n=420). METHODS Chart review. RESULTS Only two patients from our sample exhibited animal hoarding (<0.5%) and only one of them presented additional obsessive-compulsive symptoms. Both cases also collected inanimate objects, presented low insight, exhibited poor response to serotonin reuptake inhibitors and did not adhere to therapy. CONCLUSIONS There seems to be a lack of relationship between animal hoarding and OCD. However, further studies with larger numbers of patients are needed to better define their psychopathological profile and more appropriate nosological insertion.
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