1
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Aslan IH, Dorey L, Grant JE, Chamberlain SR. Emotion regulation across psychiatric disorders. CNS Spectr 2024; 29:215-220. [PMID: 38695189 PMCID: PMC7615973 DOI: 10.1017/s1092852924000270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
Abstract
OBJECTIVE Difficulties with emotion regulation have been associated with multiple psychiatric conditions. In this study, we aimed to investigate emotional regulation difficulties in young adults who gamble at least occasionally (ie, an enriched sample), and diagnosed with a range of psychiatric disorders using the validated Difficulties in Emotion Regulation Scale (DERS). METHODS A total of 543 non-treatment-seeking individuals who had engaged in gambling activities on at least 5 occasions within the previous year, aged 18-29 were recruited from general community settings. Diagnostic assessments included the Mini International Neuropsychiatric Inventory, Minnesota Impulsive Disorders Interview, attention-deficit/hyperactivity disorder World Health Organization Screening Tool Part A, and the Structured Clinical Interview for Gambling Disorder. Emotional dysregulation was evaluated using DERS. The profile of emotional dysregulation across disorders was characterized using Z-scores (those with the index disorder vs. those without the index disorder). RESULTS Individuals with probable ADHD displayed the highest level of difficulties in emotional regulation, followed by intermittent explosive disorder, social phobia, and generalized anxiety disorder. In contrast, participants diagnosed with obsessive-compulsive disorder showed relatively lower levels of difficulties with emotional regulation. CONCLUSIONS This study highlights the importance of recognizing emotional dysregulation as a trans-diagnostic phenomenon across psychiatric disorders. The results also reveal differing levels of emotional dysregulation across diagnoses, with potential implications for tailored treatment approaches. Despite limitations such as small sample sizes for certain disorders and limited age range, this study contributes to a broader understanding of emotional regulation's role in psychiatric conditions.
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Affiliation(s)
- Ibrahim H. Aslan
- Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK
- Southern Health NHS Foundation Trust, Southampton, UK
| | - Lucy Dorey
- Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Jon E. Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Samuel R. Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK
- Southern Health NHS Foundation Trust, Southampton, UK
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2
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Bezahler A, Kuckertz JM, McKay D, Falkenstein MJ, Feinstein BA. Emotion regulation and OCD among sexual minority people: Identifying treatment targets. J Anxiety Disord 2024; 101:102807. [PMID: 38101252 DOI: 10.1016/j.janxdis.2023.102807] [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] [Received: 06/23/2023] [Revised: 09/27/2023] [Accepted: 12/01/2023] [Indexed: 12/17/2023]
Abstract
Sexual minority individuals experience higher rates of psychopathology, such that sexual minority people are nine times more likely to receive a diagnosis or treatment for obsessive-compulsive disorder (OCD) compared to heterosexual people. Poor emotion regulation capacity is a risk factor for OCD, but little is known about sexual orientation differences in dimensions of emotion regulation and how dimensions of emotion regulation relate to OCD severity among sexual minority people. The aims of the current study include 1) comparing sexual minority to heterosexual people on OCD severity and emotion regulation capacity upon admission to treatment for OCD, and 2) examining emotion regulation in relation to OCD severity among sexual minority people. Participants (N = 470) were adults in partial hospital/residential treatment with an average stay of 59.7 days (SD = 25.3), including 22 % sexual minority people. Sexual minority people reported a lower emotion regulation capacity. Among the largest three subgroups (heterosexual, bi+, and gay/lesbian), bi+ individuals reported a lower emotion regulation capacity compared to heterosexual but not gay/lesbian people. Results suggest there are sexual orientation differences in emotion regulation capacity, and that bi+ people have the most difficulty with ER. There is a need for OCD treatment to directly target emotion regulation strategies and be affirming of sexual minority identities.
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Affiliation(s)
| | - Jennie M Kuckertz
- Obsessive Compulsive Disorder Institute, McLean Hospital, USA; Department of Psychiatry, Harvard Medical School, USA
| | - Dean McKay
- Psychology Department, Fordham University, USA
| | - Martha J Falkenstein
- Obsessive Compulsive Disorder Institute, McLean Hospital, USA; Department of Psychiatry, Harvard Medical School, USA
| | - Brian A Feinstein
- Department of Psychology, Rosalind Franklin University of Medicine and Science, USA
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3
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Allen KB, Tan PZ, Sullivan JA, Baumgardner M, Hunter H, Glovak SN. An Integrative Model of Youth Anxiety: Cognitive-Affective Processes and Parenting in Developmental Context. Clin Child Fam Psychol Rev 2023; 26:1025-1051. [PMID: 37819403 DOI: 10.1007/s10567-023-00458-z] [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] [Accepted: 09/14/2023] [Indexed: 10/13/2023]
Abstract
Multiple theoretical frameworks have been proposed to provide a more comprehensive picture of the risk factors that influence anxiety-related developmental trajectories. Nonetheless, there remains a need for an integrative model that outlines: (1) which risk factors may be most pertinent at different points in development, and (2) how parenting may maintain, exacerbate, or attenuate an affective style that is characterized by high negative emotional reactivity to unfamiliar, uncertain, and threatening situations. A developmentally informed, integrative model has the potential to guide treatment development and delivery, which is critical to reducing the public health burden associated with these disorders. This paper outlines a model integrating research on many well-established risk mechanisms for anxiety disorders, focusing on (1) the developmental progression from emotional reactivity constructs early in life to those involving higher-level cognitive processes later in youth, and (2) potential pathways by which parenting may impact the stability of youth's cognitive-affective responses to threat-relevant information across development.
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Affiliation(s)
- Kristy Benoit Allen
- Departments of Applied Behavioral Science and Psychology, University of Kansas, Lawrence, KS, USA.
| | - Patricia Z Tan
- Department of Psychiatry/Mental Health, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | | | - Megan Baumgardner
- Department of Psychology, University of Tennessee, Knoxville, TN, USA
| | - Hannah Hunter
- Department of Psychology, University of Tennessee, Knoxville, TN, USA
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4
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Öztürk Y, Özyurt G, Turan S, Tufan AE, Akay AP. Emotion dysregulation and social communication problems but not ToM properties may predict obsessive-compulsive disorder symptom severity. Nord J Psychiatry 2023; 77:778-787. [PMID: 37665655 DOI: 10.1080/08039488.2023.2251953] [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] [Received: 03/30/2023] [Revised: 07/06/2023] [Accepted: 08/16/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVE Studies have shown that theory of mind, emotion regulation and pragmatic abilities are negatively affected in people with obsessive-compulsive disorder (OCD). We aimed to investigate theory of mind (ToM) abilities, social responsiveness, pragmatic language, and emotion regulation skills in children with OCD and to compare them to healthy controls. METHODS This study was designed as a single-center, cross-sectional, case-control study. ToM abilities were evaluated via "Reading the Mind in the Eyes Test" (RMET), "Faces Test", "Faux-Pas Test", "Comprehension Test" and "Unexpected Outcomes Test". Social responsiveness, pragmatic language and emotion regulation were evaluated by Social Responsiveness Scale (SRS), Children's Communication Checklist- Second Edition (CCC-2), Difficulties in Emotion Regulation Scale (DERS) and Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). Within the study period, we enrolled 85 adolescents (42 with OCD and 43 controls). RESULTS The OCD group performed significantly lower than healthy controls in the Faux Pass and Comprehension tests (p = 0.003 for both). We found a statistically significant difference between groups in terms of the goal, strategy, non-acceptance subscales of the DERS (p < 0.001, p = 0.006, p = 0.008, respectively) as well as the total DERS score (p < 0.001). CY-BOCS total scores correlated significantly and negatively with Comprehension, Faux Pas and Unexpected Outcomes tests, and positively with CCC total, SRS total and DERS total scores. In regression analysis the DERS, SRS and CCC tests emerged as significant predictors of CY-BOCS total score. CONCLUSION Addressing ToM, pragmatic, and ER difficulties when planning the treatment of young people with OCD may contribute to positive outcomes.
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Affiliation(s)
- Yusuf Öztürk
- Department of Child and Adolescent Psychiatry, Bolu Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - Gonca Özyurt
- Department of Child and Adolescent Psychiatry, Izmir Katip Çelebi University Medical Faculty, İzmir, Turkey
| | - Serkan Turan
- Department of Child and Adolescent Psychiatry, Uludağ University Medical Faculty, Bursa, Turkey
| | - Ali Evren Tufan
- Department of Child and Adolescent Psychiatry, Bolu Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - Aynur Pekcanlar Akay
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University Medical Faculty, Izmir, Turkey
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5
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Ferrández-Mas J, Moreno-Amador B, Marzo JC, Falcó R, Molina-Torres J, Cervin M, Piqueras JA. Relationship between Cognitive Strategies of Emotion Regulation and Dimensions of Obsessive-Compulsive Symptomatology in Adolescents. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050803. [PMID: 37238351 DOI: 10.3390/children10050803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/26/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023]
Abstract
Cognitive emotion regulation refers to the management of one's emotions through cognitive strategies. Studies have found that individuals with obsessive-compulsive symptoms utilize emotion regulation strategies differently compared to those without these symptoms. This study aims to investigate the relationship between cognitive strategies for emotion regulation and specific dimensions of obsessive-compulsive symptoms in adolescents. A cross-sectional descriptive study was conducted with 307 adolescents between 12 and 18 years old. Associations between sociodemographic variables, obsessive-compulsive symptoms, and emotion regulation strategies were examined using regression and network analyses. Regression results indicated that emotion regulation strategies and gender accounted for 28.2% of the variation in overall obsessive-compulsive symptoms (p < 0.001) and that emotion regulation explained most variance in the symptom dimension of obsessing. Network analysis showed that self-blame and catastrophizing were uniquely linked to overall obsessive-compulsive symptoms, while several strategies were uniquely linked to specific symptom dimensions. The adaptive strategy that demonstrated the strongest association with obsessive-compulsive symptoms was refocus on planning, while maladaptive strategies included catastrophizing, self-blame, and rumination. In conclusion, the results support the relationship between cognitive strategies for emotion regulation and dimensions of obsessive-compulsive symptoms in adolescents, though these relations appear complex and require further investigation. Addressing emotion regulation in the prevention of obsessive-compulsive symptoms may be warranted, but prospective studies are needed.
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Affiliation(s)
- Jesús Ferrández-Mas
- Department of Health Psychology, Miguel Hernández University of Elche, 03202 Alicante, Spain
| | - Beatriz Moreno-Amador
- Department of Health Psychology, Miguel Hernández University of Elche, 03202 Alicante, Spain
| | - Juan C Marzo
- Department of Health Psychology, Miguel Hernández University of Elche, 03202 Alicante, Spain
| | - Raquel Falcó
- Department of Health Psychology, Miguel Hernández University of Elche, 03202 Alicante, Spain
| | - Jonatan Molina-Torres
- Department of Health Psychology, Miguel Hernández University of Elche, 03202 Alicante, Spain
| | - Matti Cervin
- Department of Clinical Sciences Lund, Lund University, Box 117, 221 00 Lund, Sweden
- Child and Adolescent Psychiatry, Skåne, Sofiavägen 2E, 221 85 Lund, Sweden
| | - José A Piqueras
- Department of Health Psychology, Miguel Hernández University of Elche, 03202 Alicante, Spain
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6
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Lee SW, Jang TY, Kim S, Lee SJ. Heightened but Inefficient Thought-Action Fusion in Obsessive-Compulsive Disorder: New Insight From a Multiple Trial Version of the Classic Thought-Action Fusion Experiment. Psychiatry Investig 2023; 20:120-129. [PMID: 36891596 PMCID: PMC9996149 DOI: 10.30773/pi.2022.0262] [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: 09/09/2022] [Accepted: 11/13/2022] [Indexed: 02/25/2023] Open
Abstract
OBJECTIVE Thought-action fusion (TAF), which is a tendency to make the relationship between one's thoughts and external consequences, is a dysfunctional belief linked to obsessive-compulsive disorder (OCD). While the TAF is commonly evaluated using the Thought-Action Fusion Scale (TAFS), it cannot fully reflect the actual experience of experimentally evoked TAF. In the present study, we applied a multiple-trial version of the classic TAF experiment and evaluate two variables, reaction time (RT) and emotional intensity (EI). METHODS Ninety-three patients with OCD and 45 healthy controls (HCs) were recruited. The participants were asked to read the name of a close or neutral person embedded in different positive (PS) or negative (NS) TAF statements. During the experiments, RT and EI were gathered. RESULTS The OCD patients presented with longer RT and lower EI in the NS condition than HCs. In each group, the HCs showed a significant relationship between RT in the NS condition and TAFS scores, whereas the patients did not, although they had higher TAFS scores than the HCs. In contrast, the patients showed a trend toward a correlation between RT in the NS condition and guilt. CONCLUSION These findings may indicate our multiple-trial version of the classical TAF showed reliable results of the two new variables, especially RT, in the task and allow to newly identify paradoxical patterns in which the TAFS scores are high but actual performance is impaired, that is, the inefficient activation of TAF in OCD.
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Affiliation(s)
- Sang Won Lee
- Department of Psychiatry, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea.,Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Tae Yang Jang
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.,Department of Psychiatry, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Seungho Kim
- Department of Medical & Biological Engineering, Kyungpook National University, Daegu, Republic of Korea
| | - Seung Jae Lee
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.,Department of Psychiatry, Kyungpook National University Hospital, Daegu, Republic of Korea
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7
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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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8
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See CCH, Tan JM, Tan VSY, Sündermann O. A systematic review on the links between emotion regulation difficulties and obsessive-compulsive disorder. J Psychiatr Res 2022; 154:341-353. [PMID: 36049435 DOI: 10.1016/j.jpsychires.2022.07.023] [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: 11/15/2021] [Revised: 06/23/2022] [Accepted: 07/04/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Growing evidence suggests a link between emotion regulation (ER) deficits and obsessive-compulsive symptoms (OCS). AIMS A systematic review was conducted to integrate empirical research on the nature of ER difficulties associated with obsessive-compulsive disorder (OCD), validated measures of ER for OCD and evidence base for psychological interventions targeting ER difficulties in OCD. METHODS Database searches were conducted on CINAHL, Cochrane Library, EMBASE, MEDLINE, PUBMED, PsycINFO and Scopus with keywords related to ER and OCD. 2609 articles were found, six were identified from other sources and 21 studies were included in this review. The review was registered on PROSPERO (CDR42020184076). RESULTS The non-acceptance of emotions was the most consistently related to OCS - albeit not uniformly with all OCS dimensions. There was also some evidence suggesting that difficulties in impulse-control, accessing effective ER strategies and engaging in goal-directed behaviours to be related to OCS. No OCD-specific ER measure was identified. Interventions with ER components appeared to be promising for the treatment of OCD. FUTURE DIRECTIONS Recommendations on how to build on the existing literature and improve the quality of evidence were provided.
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Affiliation(s)
- Cassandra C H See
- Department of Psychology, National University of Singapore, Block AS4, 9 Arts Link, Singapore, 117570, Singapore.
| | - Jia Min Tan
- Department of Psychology, National University of Singapore, Block AS4, 9 Arts Link, Singapore, 117570, Singapore
| | - Vanessa S Y Tan
- Department of Psychology, National University of Singapore, Block AS4, 9 Arts Link, Singapore, 117570, Singapore
| | - Oliver Sündermann
- Department of Psychology, National University of Singapore, Block AS4, 9 Arts Link, Singapore, 117570, Singapore
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9
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Lazarov A, Oren E, Liberman N, Gur S, Hermesh H, Dar R. Attenuated Access to Emotions in Obsessive-Compulsive Disorder. Behav Ther 2022; 53:1-10. [PMID: 35027151 DOI: 10.1016/j.beth.2021.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 04/01/2021] [Accepted: 04/08/2021] [Indexed: 12/12/2022]
Abstract
The Seeking Proxies for Internal States (SPIS) model of obsessive-compulsive disorder (OCD) posits that OCD is associated with attenuated access to internal states. Here we explored the implications of this model in the realm of emotions. Participants with OCD, anxiety disorders, and nonclinical control participants completed the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT), assessing two domains of emotional intelligence: Experiential emotional intelligence (EI), reflecting the ability to perceive and feel emotions accurately, and Strategic EI, reflecting the ability to understand and manage emotions correctly. As only Experiential EI requires accurate perception of one's emotions for adequate performance, we predicted an interaction between group and EI area. Specifically, we predicted that compared to both anxiety disorders and healthy control participants, OCD participants would show a larger deficit in Experiential area of the MSCEIT relative to the Strategic area. Results were fully in line with this prediction. Moreover, supporting the specificity of the hypothesized deficit to OCD, participants with anxiety disorders did not differ from nonclinical control participants in their performance, and findings were not attributable to anxiety or depression levels. These results replicate and extend previous findings obtained with analogue samples and suggest that OCD is associated with attenuated access to emotional states, which may be partially compensated for by reliance on semantic knowledge of emotion.
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10
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Abstract
BACKGROUND Obsessive compulsive disorder (OCD) and depression commonly co-occur. Past research has evaluated underlying mechanisms of depression in the context of other diagnoses, but few to no studies have done this within OCD. AIMS This study examines the relationships between distress tolerance (DT), experiential avoidance (EA), depression, and OCD symptom severity across intensive/residential treatment (IRT) for OCD. It was hypothesized that all variables would be significantly moderately related and EA would emerge as a potential contributing factor to change in depression and OCD symptoms across IRT for OCD. METHOD The sample included 311 participants with a primary diagnosis of OCD seeking IRT. Correlations were performed between all variables at both admission and discharge. A two-step hierarchical regression with change in OCD symptoms and change in DT in the first block and change in EA in the second block examined if change in EA explained change in depression above and beyond change in OCD and DT ability. RESULTS At both admission and discharge, higher EA, lower DT, and higher OCD symptom severity were significantly associated with more depressive symptoms. Change in EA explained a significant amount of variance in change in depression above and beyond change in OCD symptom severity and change in DT. CONCLUSIONS This study expands past results within an OCD sample, emphasizing EA as an important treatment target in OCD. Future studies could utilize samples from other treatment contexts, use a measure of EA specific to OCD, and utilize a longitudinal model that takes temporal precedence into account.
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11
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Akbari M, Seydavi M, Zamani E. The mediating role of personalized psychological flexibility in the association between distress intolerance and psychological distress: A national survey during the fourth waves of COVID-19 pandemic in Iran. Clin Psychol Psychother 2021; 28:1416-1426. [PMID: 34731531 PMCID: PMC8653034 DOI: 10.1002/cpp.2685] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 12/22/2022]
Abstract
The global COVID-19 outbreak has put the human race's distress tolerance abilities to the test. And, the distress experienced getting worse with each pandemic wave; however, the more flexible the person, the greater the chance of surviving. Thus, the current study aimed to examine the mediating role of personalized psychological flexibility (PPF) in the link between distress intolerance to psychological distress during the fourth wave of the pandemic in Iran. A total of 576 individuals (Meanage 34.80, ±10.9, females 55.6%) took part in the online survey. In this national sample, PPF partially played a role in mediating the association mentioned above. Interestingly, this mediation was independent of demographic factors (age, gender, marital status, and educational level) and fear of COVID-19, mindfulness, and satisfaction with life. So, despite the mentioned variables, accepting and using unpleasant emotions as fuel to achieve valued goals rather than avoiding them would mitigate the psychological distress during the pandemic. Consequently, public health services can aim to provide psychological flexibility enhancing interventions to decay COVID-19-related mental distress.
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Affiliation(s)
- Mehdi Akbari
- Department of Clinical Psychology, Faculty of Psychology and EducationKharazmi UniversityTehranIran
| | - Mohammad Seydavi
- Department of Clinical Psychology, Faculty of Psychology and EducationKharazmi UniversityTehranIran
| | - Elahe Zamani
- Department of Clinical Psychology, Faculty of Psychology and EducationKharazmi UniversityTehranIran
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12
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Şahin B, Özçetinkaya Erdoğan S, Cura Şahin G, Karlı P, Kara OF, Hatırnaz Ş, Tinelli A. Nausea and vomiting during pregnancy: a possible correlation with obsessive compulsive disorder and alexithymia. J OBSTET GYNAECOL 2021; 42:929-934. [PMID: 34693875 DOI: 10.1080/01443615.2021.1960492] [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] [Indexed: 10/20/2022]
Abstract
The possible correlation between nausea and vomiting during pregnancy (NVP) with obsessive-compulsive disorder (OCD) and alexithymia were examined in this cross-sectional study. A cohort of pregnant women at the first trimester of pregnancy experiencing NVP were divided into three groups, according to severity (mild, moderate and severe) with the Pregnancy Unique Quantification of Emesis and Nausea (PUQE) test. The Maudsley Obsessive Compulsive Disorder Scale (MOCQ) and the Toronto Alexithymia Scale (TAS-20) were applied. Scores of scales were compared in all three groups, and the relationship between NVP severity and OCD and alexithymia was evaluated. On the 110 enrolled pregnant women, 42 had mild, 36 had moderate and 32 had severe NVP. Pregnant women with mild NVP had lower MOCQ scores than those with severe NVP (p = .010). Total scores of TAS-20 were higher among subjects with greater NVP severity (p < .001). PUQE scores were demonstrated significant correlations with MOCQ and total and subsection scores of the TAS-20, regardless of NVP groups. Study results showed that women with more pronounced OCD and/or alexithymia can experience somatic complaints, such as NVP, particularly intense in their first trimester of pregnancies. For this reason, psychotherapy in addition to medical treatments could be recommended to pregnant women with severe NVP.Impact statementWhat is already known on this subject? NVP is a condition experienced by most women, particularly in the first trimester of pregnancy, which can be affected by the psychosomatic condition of the pregnant woman.What do the results of this study add? The severity of nausea and vomiting according to PUQE test were significantly associated with OCD and alexithymia presence in pregnant women during their first trimester period.What are the implications of these findings for clinical practice and/or further research? These findings might demonstrate the symptoms of NVP are correlated to OCD, as well as alexithymia. Longitudinal studies are required to demonstrate the clear causal relationship between NVP and psychiatric symptoms as in OCD and in alexithymia.
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Affiliation(s)
- Banuhan Şahin
- Gynecology and Obstetrics Department, Amasya University Sabuncuoglu Serefeddin Training and Research Hospital, Amasya, Turkey
| | - Serap Özçetinkaya Erdoğan
- Psychiatry Department, Amasya University Sabuncuoglu Serefeddin Training and Research Hospital, Amasya, Turkey
| | | | - Pervin Karlı
- Gynecology and Obstetrics Department, Amasya University Sabuncuoglu Serefeddin Training and Research Hospital, Amasya, Turkey
| | - Osman Fadıl Kara
- Gynecology and Obstetrics Department, Amasya University Sabuncuoglu Serefeddin Training and Research Hospital, Amasya, Turkey
| | - Şafak Hatırnaz
- Gynecology and Obstetrics Department, IVF Unit, Medicana International Hospital, Samsun, Turkey
| | - Andrea Tinelli
- Obstetrics and Gynecology Department, Veris delli Ponti Hospital, Scorrano, Lecce, Italy.,Division of Experimental Endoscopic Surgery, Imaging, Technology and Minimally Invasive Therapy, Vito Fazzi Hospital, Lecce, Italy.,Faculty of Biological and Medical Physics, Phystech BioMed School, Moscow Institute of Physics and Technology (State University), Dolgoprudny, Moscow Region, Russia
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13
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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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14
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Sinha R, Mahour P, Sharma E, Mehta UM, Agarwal M. Obsessive belief and emotional appraisal correlates of symptom dimensions and impairment in obsessive-compulsive disorder. Indian J Psychiatry 2021; 63:348-354. [PMID: 34456347 PMCID: PMC8363904 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_1194_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 01/29/2021] [Accepted: 05/04/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a heterogeneous and debilitating illness. Symptom dimensions of OCD lend homogeneous avenues for research. Variations in one's appraisal of thoughts and emotions can influence symptom dimensions and impairment. However, little is known about the combined influence of these appraisals in OCD. A clear understanding of these relationships has putative treatment implications. AIM The aim of the study is to examine the associations among obsessive beliefs, emotional appraisals, and OCD symptom dimensions in adults. MATERIALS AND METHODS We examined 50 drug-naïve/drug-free adults with active OCD. Symptom dimensions and impairment were assessed using the Dimensional Yale-Brown Obsessive-Compulsive Severity Scale. Obsessive beliefs and emotional appraisals were studied using the Obsessive Beliefs Questionnaire-44 and Perception of Threat from Emotion Questionnaire. RESULTS Tobit regression analysis showed the differential association of obsessive beliefs and symptom dimensions - perfectionism/certainty associated with contamination and responsibility/threat estimation associated with aggressive obsessions. Impairment was associated with dimensional symptom severities and with the perception of threat from anger. This association remained even after controlling for depression severity and obsessive beliefs. CONCLUSIONS OCD symptom dimensions are heterogeneous in underlying obsessive beliefs. Emotional appraisals contribute significantly to impairment alongside symptom severity. Emotion-focused interventions must be included in the psychotherapeutic interventions for OCD.
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Affiliation(s)
- Reema Sinha
- Department of Psychiatry, Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India
| | - Pooja Mahour
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Eesha Sharma
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Urvakhsh M Mehta
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Manu Agarwal
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
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15
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Raines AM, Koscinski B, Mathes BM, Portero AK, Allan NP, Schmidt NB. Examination of a brief computerized Cognitive Anxiety Sensitivity intervention on obsessive-compulsive symptoms. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 61 Suppl 1:93-110. [PMID: 33945163 DOI: 10.1111/bjc.12298] [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: 08/20/2020] [Revised: 04/14/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Despite the existence of several first-line treatments for obsessive-compulsive disorder (OCD), many patients fail to experience symptom reduction and/or do not complete treatment. As a result, the field has increasingly moved towards identifying and treating malleable underlying risk factors that may in turn improve treatment efficacy. One salient underlying risk factor, anxiety sensitivity (AS) cognitive concerns, has been found to be uniquely associated with obsessive-compulsive (OC) symptom dimensions. However, no studies have yet examined whether reductions in AS cognitive concerns will lead to subsequent reductions in OC symptoms. METHODS The current study attempted to fill this gap by recruiting individuals reporting elevations on both AS cognitive concerns and at least one OC symptom dimension. Participants were randomly assigned to receive either a one-session AS cognitive concerns intervention (n = 35) or a single health information control session (n = 37). AS cognitive concerns were assessed at post-intervention and one-month follow-up. RESULTS The active intervention produced significantly greater reductions in AS cognitive concerns post-intervention than the control intervention. However, this effect was no longer significant at one-month follow-up. Further, while there was not an effect of treatment condition on OC symptoms at one-month follow-up, changes in AS cognitive concerns from baseline to post-intervention mediated changes in OC symptoms at one-month follow-up. CONCLUSIONS Findings support previous research attesting to the malleable nature of AS. Extending this research, findings provide initial support for the efficacy of AS interventions among individuals with elevated OC symptoms. PRACTITIONER POINTS Clinicians should consider assessing anxiety sensitivity (AS) among patients with obsessive-compulsive disorder. If elevated, clinicians should consider targeting AS as an adjunct to treatment as usual.
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Affiliation(s)
- Amanda M Raines
- Department of Psychology, Florida State University, Tallahassee, Florida, USA.,Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, Louisiana, USA.,South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans, Louisiana, USA
| | | | - Brittany M Mathes
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Amberly K Portero
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | | | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
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16
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Cho J, Bello MS, Christie NC, Monterosso JR, Leventhal AM. Adolescent emotional disorder symptoms and transdiagnostic vulnerabilities as predictors of young adult substance use during the COVID-19 pandemic: mediation by substance-related coping behaviors. Cogn Behav Ther 2021; 50:276-294. [PMID: 33706676 DOI: 10.1080/16506073.2021.1882552] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The COVID-19 pandemic presents unique stressors (e.g. social isolation) that may increase substance use risk among young adults with a history of emotional disturbance. This study examined whether emotional disorder symptoms and transdiagnostic vulnerabilities during adolescence predicted young adult substance use during COVID-19, and whether using substances to cope with the pandemic's social conditions mediated these associations. Adolescents (N = 2,120) completed baseline surveys assessing transdiagnostic emotional vulnerabilities (anhedonia, distress intolerance, anxiety sensitivity, negative urgency) and symptoms (major depression[MD], generalized anxiety[GAD], panic disorder[PD], social phobia[SP], obsessive-compulsive disorder[OCD]) in adolescence (September-December 2016; M[SD] age = 17.45[0.38]). At follow-up (May-August 2020; M[SD] age = 21.16[0.39]), past 30-day substance use and using substances to cope with social isolation during the pandemic were reported. Adjusted models showed that baseline distress intolerance, anxiety sensitivity, negative urgency, and MD symptoms each significantly predicted higher number of past-month single-substance using days and number of substances used at follow-up (βs = 0.04-0.06). In each case, associations were mediated by tendency to use substances to cope with the pandemic (βindirect range: 0.028-0.061). To mitigate disproportionate escalation of substance use in young adults with a history of certain types of emotional disturbance, interventions promoting healthy coping strategies to deal with the pandemic's social conditions warrant consideration.
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Affiliation(s)
- Junhan Cho
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mariel S Bello
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Nina C Christie
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - John R Monterosso
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Adam M Leventhal
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Department of Psychology, University of Southern California, Los Angeles, CA, USA
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17
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Ociskova M, Prasko J, Vanek J, Holubova M, Hodny F, Latalova K, Kantor K, Nesnidal V. Self-Stigma and Treatment Effectiveness in Patients with SSRI Non-Responsive Obsessive-Compulsive Disorder. Psychol Res Behav Manag 2021; 14:85-97. [PMID: 33574718 PMCID: PMC7873032 DOI: 10.2147/prbm.s287419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 01/04/2021] [Indexed: 12/16/2022] Open
Abstract
Purpose Obsessive compulsive disorder (OCD) is a debilitating mental disorder that often takes a chronic course. One of the factors influencing the treatment effectiveness in anxiety and depressive disorders is the self-stigma. This study focused on the relationship between the self-stigma, symptomatology, and therapeutic outcomes in patients with OCD. Patients and Methods Ninety-four inpatients with OCD, who did not sufficiently respond to at least one selective serotonin reuptake inhibitor trial, participated in the study. They attended a six-week therapeutic program consisting of exposure and response prevention, transdiagnostic group cognitive behavioral therapy, individual sessions, mental imagery, relaxation, sport, and ergotherapy. The participants completed several scales: the Internalized Stigma of Mental Illness Scale (ISMI), the self-report Yale-Brown Obsessive Compulsive Scale (Y-BOCS-SR), Beck Anxiety Scale (BAI), Beck Depression Scale-II (BDI-II), and Dissociative Experiences Scale (DES). A senior psychiatrist filled in the Clinical Global Impression (CGI-S). Results The average scales' scores considerably declined in all measurements except for DES. The self-stigma positively correlated with all psychopathology scales. It was also higher in patients with a comorbid personality disorder (PD). The higher self-stigma predicted a lower change in compulsion, anxiety, and depressive symptoms but not the change of obsessions or the overall psychopathology. Conclusion The self-stigma presents an important factor connected to higher severity of OCD. It is also a minor predictor of a lower change in symptomatology after combined treatment.
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Affiliation(s)
- Marie Ociskova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University in Olomouc, University Hospital in Olomouc, Olomouc, The Czech Republic
| | - Jan Prasko
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University in Olomouc, University Hospital in Olomouc, Olomouc, The Czech Republic.,Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic.,Institute for Postgraduate Education in Health Care, Prague, The Czech Republic
| | - Jakub Vanek
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University in Olomouc, University Hospital in Olomouc, Olomouc, The Czech Republic
| | - Michaela Holubova
- Department of Psychiatry, Hospital Liberec, Prague, The Czech Republic
| | - Frantisek Hodny
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University in Olomouc, University Hospital in Olomouc, Olomouc, The Czech Republic
| | - Klara Latalova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University in Olomouc, University Hospital in Olomouc, Olomouc, The Czech Republic
| | - Krystof Kantor
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University in Olomouc, University Hospital in Olomouc, Olomouc, The Czech Republic
| | - Vlastimil Nesnidal
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University in Olomouc, University Hospital in Olomouc, Olomouc, The Czech Republic
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18
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Patel TA, Mann AJD, Blakey SM, Aunon FM, Calhoun PS, Beckham JC, Kimbrel NA. Diagnostic Correlates of Nonsuicidal Self-Injury Disorder among Veterans with Psychiatric Disorders. Psychiatry Res 2021; 296:113672. [PMID: 33383275 PMCID: PMC7855413 DOI: 10.1016/j.psychres.2020.113672] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 12/20/2020] [Indexed: 11/30/2022]
Abstract
With its recent inclusion in the Diagnostic and Statistical Manual, nonsuicidal self-injury disorder (NSSID) has received limited research attention, especially in samples of military veterans. The present study sought to identify diagnostic predictors of NSSID within a veteran sample. Study participants included 124 veterans with at least one psychiatric diagnosis. Chi-square tests and t-tests evaluated bivariate associations between NSSID and twenty diagnostic correlates. Logistic regression models identified psychiatric disorders that were unique correlates of NSSID among veterans. Veterans with lifetime NSSID (n = 59) met criteria for a greater number of lifetime disorders than veterans with other psychiatric disorders. Bivariate associations were noted between NSSID and borderline personality disorder, depression, obsessive-compulsive disorder, generalized anxiety disorder, and cannabis use disorder. In the logistic regression model, only borderline personality disorder (AOR = 7.67) and obsessive-compulsive disorder (AOR = 3.23) continued to be associated with NSSID. The present study represents the first examination of the association between NSSID and psychiatric disorders among veterans. The findings shed light on psychiatric disorders associated with lifetime NSSID in veterans, with special consideration toward obsessive-compulsive disorder as a risk factor for NSSID.
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Affiliation(s)
- Tapan A. Patel
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA,VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA,Correspondence concerning this article should be sent to: Tapan A. Patel, M.S., Durham Veterans Affairs Health Care System, Mid-Atlantic MIRECC, 3022 Croasdaile Drive, Durham, NC 27705,
| | - Adam J. D. Mann
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Shannon M. Blakey
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA,VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Frances M. Aunon
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA
| | - Patrick S. Calhoun
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA,VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA,VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Jean C. Beckham
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA,VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA,VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Nathan A. Kimbrel
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA,VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA,VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
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19
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Eddy CM, Hansen PC. Alexithymia Is a Key Mediator of the Relationship Between Magical Thinking and Empathy. Front Psychiatry 2021; 12:719961. [PMID: 34504448 PMCID: PMC8421603 DOI: 10.3389/fpsyt.2021.719961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/28/2021] [Indexed: 11/24/2022] Open
Abstract
Thought action fusion (TAF), whereby internal thoughts are perceived to exert equivalent effects to external actions, is a form of magical thinking. Psychiatric disorders associated with TAF (e.g. schizophrenia; obsessive compulsive disorder) can feature atypical social cognition. We explored relationships between TAF and empathy in 273 healthy young adults. TAF was directly correlated with higher personal distress, but not perspective taking, fantasy or empathic concern. TAF moral (the belief that thinking about an action/behaviour is morally equivalent to actually performing that behaviour) was predicted by emotion contagion, alexithymia and need for closure. TAF likelihood (the belief that simply having a thought about an event makes that event more likely to occur) was predicted by personal distress, sense of agency and alexithymia. Both cognitive (TAF and negative sense of agency) and emotional (emotion contagion, alexithymia) factors contributed to personal distress. TAF, negative sense of agency and personal distress mediated the effect of emotion contagion on alexithymia. Our findings reveal complex relationships between emotional processes and TAF, shedding further light on the social cognitive profile of disorders associated with magical thinking. Furthermore, they emphasise the potential importance of alexithymia and emotion contagion as mediators or potential risk factors in the development of psychiatric symptoms linked to TAF, such as intrusive thoughts about harm to others.
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Affiliation(s)
- Clare M Eddy
- Birmingham and Solihull Mental Health NHS Foundation Trust and College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Peter C Hansen
- Centre for Human Brain Health and School of Psychology, University of Birmingham, Birmingham, United Kingdom
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20
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Krebs G, Hannigan L, Gregory A, Rijsdijk F, Eley T. Reciprocal links between anxiety sensitivity and obsessive-compulsive symptoms in youth: a longitudinal twin study. J Child Psychol Psychiatry 2020; 61:979-987. [PMID: 31950513 PMCID: PMC7497024 DOI: 10.1111/jcpp.13183] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/27/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Anxiety sensitivity, the tendency to fear the symptoms of anxiety, is a key risk factor for the development anxiety disorders. Although obsessive-compulsive disorder was previously classified as an anxiety disorder, the prospective relationship between anxiety sensitivity and obsessive-compulsive symptoms (OCS) has been largely overlooked. Furthermore, a lack of genetically informative studies means the aetiology of the link between anxiety sensitivity and OCS remains unclear. METHODS Adolescent twins and siblings (N = 1,579) from the G1219 study completed self-report questionnaires two years apart assessing anxiety sensitivity, OCS, anxiety and depression. Linear regression models tested prospective associations between anxiety sensitivity and OCS, with and without adjustment for anxiety and depressive symptoms. A phenotypic cross-lagged model assessed bidirectional influences between anxiety sensitivity and OCS over time, and a genetic version of this model examined the aetiology of these associations. RESULTS Anxiety sensitivity was prospectively associated with changes in OCS, even after controlling for comorbid anxiety and depressive symptoms. The longitudinal relationship between anxiety sensitivity and OCS was bidirectional, and these associations were predominantly accounted for by nonshared environmental influences. CONCLUSIONS Our findings are consistent with the notion that anxiety sensitivity is a risk factor for OCS during adolescence, but also suggest that experiencing OCS confers risk for heightened anxiety sensitivity. The reciprocal links between OCS and anxiety sensitivity over time are likely to be largely mediated by nonshared environmental experiences, as opposed to common genes. Our findings raise the possibility that interventions aimed at ameliorating anxiety sensitivity could reduce risk for OCS, and vice versa.
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Affiliation(s)
- G. Krebs
- MRC Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
- National and Specialist OCD, BDD and Related Disorders Clinic for Young PeopleSouth London and Maudsley NHS Foundation TrustLondonUK
| | - L.J. Hannigan
- Nic Waals InstituteLovisenberg Diaconal HospitalOsloNorway
| | - A.M. Gregory
- Department of PsychologyGoldsmiths, University of LondonLondonUK
| | - F.V. Rijsdijk
- MRC Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - T.C. Eley
- MRC Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
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21
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Obsessive-compulsive symptoms are related to reduced awareness of emotional valence. J Affect Disord 2020; 272:28-37. [PMID: 32379617 DOI: 10.1016/j.jad.2020.03.129] [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: 12/15/2019] [Revised: 02/06/2020] [Accepted: 03/29/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND The Seeking Proxies for Internal States (SPIS) model of OCD asserts that obsessive-compulsive (OC) tendencies are associated with attenuated access to internal states. Here we explore the implications of this model for awareness of emotional valence. METHODS In Study 1, participants with high and low OC tendencies (n = 30 in each group) rated how they felt while viewing different pictures with positive, neutral, or negative valence taken from the International Affective Picture System. Study 2 replicated Study 1 among non-selected participants (n = 99) that rated positive and negative pictures chosen from the recently developed Basic-Emotions Nencki Affective Picture System. In both studies, mean deviation from norm ratings (of each picture system) served as the primary outcome measure. RESULTS Study 1 showed that high OC participants' mean deviation score was significantly higher, compared with low OC participants, across positive, neutral, and negative pictures (p=.01). Follow-up analyses revealed that while no group difference emerged for mean valence rating (p=.16), groups differed on the mean standard deviation of ratings within each valence category (p=.002). In Study 2, only OC tendencies, not depressive or anxiety symptoms, were positively correlated with mean deviation from norm ratings (p=.026). Dividing the sample to high and low OC groups based on an OC cutoff score yielded similar group differences to those observed in Study 1 (p<.001). LIMITATIONS Analog samples and a relative small sample size (Study 1). CONCLUSIONS This study suggests that OC symptoms are associated with reduced awareness of emotional valence, possibly emanating from a noisier emotional perception.
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22
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Anxiety Sensitivity Accelerates the Temporal Changes in Obsessions and Compulsions During Cognitive Behavioral Therapy. COGNITIVE THERAPY AND RESEARCH 2020. [DOI: 10.1007/s10608-020-10121-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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23
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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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24
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Association Between Alexithymia and Immature Coping Styles Is Mediated by Self-Inconsistency and Is Correlated to Obsessive-Compulsive Symptoms. J Nerv Ment Dis 2020; 208:377-386. [PMID: 31977717 DOI: 10.1097/nmd.0000000000001133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study aimed to investigate whether a multivariate association between alexithymia and coping styles is affected by self-inconsistency and whether the association contributed to obsessive-compulsive symptoms in 34 patients with obsessive-compulsive disorder (OCD) and 53 healthy participants. Alexithymia, coping styles, self-inconsistency, and obsessive-compulsive symptoms were evaluated using the Toronto Alexithymia Scale-20, the Coping Style Questionnaire, the Self-Consistency and Congruence Scale, and the Vancouver Obsessive-Compulsive Inventory, respectively. We found that self-inconsistency partially mediated the association between alexithymia and immature coping styles in the OCD patients but fully mediated the association in the healthy participants. Moreover, in the two groups, the alexithymia-coping coupling was related to contamination, obsession, indecisiveness, and ritualization, but not the checking symptom dimension. The findings suggest that the disturbance in identifying and describing feelings is associated with immature coping styles through disharmony between self-recognition and experience. The mechanism of the checking symptom seems to be distinct from other obsessive-compulsive symptoms.
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25
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Metacognitive beliefs mediate the relationship between anxiety sensitivity and traits of obsessive-compulsive symptoms. BMC Psychol 2020; 8:40. [PMID: 32336292 PMCID: PMC7184693 DOI: 10.1186/s40359-020-00412-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 04/16/2020] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Metacognition has been shown as a key contributor to Obsessive Compulsive Disorder as well as other anxiety-related disorders, yet its role in the development and maintenance of these disorders remains unclear. This study aims to investigate whether anxiety sensitivity traits are related to obsessive-compulsive symptoms in the general population and whether the relationship between anxiety sensitivity and obsessive-compulsive symptoms is mediated by metacognition. METHODS Non-clinical volunteers (N = 156, mean age: 23.97, 121 females) completed measures related to state/trait anxiety, anxiety sensitivity, obsessive compulsive symptoms and metacognition. RESULTS A direct relationship between anxiety sensitivity and obsessive-compulsive symptoms was established. Further analysis revealed that metacognition was the strongest mediator of this relationship, even when accounting for state and trait anxiety. CONCLUSIONS Results suggest that the relationships between traits of anxiety sensitivity and obsessive-compulsive symptoms are partially attributable to the role of metacognition.
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Eichholz A, Schwartz C, Meule A, Heese J, Neumüller J, Voderholzer U. Self‐compassion and emotion regulation difficulties in obsessive–compulsive disorder. Clin Psychol Psychother 2020; 27:630-639. [DOI: 10.1002/cpp.2451] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 03/20/2020] [Accepted: 03/20/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Angelika Eichholz
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - Caroline Schwartz
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - Adrian Meule
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
- Schoen Clinic Roseneck Prien am Chiemsee Germany
| | - Julia Heese
- Schoen Clinic Roseneck Prien am Chiemsee Germany
| | - Jakob Neumüller
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - Ulrich Voderholzer
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
- Schoen Clinic Roseneck Prien am Chiemsee Germany
- Department of Psychiatry and Psychotherapy University Hospital of Freiburg Freiburg Germany
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27
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Jansen M, Overgaauw S, De Bruijn ERA. Social Cognition and Obsessive-Compulsive Disorder: A Review of Subdomains of Social Functioning. Front Psychiatry 2020; 11:118. [PMID: 32231594 PMCID: PMC7082418 DOI: 10.3389/fpsyt.2020.00118] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 02/10/2020] [Indexed: 12/12/2022] Open
Abstract
Disturbances in social cognitive processes such as the ability to infer others' mental states importantly contribute to social and functional impairments in psychiatric disorders. Yet, despite established social, emotional, and cognitive problems, the role of social cognition in obsessive-compulsive disorder is largely overlooked. The current review provides a first comprehensive overview of social (neuro)cognitive disturbances in adult patients with obsessive-compulsive disorder. Results of our review indicate various social cognitive alterations. Patients with obsessive-compulsive disorder show deficits in the recognition of affective social cues, specifically facial expressions of disgust, and more general deficits in theory of mind/mentalizing. Additionally, patients show heightened affective reactions and altered neural responding to emotions of self and others, as well as poor emotion regulation skills, which may contribute to poor social functioning of patients. However, the discrepancies in findings and scarcity of studies make it difficult to draw firm conclusions with regard to the specificity of social cognitive disturbances. The review offers directions for future research and highlights the need to investigate obsessive-compulsive disorder from an interactive social neurocognitive perspective in addition to the prevalent passive spectator perspective to advance our understanding of this intricate and burdensome disorder.
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Affiliation(s)
- Myrthe Jansen
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, Netherlands
| | - Sandy Overgaauw
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, Netherlands
| | - Ellen R A De Bruijn
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, Netherlands
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Xu C, Chen J, Cui Z, Wen R, Han H, Jin L, Wan G, Wei Z, Peng Z. Abnormal Anhedonia as a Potential Endophenotype in Obsessive-Compulsive Disorder. Neuropsychiatr Dis Treat 2020; 16:3001-3010. [PMID: 33324061 PMCID: PMC7733443 DOI: 10.2147/ndt.s268148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 11/02/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is often accompanied by cognitive, particularly executive function, impairments. Recently, anhedonia has emerged as an apparently important symptom of OCD reflecting altered emotion regulation. These two aspects are often comorbid in OCD. However, little is known about whether anhedonia may be a trait marker for OCD. METHODS To verify the role of executive function and evaluate the role of anhedonia in OCD and its relationship with OCD symptoms, we recruited 60 OCD patients, 30 unaffected first-degree relatives (FDRs), and 60 healthy controls (HCs). Participants completed psychometric testing to assess depression, anxiety, and anhedonia symptoms, as well as two cognitive tests to assess executive function, namely the Wisconsin Card Sorting Test (WCST) and the Stroop Color-Word Test (SCWT). RESULTS Compared to HCs, OCD patients and FDRs had significantly lower anticipatory and consummatory pleasure scores. The severity of anticipatory anhedonia correlated positively with obsessive-compulsive symptoms (r = 0.253, p = 0.009), even after controlling for depression and anxiety symptoms. Compared to HCs, OCD patients and FDRs made more errors and achieved fewer categories in the WCST. For all three SWCT components, OCD patients and FDRs took more time to name colors than HCs, but the three groups had similar numbers of errors. CONCLUSION This family-based study showed dampened pleasure together with cognitive dysfunction in OCD patients. The similar consummatory pleasure findings between OCD and FDR groups suggest anhedonia may be considered as a candidate OCD endophenotype.
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Affiliation(s)
- Chuanyong Xu
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, People's Republic of China
| | - Jierong Chen
- Department of Child Psychiatry and Rehabilitation, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, People's Republic of China
| | - Zitian Cui
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, People's Republic of China
| | - Rongzhen Wen
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, People's Republic of China
| | - Hongying Han
- Department of Psychiatry, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Lili Jin
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, People's Republic of China
| | - Guobin Wan
- Department of Child Psychiatry and Rehabilitation, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, People's Republic of China
| | - Zhen Wei
- Department of Child Psychiatry and Rehabilitation, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, People's Republic of China
| | - Ziwen Peng
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, People's Republic of China
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29
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Leeuwerik T, Cavanagh K, Strauss C. The Association of Trait Mindfulness and Self-compassion with Obsessive-Compulsive Disorder Symptoms: Results from a Large Survey with Treatment-Seeking Adults. COGNITIVE THERAPY AND RESEARCH 2019. [DOI: 10.1007/s10608-019-10049-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Abstract
Little is known about the role of mindfulness and self-compassion in obsessive-compulsive disorder. This cross-sectional study examined associations of mindfulness and self-compassion with obsessive-compulsive disorder symptoms and with the obsessive beliefs and low distress tolerance thought to maintain them. Samples of treatment-seeking adults (N = 1871) and non-treatment-seeking adults (N = 540) completed mindfulness, self-compassion, obsessive-compulsive disorder, anxiety, depression, obsessive beliefs and distress tolerance questionnaires. Participants with clinically significant obsessive-compulsive disorder symptoms reported lower trait mindfulness and self-compassion compared to participants with clinically significant anxiety/depression and to non-clinical controls. Among the clinical sample, there were medium-large associations between mindfulness and self-compassion and obsessive-compulsive disorder symptoms, obsessive beliefs and distress tolerance. Mindfulness and self-compassion were unique predictors of obsessive-compulsive disorder symptoms, controlling for depression severity. Once effects of obsessive beliefs and distress tolerance were controlled, a small effect remained for mindfulness (facets) on obsessing symptoms and for self-compassion on washing and checking symptoms. Directions for future research and clinical implications are considered in conclusion.
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Yazici KU, Yazici IP. Decreased theory of mind skills, increased emotion dysregulation and insight levels in adolescents diagnosed with obsessive compulsive disorder. Nord J Psychiatry 2019; 73:462-469. [PMID: 31403840 DOI: 10.1080/08039488.2019.1652341] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background: An abnormal interaction between cognition and emotion may contribute to the development of obsessive-compulsive disorder (OCD). Aims: In this study, we aimed to evaluate theory of mind and emotion regulation skills in adolescents diagnosed with OCD. In addition, the results were evaluated in accordance with patients' insight levels. Methods: This study was conducted with 50 patients, who were aged between 11 and 16 and who were newly diagnosed with OCD and 50 healthy individuals. The Turkish version of the Schedule for Affective Disorders and Schizophrenia for School Age Children - Present and Lifetime was used to diagnose OCD and other comorbidities. The Children's Yale-Brown Obsessive Compulsive Scale, the Children's Depression Inventory, and the State-Trait Anxiety Inventory for Children were used for clinical evaluation. The intelligence levels were assessed using the Wechsler Intelligence Scale for Children-Revised Short Form. Reading the Mind in the Eyes Test was used in patients. The Difficulties in Emotion Regulation Scale was also used to evaluate the skills of regulating emotions. Results: Patients with OCD had lower ability with regard to reading minds in the eyes and emotion regulation than the healthy individuals. Patients with OCD, who had a poor insight, had more difficulty in reading minds in the eyes and emotion regulation than those with good insight. Conclusions: This study supports the idea that OCD is related to deficits in theory of mind and emotion regulation skills. Thus, further studies are required to confirm the findings of this study.
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Affiliation(s)
- Kemal Utku Yazici
- Department of Child and Adolescent Psychiatry, Firat University Medical Faculty , Elazig , Turkey
| | - Ipek Percinel Yazici
- Department of Child and Adolescent Psychiatry, Firat University Medical Faculty , Elazig , Turkey
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31
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Aldea MA, Michael K, Alexander K, Kison S. Obsessive-Compulsive Tendencies in a Sample of Veterans With Posttraumatic Stress Disorder. J Cogn Psychother 2019; 33:33-45. [PMID: 32746420 DOI: 10.1891/0889-8391.33.1.33] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Obsessive-compulsive disorder (OCD) is considered one of the most debilitating disorders worldwide. Data suggests that trauma may be a significant source of not only posttraumatic stress disorder (PTSD), but also OCD. An epidemiologic study of the general population found the risk for OCD to be increased 10-fold in persons with PTSD. The National Vietnam Veterans Readjustment Study found the prevalence of OCD to be 5.2% in war-zone veterans and other studies highlighted PTSD-OCD comorbidity rates ranging from 41% to 70%. However, the frequency of diagnosed OCD is low among veterans (0.6%), and veterans with OCD receive little mental healthcare after diagnosis (mean: 3.8 sessions). The present study examined obsessive-compulsive (OC) tendencies in a sample of veterans with PTSD seeking treatment in a Veterans Affairs (VA) PTSD program between 2011 and 2013. Of the 318 veterans with PTSD included in the current study, 125 (36%) also reported OC tendencies. Data analyses revealed that participants with PTSD who showed evidence of OC tendencies demonstrated more severe PTSD symptoms, higher anxiety sensitivity, and lower cognitive flexibility than participants with PTSD without comorbid OC tendencies; no differences regarding posttraumatic growth were found between the two groups. This is a preliminary study aiming to assess OC tendencies in a sample of veterans with PTSD and expand on the limited existing literature on OCD-PTSD comorbid presentation among veterans.
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32
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Schirmbeck F, Konijn M, Hoetjes V, Zink M, de Haan L. Obsessive-compulsive symptoms in psychotic disorders: longitudinal associations of symptom clusters on between- and within-subject levels. Eur Arch Psychiatry Clin Neurosci 2019. [PMID: 29520640 PMCID: PMC6726663 DOI: 10.1007/s00406-018-0884-4] [Citation(s) in RCA: 9] [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] [Indexed: 01/03/2023]
Abstract
Obsessive-compulsive symptoms (OCS) are frequently reported in patients with schizophrenia and have been associated with subjective distress and higher impairment. Recent studies suggest fluctuation in co-occurring OCS and associations with the course of psychotic symptoms. Current evidence is limited by few studies with long assessments intervals and a sole focus on between-subject comparisons. The aim of this study was to specifically investigate co-variation of symptom domains over time within individuals. Patients with a psychotic disorder (n = 56) and un-affected siblings (n = 49) completed monthly assessments of clinical and subclinical symptoms over 6 months. Mixed-model multilevel analyses examined the variability and relationship between OCS and positive, negative, and depressive symptoms on the between- and within-subject level. Symptom domains were associated across subjects and assessment times, in patients and siblings, with the strongest association between OCS and (subclinical) positive symptoms. Within-subjects, substantial variability and co-variation of all symptom domains was found. Particularly, between-subject differences in positive symptoms and within-subject change in depressive symptoms predicted subsequent OCS in patients 1 months later. This is the first prospective study disaggregating between and within-subject associations between co-occurring OCS and symptom cluster of psychosis. Differences on these two levels suggest different underlying mechanisms. The association between depressive symptoms and subsequent increase/decrease of OCS within patients may have important treatment implications.
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Affiliation(s)
- Frederike Schirmbeck
- Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands. .,Arkin Institute for Mental Health, Amsterdam, The Netherlands.
| | - Max Konijn
- Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands
| | - Vera Hoetjes
- Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands
| | - Mathias Zink
- Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands ,Arkin Institute for Mental Health, Amsterdam, The Netherlands
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33
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Tang HS, Chen PF, Lung FW. Personality and Alexithymic Disparity in Obsessive-Compulsive Disorder Based on Washing and Checking. Psychiatr Q 2018; 89:371-381. [PMID: 29038990 DOI: 10.1007/s11126-017-9541-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The aim of this study was to investigate pathway relationship of personality characteristics and alexithymic traits in OCD symptoms of obsession, and compulsive behavior of washing and checking. Two-hundred and seventy patients diagnosed with OCD were consecutively recruited from the psychiatric outpatient department of a teaching hospital. Structural equation modeling showed those more neurotic, less extraverted and with higher levels of alexithymia difficulty identifying feelings (DIF), difficulty describing feelings (DDF) and externally oriented thinking (EOT) were more likely to develop obsessive thoughts. Those less extraverted was more prone to develop washing compulsions, and those more neurotic were more likely to develop checking compulsions. EOT was the only alexithymic trait to have no gender difference within this group of patients with OCDs. The different personality and alexithymic trait pathways found between OCD obsession, washing and checking symptoms provide support that they may be different subtypes within the OCD diagnosis. Obsession was associated with washing, but not checking. Furthermore, no gender difference was found between the obsession and compulsive symptoms. Extraversion and neuroticism can be used to differentiate washing and checking, and alexithymia to differentiate washing and obsessions. This should be taken into consideration for intervention targeting patients with different OCD symptoms.
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Affiliation(s)
- Hwa-Sheng Tang
- Songde Branch, Taipei City Hospital, Taipei, Taiwan.,Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Po-Fei Chen
- Calo Psychiatric Center, No.12-200, Jinhua Rd., Xinpi Township, Pingtung County, 925, Taiwan
| | - For-Wey Lung
- Calo Psychiatric Center, No.12-200, Jinhua Rd., Xinpi Township, Pingtung County, 925, Taiwan. .,Graduate Institute of Medical Sciences, National Defense Medical University, Taipei, Taiwan.
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34
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Difficulties in emotion regulation and symptom dimensions in patients with obsessive-compulsive disorder. CURRENT PSYCHOLOGY 2018. [DOI: 10.1007/s12144-018-9859-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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35
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Katz D, Laposa JM, Rector NA. Anxiety Sensitivity, Obsessive Beliefs, and the Prediction of CBT Treatment Outcome for OCD. Int J Cogn Ther 2018. [DOI: 10.1007/s41811-018-0007-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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36
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Schirmbeck F, Swets M, Meijer CJ, Zink M, de Haan L. Obsessive-compulsive symptoms and overall psychopathology in psychotic disorders: longitudinal assessment of patients and siblings. Eur Arch Psychiatry Clin Neurosci 2018; 268:279-289. [PMID: 27988852 PMCID: PMC5861177 DOI: 10.1007/s00406-016-0751-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 11/23/2016] [Indexed: 11/26/2022]
Abstract
The course of obsessive-compulsive symptoms (OCS) and its association with alterations in other clinical variables in patients with psychotic disorders is insufficiently known. Patients (n = 602) and unaffected siblings (n = 652) from the Dutch Genetic Risk and Outcome of Psychosis (GROUP) study were investigated at baseline and after 3 years. Participants were assigned to four groups based on the course of OCS over time: no-OCS, persistent OCS, initial OCS and de novo OCS. In addition to cross-sectional comparisons, longitudinal associations between changes in OCS and symptoms of schizophrenia and general functioning were investigated. Patients with co-occurring OCS reported significantly higher severity of psychotic and affective symptoms as well as lower overall functioning compared to patients without OCS. These differences were stable over time for patients reporting persistent OCS. Subsequent repeated measure analysis revealed significant interaction effects for groups reporting changes in their OCS. Whereas the group with remission of initial OCS showed significant improvement in positive symptoms, emotional distress and functioning, the de novo group showed no significant change in these variables, but rather reported stable higher psychopathology. Similar results were found on a subclinical level in siblings. Patients with co-occurring OCS present a more severe clinical picture, especially if symptoms persist over time. The remission of OCS was associated with overall improvement, whereas individuals with de novo OCS already reported higher clinical impairment before OCS onset. More research is needed to elucidate causal pathways and to develop effective interventions for persistent comorbid OCS.
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Affiliation(s)
- Frederike Schirmbeck
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
- Arkin Institute for Mental Health, Amsterdam, The Netherlands.
| | - Marije Swets
- Arkin Institute for Mental Health, Amsterdam, The Netherlands
| | - Carin J Meijer
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Mathias Zink
- Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Arkin Institute for Mental Health, Amsterdam, The Netherlands
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37
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Kaczkurkin AN, Fitzgerald H, Tyler J, Asnaani A. The Contribution of Anxiety Sensitivity to Obsessive-Compulsive and Anxiety Symptoms in a Naturalistic Treatment Setting. COGNITIVE THERAPY AND RESEARCH 2018; 42:661-673. [PMID: 34135537 DOI: 10.1007/s10608-018-9909-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Anxiety sensitivity, a fear of arousal-related sensations, is prevalent in a number of disorders. We examined the relationship between internalizing symptoms and the anxiety sensitivity components of physical, social, and cognitive concerns in a sample of 165 patients seeking treatment in a clinic specializing in CBT for anxiety-related disorders. Social anxiety symptoms were associated with greater social concerns. Cognitive concerns were characteristic of both depression and generalized anxiety symptoms, suggesting these two classes of symptoms may share AS symptomatology. Physical concerns were specifically related to panic symptoms. Although obsessive-compulsive symptoms were related to cognitive concerns using univariate regression, these symptoms were not strongly related to any of the anxiety sensitivity components when the correlation between disorders was taken into account. Thus, within the internalizing symptoms studied here, the anxiety sensitivity domains were most relevant to panic, social anxiety, generalized anxiety, and depressive symptoms and less related to obsessive-compulsive symptoms.
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Affiliation(s)
| | - Hayley Fitzgerald
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Jeremy Tyler
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Anu Asnaani
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
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38
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Obsessive–Compulsive Disorder is Characterized by a Lack of Adaptive Coping Rather than an Excess of Maladaptive Coping. COGNITIVE THERAPY AND RESEARCH 2018. [DOI: 10.1007/s10608-018-9902-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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39
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Blakey SM, Abramowitz JS. Interoceptive Exposure: An Overlooked Modality in the Cognitive-Behavioral Treatment of OCD. COGNITIVE AND BEHAVIORAL PRACTICE 2018. [DOI: 10.1016/j.cbpra.2017.01.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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40
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Matheny NL, Summers BJ, Macatee RJ, Harvey AM, Okey SA, Cougle JR. A multi-method analysis of distress tolerance in body dysmorphic disorder. Body Image 2017; 23:50-60. [PMID: 28826046 DOI: 10.1016/j.bodyim.2017.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 07/21/2017] [Accepted: 07/24/2017] [Indexed: 11/18/2022]
Abstract
Distress tolerance (DT) is a transdiagnostic construct linked to multiple psychiatric disorders. We conducted three studies using different methods to investigate the relationship between DT and body dysmorphic disorder (BDD). Study 1 found a significant relationship between low DT and more severe BDD symptoms in an adult community sample (N=81). In Study 2, we found a similar relationship between lower DT and greater BDD symptoms in a student sample (N=192). Furthermore, we found a unique relationship between greater BDD symptoms and lower self-reported tolerance of anger and sadness mood induction tasks. Greater BDD symptoms were not significantly associated with lower self-reported tolerance of a fear mood induction task. In Study 3, a clinical sample of individuals with BDD (N=40) reported lower DT than a sample of healthy controls (N=36). Findings suggest that low DT is a broad vulnerability factor related to BDD.
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Affiliation(s)
- Natalie L Matheny
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Berta J Summers
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Richard J Macatee
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Ashleigh M Harvey
- Department of Psychology, University of Wisconsin - Milwaukee, Milwaukee, WI, USA
| | - Sarah A Okey
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Jesse R Cougle
- Department of Psychology, Florida State University, Tallahassee, FL, USA.
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41
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Blakey SM, Abramowitz JS, Reuman L, Leonard RC, Riemann BC. Anxiety sensitivity as a predictor of outcome in the treatment of obsessive-compulsive disorder. J Behav Ther Exp Psychiatry 2017; 57:113-117. [PMID: 28505489 DOI: 10.1016/j.jbtep.2017.05.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 02/20/2017] [Accepted: 05/02/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVES To address the fact that not all individuals who receive cognitive-behavioral therapy (CBT) for obsessive-compulsive disorder (OCD) exhibit complete symptom reduction, research has examined factors that predict outcome; however, no studies have examined anxiety sensitivity (AS) as a predictor of outcome of CBT for OCD. AS refers to the fear of anxious arousal that results from mistaken beliefs about the dangerousness of anxiety-related body sensations. It is important to understand whether AS influences OCD treatment outcome, considering that (a) some obsessions directly relate to AS, and (b) OCD patients with high AS may be reluctant to engage in anxiety-provoking components of CBT for OCD. METHODS Patients (N = 187) with a primary diagnosis of OCD who received residential CBT for OCD participated in this study, which involved completing a self-report battery at pre- and post-treatment. RESULTS Results supported study hypotheses, in that (a) baseline AS positively correlated with baseline OCD severity, and (b) greater baseline AS prospectively predicted higher posttreatment OCD symptom severity even after controlling for pretreatment OCD and depression severity. LIMITATIONS The study was limited by its use of an older measure of AS, reliance on self-report measures, and nonstandardized treatment across participants. CONCLUSIONS Findings highlight the importance of AS in the nature and treatment of OCD. Clinical implications and future directions are discussed.
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Affiliation(s)
- Shannon M Blakey
- University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | | | - Lillian Reuman
- University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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42
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Moritz S, Purdon C, Jelinek L, Chiang B, Hauschildt M. If it is absurd, then why do you do it? The richer the obsessional experience, the more compelling the compulsion. Clin Psychol Psychother 2017; 25:210-216. [PMID: 29154502 DOI: 10.1002/cpp.2155] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 08/02/2017] [Accepted: 10/06/2017] [Indexed: 12/26/2022]
Abstract
Mounting evidence suggests that obsessive intrusions are often accompanied and amplified by perceptual experiences of different modalities (e.g., feeling dirt on one's skin while experiencing intrusive thoughts about contamination). Pilot studies conducted online with individuals endorsing mild obsessive-compulsive symptoms have linked the co-occurrence of perceptual experiences and obsessions to the severity of subsequent compulsive behaviour as well as low insight. However, it is presently unclear whether sensory experiences accompany all types of obsessional thoughts or are restricted to certain preoccupations (e.g., contamination and aggression). The present study examined a clinical inpatient and outpatient sample with a formally diagnosed obsessive-compulsive disorder (N = 34). Perceptual properties of intrusive thoughts were assessed with the Sensory Properties of Obsessions Questionnaire. The prevalence of perception-laden obsessive thoughts was comparable with prior studies (73.5%), but the intensity was significantly greater. No association was observed between perceptual experiences and expert-rated insight. However, the severity of perception-laden obsessions predicted the frequency of and impairment associated with compulsive behaviour. This was particularly strong for obsessions about contamination. The present study confirms the high prevalence and clinical relevance of perceptual experiences that accompany obsessions and further challenges the traditional trichotomy splitting mental phenomena into thoughts, intrusions, and hallucinations.
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Affiliation(s)
- Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christine Purdon
- Department of Psychology, University of Waterloo, Waterloo, Canada
| | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Brenda Chiang
- Department of Psychology, University of Waterloo, Waterloo, Canada
| | - Marit Hauschildt
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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43
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Yap K, Mogan C, Moriarty A, Dowling N, Blair-West S, Gelgec C, Moulding R. Emotion regulation difficulties in obsessive-compulsive disorder. J Clin Psychol 2017; 74:695-709. [DOI: 10.1002/jclp.22553] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 06/07/2017] [Accepted: 09/08/2017] [Indexed: 12/28/2022]
Affiliation(s)
| | - Christopher Mogan
- The University of Melbourne
- The Anxiety and OCD Clinic; Melbourne Australia
| | | | - Nathan Dowling
- The University of Melbourne
- The Melbourne Clinic OCD Program; Melbourne Australia
| | - Scott Blair-West
- The University of Melbourne
- The Melbourne Clinic OCD Program; Melbourne Australia
| | - Celin Gelgec
- The Melbourne Clinic OCD Program; Melbourne Australia
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44
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Chasson GS, Bello MS, Luxon AM, Graham TAA, Leventhal AM. Transdiagnostic emotional vulnerabilities linking obsessive-compulsive and depressive symptoms in a community-based sample of adolescents. Depress Anxiety 2017; 34:761-769. [PMID: 28661022 PMCID: PMC5546248 DOI: 10.1002/da.22669] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 02/15/2017] [Accepted: 06/12/2017] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Transdiagnostic emotional vulnerabilities are suspected to underlie psychopathologic comorbidity but have received little attention in adolescent emotional pathology literature. We examined distress tolerance, anxiety sensitivity, and anhedonia as concomitant transdiagnostic mechanisms that account for (i.e., statistically mediate) the covariance between adolescent obsessive-compulsive disorder (OCD) and major depressive disorder (MDD) symptoms. METHOD Data on MDD, OCD, and the three aforementioned transdiagnostic vulnerabilities were collected from a community-based sample of 3,094 ninth graders in a large metropolitan area and analyzed using mixed effects modeling to evaluate mediation effects. RESULTS Individually and when controlling for each other, all three transdiagnostic vulnerabilities mediated the relation between OCD and MDD symptoms both before and after adjusting for demographics. CONCLUSIONS Distress tolerance, anxiety sensitivity, and anhedonia may be unique mechanisms accounting for comorbidity between OCD and MDD symptoms in youth. Longitudinal evaluation of these candidate transdiagnostic emotional vulnerabilities in adolescent OCD-MDD comorbidity is warranted.
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Affiliation(s)
- Gregory S. Chasson
- Illinois Institute of Technology, Department of Psychology, Chicago, IL, USA,Corresponding Author: Greg Chasson, Ph.D. Illinois Institute of Technology, Department of Psychology, 3105 S. Dearborn, Pritzker Science Center, Chicago, IL 60616, , Phone: 312.567.5936, Fax: 312.567.3493
| | - Mariel S. Bello
- University of Southern California, Department of Psychology, Los Angeles, CA, USA
| | | | - Trevor A. A. Graham
- University of Southern California Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA, USA
| | - Adam M. Leventhal
- University of Southern California, Department of Psychology, Los Angeles, CA, USA,University of Southern California Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA, USA
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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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Tajikzadeh F, Abbasi F, Sadeghi R, Aflakseir A. The Relationship Between Behavioral Inhibition Strategies for Cognitive Regulation of Emotions and Young Adult Family of Life Events and Changes with Obsessive-Compulsive Traits in Students. INTERNATIONAL JOURNAL OF SCHOOL HEALTH 2016. [DOI: 10.17795/intjsh-41814] [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] Open
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Olatunji BO, Ebesutani C, Kim EH. Does the measure matter? On the association between disgust proneness and OCD symptoms. J Anxiety Disord 2016; 44:63-72. [PMID: 27776255 DOI: 10.1016/j.janxdis.2016.10.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/16/2016] [Accepted: 10/14/2016] [Indexed: 10/20/2022]
Abstract
Although some studies suggest that the association between disgust proneness (DP) and obsessive-compulsive symptoms (OCS) is specific to the contamination subtype, others suggest that DP is associated with OCS more broadly. To examine if the discrepant findings may partially reflect differences in self-report measures used, this investigation employed structural equation modeling to examine the association between DP and OCS in three samples that completed different combinations of measures of DP, OCS, and anxiety/negative affect. In Study 1 (n=626), the path from DP to contamination-based OCS was significantly stronger than the path from DP to non-contamination OCS when controlling for anxiety sensitivity. In Study 2 (n=403), the results showed that the path from DP to contamination-based OCS did not significantly differ from the path from DP to non-contamination OCS when controlling for negative affect. Lastly, Study 3 (n=296) showed that the path from DP to contamination-based OCS was significantly weaker than the path from DP to non-contamination OCS. These findings highlight that the self-report measures employed is an important moderator when making inferences about the association between DP and contamination-based OCS and non-contamination OCS.
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Affiliation(s)
| | | | - Eun Ha Kim
- VA Tennessee Valley Healthcare System, United States
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Timpano KR, Raines AM, Shaw AM, Keough ME, Schmidt NB. Effects of a brief anxiety sensitivity reduction intervention on obsessive compulsive spectrum symptoms in a young adult sample. J Psychiatr Res 2016; 83:8-15. [PMID: 27522321 PMCID: PMC9867536 DOI: 10.1016/j.jpsychires.2016.07.022] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 07/21/2016] [Accepted: 07/25/2016] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Anxiety sensitivity (AS) has been identified as a transdiagnostic cognitive risk factor for a wide range of affective disorders, including conditions within the obsessive compulsive (OC) spectrum. A growing body of research has demonstrated that directly reducing AS leads to subsequent reductions of other psychiatric symptoms, including anxiety, worry, and mood. To date, no study has examined the efficacy of a brief AS intervention on reducing OC and hoarding symptoms. METHOD Non-treatment seeking young adults (N = 104; 83.7% female; 81.7% Caucasian) were selected for having elevated levels of AS, and were then randomized into a single-session, computer-assisted AS intervention or a control condition. OC and hoarding symptoms were assessed at post-treatment, as well as at one week and one month follow-ups. RESULTS Results revealed that the intervention, but not the control condition, reduced OC symptoms across the post-intervention follow-up period. Mediation analysis demonstrated that changes in AS mediated changes in OC symptoms due to the intervention. In contrast, the intervention did not have a specific effect on reducing hoarding symptoms. CONCLUSIONS These findings have important ramifications for understanding the relationship between AS and OC spectrum symptoms, and raise interesting treatment and prevention implications.
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Affiliation(s)
- Kiara R. Timpano
- University of Miami, Department of Psychology, Coral Gables, FL,Corresponding Author: Kiara R. Timpano, PhD, Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL 33146, , telephone: 305-284-1592
| | - Amanda M. Raines
- Florida State University, Department of Psychology, Tallahassee, FL
| | - Ashley M. Shaw
- University of Miami, Department of Psychology, Coral Gables, FL
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Wu MS, McGuire JF, Storch EA. Anxiety sensitivity and family accommodation in obsessive-compulsive disorder. J Affect Disord 2016; 205:344-350. [PMID: 27567081 DOI: 10.1016/j.jad.2016.08.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 06/24/2016] [Accepted: 08/14/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although anxiety sensitivity (AS) presents in adults with obsessive-compulsive disorder (OCD), it has received minimal empirical attention. There are postulated connections between AS and family accommodation, but this relationship has yet to be formally examined. METHODS The present study included 58 adults with OCD who completed a clinician-rated measure of OCD symptom severity, as well as self-report measures assessing AS, family variables, impairment, and co-occurring psychopathology. RESULTS Participants' AS moderately correlated with family accommodation, family functioning, and depression, while strongly correlating with anxiety symptoms. The Fear of Cognitive Dyscontrol AS subscale moderately correlated with multiple domains of functional impairment, and predicted family accommodation beyond the effects of OCD symptom severity. Family accommodation mediated the relationship between the Fear of Cognitive Dyscontrol AS subscale and functional impairment. LIMITATIONS The study was cross-sectional in nature, limiting the ability to establish directionality and causation. The sample was also limited to adults with OCD and their own symptomology, necessitating further investigations of these constructs in pediatric samples and psychopathology in the caregivers/relatives. CONCLUSIONS These findings highlight the importance of considering fears regarding the loss of mental control within the context of family accommodation in OCD when evaluating functional impairment.
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Affiliation(s)
- Monica S Wu
- Department of Pediatrics, University of South Florida, St. Petersburg, FL, USA; Department of Psychology, University of South Florida, Tampa, FL, USA; UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA.
| | - Joseph F McGuire
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
| | - Eric A Storch
- Department of Pediatrics, University of South Florida, St. Petersburg, FL, USA; Department of Psychology, University of South Florida, Tampa, FL, USA; Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, USA; Department of Health Management and Policy, University of South Florida, Tampa, FL, USA; Rogers Behavioral Health - Tampa Bay, Tampa, FL, USA; All Children's Hospital - Johns Hopkins Medicine, St. Petersburg, FL, USA
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50
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Dar R, Lazarov A, Liberman N. How can I know what I'm feeling? Obsessive-compulsive tendencies and induced doubt are related to reduced access to emotional states. J Behav Ther Exp Psychiatry 2016; 52:128-137. [PMID: 27107171 DOI: 10.1016/j.jbtep.2016.04.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 04/08/2016] [Accepted: 04/11/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVE People's feelings are not always accessible to them, and this might be especially the case for some individuals and in some situations. Based on our model of obsessive-compulsive disorder, we predicted that obsessive-compulsive (OC) tendencies and situationally induced doubt would be associated with decreased access to one's own emotions. METHODS In the first two studies we examined the relationships between OC tendencies and performance on the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT). In Study 3 we undermined participants' confidence in their ability to accurately assess their own emotions and assessed the effect of this manipulation on MSCEIT performance. RESULTS As predicted, OC tendencies were associated with lower scores on the Experiential area of the MSCEIT, which relies on access to experienced emotions, but not on the Strategic area, which relies on semantic knowledge about emotions. Similarly, undermining participants' confidence in their own emotions reduced their scores on the Experiential, but not on the Strategic area of the MSCEIT. LIMITATIONS The findings should be replicated with a clinical OCD population and with other measures of emotional experience. CONCLUSION These studies suggest that impaired access to emotional states may be caused by doubting those states, that it characterizes people with high OC tendencies, and that it might be a manifestation of a more general difficulty in accessing internal states.
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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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